Friday, February 6, 2015

Health, Wellness, and Safety for All: The BOOM!Health Model and Social Determinants of Health

By: John Hellman, Director of Advocacy & Communications, BOOM!Health

BOOM!HealthI’ve been at BOOM!Health for just over 4 months now.  It didn’t take long, however, for me to realize that BOOM!Health does health very differently.

Most policy discussions around healthcare nowadays involve a conversation about the “social determinants of health” and the impact they have on an individual’s health. Poverty, income, housing and homelessness, immigration status, and discrimination are common issues brought up in this context, and these greater social issues either prevent health care access or negatively impact health outcomes. While these issues are discussed more often, they are rarely integrated into the fabric of organizations or models of healthcare delivery. This is no easy task, since these social issues are complex and oftentimes overwhelming. How can healthcare organizations seriously grabble with poverty, discrimination, and other social determinants while taking care of the individuals that live in these realities?

I believe BOOM!Health is answering that question, with a BOOM!

BOOM!Health is located in the South Bronx, the poorest congressional district in the country. We serve some of the most vulnerable populations in the country - active injection drug users, homeless individuals, LGBT youth and adults, people living with HIV, AIDS, and HCV, and many others. The Bronx itself has some of the highest rates of a range of diseases in New York City and the country, and because of its high rates of multiple diseases, the zip code 10457 is even nicknamed “disease alley.” Because of these sobering facts, understanding these social determinants of health is unavoidable.

This reality is also reflected in the lives of our participants. Laundry, showers, food, and clothing are the most widely accessed services by the over 12,000 participants we see annually. Housing, jobs, and food insecurity are cited as the main concerns our participants have, and we know through our growing health coordination services that if these basic needs are not addressed, health and other supportive services fall to the wayside.

BOOM! Health has been working to address a variety of problems plaguing the New York City region and bringing care to those in need.

The challenges are complex, and BOOM!Health’s model is designed to address them head on because of what is at the center of everything we do: the participant. Our service model works to actively remove these barriers to health care access and preventative services while supporting clients and program participants on their journey towards wellness and self-sufficiency. We offer a full range of prevention, syringe access, health coordination, behavioral health, housing, legal, advocacy and wellness services to our participants. And if we don’t have expertise or capacity in a particular service area that we know our participants need, we find people that do. But instead of just building referral networks, we bring the experts to our participants.

At our Harm Reduction Center, which sees the majority of our former and active injection drug users, we have co-located primary care services with HELP/PSI and a pharmacy with Evers Pharmacy, which is now branded as BOOM!Pharmacy. At our brand new Wellness Center scheduled to open this summer, we will have co-located LGBT-focused primary care services with Callen-Lorde Community Health Center, the premier LGBT healthcare organization in the country. These meaningful partnerships have enabled BOOM!Health to become a growing one stop shop, so that we can ensure that our participants are being treated humanely and that they get exactly what the need in order to reach health and self-sufficiency.

But services alone will not solve these issues. Our advocacy model, informed by the lives of our participants, seeks to address the reasons why so many need the services we offer. We participate in advocacy related to LGBT discrimination, drug prohibition, harm reduction, intimate partner violence, criminalization, health care access, and many other issues that would fall under “the social determinants of health.” Even though it is rare for a health organization to also engage in advocacy, it is absolutely essential if we are to make any real and sustainable progress on the health problems that many folks face in the Bronx and beyond.

For more information on BOOM!Health, visit, or you can email me at


Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

1 comment:

Sue Saltmarsh said...

I applaud BOOMHealth and Mr. Hellman for making such a difference both in raising awareness of the barriers to healthcare access and in improving the lives of those most in need.

But I challenge them to go further. As Director of the Drive for Universal Healthcare and the primary organizer of the Healthcare Justice March, I urge BOOMHealth to become an advocate for expanded and improved Medicare for All - single-payer healthcare - in this country. By adopting such a system, healthcare access would no longer depend on a person's ability to pay; scarce funds could be directed away from healthcare delivery and towards the other social determinants Mr. Hellman identifies; and the leading cause of bankruptcy - medical debt - would be eliminated.

There will always be rich people and poor people, there will always be corruption and greed, and single-payer would bring other challenges (provider shortages, pharma company resistance to generics, IT "glitches" to name a few), but how much better off would our society be if every person in it knew they could get the medical care and treatment they need from the provider they choose, any time, anywhere?

I hope that Mr. Hellman and the BOOMers will become vociferous supporters of comprehensive, equitable, truly universal healthcare in the U.S. and add healthcare justice to the goals of their good work. - Sue Saltmarsh