As part of Northwestern Medicine’s commitment to care, the Community Engagement goal provides a framework for advancing diabetes awareness and management in Humboldt Park. A growing issue around the world, the prevalence of diabetes in this underserved community is two to three times higher than the national average. That, coupled with the neighborhood’s tradition of community organizing – a major component in the success of outreach and educational campaigns – is why we chose this initiative three years ago to kick off the Community Engagement goal. Fiscal year 2012 started with focus groups to identify two wellness initiatives – access to care and healthy food preparation – and will end with a decision on what comes next. Working with the Erie Family Health Center, Near North Health Service Corporation, and Northwestern Memorial Hospital’s Health Learning Center, the number of individuals seeking treatment for diabetes in Humboldt Park has risen, while the time before a first health care appointment has decreased. Goal owners Ronald Ackermann, MD, director of the Community-Engaged Research Center at NUCATS; Daniel Derman, MD, vice president of operations at Northwestern Memorial and president of Northwestern Memorial Physicians Group; and Richard McGee, PhD, associate dean for faculty recruitment and professional development, and administrative leads Posh Charles, director of external affairs at Northwestern Memorial, and Kirsten Yehl, Institute for Healthcare Studies administrator, discuss the goal.
The diabetes project in Humboldt Park has been a collaborative effort between Northwestern Memorial, Northwestern Medical Faculty Foundation, and Feinberg since shared annual goals were first implemented in fiscal year 2010. Seen as a natural progression on work already being done in this part of Chicago, the goal maintains its place as an important initiative. “As part of the Northwestern Medicine vision, it’s important to not just treat the patient, but also work with the community to address population health,” Dr. Ackermann said. “Community engagement offers a sense that it’s a part of the culture and that we are all part of a bigger organization that is really committed to things beyond the four walls of campus.”
Working in Humboldt Park, Northwestern Memorial and Feinberg have been able to help develop cooking classes, health fairs, safe and reliable exercise courses, ophthalmology screening clinics, and informational opportunities with the hiring of a certified health educator. After successfully collaborating with a growing number of community groups, we are also looking to work with other organizations to determine where people in Humboldt Park are most often seeking health care. “We want to continue to help community members get care, but we must also follow through to know that the care provided was good and that individual health is improving,” Dr. Derman said.
With a large Puerto Rican immigrant population and subsets of non-English speakers, figuring out how to build trusting relationships and distribute educational material in Humboldt Park was paramount to success. Goal owners had to stop, listen, and work with residents to help produce culturally sensitive diabetes information that community members could distribute. “When we started out, we really didn’t have a road map,” Derman said. “We finally arrived at the ‘ah-hah’ moment that community engagement is about working with the people, and what better way to do it than by working with existing organizations that represent and are embedded within Humboldt Park.”
“We hope to fulfill a badly needed role of bridging the gap between grassroots-type organizations and health care institutions,” Ackermann said “It’s only together that we can reduce the incidence of diabetes in Humboldt Park. We have to link the chain because many people in this community suffering from diabetes have become invisible to the health care process. Our ability to provide resources like the health learning center and to work with community organizations to raise awareness is crucial.”
The leaders of several partnering Humboldt Park organizations have helped to shine light on the community’s pressing needs and guided how we could best help to address those needs. A series of three focus groups were also conducted talking to youths, adults, and senior citizens to assess the challenges community members face in gaining access to adequate health care. “We tried to get at what people wanted and where they are currently getting it,” Charles said. “They want quality no matter what it’s about, whether it’s health care or cooking classes. It was surprising to hear children say they never had the opportunity to learn about how to eat better. It’s why the education component is so important. Seniors asked for cooking and exercise classes and we are now funding those at the Kelly Hall YMCA.”
We are working with two federally qualified health centers to shorten the time it takes for someone who is identified with diabetes to be in front of a primary care provider. With resident physicians participating in training activities at Norwegian American Hospital in Humboldt Park, Northwestern has enhanced the teaching environment there, and on most Wednesday nights the free CommunityHealth clinic is staffed by Northwestern students and residents. “For a lot of students and residents, this is what they want to do,” McGee said. “We’re enabling the people at Northwestern who want to reach people who aren’t being reached.”
One of the goals of this initiative is to identify people living with diabetes, which means there will initially be a rise in the measurable number of individuals with the disease in Humboldt Park. Although increases in these numbers might begin to make the problem look worse at first, it is essential that people are aware of their condition before health can begin to improve. The relationships and sustainable model that we helped to build are the greatest early signs of success. If the classes and educational opportunities that we helped to fund are still operational and if there are safe places for people to exercise, that would also be a level of success, but “ultimately, we have to take a defined population and see them getting better, to be considered successful,” Derman said.
Nearing the conclusion of three years of work with diabetes in Humboldt Park, we have identified two options for moving forward. Option one would allow the initiative to grow within the neighborhood by using the current model to develop new strategies for addressing different health issues in Humboldt Park. Option two would see us branching out into another community, using what has been learned as a model for coalition building and coordination of community and healthcare resources to improve the health of people with diabetes in other areas of the city. Consistent with the past work of Northwestern Medicine’s Community Engagement team, Charles adds, “deciding on our next steps has to be a process that’s inclusive of a lot of people on campus and in the community.”