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Windshield Survey Template and Instructions
Note: Content adapted from the Work Group for Community
Health and Development: Community Tool Box’s “Windshield
and Walking Surveys.”
Windshield and walking surveys are useful ways to assess
specific aspects of a community or neighborhood and help give
you a sense of the community.
Conduct your survey at the time that works best for your
schedule, but keep in mind that to truly understand the people
who live within the community (or neighborhood), you may
wish to do the survey more than once, and at different times of
the day or different days of the week. For the purposes of this
course, you are not required to do the survey more than once.
Please be mindful of your personal safety. If there is a known
issue with hostility between specific groups, it may not be safe
for some people to survey particular neighborhoods. Do not
knowingly put yourself in harm’s way.
Preparation
· Get familiar with the survey questions and know what you will
be looking for.
· Use a checklist to be sure you have covered all the questions
and observed all the areas you want to.
· Be as inconspicuous as possible. Not only do people act
differently when they know they are being observed, they may
also become suspicious or hostile.
· Be sure you carry identification.
· Take notes along the way. You can also take photos with a
camera or cell phone to help you remember what you have seen.
· Always pay attention to your safety. Be aware of the
neighborhood and the situation.
Observation
Use the spaces between the questions below for your notes. You
can write more complete observations once you return home.
· Housing: What is the age and condition of housing in the
community or neighborhood? Are the houses and apartments
kept up, or are they run-down and in need of repair? Are the
yards neat or overgrown?
· Other Buildings: Are other buildings mostly or fully occupied?
Are public and commercial buildings accessible by people with
disabilities?
· Parks and Public Spaces: Are parks and other public spaces
well maintained? Are they used by a variety of people? Are
there sports facilities such as baseball fields, basketball courts,
and soccer fields?
· Culture and Entertainment: Are there museums, libraries,
theaters, restaurants, historic sites, and so forth? Do they reflect
the culture of the community? Are they readily accessible?
· Streets: Are there trees and plants along the streets? Are there
sidewalks? Are the streets and sidewalks clean? Are there trash
cans sitting out in sight? Are there people on the streets? Do
they interact with each other? Are the streets well-lit at night?
· Business and Industry: What kinds of businesses are there?
Are there vacant storefronts? In what languages are business
signs? Do the businesses provide the necessities for the
community (such as groceries and medications)? Is there any
kind of industry present?
· Traffic and Transportation: Is there evidence of public
transportation? Is it well used? Is it easy to navigate and use?
How much does it cost? Who uses it? How heavy is the traffic?
Is there a major road or highway close by? Is the traffic mostly
commercial (such as delivery vans and trucks) or private cars?
Are there many bicycles? Are there bike lanes and bike racks?
· Public Services: Are there identifiable public service
providers such as mental health clinics, food banks, and
homeless shelters? Are there police or fire stations nearby? Are
they easy to reach?
· Religious Centers: Are there churches or other religious
institutions? Are they of one faith, or do they represent a
variety of faiths? Is there one dominant religion represented?
· Health Services: How many hospitals and clinics are there?
How big are they? Are they easy to get to?
· Education: Are there public or private K-12 schools nearby?
Are they well-maintained? Are there any two- or four-year
colleges or universities? Are they public or private?
· Population: Who lives in the community? Are there
identifiable racial or ethnic groups? Do particular groups seem
to live in particular areas? Is one age group or gender more
obvious? Do the people who live in this community seem to
interact with each other?
· What is your overall impression of the community?
Summary and Analysis
To help you analyze what you have seen and decide how to use
it, here are some questions you should consider:
· What are the community’s outstanding strengths?
· What seem to be the community’s biggest challenges?
· What was the most unexpected thing you observed?
· What aspect of the community really stood out for you?
· How can you use this information to help develop a health
promotion and wellness plan for the population that lives here?
Reference
Work Group for Community Health and Development. (n.d.).
Windshield and walking surveys. Retrieved from Community
tool box Web site: http://ctb.ku.edu/en/table-of-
contents/assessment/assessing-community-needs-and-
resources/windshield-walking-surveys/main
1
Running head: WINDSHIELD SURVEY 1
Copyright © 2017 Capella University. Copy and distribution of
this document is prohibited.
Windshield Survey
Learner’s Name
Capella University
Health Promotion and Disease Prevention in Vulnerable and
Diverse Populations
Windshield Survey
May, 2017
WINDSHIELD SURVEY 2
Windshield Survey
This paper addresses the question of diversity in health care by
focusing on the health
risks and health care needs of those living in East Harlem, New
York. The paper will first
provide an overview and statistical information about the
population demographics of the East
Harlem community. It will then discuss the findings from a
recent windshield survey of the
community. From this information, the demographic changes for
the minority population in the
community will be explained. This will be followed by a
description of health risks and health
care needs for the minority population and an examination of
the prevalence and impact of
different illnesses on the same population. Finally, there will be
an explanation of the health
disparities and the social determinants of health that can affect
the vulnerable population in this
community.
An Overview of East Harlem
East Harlem, also called Spanish Harlem or El Barrio is home to
many immigrant
communities including one of the largest Hispanic communities
in New York City with a
population of nearly 120,000. It also has a small Italian-
American population. The majority of
the population is Hispanic (50%), and the rest of the population
consists of African-Americans
(31%), whites (12%), and Asians (6%). The median age in the
East Harlem community ranges
from 25–44 years. Around 22% of the population is between 0
and 17 years of age, and 12% of
the population is more than 65 years old. The average life
expectancy of people in this
community is 76 years.
Surveillance Survey of the East Harlem Community
A windshield survey will provide a detailed picture of the
people living in the area (New
York City Department of Health and Mental Hygiene
[NYCDOHMH], 2015).
Comment [A1]: Great intro! This
lets the reader know exactly what to
expect in the paper.
Comment [A2]: You did a nice job
of describing the overall
neighborhood.
WINDSHIELD SURVEY 3
Housing. Around 76% of the homes in East Harlem are renter-
occupied homes with one
or more maintenance defects; that include water leaks, the
presence of mice or rats, cracks and
holes in the wall, inadequate heating, peeling paint, and toilet
breakdowns. The community
consists of residents from a low socioeconomic background and
cannot afford better housing.
Open Space. According to a study by the group New Yorkers for
Parks, East Harlem has
1.2 acres of open space for every 1,000 residents, which is less
than the recommended minimum
of 2.5 acres. Adequate open space allows children to play and
exercise and offers parks for
relaxation which can improve the physical health of children
and aging seniors.
Pollution. Unfortunately, East Harlem has a high concentration
of fine particulate
matter—one of the harmful air pollutants in New York City. Air
pollution is a leading cause of
health issues for people in East Harlem, especially among
children, senior residents, and those
with preexisting health issues such as asthma and other
respiratory ailments (NYCDOHMH,
2015).
Education. The neighborhood has many private, public, and
charter schools. However,
an acute lack of resources in school and poor family life cause a
majority of children to drop out
of school at an early age. Therefore, East Harlem consists of a
substantial section of adults (26%)
who have not graduated from high school.
Culture and religion. From the first wave of Italian immigrants
in the 19th century to
the tidal wave of musicians in the “mambo era,” East Harlem
has set the stage for arts and
culture for over a hundred years. Because of its Italian-
American population, East Harlem is still
influenced by southern Italian food, tradition, and ceremony.
East Harlem has residents who are
followers of different religions ranging from Christianity and
Islam to Scientology, and they have
their own places of worship in the area.
WINDSHIELD SURVEY 4
Health services. East Harlem has several health centers in its
community. Even with the
presence of these health centers, the residents of East Harlem do
not have easy access to health
care primarily because they come from low-income families and
lack health insurance.
Transportation and businesses. East Harlem has a wide range of
business institutions,
one of the most famous being the East Harlem Chamber of
Commerce. East Harlem is also
known for its well-run public transit system.
Hispanic Culture in East Harlem
East Harlem is a predominantly Hispanic neighborhood, due to
immigration of Puerto
Ricans, Latin, South, and Central Americans. About a third of
the Hispanic populations in East
Harlem are college graduates, while approximately 26% of the
population has not finished high
school. These subgroups face barriers due to lack of language
fluency. This language barrier can
lead to miscommunication and prevent Hispanic populations
from accessing important health
education material and regular medical care, which in turn make
them a vulnerable population
(NYCDOHMH, 2015).
Demographic Changes in East Harlem
Hispanics and black residents comprise 81% of the population
in this area, with about a
quarter of the residents being foreign-born. Around 31% of the
residents in East Harlem live
under the Federal Poverty Level, making it the twelfth most
underprivileged community in New
York. One out of eight East Harlem residents aged 16 and above
is unemployed. More than half
the residents use nearly 30% of their overall income on rent.
Over the last decade, East Harlem has observed a large wave of
gentrification, a process
of renovation and reconstruction of an area leading to an influx
of affluent families in that area.
The impact of gentrification takes place through increased rent
burdens instead of direct
Comment [A3]: You did a good job
of discussing East Harlem and the
transportation, health services, culture,
religion, education, housing and
available land.
WINDSHIELD SURVEY 5
displacements—rents have increased by more than 40% in East
Harlem. This has resulted in a
deeper class divide between the rich and poor (Florida, 2016).
Health Risks and Health Care Needs in East Harlem
Due to poor diets, a serious health risk faced by residents of
East Harlem is obesity,
which is a leading cause of diabetes and heart disease. Cancer
and heart disease are the leading
causes of death for people in East Harlem. Smoking is the main
cause of preventable death in
NYC and also the cause behind many illnesses including stroke,
heart disease, lung cancer, and
emphysema. More than 25% of East Harlem residents smoke,
which puts its residents at a higher
risk of suffering from cancer and heart diseases than any other
community in the state of New
York.
Substance use is a major social and health issue in low-income
neighborhoods due to
their inability to cope with their low quality of life. Limited
educational, housing, and
employment opportunities combined with the availability of
drugs contribute to drug and alcohol
addiction (NYCDOHMH, 2015).
Two other health risks in this neighborhood are asthma among
children and HIV. East
Harlem has the sixth-highest rate of asthma hospitalization
among children aged 5 to 14 in the
state of New York and death due to AIDS in East Harlem
neighborhood is thrice as high
compared to the rest of New York City.
While there are several challenges, health care in East Harlem
can be improved by
providing cultural competency training to health care
professionals in language skills, cross-
cultural communication skills, and health literacy strategies
which will help them earn the trust
of the population (NYCDOHMH, 2015).
Comment [A4]: Very nice job in
this section. You described the
demographics very well and also
identified the reasons for the change.
Comment [A5]: There seem to be
many health disparities in East Harlem.
The prevalence of various diseases
was discussed.
WINDSHIELD SURVEY 6
Health Disparities and the Social Determinants of Health in a
Diverse Population
According to the World Health Organization (WHO), the social
determinants of health
(SDH) are defined as circumstances within which persons live
and work (World Health
Organization, n.d.). The financially deprived residents struggle
to meet their basic needs; have
scarce occasions to achieve constructive goals; experience more
undesirable life events such as
marital trouble, joblessness, and monetary loss; and must deal
with discrimination,
marginalization, segregation, and helplessness. Owing to these
stressors, people with low
socioeconomic status are at a higher risk of obesity, diabetes,
substance abuse issues, violence,
and crime.
The existence of disparities in access to health care has been
recognized for a while in the
United States. Recently, the U.S. government has started many
initiatives to address the social
determinants of health. Medicaid, a government insurance
scheme for the underprivileged, has
also developed several initiatives that relate health care to
wider social needs. An important
project under this initiative is the Harlem Children’s Zone
(HCZ), which aims to improve the
health of the Harlem community through a wide range of social,
health, and family programs.
This project has reported a 92% acceptance rate for its programs
(Heiman & Artiga, 2015).
Conclusion
East Harlem is known for its diverse population and rich
cultural history. However, given
that most of the residents in the area are poor and come from
marginalized backgrounds, they
face different health risks and have difficulties accessing health
care. Reducing these health
inequities requires policymakers, health professionals,
researchers and community groups to
work together for systemic change. Framing health policies with
the help of the social
determinants of health will enable the poor residents of East
Harlem access better health care.
WINDSHIELD SURVEY 7
References
Florida, R. (2016). Where New York is gentrifying and where it
isn't. The Atlantic
CityLab. http://citylab.com/housing/2016/05/looking-back-at-
gentrification-in-new-
york-city/482310/
Heiman, H. J., & Artiga, S. (2015). Beyond health care: The
role of social determinants in
promoting health and health equity. The Henry J. Kaiser Family
Foundation. Retrieved
from http://kff.org/disparities-policy/issue-brief/beyond-health-
care-the-role-of-social-
determinants-in-promoting-health-and-health-equity/
New York City Department of Health and Mental Hygiene.
(2015). Manhattan community
district 11: East Harlem. Retrieved from
https://www1.nyc.gov/assets/doh/downloads/pdf/data/2015chp-
mn11.pdf
New Yorkers for Parks. (2012). East Harlem open space index.
Retrieved from
http://ny4p.org/research/osi/EastHarlemOSI.pdf
World Health Organization. (n.d.). Social determinants of
health. Retrieved from
http://who.int/social_determinants/en/

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Windshield Survey Template and InstructionsNote Content a.docx

  • 1. Windshield Survey Template and Instructions Note: Content adapted from the Work Group for Community Health and Development: Community Tool Box’s “Windshield and Walking Surveys.” Windshield and walking surveys are useful ways to assess specific aspects of a community or neighborhood and help give you a sense of the community. Conduct your survey at the time that works best for your schedule, but keep in mind that to truly understand the people who live within the community (or neighborhood), you may wish to do the survey more than once, and at different times of the day or different days of the week. For the purposes of this course, you are not required to do the survey more than once. Please be mindful of your personal safety. If there is a known issue with hostility between specific groups, it may not be safe for some people to survey particular neighborhoods. Do not knowingly put yourself in harm’s way. Preparation · Get familiar with the survey questions and know what you will be looking for. · Use a checklist to be sure you have covered all the questions and observed all the areas you want to. · Be as inconspicuous as possible. Not only do people act differently when they know they are being observed, they may also become suspicious or hostile.
  • 2. · Be sure you carry identification. · Take notes along the way. You can also take photos with a camera or cell phone to help you remember what you have seen. · Always pay attention to your safety. Be aware of the neighborhood and the situation. Observation Use the spaces between the questions below for your notes. You can write more complete observations once you return home. · Housing: What is the age and condition of housing in the community or neighborhood? Are the houses and apartments kept up, or are they run-down and in need of repair? Are the yards neat or overgrown? · Other Buildings: Are other buildings mostly or fully occupied? Are public and commercial buildings accessible by people with disabilities? · Parks and Public Spaces: Are parks and other public spaces well maintained? Are they used by a variety of people? Are there sports facilities such as baseball fields, basketball courts, and soccer fields? · Culture and Entertainment: Are there museums, libraries, theaters, restaurants, historic sites, and so forth? Do they reflect the culture of the community? Are they readily accessible? · Streets: Are there trees and plants along the streets? Are there sidewalks? Are the streets and sidewalks clean? Are there trash cans sitting out in sight? Are there people on the streets? Do they interact with each other? Are the streets well-lit at night? · Business and Industry: What kinds of businesses are there? Are there vacant storefronts? In what languages are business signs? Do the businesses provide the necessities for the community (such as groceries and medications)? Is there any kind of industry present?
  • 3. · Traffic and Transportation: Is there evidence of public transportation? Is it well used? Is it easy to navigate and use? How much does it cost? Who uses it? How heavy is the traffic? Is there a major road or highway close by? Is the traffic mostly commercial (such as delivery vans and trucks) or private cars? Are there many bicycles? Are there bike lanes and bike racks? · Public Services: Are there identifiable public service providers such as mental health clinics, food banks, and homeless shelters? Are there police or fire stations nearby? Are they easy to reach? · Religious Centers: Are there churches or other religious institutions? Are they of one faith, or do they represent a variety of faiths? Is there one dominant religion represented? · Health Services: How many hospitals and clinics are there? How big are they? Are they easy to get to? · Education: Are there public or private K-12 schools nearby? Are they well-maintained? Are there any two- or four-year colleges or universities? Are they public or private? · Population: Who lives in the community? Are there identifiable racial or ethnic groups? Do particular groups seem to live in particular areas? Is one age group or gender more obvious? Do the people who live in this community seem to interact with each other? · What is your overall impression of the community? Summary and Analysis To help you analyze what you have seen and decide how to use it, here are some questions you should consider: · What are the community’s outstanding strengths? · What seem to be the community’s biggest challenges? · What was the most unexpected thing you observed?
  • 4. · What aspect of the community really stood out for you? · How can you use this information to help develop a health promotion and wellness plan for the population that lives here? Reference Work Group for Community Health and Development. (n.d.). Windshield and walking surveys. Retrieved from Community tool box Web site: http://ctb.ku.edu/en/table-of- contents/assessment/assessing-community-needs-and- resources/windshield-walking-surveys/main 1 Running head: WINDSHIELD SURVEY 1 Copyright © 2017 Capella University. Copy and distribution of this document is prohibited. Windshield Survey Learner’s Name
  • 5. Capella University Health Promotion and Disease Prevention in Vulnerable and Diverse Populations Windshield Survey May, 2017 WINDSHIELD SURVEY 2 Windshield Survey This paper addresses the question of diversity in health care by focusing on the health risks and health care needs of those living in East Harlem, New York. The paper will first provide an overview and statistical information about the population demographics of the East Harlem community. It will then discuss the findings from a recent windshield survey of the
  • 6. community. From this information, the demographic changes for the minority population in the community will be explained. This will be followed by a description of health risks and health care needs for the minority population and an examination of the prevalence and impact of different illnesses on the same population. Finally, there will be an explanation of the health disparities and the social determinants of health that can affect the vulnerable population in this community. An Overview of East Harlem East Harlem, also called Spanish Harlem or El Barrio is home to many immigrant communities including one of the largest Hispanic communities in New York City with a population of nearly 120,000. It also has a small Italian- American population. The majority of the population is Hispanic (50%), and the rest of the population consists of African-Americans (31%), whites (12%), and Asians (6%). The median age in the East Harlem community ranges from 25–44 years. Around 22% of the population is between 0 and 17 years of age, and 12% of
  • 7. the population is more than 65 years old. The average life expectancy of people in this community is 76 years. Surveillance Survey of the East Harlem Community A windshield survey will provide a detailed picture of the people living in the area (New York City Department of Health and Mental Hygiene [NYCDOHMH], 2015). Comment [A1]: Great intro! This lets the reader know exactly what to expect in the paper. Comment [A2]: You did a nice job of describing the overall neighborhood. WINDSHIELD SURVEY 3 Housing. Around 76% of the homes in East Harlem are renter- occupied homes with one or more maintenance defects; that include water leaks, the presence of mice or rats, cracks and holes in the wall, inadequate heating, peeling paint, and toilet breakdowns. The community
  • 8. consists of residents from a low socioeconomic background and cannot afford better housing. Open Space. According to a study by the group New Yorkers for Parks, East Harlem has 1.2 acres of open space for every 1,000 residents, which is less than the recommended minimum of 2.5 acres. Adequate open space allows children to play and exercise and offers parks for relaxation which can improve the physical health of children and aging seniors. Pollution. Unfortunately, East Harlem has a high concentration of fine particulate matter—one of the harmful air pollutants in New York City. Air pollution is a leading cause of health issues for people in East Harlem, especially among children, senior residents, and those with preexisting health issues such as asthma and other respiratory ailments (NYCDOHMH, 2015). Education. The neighborhood has many private, public, and charter schools. However, an acute lack of resources in school and poor family life cause a majority of children to drop out
  • 9. of school at an early age. Therefore, East Harlem consists of a substantial section of adults (26%) who have not graduated from high school. Culture and religion. From the first wave of Italian immigrants in the 19th century to the tidal wave of musicians in the “mambo era,” East Harlem has set the stage for arts and culture for over a hundred years. Because of its Italian- American population, East Harlem is still influenced by southern Italian food, tradition, and ceremony. East Harlem has residents who are followers of different religions ranging from Christianity and Islam to Scientology, and they have their own places of worship in the area. WINDSHIELD SURVEY 4 Health services. East Harlem has several health centers in its community. Even with the presence of these health centers, the residents of East Harlem do not have easy access to health care primarily because they come from low-income families and lack health insurance. Transportation and businesses. East Harlem has a wide range of
  • 10. business institutions, one of the most famous being the East Harlem Chamber of Commerce. East Harlem is also known for its well-run public transit system. Hispanic Culture in East Harlem East Harlem is a predominantly Hispanic neighborhood, due to immigration of Puerto Ricans, Latin, South, and Central Americans. About a third of the Hispanic populations in East Harlem are college graduates, while approximately 26% of the population has not finished high school. These subgroups face barriers due to lack of language fluency. This language barrier can lead to miscommunication and prevent Hispanic populations from accessing important health education material and regular medical care, which in turn make them a vulnerable population (NYCDOHMH, 2015). Demographic Changes in East Harlem Hispanics and black residents comprise 81% of the population in this area, with about a quarter of the residents being foreign-born. Around 31% of the residents in East Harlem live
  • 11. under the Federal Poverty Level, making it the twelfth most underprivileged community in New York. One out of eight East Harlem residents aged 16 and above is unemployed. More than half the residents use nearly 30% of their overall income on rent. Over the last decade, East Harlem has observed a large wave of gentrification, a process of renovation and reconstruction of an area leading to an influx of affluent families in that area. The impact of gentrification takes place through increased rent burdens instead of direct Comment [A3]: You did a good job of discussing East Harlem and the transportation, health services, culture, religion, education, housing and available land. WINDSHIELD SURVEY 5 displacements—rents have increased by more than 40% in East Harlem. This has resulted in a
  • 12. deeper class divide between the rich and poor (Florida, 2016). Health Risks and Health Care Needs in East Harlem Due to poor diets, a serious health risk faced by residents of East Harlem is obesity, which is a leading cause of diabetes and heart disease. Cancer and heart disease are the leading causes of death for people in East Harlem. Smoking is the main cause of preventable death in NYC and also the cause behind many illnesses including stroke, heart disease, lung cancer, and emphysema. More than 25% of East Harlem residents smoke, which puts its residents at a higher risk of suffering from cancer and heart diseases than any other community in the state of New York. Substance use is a major social and health issue in low-income neighborhoods due to their inability to cope with their low quality of life. Limited educational, housing, and employment opportunities combined with the availability of drugs contribute to drug and alcohol addiction (NYCDOHMH, 2015). Two other health risks in this neighborhood are asthma among
  • 13. children and HIV. East Harlem has the sixth-highest rate of asthma hospitalization among children aged 5 to 14 in the state of New York and death due to AIDS in East Harlem neighborhood is thrice as high compared to the rest of New York City. While there are several challenges, health care in East Harlem can be improved by providing cultural competency training to health care professionals in language skills, cross- cultural communication skills, and health literacy strategies which will help them earn the trust of the population (NYCDOHMH, 2015). Comment [A4]: Very nice job in this section. You described the demographics very well and also identified the reasons for the change. Comment [A5]: There seem to be many health disparities in East Harlem. The prevalence of various diseases was discussed.
  • 14. WINDSHIELD SURVEY 6 Health Disparities and the Social Determinants of Health in a Diverse Population According to the World Health Organization (WHO), the social determinants of health (SDH) are defined as circumstances within which persons live and work (World Health Organization, n.d.). The financially deprived residents struggle to meet their basic needs; have scarce occasions to achieve constructive goals; experience more undesirable life events such as marital trouble, joblessness, and monetary loss; and must deal with discrimination, marginalization, segregation, and helplessness. Owing to these stressors, people with low socioeconomic status are at a higher risk of obesity, diabetes, substance abuse issues, violence, and crime. The existence of disparities in access to health care has been recognized for a while in the United States. Recently, the U.S. government has started many initiatives to address the social
  • 15. determinants of health. Medicaid, a government insurance scheme for the underprivileged, has also developed several initiatives that relate health care to wider social needs. An important project under this initiative is the Harlem Children’s Zone (HCZ), which aims to improve the health of the Harlem community through a wide range of social, health, and family programs. This project has reported a 92% acceptance rate for its programs (Heiman & Artiga, 2015). Conclusion East Harlem is known for its diverse population and rich cultural history. However, given that most of the residents in the area are poor and come from marginalized backgrounds, they face different health risks and have difficulties accessing health care. Reducing these health inequities requires policymakers, health professionals, researchers and community groups to work together for systemic change. Framing health policies with the help of the social determinants of health will enable the poor residents of East Harlem access better health care.
  • 16. WINDSHIELD SURVEY 7 References Florida, R. (2016). Where New York is gentrifying and where it isn't. The Atlantic CityLab. http://citylab.com/housing/2016/05/looking-back-at- gentrification-in-new- york-city/482310/ Heiman, H. J., & Artiga, S. (2015). Beyond health care: The role of social determinants in promoting health and health equity. The Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/disparities-policy/issue-brief/beyond-health- care-the-role-of-social- determinants-in-promoting-health-and-health-equity/ New York City Department of Health and Mental Hygiene. (2015). Manhattan community district 11: East Harlem. Retrieved from https://www1.nyc.gov/assets/doh/downloads/pdf/data/2015chp- mn11.pdf New Yorkers for Parks. (2012). East Harlem open space index. Retrieved from http://ny4p.org/research/osi/EastHarlemOSI.pdf
  • 17. World Health Organization. (n.d.). Social determinants of health. Retrieved from http://who.int/social_determinants/en/