How old is your organization? The organization that is now AIRnyc began as a Community Based Participatory Research (CBPR) project focused on pediatric asthma in 2001 at Harlem Hospital Center. In 2012, we founded AIRnyc, the organization, and began building out infrastructure based on the early positive results of that Community Health Worker-led pilot research project, first as a.i.r nyc (where the a.i.r. stood for asthma intervention and relief), and later pivoted to AIRnyc, where the AIR stands for At Home Intervention and Relief. Our mission is to address the social drivers of health that are associated with higher rates of asthma, diabetes, hypertension, and social isolation in communities of color across NYC. AIRnyc Community Health Workers are the ground troops, joining forces with people where they live to attack the root causes that lead to less health and wealth, more sickness and death, including infant and maternal mortality, for Black and Hispanic New Yorkers citywide.
What sector do you work in? Health
How long have you been working in this sector? 21 years
How long have you been with your current organization? 10 years
What has been the most significant development in your sector over the last 40 years?
There are three converging trends that are driving massive change in the health sector. The first is the staggering growth of preventable, debilitating chronic conditions such as diabetes, hypertension, and asthma as well as diseases of despair such as substance abuse, depression, and social isolation, which result in unsustainable financial costs to the country as well as enormous human suffering.
The second is the emergence of new consumer technologies in the form of smartphones, wearables, and apps that allow people to prioritize and address their health needs more directly, and new business technologies that are disrupting the way healthcare organizations analyze health data, organize their business models, and deliver care.
And the third trend driving change in healthcare is the shift away from fee-for-service payment models (that reward volume of care delivered) to value-based payment models (that reward quality of care delivered). It is within this transformation of the way we pay for healthcare that the market is finally paying attention to the social drivers of health, which determine 80% of our health. As providers become responsible for and incentivized to deliver high-quality health outcomes at lower cost, we are seeing more investment in programs and interventions that address the social barriers to health such as food insecurity, transportation, and housing, which have long been the focus of nonprofit Community Based Organization, but are only recently appearing on the radar of investors, entrepreneurs and the corporate world for the first time as worthy of investment.
What is the single greatest challenge you face today in your sector?
Raising capital to scale the high-impact model of social care that AIRnyc has built as a nonprofit, Community Based Organization. We have the vision, experience and results to scale the Community Health Workforce but, we need funders who are willing to invest at scale to allow us to further develop the business case for our model. We have to engage the whole person, the whole family, beyond transactional, single-issue encounters, or else we are just spinning our wheels and wasting resources on the heaviest part of the lift to address social drivers of health: building trust with people and community who have every reason to distrust the system.
What will nonprofits need to do to remain relevant and necessary to their clients over the next 40 years?
Nonprofits have to build capabilities around data management including analytics, security, and connectivity with other nonprofits as well as with the traditional healthcare delivery system. Nonprofits also have to realize that as the world becomes more digital, in all segments of the socio-economic spectrum, consumers expect better service and experience, including from Community Based Organizations. We have to listen and learn from the people whom we are trying to serve, including the ways in which we are failing to meet their expectations and needs.
What skills do you believe are necessary for people to succeed as managers over the next few decades?
Flexible, innovative, and non-hierarchical thinking. Willingness to keep learning. Accountability for outcomes.
Why did you join this sector?
Along with many other people I’ve encountered in the Health sector, I am outraged that Black and Hispanic Americans suffer more sickness, more hospitalization and earlier death relative to white counterparts, which, along with mass incarceration, lack of access to high quality education and other barriers to social mobility, exemplifies the deep structural racism that sickens our country. We clearly need transformation at the highest levels of our public and private sectors in order to begin to reduce the harm that we continue to inflict on our own people and planet. But I have always been drawn to working on solutions from the bottom-up. By meeting people where they live, in their kitchens, classrooms and housing project tenant association rooms, we learn what people want and need to be healthy, and our Community Health Workers engage to facilitate, motivate and inspire positive change. There’s no app for that; human contact is still the most inspiring way we connect with each other and that people power is what drives the organization that is AIRnyc as well as many others in our social care space.
As the oldest child of a single, working mother in the City of Pittsburgh, my three siblings and I were lucky to have strong community to hold us up. Buoyed by a safety net of teachers, coaches, friends and their parents helped us to overcome barriers. In those formative years, I learned a sense of Tikkun Olam — the Jewish call to action for repairing the world — which led me to choose the work of building community with and for vulnerable people. As a Peace Corps Volunteer in rural Burkina Faso, I learned to value deep engagement with the people we in the “social sector” who are trying to help, often with the best of intentions, and perhaps even more often with a ton of wrong assumptions. I was drawn to the opportunity to build AIRnyc with a community-rooted, “boots on the ground” approach to tackling complex social problems. And the time I invested in studying frameworks and playbooks from the private sector, including factoring in the perspective of the “customer”, has helped me bring an entrepreneurial and person-centered approach to our community health work.
In what ways would others say you are a trailblazer?
We were early to identify and market the value proposition of a distributed tech-enabled community health workforce, moving us from a charity-reliant organization to a social enterprise that earns upwards of 90% of our funding. For the past ten years, we have done this work, executing contracts with payers and health systems without the benefit of start-up or investment capital. AIRnyc is now navigating a new landscape being increasingly dominated by for-profit, venture-backed companies who are in some ways competing with us while also bringing a lot more sophistication and scalability to this work. I see the entrants of new players as affirming of the models of care AIRnyc has been building and refining for over a decade, but the time is now for us and other CBOs to find our way forward, and continue to blaze new trails in getting payers, providers, and patients to see the value and engage with us as the healthcare sector tries to “buy health” in new ways that address upstream social factors.
What do you want your work culture to be like?
Rigorous, positive, fun, team-oriented, and in constant learning mode.
Please name three qualities that are inherent in being a strong leader.
Be willing to innovate, be constantly learning, and have passion for the mission.