Bridging Health & Community
Improving Health Through Community Agency
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Strengthening the Field of Practice

Symposium 2017: The Bronx Healthy Buildings Program (Case Study)

At our May symposium, we’ll be hearing two case studies, both from multiple perspectives. In today’s post, we hear from Maggie Tishman, the Local Director of the Emerald Cities Collaborative, one of the organizations involved in the Bronx Healthy Buildings Program.

Pritpal S Tamber: Hi Maggie, so what is the Bronx Healthy Buildings Program?  

Maggie Tishman: It’s a cross-sector effort to address asthma in the Bronx by improving the buildings where patients live. We’re doing this in three ways:

  1. By leveraging upgrades being made to buildings for energy efficiency to address health-related concerns
  2. By connecting patients to home-based asthma resources
  3. And by helping residents understand the social determinants of health and asthma self-management.

We’re also contracting with and hiring Bronx-based businesses and workers as much as possible because we know that economic security affects health outcomes as well.

Pritpal: Wait. How is energy efficiency related to health?  

Maggie Tishman

Maggie Tishman

Maggie: A lot of measures that make buildings more energy efficient, like sealing holes and cracks that allow in cold air, can also make buildings healthier for tenants. Landlords don’t usually have an incentive to upgrade their buildings in the name of health though. Even those that want to ‘do the right thing’ might not be able to get the money they need to do so. But with an energy efficiency ‘retrofit’, landlords can get grants or borrow money to upgrade their buildings. And once we’re in the building, we can work with the landlord to make other improvements, like adopting integrated pest management, green cleaning, and other healthy management practices.

Pritpal: So where is the money coming from?  

Maggie: Lots of places. The lead community partner on this project, the Northwest Bronx Community and Clergy Coalition (NWBCCC), has been administering the federal Weatherization Assistance Program for the past 30 years, so we’ve been able to piggyback on that grant program and help landlords and tenants do more than just weatherize their buildings. There are also New York City-funded grant and loan programs for retrofits. And we’re using resources from New York State Medicaid reform and the NYC Department of Health to provide home-based asthma interventions and training for landlords and tenants. The money needed to design and manage the whole program came from the BUILD Health Challenge.

Pritpal: Are you saying that public money’s going to private landlords?  

Maggie: I suppose you could look at it that way, but the idea is that public money is going to reduce greenhouse gas emissions and make buildings safer and healthier for tenants. The landlords are just the conduits. Plus, affordability requirements are built in. Funds from the Weatherization Assistance Program can only go to buildings with low-income tenants, and if landlords use City funds, they have to agree to keep their buildings affordable for 15 to 30 years.

Pritpal: Fair enough. But if it’s a health thing, where’s the health system in all this?

Maggie: Good question. We’ve worked hard to make this multi-sectoral, which is what makes our approach unique, but our local hospital systems are definitely involved. Montefiore Medical Center in the Bronx shared data with us to help target ‘sick’ buildings and has been working with us to develop our evaluation methodology. Also, with funding from New York State’s Medicaid reform program, Montefiore and St. Barnabas Hospital are providing community health workers and integrated pest management for people with asthma, and NWBCCC is now able to refer patients to those services.

Pritpal: I know there are a lot of state-by-state attempts to reform Medicaid over there. What’s happening in New York and have you been able to benefit?

Maggie: New York State wants to reduce Medicaid costs. So, with support from the federal government, it decided to invest $8 billion over five years to address the upstream causes of poor health, in the hope that it will reduce the cost of patient care down the line. In the Bronx, two of the local hospital systems created an organization called Bronx Partners for Healthy Communities to receive and disperse their share of the funds and chose asthma as one of their primary focuses. We’ve been able to take advantage of those resources. Part of what we’re hoping to show with this project is the return on upstream investments in health.

Pritpal: Interesting. Complex, but interesting. So, you’re from the Emerald Cities Collaborative; what is that?

Maggie: We are a national organization, working in eight cities around the US, with a mission to green our cities, strengthen our democracy, and create economic opportunities for all. Our work looks different in each city depending on the local market.

Pritpal: So, you’re bringing lessons from across the country to the Bronx work?  

Maggie: Definitely. One of the big challenges with energy efficiency projects is financing predevelopment costs (audits, engineering, tenant engagement, etc.), which can be a major hurdle for building owners. In Seattle, San Francisco and Cleveland, Emerald Cities has figured out how to finance these costs and roll them into overall project financing. Emerald Cities has also developed strategies for increasing participation of minority- and women-owned businesses and disadvantaged workers on construction projects. We want to incorporate elements of both strategies into the Bronx program.

Pritpal: Great stuff. We’re ensuring that our two case studies are presented from more than one perspective; who else is presenting with you at our symposium?

Maggie: I’ll be presenting with Sandra Lobo and Evy Viruet of the Northwest Bronx Community and Clergy Coalition. They’ll be talking about implementation and evaluation, respectively.

Pritpal: Awesome. Thank you for sharing your work with us. See you in May!

Maggie: My pleasure. Thanks for the opportunity!

I’m bowled over by the sheer complexity of what it really means to go ‘upstream’ and am so glad that Maggie and colleagues will be sharing their work with us in May. Our symposium, Community Agency & Health, is May 15-16 in Oakland, CA (get your tickets through Eventbrite).

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