At The Forefront Live: Community Health Needs

UChicago Medicine experts on community health priorities for the south side and south suburbs. Among the topics we discussed were the health challenges of those communities, the work being done in violence prevention and recovery, future plans.

The following is a paid program from UChicago Medicine. 

Today on At The Forefront Live we will discuss community health priorities for the South side and South suburbs. We will discuss some of the challenges in these communities, the work being done in violence prevention and recovery, and some of the plans for the future. Joining us will be Brenda Battle, vice president of the Urban Health Initiative and chief diversity and inclusion officer, Catina Latham, director of community benefit and evaluation, and Dr. Doriane Miller, director of the Center for Community Health and Vitality. That's next on At The Forefront Live. 

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Hello, and welcome to At the Forefront Live. We're going to remind our viewers that we'll be taking your questions over the next half hour, so start typing. We also want to remind our viewers that today's program is not designed to take the place of a visit with your physician. 

First of all, welcome, everybody, to the program. Happy to have you here today. 

Thank you. 

Thank you. 

Nice to be here. 

Let's jump right into the questions, because we have quite a list so far, and I'm sure we'll get some more from our viewers, as well. And Brenda, we're going to start with you, if we can, please. And if you can tell us a little bit about the communities that UChicago Medicine serves. We're part of a neighborhood down here, and we're very proud to be part of that neighborhood. 

Yes. So the University of Chicago has two communities-- one at our Hyde Park campus, and one at our Ingalls campus. And for the purpose of community benefit for our Hyde Park campus, our catchment area comprises 12 zip codes immediately surrounding the University of Chicago. There are about 650,000 people who live in these communities, and they run pretty contiguous to our hospital. In the Ingalls service area, our Community Benefit service area is about 13 zip codes that comprise the Thornton Township community. And these communities are very diverse. They're rich in culture and history, and I'd say that they both have a lot of vulnerabilities at this time-- which is the reason why we do a lot of work in community health and community benefit. 

Dr. Miller, I've got a question for you. What are some of the overall health challenges that you see in these community areas? 

Been practicing on the South side of Chicago for a number of years. And many of the challenges that we see in communities on the South side of Chicago include things like high blood pressure, diabetes, obesity. Asthma is particularly prevalent in South side communities. But also, some of the things that are defined as more of the social determinants of health. So things like health behavior changes that people need to make in order to improve their health-- sometimes they're not possible because there aren't enough community resources to support them. 

You know, it's interesting you mentioned asthma, and we're going to talk a little bit more about that, here, in a few minutes. And in particular, there are a lot of children that are impacted pretty significantly by asthma in our community areas. And that's always been something that's been kind of fascinating to me, is why we see a greater impact here than maybe on the North side or some of the other parts of Chicago. And I don't know if you have any thoughts on that, but it's a real challenge, here. 

You know, there are multiple factors that are related to why we see higher rates of asthma here on the south side of Chicago-- particularly amongst children. They have to do with environmental issues, pollution. Sometimes people live in housing that might be subpar, and they may have issues with either mold or vermin infestation. So when you think about droppings from either cockroaches or mice or rats-- all of those things can be factors in terms of children having problems with asthma. 

But something else that's involved, too-- and that is making sure that they receive appropriate treatment for asthma. And it's one of the reasons why here at the University of Chicago we've started, actually, a pediatric asthma center. 

And we actually will go out into the community and work with children that are-- and of course, their parents and families-- but that are really battling this. Correct? 

Absolutely. 

Yeah. So what are some of the things that we can do to make that happen? 

You know, I'm actually going to defer that question to Brenda, because she's been incredible, in terms of her leadership, of bringing the South Side Pediatric Asthma Center to us. 

Thank you. Thank you, Doriane. So in 2017, we, along with the other hospitals on the South side of Chicago and the community health centers, came together around this community health need, and determined that we needed to stand up an asthma center that would address the issues of asthma. And we would put forth efforts together, collectively, to address improving the outcomes of asthma for children. 

And so it's not a physical center. It's a virtual center. It is all of us working together. We built an assessment together, where we can determine when kids are high risk for asthma. And we were fortunate to get funding to help us to staff each of the health centers and hospitals with community health workers that work along with the physicians in the clinic. And they followed the families out to their homes in the community. So after seeing the child and family in the community, they will go out to that home to do an environmental assessment in the home, to help the caretakers to learn how to manage the asthma within the home, and to identify if there are any of those factors in the home that Doriane just mentioned, and then to help them to mitigate those issues, and navigate how they could clean the environment more effectively. 

That's been super effective. We also stood up a hotline-- we call it and an asthma resource line-- for persons who want to call in and ask questions about asthma. They can call that m talk to an individual on the other end, and find out-- get their questions answered about it. And then, if they need to be referred back to their primary medical home, they can get referred back to their medical home for our ongoing care. 

It's tough for a kid to be a kid when they're suffering from asthma, Because? It's really difficult. You know, their friends are out doing things and being active, and sometimes that's a real detriment to that happening. So it's great that this is going on. It's good. 

Catina, question for you. What is the Community Health Needs Assessment? We hear a lot about it, here at UChicago Medicine, but I think a lot of the folks probably in the community don't. Why is it important, and what is it? 

OK. Well, first we'll start with "what is it?" 

Yeah. 

The Community Health Needs Assessment is a study or data collection process that we conduct every three years, here, on the South side of Chicago, or in the south land, really. And as Brenda pointed out, it covers a 12 zip code area that we've identified. And we collect data on a variety of topics. Many of the topics that Doriane mentioned-- diabetes rate, asthma rates, pregnancy rates. Other things that are some of the leading causes of death for our community. 

And it's because it's a data collection of data from both the city, the state, the federal government. But it's also data from our communities. We did community input surveys, asking the community what do they feel are their top priority health areas, and what are some of the things that we should be focusing on. And we did some focus groups, focusing in on asthma, as Brenda said, to further inform our South Side Pediatric Asthma Center. 

We also did some focus groups on diabetes and nutrition, because we want the numbers to also reflect what our community has said, as well. And what we do with this Community Health Needs Assessment, and why it's so important, is we don't want to just say, well, the hospital's going to focus on X, Y, and Z. We want to use this data to help us determine what priority health areas we should focus on, and what's the greatest need for the community, and how we should allocate our resources. 

This is our third Community Health Needs Assessment that we've conducted, and the first two informed our need to do the South Side Pediatric Asthma Center, as well as other projects that we have put in place. And like I said, it just helps us to target our resources. 

And I imagine a lot of this also kind of helps us to be proactive, to do some work on the front end to prevent some of these issues. 

That is true. Right. 

So talk to us about some of the findings of the most recent report, and what are some of the interesting things that you're seeing when you take a look at the numbers and the data? 

Well, this year, we did a first look-- or deeper look, I should say-- into some of the social determinants of health. We wanted to understand what some of the drivers of health could be. Income was one thing we looked at. Food insecurity-- you know, those who have a risk of not having enough food at home. We also want to know the education of those in our service area. and the employment rate, and whether or not they had access to care-- so access to a provider or access to health insurance. 

And some of those findings that came out helped us to identify that we wanted to focus on chronic diseases-- primarily asthma, as well as diabetes, because those arose as high indicators and top leading causes of death for our community-- particularly with diabetes and heart disease. We also wanted to focus on violence in our community, and what we can do to help people to recover from that. We have a violence recovery program that we've put into place, and we also wanted to help those to recover from any traumatic experience. So to whatever extent we can help our community partners build services to address the mental health, and help that patient recover fully from whatever traumatic experience they've had. 

And lastly, we want to focus on some social determinants of health. We've talked about access to care. We've also had issues regarding the food insecurity, as I noted, becoming one of the concerns. And we want to make sure that our programs-- we have one program, now, that's in our emergency room, where people come in and if they don't have a usual source of care, we have patient advocates that help to connect them to that care. And as they come in, and we identify access to care needs, we want to go in deeper and further, to find out-- do they have other needs, such as looking for resources for food, or housing, or what have you. So those are things we will do. 

And I think that makes so much sense. It was interesting-- we did a program just a week or two ago on primary care physicians, and just how important they are for people's health. And I think-- again, kind of to what your point is-- if we can introduce people to medical care professionals, and have them visit them regularly, and see the same person, it makes a big difference. 

You mentioned food insecurity, and that's one that kind of strikes a chord with me, too. I met a gentleman-- we were shooting a video last year, I guess it was, last summer-- on one of the programs that was being funded in part by a grant through the University of Chicago. And he told me an interesting story. He was talking about one of the community gardens that was put in place, and he said, you know-- he was an older guy-- and he said, you know, a lot of us don't drive, because we're older, and getting to a grocery store is difficult. So the community garden was a blessing to him, because he had vegetables that were within walking distance. And I never really thought of it that way. And it's a significant situation. Food insecurity is a big deal. 

That it is. And like you said, having that resource-- we want to make sure we have it here, where if you're hearing any identified needs you can obtain some food sources here, but we also want to connect people to-- as you said-- places they can go that are within walking distance, or near their community. 

To that point, we even have a garden on top of one of our apartments. 

We do. And there is a garden that's here. 

Kind of neat. Can we talk a little bit about violence recovery for just a moment, and how that program is working, because I know that's, again, a very important part of what we do. And Brenda, I know you're plugged in there, because we have worked with our community on that, as well. And PTSD is a big deal. I mean, that's a real thing that-- a lot of times, I think we think of the people that come into our trauma center-- we help them, and then we let them go. And physically they may be OK, but there are a lot of other things going on. 

Exactly. So when we stood up our trauma center, we knew that we didn't just want to patch people up and send them home to recover from their physical wounds, but we wanted to be able to help them to holistically recover from being victims of violence or being exposed to violence. So we stood up a violence recovery program. It's a hospital-based violence intervention. 

And there are not many in the country. There are some in the country where hospitals take an active role in working with victims of violence and their families to help reduce the possibility of being re-injured, to reduce violent recidivism, to promote holistic recovery, and to help people to prevent getting involved in the criminal justice system. So our violence recovery program allowed us to hire individuals to work in our emergency room, to work with families and victims of violence when they come into our trauma center, to help steer them toward the next step of recovering from violence-- or from trauma. 

And to do this, we work with a number of community-based organizations that are already working to provide support services, behavioral health services, housing, food-- any of the other socially determinant health needs that Catina mentioned-- to help individuals get what they need to recover. If it's getting a job, these specialists help them to find a job. If they need support in learning how to work in a job, they help them to do that. Whatever those needs are, our violence recovery program is able to do that. 

And we were fortunate in April to get funding from the Block family and Hassenfeld family to form the BHC Collaborative for Family Resilience, to allow us to work with children that have been impacted by violence and the children of adults who've been impacted by violence, to help them to move toward resilience and recovery after being impacted by the issue of trauma and violence. 

By doing this, we were also able to expand some existing programs that we have at our hospital. Our child life program, which helps children when they come into the hospital, through the developmental experience of being in the hospital, to navigate the hospital experience. We're able to expand those services from our pediatric hospital to our adult hospital, where we still have youth and children getting care in our adult hospital. 

We were also able to expand an existing program that we have, here, called Healing Hurt People, that provides licensed clinical social workers that provide behavioral health services to persons in the community in their home, at places where they're comfortable receiving those services. We were able to expand that, along are our bonus recovery specialists, to create a comprehensive model that is now the most comprehensive hospital-based violence intervention in the country, now, providing these services to help victims of violence and their families recover. 

So we're really proud of that program, and the impact that it's had on individuals. We've been able to help save lives through that program, and we're super proud of the impact that it's had on individuals. 

Absolutely. And you know, it's just incredible when you see the work that's being done. And you know my hat's off to you everybody that's involved in that. And I know you worked on this for a long period of time. And I got a very-- just a brief peek into the Block-Hassenfeld collaboration, and that work. And it really kind of touched me, because these are children that are impacted by trauma. And it can be various types of trauma. And again, it may not even be the physical injury, but it's the emotional and mental toll that happens after they witnessed something like that. And, you know, again, I think most people don't even think about that aspect of it. You don't consider that. You think a hospital is a place where you come in, you get some stitches, and they put you out the door. And it should be-- and I think we're showing that it can be-- so much more than that. So again, I am so impressed that your team is doing that, and working with the other teams. 

The other thing I wanted to mention about that, that I thought was important, is the collaborative aspect of it with the different community groups. We can't do this all by ourselves. 

We cannot. No. There's no way we could provide all of these services by ourselves. And it takes a village-- the adage that it takes a village to do this kind of work-- it truly does take a village and there are a lot of community based organizations working on by this prevention violence recovery. And as a hospital, these are providers, often, that we don't work with, typically. But through this program, we're able to convene those providers together with us, as a hospital. The truth is, if a person comes here impacted by trauma or violence-- they're already high risk for the next thing that can happen to them. And so, by connecting our work with the work of those organizations that are actively working in the community, it allows us to wrap around that individual all the services that they need to recover. 

And so, as I said, we're very proud of the work that we're doing here, and excited to be able to help the community in this way, and thankful to the Block and Hassenfeld family for funding this, to enable us to do this. 

That is a really good work. Dr. Miller, what do you think about the community's reaction to the findings of the Community Health Needs Assessment report? What do you expect, and what have you seen so far? 

So what I've seen so far is that our community members are not surprised by the findings. In fact, they have contributed to the information that has been put forth. And so it's not just a question of anonymous surveys, but we actually-- through my Community Grand Rounds program-- go out and we talk to people about what are the needs that they see around health and well-being in their communities. And we collect information from that. And so, when they see this information posted on our website around their communities, they'll say, yep. That's what we told you. These are the kinds of things that are affecting the lives and well-being of people in our community. And we're so glad that the University of Chicago Medicine is not just paying attention to these things, but also developing programming in order to address it. 

So talk to me about Community Grand Rounds. Because here in the hospital, when we hear "grand rounds," we think of one thing, and probably most people don't even know what that is. So if you could kind of explain to us what is Community Grand Rounds, and what do you do when that happens? 

So the medical model for grand rounds is having a number of physicians to come into a room, to sit down for about an hour and to listen to a lecture from some esteemed professor that's about an inch wide and a mile deep. Three questions are asked, and then everybody goes back to their clinical or research responsibilities. But these are really community gatherings, in which we have members of the community who sat on the sit on the same platform as members of University of Chicago Medicine, whether it be staff or faculty, just to discuss issues of importance to the community. And it's not the typical presentation of-- we're going to talk about the medical management of high blood pressure, diabetes-- but we have topics like "live love before you give love." And that has to do with the prevention of pregnancy for teenagers. 

Topics that really engage our community members, and also making sure that we respect and honor the work that's taking place in the community around these health-related topics. And so we use the Community Grand Rounds setting in order to gather information from our community members about what they think are the needs and values and priorities for health and well-being in South side communities. This is something that was started through the Urban Health Initiative. It's been going on for nine years, now. We're about to launch our 10th season this fall, and we are absolutely delighted. 

Well again, it comes back to that whole effort of collaboration. And I think it's easy, when you have an organization as large as UChicago Medicine, that people will think that they're just pushing everybody around. We don't want to do that. That's why we want to be collaborative with-- you know, this is our community. We're part of the community. And that's very important. 

Tina, can you tell us how the priorities were determined for-- and what was the community's involvement? 

OK. Well, that was a long process. [LAUGHS] 

I can imagine. 

Right. It was, because there was over 100 sort of factors to look at. We, of course, started with the Urban Health Initiative-- the staff among that group-- and just identifying what we felt were the needs. We also built on our past Community Health Needs Assessments-- you know, every year we're taking inches and inches closer to sort of further refining so we can make sure that we're properly addressing the needs. 

But I would say this year, more importantly, we used-- of course we always talk to faculty, such as doctors such as Dr. Miller-- but we also used the community more so in this go around. They were involved in designing the Community Health Needs Assessment, and they were certainly involved in helping us determine what the priority health needs would be. And we did that through our Community Advisory Council. This is a council of representatives from our community. They're people who are involved in big community-based organizations-- so partners that we work with-- but also just individuals who are devoted to making sure that the South side community is thriving. 

And we met with the work groups of this committee. We have an adult work group. We also have a maternal and child health work group, and we have a violence recovery work group. And in each group, we would go and present the information that we'd had, and get their feedback and their input on-- not just on, like I said, how we should design it, but on our findings. And they gave us directions to say what they felt was important. Like, for example, as part of our social determinants of health, they said, look-- people want to know about jobs. You know? We can go and talk about health, but at the end of the day, people want to know, how do we get jobs? And so that's how we added that as part of our social determinants of health. 

That's great. So we are getting some questions from viewers. I want to pass a few of those on, if we can. One of them is, "how is your UChicago Medicine managing the growing emergency room demands," and I assume they're talking about trauma, and our new trauma center, which has been open for about a year-- a little bit over a year. Very important thing that we're doing. And I think, obviously, there's been a benefit to the community, but there's been a benefit to us, as well. 

So I would say we are managing it through ensuring that we have the staff to support the needs in the emergency room. When we opened our new emergency room, oh, about a year and a half ago, we actually grew-- we grew it to allow us to be able to take care of more people. We grew our bays in our emergency rooms so that we could take care of more of the community in the emergency room, and staffed it as such. 

We are one of the busiest emergency rooms in Chicago, and we realize that, and with the launching of our trauma center. we're one of the busiest trauma centers in Chicagoland, as well. So we are managing it to the day we are often at capacity. But we have developed very good throughput in our emergency department to allow us to bring people in and take care of them, and allow those who are taken care of and can go home to go home in a timely manner, and those who need to be admitted to be admitted. But we are a busy trauma center and emergency department, and it is taking quite a bit of effort on our part to manage the need in the community and the capacity that we're seeing here at UChicago Medicine. 

Another question from a viewer, changing subjects just a bit-- how can the community connect with the South pediatric asthma center? 

OK. Definitely answer that. Well, we have a website that you can go to. It's southsidekidsasthma.org. You can also reach out to us at our website with the Urban Health Initiative for more information. We'd love to connect with people in the community, go into schools, daycares, other events to educate them about asthma, and also about the resources that we have available, in addition to our partners with the South Side Pediatric Asthma Center. I would say that would be the first place to start. 

Another question from a viewer. What are small steps an organization can take to improve the health of Chicago residents? And I'm not sure exactly what they're referring to as an organization, but maybe a community organization. How can they be involved, and how can they make things better for people in the neighborhood. Any thoughts on that? 

Actually, I'd like to start with that. Thank you. One of the things that was an addition to our Community Health Needs Assessment this time is the addition of community health profiles. And so we have profiles that are posted on our website that keep descriptions of the kinds of things that involve both the health and well-being of people, including their access to health care, age, and a number of other predictors that have to do with the social determinants of health. Being familiar with that data and understanding what's going on in your own community is the first step. 

Another step is to look at that information and to say, well, what kinds of resources currently exist in my community that I can connect to, that I can take advantage of in order to help to improve health? Some of those programs we actually sponsor through some of our community benefit from University of Chicago Medicine. But there are also others. And so I think about South Side Fit, for instance, as being an example of one of those programs. 

But again, there are lots of resources that are out there. They may not necessarily fill all of the needs that we have in the community, but first, information is the key. So take a look at the website, look for your community, and see what kinds of issues are going on that are impacting the health and well-being of the community 

And I would just like to add about the community profiles-- this is something that the community asked us to do, to better understand their surrounding areas. What are the assets in the community? What are the needs for the community? Where are the social determinants of health, and what drives those in those communities? So, to the point that Catina made earlier, our community advisory council members ask us to do these profiles for the communities to enable them. And some of them are leaders of community organizations that have already used that information to bring improvements to their community. So I would advise to go out and look at your community, find out what the needs are there, and utilize that. I think they'll give you some good insight in how to address some of those issues. 

So there is good data in the report, Dr. Miller. And it's not just for us. It's obviously for the community members to use, and community organizations to dive into and take a look at. How can people use this report as a resource? 

So if you're a small, community-based organization that's interested in applying for a grant, let's say, from the Chicago Community Trust, and you're interested in figuring out, OK-- so what's the employment level? What are the age levels? All of this information is packaged in those community profiles that can be put into a grant proposal very easily, that can give a very accurate description of what's going on in your community. And you can use it for other purposes. 

That is perfect. And Catina, where do people find the report? 

Well, of course it's on our website. It's at uchicagomedicine.org/community-health. You'll find the Community Health Needs Assessment, as well as the community profiles that we've been discussing. And each community is listed on the website, so you don't have to go and dig. If you want Bronzeville, if you want Auburn Gresham, if you want Hyde Park, it's easily there for you to access. 

Perfect. We're out of time. 

Oh. 

[LAUGHS] 

That was fun. 

You all did a fantastic job. 

Thank you. 

Thank you, so much. 

Thank you. 

Thank you for being on the show, and thank you for your fantastic questions. If you want more information, or would like to schedule an appointment with one of your health care providers-- because we always have to throw that out-- please visit our website at uchicagomedicine.org, or you can call 888-824-0200. Remember to keep an eye on our Facebook page for more events and live programs. 

Thanks for watching, and have a great week. 

This was a paid program from UChicago Medicine.