• Text Resize A A A
  • Print Print
  • Share Share Share Share

Morris Heights Health Center

Changing the Odds in the Bronx: A Teen Pregnancy Prevention Initiative


The Bronx has the highest poverty rate in New York City, and, as a result, is ecologically disadvantages across social, economic, and health indicators. Almost 40 percent of all children living in the Bronx live in poverty.1 In a ranking of 62 counties across New York State, the Bronx ranks last for health outcomes (62/ 62), health factors (62/62) and social and economic factors (62/62).2

Adolescents living in high poverty neighborhoods are three times more likely to become pregnant and are at greater risk of dropping out of school.3, 4 The Bronx is no exception: it has the highest teen pregnancy rate in New York City — a rate that is 45 percent higher than the national rate.5 Of particular concern is that the high rate of pregnancy disproportionately affects Black and Hispanic teens. In 2011, the pregnancy rate among Black teens ages 15-19 in New York City was 110.2 per 1,000 females; among Hispanic teens ages 15-19 it was 87.0 per 1,000 females.5 In contrast, the pregnancy rate among White, non-Hispanic females ages 15-19 living in New York City was 23.0 per 1,000 females and 17.1 per 1,000 Asian and Pacific Islander females ages 15-19.6 Furthermore, and related to the Bronx teen pregnancy rate, 31 percent of high school students in the Bronx drop out of school — more than double the national average (15 percent).6

Program Description

Since 1981, Morris Heights Health Center (MHHC) has been a major provider of healthcare in the Bronx. Through its School Based Health Center (SBHC) network, MHHC provides more than 10,000 school children in 16 high-risk elementary, middle and high schools with comprehensive medical, behavioral and dental care. For many of these children who are uninsured, the services provided at the SBHCs are the only care they ever receive. The SBHCs also provide confidential sexual and reproductive healthcare services.

In 2010, the U.S. Department of Health and Human Services Office of Adolescent Health awarded MHHC a multi-year grant to implement the Changing the Odds project. Changing the Odds is a partnership between MHHC and the New York City Department of Education to implement the evidence-based Teen Outreach Program® (TOP®) in 12 middle and high schools in the Bronx. The goals of TOP® are to engage youth ages 12 to 18 to practice healthy behaviors, learn life skills and have a sense of purpose in their lives. TOP® has been shown to be effective at preventing teen pregnancy and reducing school suspension and course failure.

Program Impact

The Changing the Odds project reaches approximately 300 students in grades 6, 7, 9, and 10 with TOP® each year. Of the students served, 57 percent were female, 48 percent were Latino, and 52 percent were African American.

Overall, TOP® participants reported:

  • 47 percent of youth served said that they would be less likely to have sex
  • 70 percent said that if they were to have sexual intercourse in the next year, they would be more likely to use a condom and 58 percent said they would be more likely to use birth control
  • 86 percent of 6th graders and 86 percent of 9th graders felt the programs helped them make good choices about their health and well-being
  • 77 percent of 6th graders and 69 percent of 9th graders said that their participation in TOP® helped them get good grades
  • 90 percent of 6th graders and 85 percent of 9th graders said that their participation in TOP® helped them think about what they could accomplish in the future

In addition, several assistant principals noticed striking changes in the behavior of some students as a result of the Changing the Odds project. One example involves Shanice*, a 6th grade student, who was normally in an “inclusion” class — a classroom with three instructors to provide one-on-one instruction to struggling students and manage challenging behavior. Shanice exhibited much of the behavior that was common in that class: verbal and physical outbursts and inability to focus on academic work. However, once Shanice started participating in TOP®, her behavior improved dramatically. Because TOP® emphasizes a safe and supportive environment and Shanice was in a TOP® club where there were less behaviorally-challenged students, Shanice learned what behavior was expected from her and started to meet those higher expectations. Her behavior not only improved in TOP® club, but also in her other classes. As a result of her improved behavior and her increased ability to attend to her studies, she has been moved from an inclusion class to a general education class, much to the surprise and delight of her teachers.

*Name has been changed to protect the identity of the participating student.

Contact Information

Estelle M. Raboni, MPH, MCHES
Title: Program Director
Organization: Morris Heights Health Center
Phone: (718) 483-1270 ext. 8152
Email: eraboni@mhhc.org

Print the full success story here.


1 U.S. Census Bureau. State and County QuickFacts 2006-2010. Retrieved October 31, 2012, from http://quickfacts.census.gov/qfd/index.html
2 University of Wisconsin Population Health Institute. (2012). County health rankings and roadmaps. Retrieved October 31, 2012, from http://www.countyhealthrankings.org/#app/new-york/2012/bronx/county/1/overall
3 Harding, D. J. (2003). Counterfactual models of neighborhood effects: The effect of neighborhood poverty on dropping out and teenage pregnancy. American Journal of Sociology, 109(3), 676-719.
4 Freudenberg, N., & Ruglis, J. (2007). Reframing school dropout as a public health issue. Preventing Chronic Disease, 4(4), 1-11. Retrieved March 26, 2013, from http://www.cdc.gov/pcd/issues/2007/oct/07_0063.htm
5 New York City Department of Health and Mental Hygiene. (2011). Summary of Vital Statistics 2011 The City of New York Pregnancy Outcomes. Retrieved May 1, 2013, from http://www.nyc.gov/html/doh/downloads/pdf/vs/vs-pregnancy-outcomes-2011.pdf
6 U.S. Census Bureau. (2010). United States population and housing narrative profile: 2005-2009. Retrieved November 1, 2012, from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml
Content created by Office of Adolescent Health
Content last reviewed on December 15, 2016