The gap between at risk population health and the general public is widening. From cradle to grave health outcomes among ethnic and racial populations are best defined as acute and the prevalence of chronic diseases like diabetes and stroke are generally accepted as epidemic among at risk population. Co-morbidities, further intensifies the disparity worsening health outcomes of those suffering from chronic diseases. The greater the co-morbidity factor the worse the health outcomes. For example, a person with diabetes, who also suffers from hypertension and high cholesterol, is significantly more at risk for stroke, kidney disease, heart disease and other critical health conditions. Primary care providers’ and specialist principal focus now becomes treating the co-morbidities like strokes and kidney diseases rather than successfully controlling blood sugar levels. Blood sugar becomes almost impossible to regain control once acute morbidities have developed. This poor health outcome is preventable. Yet among certain racial and ethnic group this scenario is a leading factor in adverse health outcomes. Properly managed and control diabetes, blood pressure and cholesterol will greatly improve health outcomes and prevent the progression of co-morbidities and premature death.
Infant mortality among African Americans is among the highest with mortality rates worse than many developing countries. These rates can be reversed by early and consistent prenatal care, proper diet with augment dosage of vitamin D therapy for the expectant mothers; and greatly improve chances of these newborns of being healthy. Data shows that low birth weight and high birth weight babies are more prone to infant mortality or a life infused with chronic diseases. The first years of their lives are under constant threat of complication arising from their low birth weight or high birth weight. These babies are more likely to develop kidney disease, diabetes and other chronic diseases and have a below average life expectancy. Unfortunately the high cost of medical treatment of infants suffering from life threatening conditions does not equate to improve health or extended life. The current system of medical treatment focuses on “sick care”; this treatment focus does not improve health outcomes or life expectancy, but maintains life until the next acute series of conditions develops further threatening the infant’s life.
The episodic nature of treating chronic diseases in hospitals’ emergency rooms and the lack of a comprehensive community health intervention initiative are factors driving the disparity gap. Those suffering from chronic diseases without a primary care physician are more likely to seek treatment in emergency rooms. Studies have shown that among those racial and ethnic groups suffering from chronic diseases, that a highly disproportionate number have not been seen by a primary care provider in twelve months or more. Studies also show that the cost of treatment of chronic diseases in the emergency room is among the highest cost for treating chronic diseases and the least effective. Yet for many, the emergency rooms treatment is a revolving door seeing the same patient repeatedly for the same health issues or related health issues, which ultimately result in hospitalization. Since many communities do not have any community health intervention programs to buffer against emergency room treatment those most at risk have little or no options in the treatment of their chronic diseases.
The argument has been made that one’s social and economic conditions are as much a contributory factor to the health disparity gap. Clearly, poor people, people with limited formal education, the unemployed and underemployed, people living in high density populations with inadequate housing accommodations have a greater risk for poor health outcomes. And those who live in such conditions are disproportionately people of color. However the health disparities gap reaches beyond just “poor people of color”. African American men regardless of their socio-economic status have the worse health outcomes among whites, Latinos and Asians Americans. African American men have the lowest life expectancy of those racial and ethnic groups. However, Native Americans without exception have among the worse health outcomes of all ethnic and racial populations. And of course, whites living in Appalachia have health outcomes as bad and in some cases worse than other racial and ethnic populations. But this nation’s chronic disease epidemic is driven in general by racial and ethnic populations of color and specifically the African American population.
The current trends reflect that chronic diseases will only widen the health disparity divide. Within the next ten years, diseases like diabetes will be a disease that primarily affects African Americans and Latinos. And that trend among infectious diseases is reflected through the HIV prevalence; where twenty-five years ago HIV rates where highest within the gay community, today HIV rates are the highest among African American women. Today, HIV rates among the gay population have been successfully reduced demonstrating that HIV is very preventable.
Prevention however remains the most cost effective method for closing the health disparity gap among at risk populations. Balance diets, with regular physical activities and addressing stress are the basis for prevention. However, among at risk populations good nutrition and regular exercise are compromised by socio economic factors that negatively impact healthy choices. Since socio economic factors are a strong determinant for health outcomes greater community health intervention is needed to address challenges and remove barriers. Community Health Intervention (CHI) workers have shown great success in addressing such barriers by creating access to affordable medical intervention, food distributions systems and prenatal intervention. CHI workers across the nation serve a diverse base and have developed a set of practices that have greatly enhanced health outcomes of newborns, children, adults and seniors.
Data, studies, personal accounts have illustrated the scope of the health disparity. These sources of information have not been effectively utilized to solve the growing health disparity divide. An alternative perspective is needed to identify solutions. Principally, health disparity is driven by the “lack ofs” and manifested by acute co-morbidities and premature death. In a broader sense the lack of access to healthcare, the lack of community health intervention initiatives, the lack of fundamental health literacy and the lack of good nutrition regardless of socio economic conditions lies where a proactive address must take place. These “lack ofs” reach into every geographic area adversely affected by health disparity linking neighborhoods, cities and states to poor health outcomes. The pervasiveness of the “lack ofs” on a national basis provides us with a unique perspective on how others communities across the nation are successfully addressing health disparities. It is indeed ironic that the answers lies not in the copious amount of data and studies detailing the depth of the health disparity but by the solution base approach that communities have been united by in addressing health disparities.
At risk populations affected by adverse health outcomes is in part triggered by the lack of medical intervention and community health intervention. Early medical intervention has shown a significant decrease in the prevalence of chronic diseases, through regular monitoring of blood glucose, blood sugar and cholesterol. If medication is needed to maintain proper metabolic rates primary care providers can get an early jump before the conditions escalate to chronic diseases with acute co-morbidities. The community health intervention workers work in tandem by identifying at risk people and providing the necessary referral to primary care providers and later providing support to ensure those patients’ successes in achieving and maintaining good health. Community Health Intervention workers provide a vital bridge between at risk communities and the medical community by addressing challenges that contribute to health disparities. Yet, beyond successful early medical intervention and community health intervention efforts a campaign is necessary to promote the intervention union.
National radio personality Tom Joyner promotes a national “Take your loved one to the doctor day”. His daily listening audience of sixteen million consisting primarily of African Americans are encourage to take love ones to their primary care provider for medical intervention. This once a year campaign creates great awareness, but a more effective campaign would be to link and expand the campaign during Black History Month (BHM) in the month of February.
BHM is recognized nationally with programs and activities celebrating African American achievements and milestones. It is within the African American community a significant month that promotes accomplishments, pride and awareness. It is a model platform for such a campaign to address and promote a community health intervention. BHM provides an ideal opportunity to address annually medical intervention, among a population that ranks among the highest in health disparities. During the month of February the medical community would extend hours for medical intervention services and promote mobile units for mammography’s screening within African American communities. Primary care providers would offer Saturday hours and extended hours to accommodate greater participation. Cancer screening for prostate, colon and breast would be a high priority during BHM, as well as, blood sugar, blood press and cholesterol screening. Elementary schools would showcase contributions of African American doctors and connect the dots for their students to associate prevention and wellness care as a vital part of staying healthy into and through adulthood. Private health insurance companies would encourage their consumers to go to their doctors for annual screenings during BHM and employers would encourage their employees to participate in smoking cessation classes and wellness doctor visits. These initiatives working together would have a lasting benefit and positive impact within the African American community.
Organizations who seek to address health disparities could build upon these initiatives of early medical intervention, community health intervention workers and in the case of the African American community promoting medical intervention during BHM. The first step would be support the utilization of community health workers in at risk communities. Where such efforts currently exist, expanding those efforts into other communities. Second, the medical community would agree to promote and support greater utilization of its services during BHM for medical intervention within the African American population. Other groups such as the Asian and Latino populations would replicate such efforts around holidays. For instance, the month of May could be used for such an awareness campaign for Latinos, celebrating Cinco De Mayo. The Chinese New Year could also be the start of a thirty day campaign for promoting medical intervention among the Asian populations.
Groups organize to address health disparities should focus on a solution oriented approach. It is important to have an understanding of the base, but it is more important to advocate approaches that are proven and support ideas and concepts that show promise and can be replicated in other communities. Communities adversely affected by the health disparity have limited resources and lack of comprehensive information, therefore organizations developed to address health disparities should focus their primary efforts in providing communities with resources that focus on a solution oriented approach. They are not intended to be the only recommended solution, but to be enhanced with other solution oriented approaches that can be replicated across the nation in improving health disparities among those most at risk.
Finally, these ideas and initiatives explored here represent a solution oriented approach rather than fixing the problem. The critical differences between fixing the problem and being solution oriented are:
• Fixing the problem involves tremendous amount of analysis and data to understand why the problem exits; and identifying tremendous resources to fix the problem. Often times the analysis fails to produce any meaningful initiative for change. This approach is the least effective in transformation.
We have all attended community health forums where experts explain why the problems exist, and then make recommendations on solving the problem. Yet the problem never gets fixed.
• The solution oriented approach seeks out examples that work well and replicates those them with modification if needed. Its’ practice is simple; identify successful engagements regardless of its scope, understand why it is successful (its impact) and replicate to other groups facing similar conditions. This approach has the greatest success in achieving transformation. To fully appreciate this approach it is recommended that one reads the book “Switch: How to change things when change is hard”, written by brothers, Chip Heath and Dan Heath.
Friday, February 3, 2012
Wednesday, February 1, 2012
The Gateway Health and Wellness Center
On November 29, 2011, I attended an event, The Fourth Annual Excellence in Healthcare Banquet sponsored by The Community Property Development Corporation. This event recognizes the contributions of African American physicians in the central Ohio area. The honorees are given the Cheryl Boyce Excellence in Healthcare Award for their significance in addressing healthcare within the African American community and the community at large.
This year’s keynote speaker was Dr. Roderick McDavis, President of Ohio University. He addressed Ohio University’s medical college expansion into the central Ohio area and the impact it will have in producing primary care physicians within Columbus’ most underserved communities and groups. The expansion was made possible by a grant from the Ohio Osteopathic Heritage Foundation in the amount of 105 million dollars.
At last year’s Excellence In Healthcare Banquet, Dr. Steven Gabbe, CEO of Ohio State University Medical Center announced that the Medical Center would be relocating it Diabetes and Endocrinology Department to the near eastside of Columbus within the CarePoint East complex. The near eastside ranks among the highest rate of diabetes in Ohio and among African Americans living on the near eastside nearly eighteen percent are affected by diabetes and prediabetes. The epidemic rate of diabetes among African Americans warranted Dr. Gabbe’s leadership and the resources of OSU Medical Center to address this disease at ground zero.
The Community Property Development Corporation is an affiliate of St. Paul A.M.E. Church sponsors the banquet and highlights its contribution towards addressing health and wellness within the African American community of central Ohio. Through the Gateway Health and Wellness Center, CPDC has established a facility that offers primary care and dentistry. The Gateway Center builds upon a legacy that Dr. William Method, an African American physician, known as the dean of the negro physicians and founder of the Alpha Hospital located on the corner of Long and North 17th Streets. This hospital established in 1920 provided African Americans with primary care, surgery and dentistry. Dr. Method’s legacy is the Gateway Health and Wellness Center and as a former trustee of St. Paul A.M.E. his church has taken the responsibility to build and operate such a facility in these most challenging economic times.
Just as noteworthy, was another St. Paul A.M.E. Church member, Isabelle Ridgeway who opened in 1916 the Old Folks Home, now known as the Isabelle Ridgeway Care Center. Both Dr. Method and Mrs. Ridgeway laid the foundation for medical care that continues to serve the community till this day. The physicians at the Gateway Health and Wellness Center provide medical support and treatment to patients at Isabelle Ridgeway Care Center. Over ninety years later, Ridgeway’s and Method’s legacies have produced an infrastructure of care that will remain through the year 2100.
With the expansions of Ohio State University East Medical Center and Ohio University’s Medical College these medical institutions would serve well to invest in Dr. Method’s legacy, the Gateway Health and Wellness Center. Other institutions support is required to ensure that the health and wellness of a community will be met for generations to come. In order for the Gateway Health and Wellness Center to continue to meet the community health and wellness needs and expand upon Dr. Method’s pioneering contributions, I urge Ohio State University Medical Center, Ohio University College of Medicine, Ohio Health and other institutions to form a meaningful sustainable relationship and collaboration with Gateway Health and Wellness Center.
This year’s keynote speaker was Dr. Roderick McDavis, President of Ohio University. He addressed Ohio University’s medical college expansion into the central Ohio area and the impact it will have in producing primary care physicians within Columbus’ most underserved communities and groups. The expansion was made possible by a grant from the Ohio Osteopathic Heritage Foundation in the amount of 105 million dollars.
At last year’s Excellence In Healthcare Banquet, Dr. Steven Gabbe, CEO of Ohio State University Medical Center announced that the Medical Center would be relocating it Diabetes and Endocrinology Department to the near eastside of Columbus within the CarePoint East complex. The near eastside ranks among the highest rate of diabetes in Ohio and among African Americans living on the near eastside nearly eighteen percent are affected by diabetes and prediabetes. The epidemic rate of diabetes among African Americans warranted Dr. Gabbe’s leadership and the resources of OSU Medical Center to address this disease at ground zero.
The Community Property Development Corporation is an affiliate of St. Paul A.M.E. Church sponsors the banquet and highlights its contribution towards addressing health and wellness within the African American community of central Ohio. Through the Gateway Health and Wellness Center, CPDC has established a facility that offers primary care and dentistry. The Gateway Center builds upon a legacy that Dr. William Method, an African American physician, known as the dean of the negro physicians and founder of the Alpha Hospital located on the corner of Long and North 17th Streets. This hospital established in 1920 provided African Americans with primary care, surgery and dentistry. Dr. Method’s legacy is the Gateway Health and Wellness Center and as a former trustee of St. Paul A.M.E. his church has taken the responsibility to build and operate such a facility in these most challenging economic times.
Just as noteworthy, was another St. Paul A.M.E. Church member, Isabelle Ridgeway who opened in 1916 the Old Folks Home, now known as the Isabelle Ridgeway Care Center. Both Dr. Method and Mrs. Ridgeway laid the foundation for medical care that continues to serve the community till this day. The physicians at the Gateway Health and Wellness Center provide medical support and treatment to patients at Isabelle Ridgeway Care Center. Over ninety years later, Ridgeway’s and Method’s legacies have produced an infrastructure of care that will remain through the year 2100.
With the expansions of Ohio State University East Medical Center and Ohio University’s Medical College these medical institutions would serve well to invest in Dr. Method’s legacy, the Gateway Health and Wellness Center. Other institutions support is required to ensure that the health and wellness of a community will be met for generations to come. In order for the Gateway Health and Wellness Center to continue to meet the community health and wellness needs and expand upon Dr. Method’s pioneering contributions, I urge Ohio State University Medical Center, Ohio University College of Medicine, Ohio Health and other institutions to form a meaningful sustainable relationship and collaboration with Gateway Health and Wellness Center.
Monday, November 1, 2010
10K Minutes of Health and Wellness Education
I am often asked, how does one adopt a healthy lifestyle. How many times must I work out? What is the proper diet? How do I take better control of my health? These are question that we all have asked ourselves. Yet we continue to struggle and our health is declining from lack of knowledge. Consider this, we live 525,600 minutes a year, we spend less than 40 minutes a year (4 (10) minutes visit a year) with a primary physician and we expect our health to improve. There are 1,440 minutes in a twenty-four hour period. We sleep, eat, work and play within those 1,440 minutes. But we don't educate ourselves on being healthy.
We all accept the truth that education improves lives. We must also accept the truth that health and wellness education improves health. Health and wellness education is the foundation towards adopting a healthy lifestyle. Let me give you my personal example, ten years ago I was diagnosed with diabetes. What I knew about diabetes could fit in a single paragraph and what I knew about living healthy was a sentence. I knew that if I wanted to live long and free from complications I would need to educate myself on what "healthy living" really means. And over the past ten years I have continued to educate myself, becoming a health expert on Tim Anderson's health.
I am not an expert on health, but an expert on my own health. I understand how my body functions, I understand how food both heals and harms my body. I understand the benefits of exercise, the type, the duration and how my body's response creates an overall feeling of well being. I read about living healthy, I attend programs like cooking demonstrations, I read about diabetes involving medication, diet and exercise. I don't profess to have all the answers, but I do believe that educating myself has prevented me from experiencing serious complications from diabetes. This health and wellness education foundation has formed the basis for me adopting a health lifestyle.
I am urging you today to allocate 10k minutes per year for health and wellness education. It is less than two percent of your total minutes per year. And it will improve the quality of your total minutes of your life. Make that investment of 10k minutes per year, it breaks down to less than 1/2 each day.
Here's how you get started:
Read, Read, Read! Buy a book about eating healthy or exercise or disease management!
Attend health and wellness programs.
Attend health support groups or start one.
Read food labels when purchasing food.
If you take medication read the affects of the medication's pros and cons.
Have a list of questions for your doctor on your next appointment.
Investigate alternative medicine for health and wellness.
Track your 10k minutes
Should you begin these simple steps in educating yourself, you will be on your way improving your health. Health and wellness education in combination with physical activity and proper diet support the adoption of a healthy lifestyle.
Write back and tell me what you will do with your 10k health and wellness education minutes.
We all accept the truth that education improves lives. We must also accept the truth that health and wellness education improves health. Health and wellness education is the foundation towards adopting a healthy lifestyle. Let me give you my personal example, ten years ago I was diagnosed with diabetes. What I knew about diabetes could fit in a single paragraph and what I knew about living healthy was a sentence. I knew that if I wanted to live long and free from complications I would need to educate myself on what "healthy living" really means. And over the past ten years I have continued to educate myself, becoming a health expert on Tim Anderson's health.
I am not an expert on health, but an expert on my own health. I understand how my body functions, I understand how food both heals and harms my body. I understand the benefits of exercise, the type, the duration and how my body's response creates an overall feeling of well being. I read about living healthy, I attend programs like cooking demonstrations, I read about diabetes involving medication, diet and exercise. I don't profess to have all the answers, but I do believe that educating myself has prevented me from experiencing serious complications from diabetes. This health and wellness education foundation has formed the basis for me adopting a health lifestyle.
I am urging you today to allocate 10k minutes per year for health and wellness education. It is less than two percent of your total minutes per year. And it will improve the quality of your total minutes of your life. Make that investment of 10k minutes per year, it breaks down to less than 1/2 each day.
Here's how you get started:
Read, Read, Read! Buy a book about eating healthy or exercise or disease management!
Attend health and wellness programs.
Attend health support groups or start one.
Read food labels when purchasing food.
If you take medication read the affects of the medication's pros and cons.
Have a list of questions for your doctor on your next appointment.
Investigate alternative medicine for health and wellness.
Track your 10k minutes
Should you begin these simple steps in educating yourself, you will be on your way improving your health. Health and wellness education in combination with physical activity and proper diet support the adoption of a healthy lifestyle.
Write back and tell me what you will do with your 10k health and wellness education minutes.
Tuesday, May 18, 2010
Casting Pebbles Upon Still Waters
Welcome to my first blog. I am not sure about the term "blog" but whatever the name blogging is here to stay and I will take advantage of it. But what a name for a format to express your thoughts and ideas. But here I am using this technology to convey to you my thoughts of the importance of making a difference in our community. No just a difference, but a positive with long-term meaningful impact in the lives of people who are most vulnerable. Working collectively the outcome will be that much more significant.
I define this effort of making a positive difference as, "casting pebbles upon still waters". I am not the first to use this term, but allow me to give you my interpretation. In neighborhoods, communities and cities across our country is an epidemic of despair, not brought on by the recent recession, but from long term neglect of the most vulnerable people and communities. The recession has shine a narrow light on this despair and hopelessness. Folks have given up and given in. I see still waters reflective of hopelessness and despairs.
Casting pebbles is the positive action to cause ripples of change. The more pebbles tossed the stronger the ripples of positve change. All that is needed is to cast the first pebble towards improving education, jobs, housing, the environment, health and wellness.
I believe in the power of hope. Where one person's actions to address despair and hopelessness can begin the process of postive change. Casting a pebble upon still waters is the metaphor for the action in promoting hope to people, neighborhoods and communities that believe there is no hope. The longer we ignore the still waters, the greater the hopelessness and despair become entrenched and the challenge becomes even greater. We cannot afford to ignore any longer but must engage ourselves to be of service, thereby instilling upon those of us a great sense of hope; cast your peebles upon still waters to begin the rippling of change. If we cast our pebbles singlarly we produce change and if we do it collectively the ripples become a force that reaches all areas and the depth of still waters.
Cast your pebbles, cause a ripple, promote hope. I invite you to respond how your pebbles are promoting hope.
I define this effort of making a positive difference as, "casting pebbles upon still waters". I am not the first to use this term, but allow me to give you my interpretation. In neighborhoods, communities and cities across our country is an epidemic of despair, not brought on by the recent recession, but from long term neglect of the most vulnerable people and communities. The recession has shine a narrow light on this despair and hopelessness. Folks have given up and given in. I see still waters reflective of hopelessness and despairs.
Casting pebbles is the positive action to cause ripples of change. The more pebbles tossed the stronger the ripples of positve change. All that is needed is to cast the first pebble towards improving education, jobs, housing, the environment, health and wellness.
I believe in the power of hope. Where one person's actions to address despair and hopelessness can begin the process of postive change. Casting a pebble upon still waters is the metaphor for the action in promoting hope to people, neighborhoods and communities that believe there is no hope. The longer we ignore the still waters, the greater the hopelessness and despair become entrenched and the challenge becomes even greater. We cannot afford to ignore any longer but must engage ourselves to be of service, thereby instilling upon those of us a great sense of hope; cast your peebles upon still waters to begin the rippling of change. If we cast our pebbles singlarly we produce change and if we do it collectively the ripples become a force that reaches all areas and the depth of still waters.
Cast your pebbles, cause a ripple, promote hope. I invite you to respond how your pebbles are promoting hope.
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