ABSTRACT: Despite medical advances in treating chronic diseases and epidemiological findings identifying risk factors for chronic diseases, there remain major persistent health disparities driven by the Social Determinants of Health (SDoH). We have come together to address these disparities through the Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (COMMUNITY Center). Our vision is rooted in public health which recognizes that medical advances alone can only partially reduce the burden of disease and that reducing health disparities in chronic diseases requires improving the health and wellness of individuals, families, communities and societies throughout life. We seek to realize this vision within the communities we serve that are among the most highly diverse in the U.S. with approximately 2/3 non-white, 1/3 foreign-born, and 1/5 living below the Federal poverty line. The mission of the COMMUNITY Center is to reduce health disparities in chronic diseases in the New York City Region through rigorous testing, disseminating and sustaining of interventions that incorporate the multiple levels of influence from individual, interpersonal, community and societal approaches. We have designed three synergistic projects that address chronic conditions identified by and responsive to the voice and concerns of the communities we serve and each involve novel interventions employing the community health worker (CHW) model for enrollment and/or retention into the studies while also connecting participants to services based on five domains of SDoH (housing instability, food insecurity, transportation problems, utility help needs and insurance enrollment). The three projects are 1) Community Health workers United to Reduce Colorectal cancer and CVD among people at Higher risk (CHURCH); 2) Addressing Sleep Duration, Regularity, and Efficiency: A Multidimensional Sleep Health Intervention for Reducing Disparities in Cardiometabolic Disease (DREAM); and 3) Intervention to iMProve AdherenCe equiTably (IMPACT TRIAL). In addition to the three research projects, the Center supports Health Equity Scholars and pilots funded through the Investigator Development Core (IDC) and community projects funded through the Community Core (known as the CONNECTOME). The Administrative Core (ADMIN) which includes faculty with expertise in biostatistics, implementation science, and data harmonization and biomedical informatics. The COMMUNITY Center involves strong collaborations between researchers, community organizations, clinicians and healthcare systems, public health agencies and other stakeholders and partners Columbia University Irving Medical Center (CUIMC) and Weill Cornell Medical Center (WCM) joined through the greater New York Presbyterian (NYP) Hospital System with City University of New York (CUNY) and the Physician Affiliate Group of New York (PAGNY). The unique collaborative is poised to create sustainable public health solutions that will result in system-level changes that promote health equity.

NARRATIVE: The COMMUNITY Center of NYC brings together an interdisciplinary team of investigators, health care providers and community stakeholders around NYC through multi-institutional partnerships (Columbia, Cornell, New York Presbyterian Hospital, Physician Affiliate Group of New York) to reduce health disparities in multiple chronic diseases. We focus on cardiovascular disease and cancer, and their risk factors, as they are the two leading causes of death and that share common social context, etiological pathways, risk factors and management strategies.