Improving the Health and Well-being of Teens in Urban, Poverty Settings

Improving the Health and Well-being of Teens in Urban, Poverty Settings

Location: Morris Heights Health Center, Bronx, NY
Delivery: In-School and afterschool with 6th – 12th Grade
2010 OAH Grant Award Winner
Teens Served: 1,600

Despite recent decreases in teen pregnancy rates, the Bronx had the highest teen pregnancy rates and sexually transmitted infections in all of New York City –not due to increased sexual activity, but due to high levels of poverty.

“Teen pregnancy doesn’t just affect the father or mother, but also their offspring for generations,” said Estelle Raboni, program director for the Teen Outreach Program® (TOP®) offered by Morris Heights Health Center (MHHC) located in the Bronx, New York. “The high dropout rate in the Bronx is the unintended consequence of teen pregnancy, and from there, the cycle of poverty begins to snowball.”

Teen parents are more likely to drop out of school and live in poverty. Their children are likely to grow up poor, experience abuse, drop out of school and become teen parents themselves.

“Our previous school-based health centers didn’t achieve the dramatic reduction in teen pregnancy we were expecting. All of our school-based health centers were staffed with social workers, physicians, health educators, school health assistants and more. But focusing on the issue from the waist down wasn’t the solution. TOP’s holistic approach was the linchpin we were seeking.”

Raboni attributes TOP’s success to the immediate engagement the program achieves with teens through community service learning.

“Once teens get their first taste of community service, we see a transformation in even the most difficult classes,” added Raboni. “These teens are usually on the receiving end of help, so when they are able to switch roles and help others, they begin to see they have a voice, and ultimately, have the ability to change the course of their future.”

While many of the schools where TOP is implemented in the Bronx have graduation rates as low as 50 percent and are at risk of being closed, TOP has been a game-changer for many of these schools.

“These teens aren’t more privileged – they live in the same neighborhoods, take the same classes and have similar family and socioeconomic backgrounds,” added Raboni. “Because of their experience in TOP, these teens are more actively engaged in school, and approach their education with an entirely different attitude. Many have grades that are consistently  10 to 15 points higher than their peers.”

Due to the success of TOP, and its broader impact on students’ academic success, MHHC received funding to expand its reach to support immigrant students.

“The majority of these new-immigrant students arrive to New York with poor or inconsistent education, requiring them six years to graduate high school rather than four years,” added Raboni. “Thanks to the program, these students show more persistence in their schoolwork since the program launched in April 2011.”

MHHC received OAH funding to implement TOP in 12 middle and high schools in south, central and northeast Bronx in 2010. TOP programming is offered in-school and after school for teens ranging from 12 to 17 years of age. To learn more, visit:

Photo credit: Uli Seit for The New York Times


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