ADDRESSING COMMUNITY HEALTH

AltaMed Health Services

AltaMed Health Services is a federally qualified health center (FQHC) that serves over 300,000 low-income people of color in underserved communities through a network of 40 clinics in Los Angeles and Orange Counties in Southern California. In addition to being impacted by health disparities, lack of access to health care, and the systemic presence of poor social determinants of health, these communities have historically been disengaged from civic life. This includes a history of low-propensity voting.

With a 50-year history rooted in a tradition of civil rights activism, AltaMed seeks to address these conditions by moving beyond traditional health care service delivery.  All of AltaMed’s clinics are located in communities with high percentages of hard to count populations, presenting a unique opportunity to leverage existing infrastructure to mobilize surrounding communities. With the understanding and belief that voting is an indicator of community engagement, AltaMed strives to use its clinics as centralized civic engagement “hubs” to engage and organize patients and other community residents in education about SDoH challenges in their community, fostering their advocacy for local policy changes, as well as for regional systemic and environmental changes that advance health equity. Leveraging its reputation as a trusted community health provider, AltaMed has used this innovative model to successfully engage residents and community stakeholders to achieve the following advances towards health equity:

  1. Supporting and advocating for the California’s Health4All initiative that provides health care access for all children regardless of immigration status;
  2. Implementing an evidence-based “5-touch” voter engagement methodology to engage more than 1 Million low-propensity voters (predominantly working class residents of color) through a grassroots, community-led non-partisan and health-equity focused campaign for the 2018 elections, resulting in as much as 400+% increase in voter precincts with historically low turnout;
  3. Engaging Southeast Los Angeles residents in an education campaign related to the public health impact of climate change stressors through a grassroots initiative address the issue of air quality;
  4. Launching a leadership academy to train additional community members in statewide advocacy around climate change and its inequitable impact on working class Southeast Los Angeles communities;
  5. Achieving menu and health food signage changes at restaurants ad grocery stores in Southeast Los Angeles to increase access to healthier food options.
  6. Improving school lunch and exercise policy changes at K-12 grade schools throughout Southeast Los Angeles.

FOCUS:

With a current grant from The California Endowment, AltaMed is working with two other clinics throughout the state of California to replicate the “5-Touch” civic and voter engagement model in preparation for the forthcoming elections in 2020. It is also developing trainings and a toolkit to teach other clinics and health care organizations how to conduct in-clinic civic engagement outreach using the “5-Touch” model. Concurrent with civic engagement activities, AltaMed’s Census 2020 outreach campaign aims to increase response rates among Hard to Count Populations in Los Angeles County through a comprehensive grassroots campaign. Through this campaign, AltaMed also seeks to sustain and expand civic engagement of communities previously mobilized through AltaMed’s voter engagement work, and to set the foundation for future engagement for those who are mobilized through the Census campaign.

In partnership with the UC Riverside, AltaMed is developing an evaluation framework to measure the impact of its civic engagement activities along five dimensions: Service Delivery Outcomes, Constituent Empowerment, Community Partnerships, Funding Impact, and Public Policy Impact. This will include examining voter registration rates as a predictor of health outcomes in underserved communities. This work is driven by a fundamental belief that health itself  – not just health care – is a basic right, as well as recognition of the need to “correct the imbalances” that exist in current systems and structures across racial, ethnic, socioeconomic, and citizenship backgrounds. Empowering underserved residents to engage in the decision-making processes that impact their communities addresses the root cause of health disparities.

Episcopal Health Foundation: Texas Community Centered Health Homes Initiative

Episcopal Health Foundation’s Texas Community Centered Health Homes (CCHH) Initiative is a four-year, $10 million investment to create more active roles for clinics to address the community conditions that lead to poor health.

FOCUS:

The CCHH initiative creates a model for 13 community-based clinics to go beyond the exam room with a systematic approach to address the non-medical factors that contribute to poor health. Clinics are developing specific ways to take community-wide action to prevent illness and improve health, not just healthcare in the areas they serve.

Poverty, substandard housing, lack of affordable healthy food, and limited safe places to exercise are a few of the underlying conditions that contribute to high rates of chronic health issues like obesity, diabetes, heart disease, asthma, and more. As described by Prevention Institute, a CCHH clinic “not only acknowledges that community conditions outside the clinic walls affect patient outcomes, it actively participates in improving them.” The CCHH approach goes beyond patient-only treatments and promotes change at the systems and community levels. Clinics are partnering with community groups, government agencies, schools, businesses, and other organizations to create community-wide prevention strategies and other similar efforts.