By Dennis Archambault
Norwegian American Hospital in Chicago, one of the awardees in the 2017 American Hospital Association Nova Awards program, was credited with helping reduce health disparities among children on Chicago’s Westside through a mobile clinic. While access to transportation may be one of the social determinants addressed through the project (it wasn’t mentioned in the award narrative), other social determinants such as environmental quality, interior household and school air quality, lead abatement programs, and school health and fitness programs were not addressed.
The first two paragraphs of the narrative are revealing:
“Norwegian American Hospital serves some of Chicago’s neediest zip codes. The average per capita income in its core service neighborhood is $13,391, while the unemployment rate stands at 12 percent.
“Those numbers translate into health problems, such as childhood asthma, elevated blood lead levels and high rates of childhood obesity and teen pregnancy. Because they lack regular medical care, many children in the community can’t meet the vaccine requirements for public school registration.”
Norwegian American Hospital certainly is contribution to the public health infrastructure of Chicago through the mobile clinic, but what if it had approached the health issues addressed in the first two paragraphs – asthma, related to internal and external air quality; elevated blood lead levels related to lead-based paint in old housing stock; and high rates of childhood obesity and teen pregnancy. These are social issues the hospital could partner with public health authorities in its community benefit investment. Depending on your source, household air quality is a major contributor to up to half of asthma cases. (Locally, one community development corporation notes that during the winter, houses with forced air push contaminated dust up into the breathing space of children, increasing their risk to lung ailments.)
The ultimate irony in this case is that the mobile clinic addresses a major social determinant – transportation. Providing a mobile clinic financed through philanthropy – an unsustainable funding model – has limited applications. However, funding an alternative transportation system that provides patients access to primary care medical homes might be more cost efficient.
Speaking of funding, it’s curious that the program is entirely funded through philanthropy: children’s Care Foundation, Northern Trust Co. Charitable Trust, the Col. Stanley McNeil Foundation, and the Illinois Association of Free and Charitable Clinics. There doesn’t appear to be an investment by the hospital itself.
A mobile clinic connected with schools in underserved communities is a good idea and could deliver much primary care than would otherwise be provided to this community. But what if Norwegian American Hospital and its competitors found common purpose in this or other health disparities and decided to improve the social systems that helps create the health disparity? Is that still a radical concept for hospitals?
Dennis Archambault is vice president, Public Affairs, for Authority Health.