Op-Ed Published on worsening conditions in Harlem

Greater Harlem Coalition has published this Op-Ed on New York Daily News describing the impact of excessive number of methadone clinics in Harlem. Please help forward to your neighbors and elected officials to raise awareness

Although the opioid epidemic led to a 200% increase in overdose deaths in New York State from 2010-17, even before the sharp rise last year during the COVID pandemic, medical strategies to address Substance Use Disorder (SUD) haven’t substantially changed in decades. In New York City, the state Department of Addiction Services and Supports (OASAS) relies on approximately 70 Opioid Treatment Programs (OTPs) that primarily dispense methadone.

National Institutes of Health research shows that opioid treatment is most successful when it is available locally, but OASAS data on the distribution and attendance of treatment programs in New York City show a systemic overconcentration of OTPs in majority Black and Brown neighborhoods. Harlem is particularly oversaturated, with eight OTPs in a five-block radius of 125th St. and Park Ave. More than 75% of patients being treated in Harlem live elsewhere and commute into the neighborhood from elsewhere in the city, and even from Long Island and Upstate New York. Since successful treatment negatively correlates with distance from a treatment site, OASAS’s decision to concentrate treatment centers in Harlem is clearly not based on patient welfare.

Profit margins, instead, seems to be the major factor that has led to Harlem becoming the city’s “methadone hub,” primarily through three OTP providers: Mount Sinai (which absorbed Beth Israel’s many OTPs during their merger), Kaleidoscope and START, who benefit from Harlem’s relatively inexpensive real estate. And given the economic and political advantages that accrue from expanding an existing facility, OTP capacity in Harlem has continued to increase over the years, leading social services to refer more patients to Harlem, leading to more increases, and so on, with full approval from OASAS.

This hyper-concentration of drug treatment resources in Harlem unfairly burdens the patients who have to travel up to six days a week to get their medication. It also burdens area residents and businesses. Along much of 125th St., used needles lie in gutters and on the sidewalks; people nod out and use doorways as toilets. Drug dealers operate openly, taking advantage of this concentration of vulnerable patients. Small businesses suffer from a lack of foot traffic and high rates of shoplifting. Restaurants note that customers often report being uncomfortable and do not return. New businesses are reluctant to open in the neighborhood when they see the street drug dealing and use.

And Mount Sinai is now planning to relocate its CARES program, an education program for at-risk kids (with mental and addiction issues), from Morningside Heights into the middle of this methadone hub — another decision that seems unlikely to benefit the clients.

Some believe that this kind of oversaturation is part of Harlem’s identity. In reality, the neighborhood’s history of compassion for people who are working through difficulties is being exploited. OASAS and Mount Sinai’s relentless concentration of treatment facilities in this neighborhood of color is simply medical redlining. Wealthier and frequently whiter communities are rarely asked to shoulder their fair share of vulnerable OTP patients.

It’s past time that this problem be addressed. While the Mainstreaming Addiction Treatment Act currently under consideration at the federal level would increase Medicaid reimbursement for helping those struggling with drug abuse and make alternative forms of treatment more readily available, it is expected to do little to alleviate Harlem’s burden unless more direct actions are taken.

New York State must take responsibility for the oversaturation and adopt measures to address it without further delay.

First, to allow a systematic assessment of whether treatment programs are being fairly situated, OASAS should publish data on addiction and overdose rates, capacities, services, locations of drug treatment centers in each district, and audit reports and verified complaints should be made publicly and easily available.

Then, the state should move OTPs that exceed the demonstrable need of the neighborhood into other, less serviced, neighborhoods in each renewal cycle. When homeless shelters or environmental hazards are unfairly clustered in relatively poor and powerless parts of the city, we call it racism.

Input from community organizations, local government officials and government agents such as police and social workers regarding the impact of OTPs on their neighborhoods should also be made public and included when considering license renewal.

And more weight in OTP placement decisions should be given to New York City officials. The mayor’s office and the City Council, in turn, must commit to redressing this inequity.

If the officials of New York State and New York City are committed to rooting out systemic racism, they must also commit to distributing social services equitably. No community should be asked to do more than its fair share — or allowed to do less — regardless of its economic, political or racial make-up. We should have tremendous compassion for those struggling with drug addiction, and part of that compassion should be ensuring that services designed to help them are close to their homes.

Hill and Asberry-Chresfield are founders of The Greater Harlem Coalition, a grassroots organization focused on improving quality of life.

GHC Addiction Program Candidates’ Questionnaire

We’ve begun to poll the candidates for City Council District 9 on their positions on the following questions:

  • Do you agree that Harlem and East Harlem have more than their fair share of substance use programs?
  • If elected, will you work to reduce the unfair oversaturation of substance use programs in Harlem and East Harlem?
  • Do you support locating Safe Injection Sites in New York?
  • Will you oppose locating Safe Injection Sites in Harlem and East Harlem?
  • Additional comments regarding your plans for existing and future substance use programs in Harlem and East Harlem?

So far we have answers from a number of the candidates and we’ll highlight their responses and comments, here.

(NYT 2018) Experts await wider adoption of buprenorphine to replace methadone which allows patients to obtain treatment from local doctors

By Jose A. Del Real

  • Jan. 12, 2018

Opioid Addiction Knows No Color, but Its Treatment Does

In New York, treatment is sharply segregated by income, as those with money can avoid methadone clinics and use an alternate treatment.

On a street lined with garbage trucks, in an industrial edge of Brooklyn, dozens of people started filing into an unmarked building before the winter sun rose. Patients gather here every day to visit the Vincent Dole Clinic, where they are promised relief from their cravings and from the constant search for heroin on the streets.

Robert Perez exited the clinic on a recent Wednesday and walked toward the subway, along the Gowanus Canal. Within the clinic’s antiseptic blue walls, he had just swallowed a red liquid from a small plastic cup. The daily dose of methadone helps Mr. Perez, 47, manage withdrawal symptoms as he tries to put decades of drug abuse behind him.

“I wish I didn’t have to come here every day, but I have to,” Mr. Perez said outside the clinic. “If you don’t do it, you’re sick. You wake up sick.”

Mr. Perez is not alone. For recovering users without money or private health insurance, these clinics are often the only option to get their lives on track, even as less cumbersome alternatives have become available for those who can pay for it.

In New York City, opioid addiction treatment is sharply segregated by income, according to addiction experts and an analysis of demographic data provided by the city health department. More affluent patients can avoid the methadone clinic entirely, receiving a new treatment directly from a doctor’s office. Many poorer Hispanic and black individuals struggling with drug addiction must rely on these highly regulated clinics, which they must visit daily to receive their plastic cup of methadone.

Mr. Perez expressed gratitude at the chance to treat his addiction, but lamented that his days are now oriented around the clinic. He had commuted 45 minutes from Bushwick to receive his methadone, a highly regulated opioid used to treat heroin and painkiller dependence, as he does every day of the week. Sometimes he waits in line at the clinic for an hour for his turn. “You have to come every day. I hate it, I hate it, but you have to do it.”

This is what opioid addiction recovery is like for more than 30,000 patients enrolled in New York City’s approximately 70 methadone-based treatment programs, which provide medication-assisted treatment, counseling and other social services. Hundreds of thousands of patients across the country are enrolled in similar programs, which often receive government funding and are covered by Medicaid in New York.

For more than 40 years, methadone was the most effective method for people addicted to heroin to keep their cravings in check. But in 2002, the Food and Drug Administration approved another medication to treat opioid addiction: buprenorphine, sold most widely in a compound called Suboxone. Both methadone and buprenorphine are extremely effective in keeping recovering users from relapsing, according to medical research, but Suboxone is engineered to reduce the possibility of abuse and overdose. Crucially, the medication can be prescribed in doctors’ offices and then taken at home.

Many hoped that buprenorphine could mean an end to the daily hurdles to receiving treatment for tens of thousands of patients: no additional commute, no security check, no waiting, no line for the plastic cup.

But today in the city, that is primarily true only for middle-class or upper-middle-class patients seeking help with their addiction.

More patients arrived at the clinic as Mr. Perez spoke. They were nearly all Hispanic or black. Those who are white, like Melissa Neilson, are often unemployed or have few resources to dedicate to recovery. She and her partner, JC Marin, visit the clinic from Copiague, Long Island, in a taxi paid for by Medicaid. More than two hours each way, six days a week, for their daily dose.

Methadone treatment was pioneered in New York, a city with a deep history of opioid addiction; access to the treatment is easier here than anywhere else in the United States.But because methadone is highly regulated — owing to fears that it could be sold in illegal markets — physicians can provide methadone for addiction treatment only in specialized clinics like Vincent Dole. Employment, child care, unexpected emergencies and other life events have to be oriented around the clinic. On the street, methadone is sometimes referred to as the “liquid handcuffs.”

The limited data recently made available by the New York City health department hints at structural discrepancies in access to treatment that become obvious during visits to these clinics. In New York City, 53 percent of participants in methadone programs are Latino, 23 percent are black, and 21 percent are white, according to 2016 health department data.

The city said it does not keep track of the income or race of buprenorphine patients, and data on buprenorphine treatment demographics is sparse at the national level as well. A study published in 2016 in Drug and Alcohol Dependence, a scientific journal, found that buprenorphine and methadone access were correlated with income and ethnicity in New York City. Without broad government surveys, precision is difficult; the report lamented that no nationally representative data on ethnicity or income has been published since 2006, when a survey by the Substance Abuse and Mental Health Services Administration showed that 92 percent of buprenorphine patients were white.

In 2016, according to data provided by the city, more than 13,600 New Yorkers filled prescriptions for Suboxone at least once — and nearly 80 percent paid for the medication with private insurance. No reliable payment data is available for methadone in New York City, but a representative for the Dole clinic said virtually all of its patients receive Medicaid.

City Hall has sought to increase the number of physicians certified to prescribe buprenorphine. Mayor Bill de Blasio and his wife, Chirlane McCray, have spoken about the urgent need to expand treatment options. But despite their efforts, the growth of buprenorphine prescribers has been slower than many experts would like.

“What this crisis is again calling attention to is the need for more health professionals to step in,” said Dr. Hillary Kunins, an assistant commissioner at the New York City Department of Health. “I think because of stigma and because of inadequate education in health professional settings, physicians were not taught to think about addiction in their specialties.”

Dr. Andrew Kolodny, an opioid addiction expert affiliated with Brandeis University, said regulatory burdens on buprenorphine by the government — like the eight-hour certification requirement — have most likely discouraged physicians from offering it in their practices.

He added that many doctors who are certified to prescribe buprenorphine choose not to after realizing the complicated task of treating patients with substance abuse problems. Those who do work with the patients often do not accept insurance, he said, in some cases because demand is high and they can make more money charging directly. That means the patients must have enough money to pay out of pocket for the visit.

“Your insurance will pay for the prescription, but you have to pay for the doctor,” he said.

What has emerged is a private and expensive market for buprenorphine treatment.

The fight for equity in treatment for opioid addiction can feel like a multifront battle; in some cases, experts struggle just to persuade policymakers and nonspecialists that prescribing an opioid to a drug addict is a reasonable course of action. Numerous studies confirm that methadone and buprenorphine are both highly effective for treating opioid addiction. (The effectiveness of detoxification — total abstinence from opioids — for long-term addiction management, which is strongly emphasized in popular treatment narratives, has been called into question by experts and by medical research. It can also leave those who relapse at higher risk for overdose.)

The clinics themselves are often vulnerable because they work with such a highly stigmatized population, especially in rapidly gentrifying areas. Mr. Perez was enrolled in the Cumberland Clinic on Flatbush Avenue, near the Barclays Center, before it closed late last year. Mount Sinai Beth Israel, which ran the clinic and also runs the Dole facility, had its lease for the clinic terminated when a private owner sold it to a development company. A new high-rise development is going up in its place.

Dr. Helena Hansen, a research psychiatrist and cultural anthropologist, said racially charged stereotypes historically associated with opioid and heroin addiction have led to persistent stigma around methadone. Methadone, she said, carries criminal connotations that can be traced back to the War on Drugs rhetoric that escalated in the 1960s.

Methadone clinics, Dr. Hansen pointed out, can often look and function like probation offices. “And they’re organized as such,” she said. “People line up, they have to have their urine checked, you have to come every day.”

Noa Barreto, 43, started using heroin about four years ago after “a tragic loss” in his life. He was dealing drugs at the time and he “started getting high on my own supply.” Two years ago, after battling with addiction, he made a decision to enroll in methadone treatment. Mr. Barreto said after he overcame the initial shock of entering treatment, he was able to reorient his day around the methadone doses.

“It’s like a job, you know?” he said. “Once you get on it, and you become accustomed to it, it becomes easy. You get up in the morning and it becomes a routine.”

Earlier this month, Mr. Barreto said, he had to turn down a job offer because it would interfere with his ability to get to the methadone clinic. Some patients who have made progress with their addiction are trusted with limited “take home” bottles, but the process can take months or years. And with good reason. When abused, methadone carries an extremely high potential for overdose. (Mr. Barreto currently qualifies for take-home bottles on the weekends; he visits the clinic five times a week.)

Rick Harwood, the deputy director at the National Association of State Alcohol and Drug Abuse Directors, said the demographics of methadone clinics could be partly explained by patients who are middle class or white being less likely to see methadone as a treatment option.

“Ask people, middle class or otherwise, would they go to an opioid treatment program, a methadone clinic?” Mr. Harwood said. “Not too many of them probably would. A lot of times they’re inconvenient to where they live, or are in depressed neighborhoods, places people might consider unsafe.”

Mr. Harwood said that low-income patients could conceivably access buprenorphine treatment at methadone clinics, if they are interested. But methadone clinics are often already overwhelmed with methadone logistics and the social service programs they are required to provide; buprenorphine consultations are an additional service. That can produce an information gap in addition to a financial one. Dr. Kolodny also said that, realistically, buprenorphine treatment cuts against the business interests of for-profit methadone clinics, which are becoming more common nationally.

Mr. Perez could be served well by the flexibility that Suboxone would give him as he manages employment as a tattoo artist. He said he would like to consider transitioning to buprenorphine treatment, but does not know where he can get it or how he might pay for it. Meanwhile, some long-term users, including Ms. Neilson, who travels to the clinic from Long Island, say that methadone has a more satisfying effect than buprenorphine.

“I tried to go back on Suboxone,” she said. “I didn’t feel sick, but I still wanted to get high. I had no energy not even to get up and take a shower, let alone leave the house or stand up.” She added that she’s afraid to transition away from methadone. “The sickness is not something I can describe to anybody. This is a better way to do it. Methadone. I’m never getting off.”

Dr. Chinazo Cunningham, a Bronx-based addiction medicine expert who has worked with vulnerable populations for decades, said that she “just knew” a two-tier system would emerge, excluding many patients. But she stressed that methadone programs do important work for patients with complicated needs. Beyond drug treatment itself, the clinics provide a critical reprieve for patients without support networks.

“The people whose lives are a little bit more chaotic could benefit from methadone, or people who have poly-substance use, alcohol or cocaine, or others,” said Dr. Cunningham, who is affiliated with Montefiore Medical Center, in the Bronx. “Primary-care settings have limited resources and maybe can’t take on someone who is more complicated.”

Such was the case with Jonathan Roman, 33. He is homeless and sleeps in his van. He arrived at the Vincent Dole clinic about eight months ago without insurance, looking for help with his addiction; the team at the clinic helped him enroll in Medicaid. They are also helping him find housing, he said, while speaking glowingly about his counselor at the clinic.

At one point, Mr. Roman estimated that he was using $300 of heroin a day, which he paid for by “stealing and doing side jobs.” People took advantage of his addiction, he said, giving him work in construction and as an electrician but then paying him less than they should because they knew he was desperate. His dealer used to pick him up on payday, at 4:30 a.m., and drive him to the nearest A.T.M.

Mr. Roman said that for him and countless other patients, the concentrated resources available at the clinic provide a life-support system. He currently qualifies for take-home bottles of methadone, but he has refused them; the discipline of coming to the clinic each day helps him, he said.

“You can be on the good path, but if something happens in your life, and you think you’re not worth anything, or that life is not worth living, you do stupid things,” he said. “Now I think about all the things that I do and I laugh sometimes. I was this close to losing my life.”

(Jan 27)GHC to speak in public forum related to integration of OASAS and DOMH

The support of substance abuse patients in the state of New York is regulated at the state level by the Office of Addiction Support and Services (@NYSOASAS) – which reports to Governor Cuomo.

Under Governor Cuomo, the merger of the Office of Mental Health (DOMH) and OASAS continues to gain momentum and there is an upcoming virtual session where public are invited to speak up on their concerns on January 27th to decision makers in Albany.

WE INVITE YOU TO SPEAK in this forum on how the oversaturation of substance abuse facilities of your community has impacted you and your family. Greater Harlem Coalition will also speak to urge the new agency to reduce and monitor the over concentration of such facilities in Harlem.

To register to speak, please contact them:
-By phone:518-474-4403
-By email:Leesa.Rademacher@omh.ny.gov

To listen only, go to the webex session on this link

Although OASAS and OMH have always collaborated well to serve New Yorkers, the creation of a unified behavioral health agency is being explored as a way to increase coordination of services and support people with both substance use disorders and mental illnesses. An integrated behavioral health agency could also help streamline service delivery and increase efficiency.

NYOASAS/DOMH

As we always say, Albany cannot read your mind.  They will not change course unless they hear from you.  If you don’t tell them what you think, what you are experiencing, what you want done, they will ignore you.  

Your voice can make a difference.  Please contact them, sign up to speak, and ask them why Harlem is oversaturated with methadone clinics when wealthier and whiter neighborhoods have none.

More details of the meeting on Jan 27 are here: https://oasas.ny.gov/news/behavioral-health-services-advisory-council-meet-virtually-january-27-2021 

More details of the integration of the two organizations are here: Reimagining Behavioral Health Services – Overview and Discussion Questions (ny.gov)

Recording of the previous 4 listening sessions can be found here: Reimagining Behavioral Health Listening Sessions | The State of New York (ny.gov)

For previous related posts, see also a letter our members Keith Taylor @Taylor4Harlem sent to DOMH and OASAS here

(Jan 14) Greater Harlem Coalition 2021 Townhall

Speaker will include our three founders: Syderia Asberry-Chresfield, Carolyn Brown, Shawn Hill. Guest speaker is Mount Sinai

14 Jan 2021 ( 7-830 pm)

Register to join the meeting here

Community-Based Participatory Research: How it can help our community

Community-Based Participatory Research: How it can help our community
Date: Jan 13, 2021
Time: 12:00 – 1:00pm
Location: Zoom Link after YOU REGISTER VIA EVENTBRITE

This workshop will present an introduction to Community-Based Participatory Research (CBPR), a powerful framework to improve community health. CBPR provides guiding principles for communities to mobilize their power and resources, and to work collaboratively with researchers to improve health and health equity.

Presenters:
Meredith Manze, MPH, PhD teaches and advises master’s and doctoral students on topics that span research methods (including participatory methods and using a CBPR orientation), community health assessment, program planning, grant writing, and more.

Chris Palmedo, PhD, MBA teaches courses in health communication and health advocacy, and directs the CUNY SPH master’s degree program in Health Communication for Social Change. His CBPR work includes working with communities to design and implement communication and advocacy strategies for health equity.

Deborah A. Levine, LCSW, ACSW | pronouns: she, her

Director, Harlem Health Initiative

CUNY Graduate School of Public Health &Health Policy

55 W. 125th Street | New York, NY 10027

deborah.levine@sph.cuny.edu | 917.549.6155

Waiting on a FOIL

The Greater Harlem Coalition–a data-driven activist group–files FOIL requests to help Harlemites and elected officials see how decades of systemic racism overburdens Harlem and escalates the risks for vulnerable New Yorkers seeking addiction treatment.

We expect this FOIL request to become available in early January 2021:

Black Lives Matter

“What shall Virtue do to meet Brute Force? There are so many answers and so contradictory; and such differences for those on the one hand who meet questions similar to this once a year or once a decade, and those who face them hourly and daily.”

W. E. B. Dubois

“Please try to remember that what they believe, as well as what they do and cause you to endure does not testify to your inferiority but to their inhumanity”
― James Baldwin, The Fire Next Time

On May 25th, the world watched in horror   as George Floyd, a community organizer in Minnesota, was slowly murdered by a Minneapolis policeman.  This video made us all traumatized witnesses to a horrible murder.  With raw, callous indifference an ‘officer of the law’ violently pressed his knee on Floyd’s neck, ignoring pleas for his life, his labored ‘I can’t breathe’, and finally his heart-wrenching call to his deceased “Mother!”  He then slipped into unconsciousness and death. For Harlem, this murder was all too familiar – with so many echoes of the ‘I Can’t Breathe!’ cries of Eric Garner (2014) and others in the long history of victimization and police violence. Our entire nation faced the reality of racial terror that Black men and women fear in every interaction with the police.  George Floyd’s death became the spark of a momentous uprising that began in the U. S. and spilled into the streets throughout the world. For the first time, Black protesters were joined with hundreds of thousands of white men, women, and children in marches whose size exceeded those of the anti-Vietnam war protests.  “I can’t breathe“ and ‘Black Lives Matter’ became the slogans blazoned on walls from San Francisco to New York, from London to Johannesburg. Within 24 hours hundreds of thousands of protesters poured into the streets and hundreds of artists drew his sorrowful face on buildings, banners and in one tragic case, on the rubbles of bombed homes in the rebel-areas of Syria.

Here in New York’s Harlem a network of community organizations grouped in the Greater Harlem Coalition follow the rich tradition of activism in Harlem.  Our community has been a center of African American political mobilization for over 100 years. Now, as in countless times before, Harlem challenged America to fulfill its stated goal of democracy.  As America’s ‘Black Mecca’, Harlem has focused the nation’s conscience on acts of violence against African Americans locally and nationally.  In 1917 the NAACP met in St. Philips Church to organize the famous Silent Parade (28 July 1917) to protest the East St. Louis Riots [May-July 1917]. And later Harlem protested the Tulsa Race Massacre [1921] when whites destroyed a proud Black community – ‘Black Wall Street’ – and massacred some 300 Black Americans.[1]  There followed mobilizations for Marcus Garvey, frequent protests of the lynchings, the Italian invasion of Ethiopia (1939) and riots.  Harlem has always demanded that the American promise of equal rights, justice, and opportunity extend to all people.

The Greater Harlem Coalition (GHC), an alliance of over 60 local businesses, block associations, and faith-based organizations, represents over 4,000 residents in the Harlem area. We firmly support and respect the right of people within our community who are struggling to get the services they need. However, The New York State Office of Alcohol and Substance Abuse Services (OASAS) and the Department of Health and Mental Health (DOHMH) have systematically overloaded our community with substance abuse and mental health programs.  The GHC was formed two years ago to address a policy of Medical Redlining inwhich local, state, and federal agencies (along with program service providers) saturate minority communities with drug treatment facilities far in excess of the drug dependent population in the area.  These are the programs that wealthier and more privileged communities have rejected and opposed. 

Harlem is /was NOT an area with a large concentration of drug addicts — at least until service organizations saturated the area with treatment facilities. The presence of unmonitored patients vulnerable to predatory drug sellers is tearing at the fabric of community stability. In areas where dozens of clinics are concentrated the trip to treatment must pass a gauntlet of temptations, harassment and crime. This could be avoided if New York adopted community-based and distributed addiction programs that reflect actual addiction rates rather than destroy areas historic areas like Harlem with an assault on Black heritage. 

The Floyd murder sparked a powerful national and international movement against racism, inequality, and for the regulation of police violence. Here at home, this murder has forced America to interrogate our flawed democracy in which the historic conditions of racist violence and discrimination have thwarted the opportunities and safety of Black people. The antiracist work of Color of Change, Black Lives Matter and older organizations like the NAACP Legal Defense Fund are bearing fruit.  The Greater Harlem Coalition supports these organizations and their initiatives to hold police accountable, to reform a prejudicial justice system of mass incarceration, and to eliminate the laws and policies that constitute a near-impenetrable system of structural racism.  The nation is now engaged in a wide-ranging and powerful discussion that is centered on racism and systemic inequality

In our nation’s capital demonstrations showed that the streets were ungovernable and police abuses of demonstrators only made the protests grow. The government’s weakness was exposed in the president’s use of the military to evict peaceful protestors from Lafayette Park. The holding of a presidential photo op backfired because it   strongly resembled the tactics of authoritarian leaders and suggested that the U.S. military forces were engaged in domestic politics. The backlash only increased the number and intensity of protests.

The Greater Harlem Coalition can use this tragedy to discuss how this political energy can assist us to explore the ways that we can be most effective in our community. Specifically, many in our community and beyond are demanding a reconceptualization of our police forces and an analysis of the Coalition in the context of racism and white privilege. Racism and white privilege are two topics that are the ‘800-pound elephant’ in the room that impact and underlie so much of what America and its institutions are built upon.  We welcome the opportunity to support the members of our   60 organizations to begin an honest discussion that, though uncomfortable will strengthen   our unity and effectiveness as an organization. We may call upon the assistance of professional groups that work with multi-cultural community organizations – Undoing Racism: The People’s Institute for Survival and Beyond https://www.pisab.org/. Perhaps the Greater Harlem Coalition can be an example of how a mythic Black community can retain its historic significance and mediate the conflicts from gentrification.


[1] https://www.okhistory.org/publications/enc/entry.php?entry=TU013