Isolating genetic markers for crippling hereditary diseases is, without a doubt, a health innovation. So is manufacturing prosthetic limbs that respond to the neural stimuli of patient brains. But as one local neighborhood is determined to show, important health innovations don’t always occur in the laboratory or in the hospital. Sometimes they occur when a community health project decides to sit down and listen to more than 1,500 residents talk about health issues in more than a dozen languages.
That is just one of the innovative health practices employed by the Building Healthy Communities Project in San Diego’s City Heights neighborhood. Supported by a 10-year funding commitment from the California Endowment, the City Heights project is one of 14 neighborhoods involved in the statewide Building Healthy Communities Initiative. Steve Eldred, program manager at the California Endowment, said one of the main factors that makes this initiative so unique is a commitment to community health that is “long-term, comprehensive and fundamentally changing the way we think about health.”
While City Heights is a community rich in diversity -- the area is home to thousands of Somalis, Burmese, Ethiopians and many others -- the neighborhood also has a high incidence of poverty and poor health. Nearly a third of residents live below poverty, and the median income is less than $26,000 a year. The federal Health Resources Service Administration has designated City Heights a “medically underserved area” because of these high levels of poverty and a shortage of primary care physicians.
Bonnie Copland, manager of the Central Region Public Health Center for the County of San Diego Health and Human Services, said that diseases such as hypertension, diabetes and asthma are some of the most common chronic health conditions among City Heights residents.
Taking the time to listen to City Heights residents and engage them in improving their own health is one of the things that make the Building Healthy Communities project “so innovative,” according to Diana Ross, collaborative director of Mid-City CAN, which is helping to coordinate the project.
During a one-year planning period, residents identified many challenges contributing to poor health. A shortage of health care workers who can communicate in the diverse languages of the neighborhood is prevents many residents from receiving quality care. The medicines required to manage chronic conditions are often costly, and for residents with limited English proficiency, understanding the proper way to take the medicine is difficult. Access to fresh, affordable food is a challenge. Fear of immigration arrests, even for those with legal status, cause people to miss doctor appointments. Families stressed by poverty struggle to find the time to manage chronic conditions such as diabetes. Children do not get enough exercise as their parents worry about the availability of safe outdoor play spaces.
Ross noted that at its core, the Building Healthy Communities project in City Heights is helping to spearhead a new definition of what “health” really means. “We are moving from a model where health means going to the doctor when you are sick to a model where health is about the environment we live in and the resources in our community that enable us to make positive choices every day that contribute to good health.”
Lisa Vandevort, manager of the City Heights Wellness Center, stressed that the notion of preventative care is a “really new concept” for some of the area’s recent immigrants.
What is clear, said those working on the project, is that building a healthier City Heights will require a multifaceted approach and collaboration among residents, community groups, government and health care providers. Progress is already being made. Eldred noted how in the coming months Scripps Mercy Hospital and Rady Children’s Hospital will be “helping to teach neighborhood residents what they need to know to navigate the system and receive quality care.”
Ross highlighted recent efforts of residents to “influence local zoning ordinances to expand the opportunity for backyard farming to increase the supply of low-cost, fresh produce.”
A planned expansion of a project where local African women educate their peers about basic health issues has Vandevort excited about “increased awareness of how to make sure all family members are healthy.”
Each of these small projects represents the responsive, collaborative and culturally sensitive approach that is central to the Building Healthy Communities effort.
The California Endowment will ramp up investments in the next several years, funding a range of specific activities that contribute to achieving resident-identified priorities such as improving access to health care, enhancing food security, and teen sexual health. Over the next decade, the California Endowment plans to spend hundreds of millions of dollars on investments in the 14 neighborhoods within the Building Healthy Communities Initiative.
While the financial resources are coming from the California Endowment, Eldred characterized the project as belonging “to the residents -- this isn’t a California Endowment project, this is a City Heights project.”
Bouris is a San Diego-based freelance writer.