Health Disparities grassroots clinics

							March 11, 2009 Summit on Public Health
Improving Healthy Lifestyles in the Miami Valley
Breakout Sessions

Health Disparities
Recommendation                                                                               Target Areas                          Key Partners                        Priority
Baby Friendly Initiative from WHO                                                 Evidence based practice for           Hospitals, WIC, Lactation               High
                                                                                  maternity care for infants to help    Consultants
                                                                                  reduce risk of obesity
Possible Health Department public course for employees on cultural                Competency/learning for those in      Universities, Health Department,        High
competency, available for other organizations to train employees,                 public health, Development of         Hospitals, Healthcare Organizations,
                                                                                  trustworthy role models who the       EMR for data tracking, Physicians
                                                                                  public can relate to
                                                                                  Include disparities in populations
                                                                                  with mental health disorders

Advocacy Initiatives: Reach out to individuals to help provide care and “plug     Undocumented/peoples without          “spokes” on the wheel of the Get Up     High
into system”                                                                      healthcare provider or insurance      program. Utilize healthcare
                                                                                  options                               providers, public health
                                                                                                                        departments, groups that target
                                                                                                                        youth
Improve education, Identify needs, especially at outreach clinics, uninsured,     Literacy/capacity of individuals to   Healthcare Facilities, Organizations    High
improve identifying those who are in need and provide care to help manage         manage medical system, Improved       with case managers, Centers that
care.                                                                             support from policy-makers            provide care for the uninsured/self
                                                                                                                        pay patients, (Medicare/Medicaid)
Partner with GADAHA and Medical Society to support efforts to specialties         Improve adherence by physicians       GADAHA, Physician peer                  High
to adhere to evidence based guidelines.                                           and people to evidence based          community, EMR, Hospitals
                                                                                  guidelines of care
Seek funding to create outreach/mobile units and other modalities to address      Improve healthcare access to           Life Essentials of Dayton (establish   High
needs of those without financial recourse, Explore partnerships to fill gaps in   elderly, those with limited           guardianships, service and care for
service                                                                           finances/education/other barriers     disabled individuals),
                                                                                                                        Pharmaceutical companies, medical
                                                                                                                        supply companies, Hospitals,
                                                                                                                        Outreach clinics,

Meet quarterly to facilitate partnerships and improve exchange of ideas,          Improve communication and             (Centerville group for change           High
Identify strategies and priorities to help know about what kinds of resources     interaction between groups with       (centervilleforchange.org)), any
are available in the community. Identify priorities in the next meeting. Invite   public health/community interests    other spokes or groups that might be
other community members who have skills/services/interests to benefit                                                  interested in working on Get Up
communication                                                                                                          projects
Identify ways to disseminate information about special pharmaceutical             4 dollar prescription awareness      Physicians, Nurses, Pharmacists,        High
programs. (Example: 4 dollar prescription cards/additional prescription cards     among physicians/pharmaceutical      grass-roots organizations, Hospitals,
that are available through the general medical community/pharmaceutical           cards to decrease costs and copays   Advocacy groups, Community
companies)                                                                                                             Nurses, Community Health
                                                                                                                       Workers,




Black, Hispanic, Asian Americans, Native American, low socio-economic status, minority groups, Disabled, mentally ill, deaf, etc.

   1. Potential Target Areas/Needs: Evidence based practice for maternity care for infants to help reduce risk of obesity.
      Recommendation: 6 months of exclusive breast feeding as a priority. Improved appropriate feeding. “Baby Friendly Hospital Initiative from WHO”
       web link for BFHI USA... http://www.babyfriendlyusa.org/eng/index.html
      Partners: Hospitals, WIC, Lactation Consultants,
      Priority: High, sustainable and cost neutral in UK in 12-18 months. Already in motion at all Dayton hospitals. Could be implemented in 2 years.
   2. Potential Target Areas/Needs: Cultural competency/learning for those in public health. Incorporate into mission of organizations,
              Development of trustworthy role models who the public can relate to, Include disparities in populations with mental health disorders, Improve access to undocumented individuals
              Recommendations: Requirement for organizations to incorporate into missions of organizations. Possible Health Department public course for employees on cultural competency.
      Partners: Universities, Health Department, Hospitals, Healthcare Organizations, EMR for data tracking, Physicians,
      Priority: High

    3. Potential Target Areas/Needs: Undocumented/peoples without healthcare provider or insurance options.
                 Recommendations: Outreach to target before onset of diseases. Reach out to individuals to help provide care and “plug into the system” Broaden efforts throughout the
                 community. Learn about early death and disease to understand acceptable levels of health that are “normal”
         Partners: “spokes” on the wheel of the Get Up program. Utilize healthcare providers, public health departments, groups that target youth.
         Priority: Medium
    4. Potential Target Areas/Needs: Literacy/capacity of individuals to manage medical system
                 Recommendations: Improve education, Identify needs, especially at outreach clinics, uninsured, improve identifying those who are in need and provide care to help manage care.
                 Improve sensitivity of healthcare providers/facilities to enable consumers/patients to be identified who have difficulty navigating the system and provide advocacy for them to help
                 improve disparities, Improve existing advocacy models, provide additional people who can help with appointments and improved retention of medical information, Find out what
                 kind of community workers are available and identify what overlap may exist or how existing forces can be partnered and strengthened. Idea of creating a notebook/recordkeeping
                 to help facilitate patients ability to track their own care (creates expectation of always writing things down about their visits, improves adherence.) Help to improve the
                 identification of case-workers (instead of having multiple case-workers per case, complicates care greatly)
         Partners: Advocacy groups, Healthcare Facilities, Organizations with case managers, Centers that provide care for the uninsured/self pay patients, Improved support from policy-makers,
(Centers for Medicare and Medicaid),
         Priority: Medium
    5. Potential Target Areas: Improve adherence by physicians and people to evidence based guidelines of care.
                 Recommendations: Partner with GADAHA to support efforts to specialties to adhere to evidence based guidelines.
         Partners: GADAHA, Physician peer community, EMR, Hospitals,
         Priority: High
    6. Potential Target Areas: Improve Primary access to elderly, those with limited finances/education/other barriers
                 Recommendations: Seek funding to create outreach/mobile units to address needs of those without financial recourse, Explore partnerships to fill gaps in service
         Partners: Life essentials of Dayton (establish guardianships, service and care for disabled individuals), Pharmaceutical companies, medical supply companies, Hospitals, Outreach
clinics,
         Priority: High
    7. Potential Target Areas: Improve communication and interaction between groups
                 Recommendations: Meet quarterly to facilitate partnerships and improve exchange of ideas, Identify strategies and priorities to help know about what kinds of resources are
                 available in the community. Identify priorities in the next meeting. Invite other community members who have skills/services/interests to benefit communication. Possible “getting
                 to know you activities….going out and having a cocktail, orderves, etc. Create a community amongst ourselves in the sphere of public health to improve trust and interaction in
                 the community.
         Partners: (Centerville group for change (centervilleforchange.org)), any other spokes or groups that might be interested in working on Get Up projects,
         Priority: High

   8. Potential Target Areas: 4 dollar prescription awareness among physicians/pharmaceutical cards to decrease costs and copays
        Recommendations: Identify ways to disseminate information about the 4 dollar prescription cards
Partners: Physicians, Nurses, Pharmacists, grass-roots organizations, Hospitals, Advocacy groups, Community Nurses, Community Health Workers,
Priority: Medium