Many patients come to our Manhattan practices from local neighborhoods, while others travel to us from neighborhoods around the city. They represent a diverse spectrum of economic and social backgrounds, from the middle class and the working poor, to welfare recipients and the homeless. They come from many ethnic backgrounds, and a wide variety of cultures. Some of our patients present medical, psychosocial, and economic challenges that require extra skills and sensitivity on the part of our staff.

In the Bronx, we serve the Morrisania, Mt. Hope, Tremont, and Parkchester neighborhoods — all the Institute’s Bronx practice sites are located in Health Professional Shortage Areas. These communities have high rates of asthma, tuberculosis, substance abuse, and HIV, increasing the need for counseling and crisis management. There are more children per household, and the level of educational attainment is lower than that of the city as a whole.

Many of our Bronx patients are African-American or Hispanic; many receive public assistance; and more than half are women, who face numerous obstacles to getting good health care—difficulty in obtaining insurance coverage, competing priorities in their lives, and a strong tendency to provide for the health care needs of their children, often at the expense of their own health care.