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Partnerships Closing the Economic Opportunity Divide to Transform Health Trajectories

An internship program disrupts systemic barriers to education that force young adults into lifelong cycles of poverty and poor health.
Matthew Dorris

Elian Bedoya's lifelong dream to attend college ended abruptly in his high school guidance counselor's office. That afternoon, he learned he was ineligible for federal financial aid — and without it, attending university was beyond his reach. Bedoya's situation is unfortunately all too common. He is one of five million young adults in America who are up against systemic barriers to higher education exacerbated by poverty, structural racism, and immigration policies. Without a four-year degree (what many view as the U.S. gold standard for entry into high-paying careers), many people can only obtain low-wage, low-opportunity jobs, perpetuating a cycle of poverty that impacts a person's health and opportunities over a lifetime.

Thea James, MD, emergency medicine physician and vice president of mission at Boston Medical Center (BMC), sees the impact of poverty on her patients daily.

"In the emergency department here at Boston Medical Center, most of what we see is people who don't have the basic things they need to stabilize themselves to prioritize health," explains James. "They are making tough decisions every day, asking themselves, do I use my limited resources to pay rent or to feed my family? Or do I use my limited resources for a copay for a medical appointment or a prescription?"

Millions of young adults in America are up against systemic barriers to higher education, perpetuating a cycle of poverty that impacts their health and opportunities over a lifetime. Click To Tweet

Study after study shows income is a powerful predictor of health outcomes. Low-income Americans are more likely than wealthier Americans to suffer from chronic health conditions and forgo preventive health screenings, elective procedures, and beneficial medications. Low-wage earners are also more likely to eat a poor diet and suffer from toxic stress, leading to disease and even premature death. These health disparities cannot be addressed without investment in root causes, the most powerful of which is helping low-income adults gain a foothold into a living wage.

This "beyond the bandage" approach requires multisector partnerships among health systems, nonprofits, and businesses seeking young talent, James says. It's an approach that Year Up founder and CEO Gerald Chertavian has made his life's work. His national nonprofit provides low-income young adults with year-long intensive job training, including six-month internships at leading U.S. companies. The program offers a pathway to careers for talented young people like Bedoya who have been shut out of traditional opportunities for higher education.

A "beyond the bandage" approach requires multisector partnerships among health systems, nonprofits, and businesses seeking young talent

In Greater Boston, Year Up's corporate partners include some of the city's major healthcare systems, including Boston Medical Center, Boston Children's Hospital, and Partners HealthCare Systems. Internships can translate into full-time positions that add talent to hospital workforces — at BMC, for example, four of 18 full-time employees in IT are Year Up alumni — while also allowing medical systems to invest in individuals in their patient communities, improving their economic mobility and in turn their health trajectories.

The program has a transformative impact. About 90% of Year Up participants are hired or enroll in postsecondary education after graduation from the program. Students that enter Year Up earn less than $6,000 annually on average — but upon re-entering the workforce, Year Up graduates make a yearly average of $43,000. The added income makes future opportunities accessible. When Bedoya applied to Year Up, he received training as an IT technician, securing a six-month internship in the IT department at Boston Medical Center. Now, in addition to his work responsibilities, he is pursuing an online degree focused on business communications. He has a new dream to build his own business, creating further jobs for more people.

"This partnership with Year Up is more than just having an intern, it is an investment that enables the patients we serve to have the financial security to prioritize health, changing what we see coming through our doors every day." Click To Tweet

"This partnership that we have with Year Up is more than just having an intern, it is an investment that actually allows us to achieve things upstream," emphasizes James. "It enables the patients we serve to have financial security and economic mobility where they are able to prioritize health, changing what we see coming through our doors every single day."

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Meryl Bailey


Meryl is a freelance writer passionate about public health, social justice, and medical innovation. As part of her writing career, she worked as a communications specialist in both the healthcare and nonprofit sectors. She holds a bachelor's degree in English literature from Georgetown University.