SIU School of Medicine

A Case Study on Partnering In One Springfield Neighborhood

For the health of our communities, health care organizations must develop ways to incorporate community determinants of health into the clinical environment.  To do this, strong community partnerships must be established, communities must be engaged, and collective impact must be obtained.   It is imperative that the role and impact of primary care and other community based services be developed into a seamless journey through the whole system of care for clients. The Enos Access to Health Program is a case study to facilitate learning around these concepts.

In 2014, Springfield had their two competing hospitals and local health department take on the challenge to improve the health of Springfield. The program grew out of the County Health Needs Assessment, in which area residents identified the region’s top health priorities. Research into neighborhood-specific data show health outcomes and social determinants of health for people living between the six blocks separating the two hospitals as a problem. The goal was set to improve conditions for those who are becoming marginalized within the neighborhood and offer a model for improving the health of impoverished communities while at the same time training healthcare providers and trainees how to provide this type of care. Launched in October  2015, the Access to Health Collaborative is a three year program that provides neighborhood outreach for the underserved, utilizing community health workers. Some of the key metrics include connection to primary care providers, enrollment in insurance programs, ability to schedule and cancel one’s own appointments, achievement of basic needs (food, housing and income), and effects on crime and recidivism. The focus is on community development and engagement of numerous community partners in the process.

This has become a case study around a Springfield initiative to increase health access in a blighted neighborhood. Activities, strategies, and practices can assist in building strong partnerships with community based organizations and nontraditional partners to engage the community and facilitate community change.  SIU developed and applied a community health worker program, along with new partnerships with landlords, the local neighborhood association, law enforcement, service agencies, government agencies, churches, and schools. Also, changes were made to one local medical clinic in the provision of care of patients who are socially fragile and law enforcement was trained on how they can be an entry point for access to health care services.

EPNIA provides affordable rental housing to four individuals who are enrolled in the Access to Care program, in addition to many others who rent from private landlords throughout the neighborhood. The community health workers take a holistic approach in helping clients address needs such as furthering their education, accessing job training, finding affordable child care, and food insecurity, in addition to more traditional access to health care such as navigating insurance and transportation to doctor’s appointments. Halfway through the three year pilot program, the results were already so significant that the program was replicated in other Springfield area neighborhoods.