Poster Paper: Community Healthcare Redefined: The Role of Grass-Roots Community Health Organizations and Outreach Workers in Bridging the Gap in Education, Access, and Equity

Thursday, November 7, 2013
West End Ballroom A (Washington Marriott)

*Names in bold indicate Presenter

Straso Jovanovski, Rutgers University
The broad topic of health policy, along with issues of access to care, quality, and alternative approaches to delivery has been part of the national policy discourse in recent years. This paper looks to catalogue and conduct preliminary assessment of alternative approaches to ground level healthcare service provision through the engagement of third sector community resources. This innovative approach to bridging the gap of health service access for at-risk urban populations works on multiple levels, through helping alleviate the sizable mismatch between optimal primary physician utilization and overburdened hospitals within distressed cities. The other ‘side-effect’ of addressing chronic disparities in access is taking hold of rising public health expenditures by curbing unnecessary Emergency Room visits while promoting preventative action, education, and focus on a long-term, involved view to coordination and provision of services. A review of the relevant literature streams suggests that often strategies aimed at fighting entrenched, concentrated poverty, are highly pertinent to increasing equity in access to healthcare in U.S. postindustrial urban cores. Examples from emerging economies provide a particularly salient backdrop for studying new and different strategies for tackling the greatest issues of the day here at home. Case studies from India and Brazil illustrate how these nations were successful at making a tangible imprint on poverty by setting clear priorities in areas such as strengthening women’s and girls’ positions in society through education and professional uplift, as well as providing incentives in guiding families with young children to make the right decisions for future generations of citizens. The idea of community health workers is a concept of focus of this research. These individuals, who often aren’t medically trained, have been documented to bring a unique value in their interactions with patients (individuals and families) struggling with life changing illnesses and difficulties with access to appropriate resources. The emphasis is on aspects like cultural sensitivization, language training, and a genuine desire to adopt individuals and households as their own in ensuring the highest attainable quality of life under often far from ideal circumstances.  Many of the communities where these outreach health workers make their greatest impact are among immigrants, the elderly, the working poor, and families with special needs children. In spite of well intended and designed legislative solutions, there remain gaps and significant disparities, which could arguably be bridged through a concerted and sustained effort by dedicated grassroots community groups. The paper attempts to evaluate and assess the work of various organizations and groups in existence across the United States providing community based health services, and in particular those taking on facilitator roles between disadvantaged groups and system resources. The methodology consists of a comprehensive literature review augmented by quantitative (GIS or spatial) data analysis in establishing valid metrics to arrive at variables of interest in attempting to measure the level and extent of social change and substantive impact at the community level.  Further attention is needed in developing a body of data, and defining concepts around the notion of culturally-tailored healthcare education and outreach.