CLEVELAND — The National Institutes of Health has funded $18.2 million for a program in both Cleveland and Detroit to see if grassroots efforts can make a difference in health disparity.
It's called "Addressing Cardiometabolic Health Inequities by Early PreVEntion in the Great LakEs Region." otherwise known as "ACHIEVE GReaTER." The multi-institution partnership includes Case Western Reserve University, University Hospitals, Wayne State University, and the Cuyahoga Metropolitan Housing Authority to address health outcomes by using trained community health workers to build trust in communities that have too long felt their issues and needs were being overlooked due to systemic racism.
Fonda McClain is a certified community health worker. For the last six months, she's been visiting residents who live in the neighborhoods of the Cuyahoga Metropolitan Housing Authority (CMHA). She sees healthcare gaps firsthand.
“Food insecurities, not having enough food, food sources in different areas, not having pharmacies in different areas, not addressing mental health, not only in adults but as well as children,” said McClain.
Those disparities often lead to poor health choices and eventually disease.
“Cardiovascular disease is one of the most common reasons why people die because of heart attack and stroke. And that happens to be a very common cause of mortality in urban African-Americans,” said Dr. Sanjay Rajagopalan Chief of Cardiovascular Medicine and the chief academic and scientific officer for the Harrington Heart and Bastille Institute at the University hospitals, part of the University Hospitals Harrington Heart and Vascular Institute
“What we want to be able to show is that the community health worker model is actually a model that is worth investing in and the community health worker model. The other thing that's important to understand is that we want to make these mechanisms sustainable in the future. This is not a one off. You just go do something for two, three years and you disappear,” Dr. Rajagopalan said.
Fonda is on the front lines literally saving lives. Nadine Head was one of the first.
"She became a friend and so I started getting more engaged with keeping up with my appointments and doing more for myself,” Nadine said.
Like many, Nadine has a myriad of health issues, including obesity, diabetes, hypertension, anemia, COPD and sleep apnea. Just walking made her winded. But when Fonda walked in, she gave Nadine the tools and education she needed.
“I started eating vegetables and stopped eating hot dogs and cold cuts,” Nadine said.
Fonda gave Nadine technology, like a fit watch, smart scale, blood pressure cuff even a pill bottle with a smart cap that's monitored daily by a healthcare provider. She also received a free coronary calcium score test to check her heart. Once Nadine understood how it all worked, it motivated her to make a difference.
“Less junk food, less fatty foods, and I cut out all fast foods, no more McDonalds,” Nadine said.
She also started exercising. Slowly at first, but now walking is a breeze and in six months she watched fifty pounds melt away. She has about twenty more to go, but now knows she'll be able to get that knee and hip replacement surgery she'd been waiting for. The weight loss also had a huge impact on her diabetes and lung issues.
“I can actually come off my (diabetes) medicine now, I can breathe and it don't feel like someone sitting on my chest anymore, I can actually do things,” Nadine said, referring to spending time with her grandchildren.
Having someone she can relate to, like Fonda, helped Nadine start to trust healthcare again, and the hope is that she’ll inspire her neighbors to do the same.
“I'm here to serve you. I'm here to take care of your health. So their support staff is their conscience. We listen to those things. We address those things and try to help them find a way to add a resolution, to add better quality and help to close that gap for them,” Fonda said.
ACHIEVE GreatER will pay for community health workers, nurses and care coordinators to work with CMHA and provide health services, including free risk factor screening. A nurse-dietician-pharmacist will also join the research, provided by UH’s Center of Integrated and Novel Approaches for Vascular-Metabolic Disease.
Better Health Partnerships (BHP), a Cleveland based non-profit, will partner with UH to offer a community-health-worker model of care to provide sustainability for this effort beyond the grant funding period of five years.
The goal of the program is to recruit about 250 people. Currently they've enrolled less than 25, but Fonda will not give up. She'll continue to reach out because CMHA is also a partner in this endeavor as they have more than 50,000 residents.
She says it's frustrating to see people have to choose between food, rent and medicine, or not have transportation to a doctor's appointment. Her goal is not only to empower them to get their health under control, but also point them to resources they didn't know existed.
"When COVID hit, one of the great things that came about was that if you call your insurance company, they'll help provide transportation to and from the pharmacy, grocery store, some will even help you get to the gym," Fonda said.
She's also very proud of her first participant, Nadine.
"It's going to make a huge difference because she can actually pass that along as generational wealth of a healthy lifestyle. Making it a lifestyle, not just a change, but a lifestyle is going to be passed on because you're not going to want your children to be introduced to generational hypertension, diabetes, high cholesterol and other things," Fonda said.
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