Category Archives: Community outreach
To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Marni Kuyl, RN, MS, interim health and human services director in Washington County, Oregon, responds to the question, “What does the country need to do to address disparities and build a culture of health that includes all people?” Kuyl is an RWJF Executive Nurse Fellow.
When I was first asked to consider this question, I pondered the issues by describing theoretical approaches, including the need to address social determinants, use a social-ecologic framework, and take a life course perspective. I threw in the need to use evidence-based practices and research. I gave this first draft to someone and asked ... So what do you think? She very politely asked: Are you in outer space?
I continue to believe that addressing inequality in our country requires that we recognize, understand, and commit to changing its root causes which include racism, inadequate affordable and safe housing, inadequate access to quality education (pre-to post graduate), and grossly uneven wealth distribution. These are deeply rooted in our political and economic structures and must be fundamentally changed if we truly want to build a culture of equality and health for all.
Shreya Kangovi, MD, is an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine, executive director of the Penn Center for Community Health Workers, and a Robert Wood Johnson Foundation/U.S. Department of Veterans Affairs Clinical Scholars program alumna.
“What do you think will help you stay healthy after discharge?”
Mr. Manzi, a soft-spoken man in his early 60s, paused to consider. No one had asked him this question before. He had come to the hospital because of blurry vision and thirst too severe to ignore. The doctors told him that he had severe diabetes and hypertension, and that he needed to adhere to a long list of new medications, tests, and appointments.
“Not just medical stuff,” Anthony, the community health worker, continued. “Talk to me about anything. Dealing with shut-off notices, housing issues, whatever you think you need to stay healthy.”
Mr. Manzi opened up. He explained that he was originally from Ghana but had been living and working odd jobs in Philadelphia for 20 years as an undocumented immigrant. He had not had a job in six months and twice, his home had gone into foreclosure. Mr. Manzi was uninsured and had not been able to get outpatient care before coming to the hospital.
“I’m willing to do whatever it takes to stay healthy,” he concluded. “But I need to make sure I can pay for all of these medications and a doctor. And I need some help with the foreclosure—I can’t take care of myself if I lose my home.”
Mr. Manzi’s answers became the basis for his tailored intervention. IMPaCT (Individualized Management for Patient-Centered Targets) is an innovative model of care in which community health workers (CHWs) provide tailored support to help patients achieve individualized goals. Anthony, an IMPaCT CHW, shares socioeconomic background with patients like Mr. Manzi. He and other IMPaCT CHWs are selected for traits such as empathy, active listening, and reliability.
Ruchi S. Gupta, MD, MPH, is an alumna of the Robert Wood Johnson Foundation Physician Faculty Scholars program. She is an associate professor of pediatrics and director of the maternal and child healthcare program at the Northwestern University Feinberg School of Medicine, and an attending physician at the Ann & Robert H. Lurie Children's Hospital of Chicago. Learn more at www.ruchigupta.com.
This past spring, 12 students with asthma at James Hedges Elementary in Chicago’s Back of the Yards neighborhood took hundreds of pictures, filmed video Public Serve Announcements (PSAs), created a website, and rolled out a community intervention to improve asthma conditions. These activities were part of the Student Media-Based Asthma Research Team, or SMART program. We developed this program from a previous pilot program in Chicago’s Uptown neighborhood that empowered students to learn about their asthma and challenged them to create change in their own communities.
As the most common chronic condition in children and the most common cause of school absenteeism, asthma is responsible for 13 million days of school missed each year. Asthma disproportionately affects racial and ethnic minorities, as African Americans and Hispanics/Latino children have significantly higher asthma-related morbidity and mortality rates compared to White children. While evidence-based guidelines for asthma care have been available for 20 years, ethnic minorities have a lower likelihood of receiving or following proper asthma treatment. Across and within racial/ethnic groups, asthma care has been shown to be more effective when it is tailored to the individual community instead of one-size-fits-all intervention.
Six libraries in downtown Tucson, Arizona, have some unexpected new employees: public health nurses. In what many believe to be a first-of-its-kind program, Pima County libraries teamed up with the county Health Department to start a jointly-funded “library nurse program.”
Libraries across the country often serve patrons living without shelter, health insurance, medical care or computer access, the Arizona Daily Star reports. As the need for health care and social services has grown in recent years due to a faltering economy and high unemployment, leaders in Pima County were inspired to provide more than just books to their patrons.
Now, five Pima County public health nurses divide the equivalent of one full-time public health nurse position among themselves, working weekdays at six local libraries. The nurses wear stethoscopes so they can be easily identified, but mostly provide health education and referrals to other health care resources in the area rather than actual medical care.
In addition to helping patrons get the health information they need, the program has also reduced the number of 911 calls from the libraries, “partly because nurses trained library staff to recognize when behavioral issues are escalating and to intervene appropriately,” Nurse.com reports.
“If I weren’t here, I think a lot of these individuals would fall through the cracks,” Daniel Lopez, one of the “library nurses” told Nurse.com. “I can open doors for them and they can walk on through. Overall, I think it makes for a healthier Pima County.”
The Robert Wood Johnson Foundation (RWJF) Human Capital Blog published more than 350 posts in 2012. On Friday, we shared five of the ten most-read posts published on this blog in 2012. Today, as we prepare to usher in a new year, we report on the top five.
Isolation in America: Does Living Alone Mean Being Alone? In this provocative piece, Eric Klinenberg, PhD, recipient of an RWJF Investigator Award in Health Policy Research, discussed his well-reviewed book, “Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone.” It looks at the health problems associated with social isolation. Klinenberg calls the increase in people living alone the country’s “biggest demographic change since the baby boom.” His post attracted the biggest audience on this blog in 2012.
Supreme Court Ruling Offers a Sense of Hope. This very personal piece by Thomas Tsang, MD, FACP, an alumnus of the RWJF Health Policy Fellows program, was the second most-read post on this blog in all of 2012. Tsang reacted to the U.S. Supreme Court ruling upholding key elements of the Affordable Care Act from the perspective of immigrant families like his own. Tsang said he hoped the ruling would allow “the country [to] start healing together and work on finding better solutions for future generations who believe that life is indeed better here in America—as my parents and I still do.”
Legal Experts Were Completely Stunned by John Roberts’ Health Care Opinion. This post by RWJF Investigator Mark Hall, JD, also addressed the U.S. Supreme Court’s health reform ruling. “We all knew it would be close, but we never saw this coming,” he blogged about the Chief Justice’s vote to uphold the highly controversial individual mandate. It was the third most-read post on the RWJF Human Capital Blog in 2012.
Gabriel Rincon, DDS, is the founding executive director of Mixteca Organization, Inc., in Brooklyn, N.Y., which provides a broad scope of health and education programs, including literacy and computer classes, English-language courses, and afterschool programs, to thousands of Hispanic New Yorkers each year. He is also a 2011 recipient of a Robert Wood Johnson Foundation (RWJF) Community Health Leader Award. The Human Capital Blog asked Rincon to reflect on his experience as an RWJF Community Health Leader.
Human Capital Blog: How did you come to found the Mixteca Organization?
Gabriel Rincon: In the 1990s distribution of information about AIDS was on the rise in developed nations such as the United States, but in immigrant communities—particularly Hispanic ones—levels of HIV/AIDS infection and general ignorance of the disease was still high. The City of New York was one of the locations with the highest number of Hispanics infected with HIV/AIDS. In 1991, I witnessed the lack of information available in Spanish. I decided in 1992 to take action by designing a slide presentation and organizing talks about HIV/AIDS, signs and symptoms its risks, forms of prevention, and treatments. With the use of a portable projector and informational pamphlets, I made presentations in factories, churches, houses and community centers, and on radio and TV. In 2000, together with other community members, my work was formalized; Mixteca Organization, Inc., obtained its official status as a non-governmental, non-profit community based organization.
RWJF Community Health Leader’s 'Practice Without Pressure' Model Eases Stress of Medical Visits for Children with Disabilities
Deb Jastrebski is the founder and chief executive officer of Practice Without Pressure in Newark, Delaware, and a 2011 recipient of a Robert Wood Johnson Foundation (RWJF) Community Health Leader Award. Practice Without Pressure works with patients, family members, caregivers and providers to help people with disabilities receive quality medical, dental and personal care. The Human Capital Blog asked Jastrebski to reflect on her experience as an RWJF Community Health Leader.
Human Capital Blog: You founded Practice Without Pressure because of your son’s experience. Would you tell us about that, please?
Deb Jastrebski: My son, Marc, was born with Down Syndrome, and he had always been scared—terrified really—of going to the doctor, the dentist, or even to get his hair cut. And he had a number of health issues that required needles or other medical devices that scared him, so it was a frequent problem. We sometimes ended up holding him down just to get it done. It was a horrible experience for him, for me, and for the provider. We reached the breaking point when he was 11 and had to have allergy testing done. It scared him so badly, and he was screaming so hard, that he had blood vessels bursting in his face. I looked at him—my son in agony—and I just told the doctor we couldn’t do this anymore. So the doctor stopped the test, gave me a prescription, and wished me luck. It was clear to me then and there that there was no specialist who could help us, no low-stress path for us.
The truth is that it was like that with dentist visits and haircuts, too — whenever someone was in his personal space. And it wasn’t the specific procedure so much as it was the process itself that seemed to scare him. Marc didn’t have a lot of speech then, but he’d gotten his message through to me that day, finally. And as we were driving home, I promised him that we’d never do this to him again.
Ten individuals who have overcome significant challenges to help improve health and health care in their communities will be named 2012 Robert Wood Johnson Foundation (RWJF) Community Health Leaders at an awards ceremony in San Antonio.
These remarkable individuals are providing vital health services to residents in their communities, from Anchorage, Alaska to Charleston, South Carolina, and in cities and towns in between. They are helping: refugees grappling with the after-effects of war; low-income workers without insurance; children facing obesity; survivors of sexual violence; senior citizens who live in remote, rural areas; and substance abusers at risk for overdose.
The 2012 Community Health Leaders Award recipients are:
- Kay Branch, MA, elder/rural health program coordinator, Alaska Native Tribal Health Consortium, Anchorage, Alaska;
- Fred Brason, CEO of Project Lazarus and Project Director of the Community Care Network Statewide Chronic Pain Initiative, Wilkes County, N.C.;
- Debbie Chatman Bryant, DNP, RN; assistant director for cancer prevention, control, and outreach, Hollings Cancer Center at the Medical University of South Carolina, Charleston, S.C.;
- Beth Farmer, MSW, international counseling and community services program director, Pathways to Wellness Project, Lutheran Community Services Northwest, Seattle;
- Amy Johnson, JD, executive director, Arkansas Access to Justice Commission, Little Rock, Ark.;
- Ifeanyi Anne Nwabukwu, RN, BSN, chief executive officer, African Women’s Cancer Awareness Association (AWCAA), Silver Spring, Md.;
- Cristina Perez, MA, director of community outreach and counselor, Women Organized Against Rape, Philadelphia;
- Marlom Portillo, executive director, Instituto de Educacion Popular del Sur de California (IDEPSCA), Los Angeles;
- Darleen Reveille, RN, senior public health nurse, Garfield, N.J.; and
- Kathi Toepel, director of senior services for the Mother Lode Office of Catholic Charities – Diocese of Stockton, Sonora, Calif.
Chrysanne Grund is Project Director for Greeley County Health Services in Sharon Springs, Kansas, and a recipient of a Robert Wood Johnson Foundation (RWJF) 2011 Community Health Leader Award. She has touched the lives of nearly every resident of Greeley and Wallace Counties in Kansas through her work providing access to free or low-cost prescriptions, developing a parenting class, providing breast cancer awareness information and cooperating with a co-located behavioral health project. She is also the founder of the Greeley-Wallace County Health Foundation, a two-community partnership that provides funds to local cancer patients. The Human Capital Blog asked Grund to reflect on her experience in the year since she was named an RWJF Community Health Leader.
What a surprise to find it has been almost a year since the 2011 Community Health Leader awards. In so many ways, the time has flown by and, in others, it seems like just yesterday. To continue the conundrum, I have found that my life has changed in some immeasurable ways and yet, once again, is very much the same.
As a rural health worker in very frontier Western Kansas, I wear many hats. I am often health care professional, volunteer, coordinator and Mom all at the same time. The level of recognition the Community Health Leader (CHL) Award brought to my work, and most important to my health system, has been very gratifying and professionally rewarding. It is a thrill to be recognized for excellence.
My co-workers, colleagues and community members have been very gracious in their efforts to celebrate the award. There is a level of credibility that comes with this type of award that can’t be duplicated. I was once introduced as a “respected rural health leader in Kansas” and had to look around to be sure it was me! We do our work because it is important to us, we understand what it means to take care of our patients and our community and daily navigate the challenges of doing so. I’m happy to be the flag-bearer in representing rural health needs because I truly believe they are as important and relevant as those of any community. I was, and am, committed to that cause.
This is part of a series introducing programs in the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio.
Each year, the Robert Wood Johnson Foundation Community Health Leaders Award honors 10 of America’s best―unsung heroes who have forged their own solutions to the shortcomings and challenges facing our nation’s health care system.
On Wednesday, RWJF will announce its selection of the 2012 Community Health Leaders, who have surmounted significant challenges to improve health and health care in their communities.
Community Health Leaders see unmet health needs in their neighborhoods and communities, and they move tirelessly to fill those gaps. They have taken matters into their own hands and accomplished what others may have believed was impossible. And often, they have overcome daunting personal obstacles in their quest to serve others.
Community Health Leaders are nurses, physicians, dentists, pharmacists, clergy, attorneys and judges, school officials, activists and advocates. The problems they tackle are varied and complex: promoting statewide policies to improve and expand access to health care services, providing HIV/AIDS education and breast cancer detection, helping low-income people control their children’s asthma, establishing accessible health centers and clinics, and much more.
Now in its 19th year, the Community Health Leaders Award raises awareness of the leaders’ extraordinary contributions through a $125,000 award, national visibility, and networking opportunities. RWJF has honored more than 200 outstanding Community Health Leaders from nearly all 50 states, the District of Columbia, and Puerto Rico.
In the coming weeks, the RWJF Human Capital Blog will hear from the 2011 Community Health Leaders about what they’ve experienced during their first year as Leaders.
For details on how to submit a nomination, including eligibility requirements and selection criteria, visit www.communityhealthleaders.org.