P&S Annual Report
Community Outreach

Our Place in the Neighborhood 

Columbia-Presbyterian Medical Center has been a part of the Washington Heights-Inwood neighborhood for nearly 70 years and, as the largest organization in the neighborhood, takes its role as a good neighbor seriously. It's a commitment that meshes naturally with the educational and research missions of the schools, hospitals, clinics, and other facilities that comprise the medical center. The most profound event in the neighborhood's evolution this year was the opening of the first building in the Audubon Research Park. The park, once a project many people thought would never leave the proposal stage, has become a major force in the revitalization of the neighborhood CPMC calls home.

Several community programs are profiled in brief on these pages. Some projects can be seen in a video overview of outreach programs. The 15-minute video, produced jointly by the Office of External Relations and the Center for Biomedical Communications, includes footage from the school-based health clinic at George Washington High School and interviews with students and staff of the clinic. Several other programs also are highlighted in the video. Community Affairs: (212) 305-6359.

Future: M.D.s 
Now: P.A.L.s to Neighborhood Children

Imagine spending your childhood with only your imagination letting you soar beyond the boundaries of your neighborhood. That's the experience of many children who grow up in Washington Heights, unable to take advantage of opportunities that exist outside their community. But thanks to the Audubon School/Columbia Partners as Leaders program, fifth-grade students in one school can count on P&S students to help them realize their potential.

The program allows mentors to act as positive role models for the children, offering friendship, advice on important life decisions, and assistance with the occasional math problem. Each student/mentor pair is matched according to common interests, giving each set a foundation upon which to build a friendship. The program is designed for the pairs to stay together for one school year, with the hopes that they will stay in touch after the year ends. The mentors meet with their students twice a month after school, spending about two hours together each visit. These sessions usually include some one-on-one time for the students and mentors to get to know each other better, as well as some time for group activities or field trips.

Derek Mattimoe'97, a former student coordinator for the program, says the students perceive their mentors as friends rather than disciplinary figures. Since the meetings take place in the elementary school, much of the mentoring focuses on tutoring. After spending time together in their assigned pairs, the group closes some meetings with a game of dodge ball. 

The mentors also plan educational activities and field trips for the group, such as a tour of the hospital, where the mentors explain what it's like to be a medical student, a discussion about health and nutrition, a 3-D IMAX movie, a visit to the New York Public Library, and a trip to the Cloisters museum. 

Some mentors ask the students' families for permission to meet outside of the scheduled meetings. Mr. Mattimoe and his fiancée took his student, Roy, ice skating one winter. The number of students who want mentors far outnumber the volunteers, so teachers at the Washington Heights elementaryschool must choose the 10 students who ultimately participate.

Mr. Mattimoe describes the elementary students as intelligent and capable, but too young to give much thought to their options. "This is a critical time for us to develop relationships with these kids. Only after we develop a bond will we be fully able to help these kids with choosing their futures." Mr. Mattimoe plans to stay in touch with Roy and help out when it's time for him to tackle some of life's challenges, such as whether to attend college, choosing a career, or seeking financial aid for college. 

(Future) Physicians for Social Responsibility

Several P&S students started a chapter of Physicians for Social Responsibility (PSR), a national organization committed to social issues and community service, as part of their effort to become more active participants in the community. PSR members are committed to the belief that health care providers must attempt to prevent as well as cure the diseases of society. Although the group is called Physicians for Social Responsibility, PSR is known nationally for welcoming all health care professionals. The 50 members in the P&S chapter include students from the nursing and dental schools. 

The P&S chapter is especially concerned about gun violence as a public health issue. Its first community service project was assisting the NYPD's 33rd precinct in Washington Heights and the Goods for Guns Foundation with the annual gun exchange. 
Approximately 25 to 30 guns were collected through the drive, and the group made some influential friends in the community along the way. 

PSR leadership plans an "Alternative to Violence" project as an elective for second-year medical students and plans to sponsor speaking events that will highlight the social responsibility of physicians and what it means to be a "physician activist." 

Ensuring Best Beginnings 

Washington Heights has the highest birthrate in New York City. Twenty percent of mothers get no prenatal care, and 7.5 percent of the births are to teen-agers. Also, 8 percent of babies are born before 37 weeks gestation. The neighborhood has the second highest filing rate of juvenile reports--such as truancy, drug abuse, and child abuse--in the city. Overall 84.5 percent of families in Washington Heights are on Medicaid assistance but some of the children at highest risk are not covered. 

In collaboration with the School of Public Health, the New York Society for the Prevention of Cruelty to Children, the New York City Early Intervention Program, and Alianza Dominicana (a leading social service organization in Washington Heights), the Department of Pediatrics developed Best Beginnings with the goal of making a difference in the lives of neighborhood families.  

"Best Beginnings is based on a Hawaii program: helping every vulnerable family when they can most use help, right at the time of birth and at home where it works best," says Dr. Nicholas Cunningham, professor of clinical pediatrics and of clinical public health and a founder of the program. "The goal is to reach every pregnant woman and family with a newborn in two census tracts to get that first love affair off to a good start and thereby promote healthy, self-sufficient, and productive citizens." Best Beginnings costs less than $3,000 per family per year, significantly less than the average yearly cost ($25,000) of placing a child in foster care. 

Paraprofessionals from the community make regular home visits from pregnancy until a child is 4 or 5 years old. Families are linked to available resources, such as their own primary health care provider, infant development centers, housing, child care, substance abuse and spouse abuse programs, literacy training, and government benefits. The home visitors work with the mothers on parenting skills and help families coordinate medical care and social services to promote child well-being and positive early childhood development. 

Over the next three years, Best Beginnings will be evaluated. "Head Start survived because it was shown through research that it worked," says Dr. Cunningham. "That's what we're trying to do with Best Beginnings." 

Summer Youth Employment

The Summer Youth Employment Program provides community residents between the ages of 14 and 21 with structured, well-supervised work activities that encourage individual initiative and responsibility. The work activities help participants acquire the kinds of skills, habits, and attitudes that will increase their knowledge of the working world. 

The Health Sciences Division of Columbia employs 100 young adults from the Washington Heights-Inwood area each summer from July through August. Hundreds of other participants work for Presbyterian Hospital, Isabella Geriatric Center, neighborhood summer camps, and community-based groups. Participants, who attend weekly workshops that supplement their work experience. must be students and meet income eligibility guidelines set by New York City's Department of Employment. 

Most participants placed at Columbia-Presbyterian are assigned clerical jobs. Some develop new skills over the course of the summer, depending on their job placement. Many departments take on a mentoring role and make the extra effort to train their participants. 

The program is organized by the Children's Arts and Sciences Workshop, which provides three supervisors to oversee the 100 participants employed at Columbia. Ivy Fairchild, director of Community Affairs, coordinates the program for the university. Ms. Fairchild also conducts pre-hire interviews with all of the participants, assists in planning workshops, and conducts some of the workshops. The workshops cover such topics as résumé writing, interviewing, pregnancy prevention, computers, police/youth relations, and careers. 

* Neighbors Helping Neighbors-The CPMC Neighborhood Fund was established in 1987 to enable CPMC employees to contribute financial support, and in-kind gifts when available, to community programs that provide services to the residents of Washington Heights and Inwood. This year, the Neighborhood Fund gave $75,900 to community-based agencies. First-time recipients were Asociacion De Mujeres Progresistas, Audubon Triangle Association, Bronx Eagles Football, Chamber of Commerce of Washington Heights-Inwood, Columbia University Head Start, Columbia University Tennis Center, Credit Where Credit Is Due, Dyckman Farm Museum, Explorer Post 280: Dreamers, Heights Center for Immigrants Advocacy, I.S. 164 Parents Association, Isabella Geriatric Center, St. Elizabeth School, and Uptown Treasures. 

* Women in Sports-The Ivy League: Uptown W.I.N.S. (Women in Neighborhood Sports) is a sports league that provides recreational/educational programs for girls and young women ages 6 to 21. Participants in basketball, volleyball, and softball programs also attend workshops on relevant topics (sexuality, health, college preparation) and special events, including a sports day at Riverbank State Park and a celebration of National Women in Sports Day. The league, which serves as an umbrella organization for other female sports programs in the area, was highlighted on national television as a model program involving women in sports. The program is offered through P&S Community Affairs and operates out of five schools in School District 6: P.S. 128, P.S. 173, P.S. 5, I.S. 90, and I.S. 218. 

* House Calls with a Modem-Nurses visiting the homes of tuberculosis patients can now transmit information to CPMC via a hand-held computer and wireless modem that links the medical center, the New York City Department of Health, and the Visiting Nurse Services of New York City to improve monitoring of tuberculosis patients. The nurses can access all the records regarding a patient's treatment at CPMC, and CPMC doctors can review the data entered by the nurses anytime they review patient records. Also, the computerized system automatically reports new TB cases to the Department of Health. 

* Mobile Crisis Services-The Collegiate Church at Fort Washington Avenue and 181st Street awarded a $2,000 grant to CPMC's Mobile Crisis Services unit in recognition of the unit's work in the community. 

* Neighbors Helping Advance Research-The Northern Manhattan Stroke Study is an epidemiological study that focuses on risk factors associated with strokes in the ethnically diverse Northern Manhattan population. Both stroke patients and stroke-free individuals are enrolled and given neurological exams, quality of life surveys, and full stroke assessments with follow-up for five years. Another epidemiological study, the Stroke and Aging Research Project, is a prospective study of the association between cerebrovascular disease and dementia. The project enrolls Northern Manhattan patients who are 60 or older following stroke and administers neurologic, neuropsychological, and functional examinations during annual follow-up visits. Researchers: Ralph L. Sacco, David W. Desmond 

* Stroke Prevention and Support-STOP (Stroke: Targets of Prevention) provides ongoing community stroke education, publishes a bilingual stroke information book, and holds annual stroke screenings. The Washington Heights Stroke Club for stroke patients and caregivers helps with adjustment after leaving the hospital. 

* Incarnation Center-The Incarnation Children's Center is internationally recognized as a community-based model for providing high-quality medical and social services for HIV-infected children. Specialized care, both residential and outpatient, has been provided to more than 500 HIV-infected children in the past five years. The center also conducts clinical research under the auspices of the National Institute of Allergy and Infectious Diseases and provides education and training for students of medicine, nursing, social work, and law at Columbia University. The center is a joint effort of the P&S Department of Pediatrics and the Catholic Home Bureau, a foster care and adoption agency of the Archdiocese of New York. 

* Organized Community Outreach-Community Affairs serves Washington Heights/Inwood by providing technical assistance to community-based organizations on fund raising, proposal writing, special events programming, and university space acquisition. The office published the 1996 edition of the CPMC/Community Connection: A Guide to Community Programs at CPMC, which is three times larger than the first guide published three years ago. The guide represents CPMC's important role in the community: CPMC is involved in almost every aspect of the community in terms of education and health. The guide serves as a resource for Columbia researchers and outside community groups. 

* The World as Community-If "community" is defined in global terms, a neurological surgery resident and an orthopedic surgery resident, working with P&S students, have done their part in helping Third World countries. The group set up a surgical salvage program that collects, sterilizes, and packages supplies that otherwise would become medical waste and ships the materials to needy countries. 

* Family Planning-The Community Health and Education Program in the Center for Population and Family Health expanded its Family Planning Clinic and moved to its own building in the community. The new location allows the program to offer more services and serve more people through its Young Adult Clinic, Young Men's Clinic, and Family Planning Clinic. 

* High School Health-George Washington High School's health clinic provides medical and mental health services. The clinic is one of five New York City school-based programs run in collaboration with Columbia Health Sciences, Presbyterian Hospital, and the Community Health and Education Program of the School of Public Health's Center for Population and Family Health. The goal of the clinic is to provide primary health care to students who might not have access to health care because of financial or logistical constraints. In addition to routine health care, the clinic provides prenatal care, sports medicine, AIDS education, and mental health services. CPMC health care providers staff the clinic. 

* Quality of Life-P&S researchers, collaborating with Harlem Hospital and the Harlem Prevention Center, have started an investigation of health-related quality of life among older African-American men in central Harlem. The study, funded by the Centers for Disease Control and Prevention, stresses the quality of life impact of "everyday morbidities," especially genitourinary symptoms.