Caring for the Whole Person

9Caring for the Whole Person

Penn Medicine reaches out in health clinics, homes, community centers, and in far-reaching corners of neighborhoods.

Healthy food leads to better health, but if it’s not within reach, chances are it won’t get eaten. That’s a barrier many people face living in Lancaster city neighborhoods, where supermarkets are few and the corner stores are more likely to carry high-calorie junk foods than fresh fruits and vegetables.

For the past five years, Lancaster General Health (LGH) has been spearheading the Healthy Corner Store Initiative, with assistance from a national organization, The Food Trust. The goal is to help turn this problem around by stockingLancaster city’s own corner stores — known as bodegas to the predominantlyLatino community — with affordable, healthier foods for its residents.

>>>

Store owners say that they are excited to learn that there are local resources to help them provide more healthful foods for their customers. “It’s all about developing relationships with the store owner and working together to make gradual changes,” says Sue Lackmann, a LG Health community health educator. “We’re helping them make the connection between certain foods and health problems.”

Owners who participate agree to introduce at least four healthy food choices, and in return, receive $100. Outreach coordinators from LGH, who visit every week, also deliver marketing materials, training on the food, samples, and healthy recipes — in both English and Spanish — for the owners to display. So far, 22 corner stores in Lancaster have become official healthy corner stores.

More recently, a grant from the Pennsylvania Department of Health made it possible to supply refrigeration units to several stores to sell bottled water, fresh milk, yogurt, and cheese. Lackmann says the responses to the initiative have been positive. One owner, from the Cabrera Mini Market on Strawberry Street, who received a cooling unit, even inspired his own brother in Harrisburg to open a “healthy” store.

For the past 11 years, Puentes de Salud (“Bridges to Health”) has given Philadelphia’s growing Latino immigrant population a safe haven to receive the medical care and support they need to survive and thrive, no questions asked.

Run by mostly volunteer doctors, nurses, and other staff across a variety of disciplines at Penn Medicine, Puentes has been servicing this community — many of whose members are undocumented — since 2006. Steven Larson, MD, an Emergency Medicine physician at Penn Medicine, and Jack Ludmir, MD, the former chair of Obstetrics and Gynecology at Pennsylvania Hospital, co-founded the organization.

“In many communities, they are invisible,” says Larson, in the 2017 HBO documentary “Clinica de Migrantes” profiling the center. “There was a need, so we just said, ‘We’re going to build something.’”

Since then, Puentes has worked to empower the community with its multidisciplinary, collaborative approach

to care by offering free or low-cost medical and dental services coupled with educational, social, and wellness programs. That last one is often out of reach.

For some, it’s a break from the everyday stresses of work or kids. For others, it’s a chance to get fit or manage a chronic disease. Whatever it may be, the yoga classes at Puentes are helping men and women lead healthier lives.

“This is a population that doesn’t have as many opportunities to address wellness,” says Adina Lieberman, a certified yoga instructor at Puentes. “Many times, they are doing labor, cleaning houses, taking care of kids, working in restaurants — there is a lot of physical stress related to their work. There’s also the stress of not having papers or having kids in school.” >>>

The 7,000-square foot space on South Street, a former IT center donated by Penn that was completely renovated in 2015, also gives patients access to behavioral health services three days a week. Plus, art and culture classes are conducted on Wednesdays and Lieberman teaches her yoga class in Spanish on Tuesday.

“It’s a way to turn your brain off,” she says. “And it gives people a tool in their everyday life to have mindfulness throughout their day.”

Forty miles to the west, in Chester County, an alliance between Chester County Hospital (CCH) and La Comunidad Hispana (LCH), a bilingual medical and social services agency, is making a tangible difference in its

underserved community, many of whom are Latino and working in the mushroom farms.

One initiative focuses on hands-only CPR. Another one provides blood pressure screenings. One fall day, on the To-Jo Mushrooms Farm in Avondale, Pa., it was about breast health.

During their lunch break, more than 35 women joined Susan R. Pizzi, MS, RN, a CCH community health educator, Cindy Brown, RN, a CCH Breast Care Nurse Navigator, and their colleagues from LCH, for a bilingual presentation on breast cancer awareness. Early detection is key, but often out of reach for these women because of language barriers and insurance deficits. Together, both organizations have been

visiting farms throughout this part of the county trying to change that. And companies like To-Jo have played a big part in making sure their female employees stay informed.

“It’s breast health 101,” Pizzi says. “It reviews basic info, increasing their awareness about prevention, the risk factors, and it covers how they can be advocates to make sure they decrease their risk of cancer by knowing their own history, as well as their family’s history.”

The importance of mammograms is also stressed at the “Lunch and Learn” Breast Health Education events. “We have women who are not being covered for mammograms, way past the age of 40, who haven’t had them in years,” Pizzi says.

CCH works with LCH to identify these uninsured women in need, and offers mammograms at a CCH radiology site at no cost to them.

Outside the city of Lancaster and far from clinical care, rural communities are facing another kind of access problem. For them, it’s childhood immunizations.

LGH’s ChildProtect program began as an emergency response to a German measles outbreak in the Amish community in 1991, but it has since evolved into a robust immunization program that many familiesliving in the remote areas of Lancaster County rely on.To date, ChildProtect has provided almost 167,000

immunizations to nearly 74,000 children who are uninsured or enrolled in medical assistance. In 2017 alone, 1,532 school-aged children were vaccinated.

Staging care closer to home is key, so nurses and staff administer the vaccinations at local fire companies out in these areas, as well as the LGH Outpatient Center in Columbia, Pa.

“Removing any barrier to receiving care is vital in making sure all children that can be immunized in Lancaster County are immunized so that there is little opportunity for outbreaks,” says Alice Yoder, MSN, RN, director of Community Health for LGH. “Remember, these are people who often might have two jobs or more, and have a limited window to be able to get their child in for immunizations.

It’s that added service beyond primary care for people in our community to get care.”

ChildProtect’s importance became even clearer last year, after a vaccination rule in Pennsylvania requiring children to be immunized within the first five days of school went into effect. LGH practices stepped up outreach and the number of immunization clinics, not only in rural areas but throughout the community, to help make those vaccinations happen.

“Immunizations are the basis of health and wellness that are often taken for granted,” Yoder says. “But there are still gaps related to this basic wellness that people need. We tryto continue to fill that gap.”