Seventy-five percent of Betances' Health Center's patients reside in the Lower East Side, an area extending from the Bowery to the East River, and from 14th to Pearl Streets. This Community of approximately 200,000 is a prototype of multiculturalism, with a rich variety of ethnic groups dominated by Latinos (32% Puerto Rican), followed by Asians and African Americans.

The Lower East Side's poverty rate is high, 30% of the population qualifies for some form of public assistance. Almost half of Betances' patients are Medicaid recipients, the majority representing Latinas of childbearing age and their young children. Latinos are particularly targets for poverty. During 1997, two in ten New York City Latinos received public assistance, one quarter received food stamps, while more than one-third were Medicare enrolled.

Morbidity rates for Betances' patient population shows high rates of diabetes, heart disease, hypertension and asthma which could easily be addressed through improved primary care access. Persistent rates of obesity, anxiety and high cholesterol, demonstrate a radical need for nutrition intervention. The community reflects an extremely high rate of HIV infection, amounting to 14% of all HIV/AIDS cases in Manhattan. An estimated one in 17 Latinos in our catchment area is AIDS infected, and a much larger percentage test HIV+.

As in many economically-disadvantages neighborhoods of New York City, the Lower East Side's heavy share of HIV/AIDS morbidity is tragically matched by relatively high rates of drug abuse. Hospital admission rates for substance abuse in this area are higher than those citywide. Similar findings have been made with regard to drug related or poisoning death rates. Additionally, a significant share of infant mortality and morbidity in this area is associated with substance abuse by the mother.