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Capital Region Gives Back: Nancy Underwood, Program Director of BEST Saratoga

Underwood and the rest of the Backstretch Employee Service Team provide healthcare and wellness services to those who care for Saratoga Race Course's horses.

BEST's Nancy Underwood works seven days a week during track season to care for the race course's backstretch workers. "They love being here in Saratoga," she says. "We create a community. They know they come to us if they're sick, or sad." (Francesco D'Amico)

This story is part of a larger feature on 10 do-gooders from Saratoga and the rest of the Capital Region. To meet the other nine honorees and purchase tickets for annual fundraising event, visit our Capital Region Gives Back event page.


When Saratoga’s track meet ran a spectator-less season in 2020, Nancy Underwood’s work at the Backstretch Employee Service Team (BEST) of Saratoga barely slowed down. After all, with the horses still running, the legion of backstretch workers who tend to the Thoroughbreds needed care as well. This year, with Saratoga Race Course back in full swing? Underwood and team toiled day and night, seven days a week, to ensure that all workers not only got the healthcare they needed but also felt part of a tight-knit community.

“Wednesday nights we do Bingo with 300 backstretch workers, and we do Sunday night dinners,” says Underwood, BEST’s Saratoga program director. “It’s how we touch them on a personal level to make sure they know us and will come to us when they need something.”

Those needs run the gamut. The majority of the backstretch workers hail from Spanish-speaking areas, often countries where treating an ailment means simply popping into a pharmacy. Given the US’s confusing healthcare web, BEST operates a unique clinic that assists with everything from injuries to diabetes. If they have to travel for an appointment, the nonprofit secures transportation and a translator.

“One 18-year-old had never been to a doctor and came in with an untreated eye infection that had left him blind in one eye,” Underwood says. “He was a kid from the mountains of Guatemala and was terrified. They fit him with a prosthetic.”

Horse training goes well until November, and BEST works full-time until the very last horse and worker leaves. “We offer the most comprehensive services across the country,” she says. “But when they leave us, how do we prepare them? We make sure that prescriptions are set up for refills, role play asking for things they need. We push at the end of the season so when people come back in April, it’s not a crisis situation.”

Abby Tegnelia

Abby Tegnelia is the chief executive officer of Saratoga Living and Capital Region Living. She previously worked at New York magazine, Glamour and Us Weekly, and has contributed to Marie Claire, Women's Wear Daily and Maxim.

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