A diagnosis of diabetes can stop someone in their tracks, according to Constance Brown.
“Imagine if you get a diagnosis like diabetes. You can be overwhelmed trying to figure out what your next steps will be, and how to take ownership of your medical care,” said Brown, the clinical director at Shepherd’s Hope, Inc., the largest free clinic in central Florida.
But there’s good news, Brown said: Small lifestyle changes can make a significant difference – and keep patients healthy and out of the emergency room.
Shepherd’s Hope, which serves primarily Black and Latino patients, recently announced the launch of a new pilot program, Healthy Education Active Lifestyle (HEAL), designed to address the health needs of individuals with severe chronic illnesses. The program is focused on increasing access to healthy foods while teaching patients how to manage their health better.
A new teaching and commercial kitchen is a major part of the program, along with a community garden and micro-farm. “We see [the teaching kitchen] as both a teaching tool and prescription for health,” Brown said.
In addition, the clinic’s staff is partnering with area food pantries to develop healthy food for patients in the program, who often experience food insecurity. Clinic staff will offer people enrolled in the program containers for the healthy portioning of tools and glucose strips to support daily diabetes monitoring.
Each patient makes a six-to-eight-week commitment to completing the program and is supported and tracked by a case manager to ensure consistent participation.
A vulnerable population
While media focus over the past two years has been on the direct health impacts of Covid-19 infections, chronic health issues were prevalent in communities of color even before the pandemic. The two aren’t disconnected, either – national data shows that Black and brown people with chronic illnesses were more likely to be seriously affected by Covid-19.
That’s why there’s a sense of urgency in launching HEAL, which is expected to be fully operational in 2022 – because treating diabetes, obesity, and high blood pressure is a significant part of the comprehensive health services that Shepherd’s Hope provides.
Nearly 70% of Shepherd’s Hope patients are Black or Latino, and many have health conditions that put them at high risk for heart disease and stroke. According to CEO Pam Gould, one in four people living in the area the clinic serves don’t have health insurance, “due to job loss, financial hardship, or unforeseen crisis.”
To complicate matters, “many of our patients have a real fear of institutional care,” Brown said.
The fears are complicated by a large population of undocumented individuals and families with limited resources and medical care access. “Shepherd’s Hope works to get and keep them in care,” Brown explained. “We don’t ask the tough questions that might keep them away from getting the support they need.”
A new intervention
The HEAL program will address the systemic lack of healthy food and education programs in the area and will be a significant part of Shepherd’s Hope’s continuum of care.
While programs like HEAL are becoming more common, they’re a remarkable achievement at free and charitable clinics, which rely on volunteers and operate on skeletal budgets. “Many of our volunteer doctors are retired, and others come in and see patients before or after they go to their own practices,” Brown said. The clinic has also tapped into the services of interns and medical students. Shepherd’s Hope’s four locations have case managers, a medical records department, and a lab.
Gould and her fellow staff members see HEAL as a way to empower patients to take more control of their health. It’s been particularly challenging in the face of Covid-19. “One of the things we have been dealing with is that people are coming to us sicker, because they have been putting off screenings, diagnoses, and getting routine care,” Gould said.
That’s true despite the fact that the clinic offered telemedicine services and returned to walk-in health care as soon as possible.
Brown said that HEAL would be able to holistically address the health challenges of both individual patients and the larger community, relying on collaborations with local hospitals and the Primary Care Access Network to identify patients with heart disease, high blood pressure, asthma, and diabetes who would benefit from the program.
By creating programs and services that keep people out of the hospital, Shepherd’s Hope expects to contribute directly to Central Florida’s health care economy, mitigating the financial impacts of caring for uninsured and unsheltered patients. That means that hospitals and other care providers will be in healthier shape, too – and have more capacity to serve the needs of their communities.
But primarily, the hope is that HEAL and other services will help improve health outcomes – for the long haul – for those most likely to be marginalized by the health care system.
“Shepherd’s Hope’s focus, throughout its 25-year history, has been to keep our patients who are living with chronic conditions healthy and out of the hospital,” Gould said.
Andrea King Collier is a freelance writer based in Lansing, Michigan. She has written for The New York Times, The Washington Post, The Atlantic, and many other media outlets and is the author of two books: Still with Me… A Daughter’s Journey of Love and Loss and The Black Woman’s Guide to Black Men’s Health.
