Focusing on Children's Health Community Approaches to Addressing Health Disparities: Workshop Summary (2009) / Chapter Skim
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5 Community Development Approaches: Overcoming Challenges, Striving for Change
5 Community Development Approaches: Overcoming Challenges, Striving for Change
Pages 35-54
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From page 35... ...
This chapter highlights three community-based approaches that are making a difference at both the local and national levels, serving as examples of how individuals and communities can improve the health and lives of children. Veda Johnson of Emory University spoke about the Whitefoord Community Program she helped to found, which empowers residents of the Whitefoord Elementary School area to improve the health and education of their children.
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From page 36... ...
They set up the Whitefoord Elementary School-Based Center, located in Southeast Atlanta, as a typical practice with pediatric primary health services for the children who attended the school and their preschool siblings. Johnson and Grimley's goal was to increase access to quality health care and thereby improve the academic achievement of the students.
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From page 37... ...
The clinics are staffed by medical providers, including physicians, nurse practitioners, physicians assistants, nursing assistants, a dentist and dental assistant, social workers, and mental health providers. There is also a fulltime health educator, as health promotion and disease prevention is the best approach to decreasing health disparities, and administrative staff.
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make up about 5 to 10 percent. Programwide Accomplishments and Individual Success Stories The Whitefoord Community Program has some impressive programwide accomplishments.
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In meeting needs and bridging gaps, Johnson concluded, the program has been able to increase access to health care, improve health outcomes for children and their families, decrease health care costs, and improve school attendance and academic performance. Accountable Communities: Healthy Together Atlanta, Georgia is divided into 25 neighborhood planning units (NPU)
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After receiving the NCMHD grant for the community-based, participatory research program, community health workers were recruited and trained, and collection of health information for NPU-V began. One primary source of health information was medical records from Southside Medical Center.
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Everyone has an opportunity to respond, participants remain engaged throughout the presentation, and the tallied responses can be displayed in real time, spurring further discussion. Participants in the listening sessions, for example, were shown the GIS maps on breast cancer incidence and the data on mortality, described above, and were asked to provide instant feedback using the perception analyzer.
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Quantile Classification FIGURE 5-1 All cancer deaths among males in Atlanta, Georgia, neighborhood planning units V and F, 1998–2002. SOURCE: Georgia Department of Human Resources Behavioral Risk Factor Surveillance System.
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Quantile Classification FIGURE 5-2 Type II diabetes prevalence among males in Atlanta, Georgia, neighborhood planning units V and F, 2002–2004. Figure 5-2.eps SOURCE: Georgia Department of Human Resources Behavioral Risk Factor Surveillance System.
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Quantile Classification FIGURE 5-3 Type II diabetes prevalence among females in Atlanta, Georgia, neighborhood planning units V and F, 2002–2004. Figure 5-3.eps SOURCE: Georgia Department of Human Resources Behavioral Risk Factor Surveillance System.
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Quantile Classification FIGURE 5-4 Breast cancer incidence among females in Atlanta, Georgia, neighborhood planning units V and F, 1999–2002. SOURCE: Georgia Department of Human Resources Behavioral Risk Factor Surveillance System.
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From page 46... ...
I've been in the Pittsburgh community for a long time, and this house is one of the issues in our community. When I walk by this house on the way to school with my friends, it makes us worried, especially the little kids." Another photovoice picture of a house in disrepair was used as part of a campaign entitled "The Dirty Truth." The campaign was designed to spread the message about the high number of vacant properties in NPU-V, and the associated concerns including increased crime, rodents and pests, pollution, strained community services, and poor physical and mental health.
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data at Grady Memorial Hospital led to a 2-year pilot grant funded by the Healthcare Georgia Foundation to determine whether a strategy to make primary care services more available to NPU-V residents would result in a decline of EMS and 911 services for nonemergency health needs.
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From page 48... ...
Other institutional challenges include time-consuming processes, budget issues, benefits for community health workers, documenting intervention success, and the inability to fully specify all aspects of research up front. Leslie concluded with advice for those who undertake the communitybased participatory approach, from her perspective as a community health worker and NPU-V resident.
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From page 49... ...
A second example, in Lawrence, Massachusetts, focused on Latinos with diabetes and has demonstrated a nearly 9 percent improvement in blood sugar levels, 18 percent improvement in systolic blood pressure, and 14 percent improvement in diastolic blood pressure. A REACH community in Fulton County, Georgia, and others across the country, are conducting blood pressure and cholesterol screenings at the barber shop as young men are sitting down to get a haircut.
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And within the REACH communities, cholesterol screening of African Americans is actually greater than the national average for all races. Today, only one out of every three people with hypertension has their blood pressure adequately treated and controlled.
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A second key component for success is having community, academic, and governmental partnerships. All of the REACH community coalitions were required to include a state or local health department, an academic or research institution, and a community-based organization.
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. Giles concluded by emphasizing that over the last 9 years, REACH communities have been able to show that disparities can be addressed and can be eliminated.
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From page 53... ...
In response to a question about the costs of clinic services provided by the Whitefoord program, Johnson said that the clinics are federally qualified health centers (FQHCs) , and there is a sliding fee scale, with some patients charged a zero fee.
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