Capital Health's Institute for Urban Care is committed to optimizing the delivery of health care services and advancing outcomes related to health equity for the residents of Trenton, New Jersey. The Institute has three main pillars which are based on the most pressing needs of the community – Chronic Disease, Maternal Child Health, and Behavioral Health/Substance Use Disorder. Working with a robust network of community partners, the Institute develops innovative, scalable, and reproducible programs that go beyond the scope of traditional care to improve the health and well-being of Trenton residents.