Addressing Violence in Public Housing Communities: Genesee Health Systems, Flint, MI
Violence is a significant social determinant of health for public housing residents. Exposure to violence is higher in communities where there are limited economic opportunities, high concentrations of poverty and unemployed people, and limited access to health and social services. And experiencing violence of any type-physical, sexual, or psychological- is associated with increased risks of physical, mental health and behavioral health disorders. Therefore, effective violence prevention and intervention programs at Health Centers that are located in or immediately accessible to public housing developments are critical to improving health.
Addressing Violence in Public Housing Communities: OIC Medical, Rocky Mount, NC
Violence is a significant social determinant of health for public housing residents. Exposure to violence is higher in communities where there are limited economic opportunities, high concentrations of poverty and unemployed people, and limited access to health and social services. And experiencing violence of any type-physical, sexual, or psychological- is associated with increased risks of physical, mental health and behavioral health disorders. Therefore, effective violence prevention and intervention programs at Health Centers that are located in or immediately accessible to public housing developments are critical to improving health.
Barriers for Achieving Glycemic Targets
Improved glycemic control in people with diabetes delays the onset and progression of severe microvascular complications of diabetes. Despite advances in pharmacotherapy and diabetes treatment devices and the emphasis placed on treatment adherence over the last decade, National Health and Nutrition Examination Survey (NHANES) data showed 45% of patients with diabetes did not achieve glycemic targets of <7%. Although some patients with diabetes may be undertreated (e.g., inappropriate treatment regimens, psychosocial issues that require adjustment in therapeutic targets), one reason for poor glycemic control is patients’ difficulty in following treatment prescriptions and recommendations for diabetes self-care. This collaborative addresses barriers for achieving glycemic targets and approaches and interventions that assist patients with managing diabetes.
Cervical Cancer Prevention: Communication Interventions and Peer Health Education
The incidence of human papillomavirus (HPV)–related cancers is more than 35 000 cases in the United States each year. Preventing high-risk HPV infection is the key to the prevention of cervical dysplasia and cancer. Barrier contraceptives, such as condoms, are only about 70% effective at preventing HPV transmission. Effective HPV vaccines have been available in the United States for several years but are underused among adolescents, the target population for vaccination. Interventions to increase uptake are needed. This learning collaborative explores the use of communication interventions and peer health education to increase cervical cancer screening and the use of the HPV vaccine.
Cervical Cancer Screening and Prevention
A cervical cancer prevention and control program comprises an organized set of activities aimed at preventing and reducing morbidity and mortality from cervical cancer. The program provides a plan of action with details on what work is to be done, by whom and when, as well as information about what means or resources will be used to implement the program. The achievement of the program is assessed periodically using a set of measurable indicators. The goal of any comprehensive cervical cancer prevention and control program is to reduce the burden of cervical cancer by reducing human papillomavirus (HPV) infections, detecting and treating cervical pre-cancer lesions, and providing timely treatment and palliative care for invasive cancer. Monitoring and evaluation (M&E) in any health program is conducted to ensure that the processes and systems are developed and adhered to in such a way that the deliverables are of good quality and maximize the benefits to the target population.
Clinical Quality Group Diabetes and Staff Needs
On February 23 the Clinical Quality Working group, STAR² Center, and National Nurse-Led Care Consortium discussed diabetes and staffing needs in Public Housing Primary Care. People with diabetes have differing health care needs relating to their diabetes subsequently the diabetes workforce comprises a large multidisciplinary team spanning the health continuum and service providers with varying levels of expertise. As diabetes occurs across the lifespan and concomitantly with many other conditions, multiple services are required at different times or at the same time.
Diabetes and Eye Exams in Primary Care
The American Academy of Ophthalmology recommends that anyone with diabetes should receive a retinal exam every year. Early detection can reduce the risk of severe vision loss by 90% and significantly reduce long-term healthcare costs. Unfortunately, fewer than 50% of patients with diabetes get a diabetic eye screening annually. During this session NCHPH explored ways to prevent and limit the extent of DR in public housing primary care settings.
Diabetes: Culturally and Linguistically Appropriate Services
Minority groups are affected by diabetes at significantly greater rates when compared to non-Hispanic white Americans for reasons that are multidimensional. Diabetes educators need be mindful of the cultural traditions and customs among all cultural and ethnic groups and to recognize socio-economic challenges that may exist. When diabetes education programs are delivered using culturally appropriate methods in diverse populations, they can result in improved patient health behavior, knowledge, health status, and self-efficacy.During this session, NCHPH exploredstrategies to provide culturally and linguistically appropriate services to diabetic patients.
Forging Community Collaborations
During this informative conference call, NCHPH and PHPC Health Centers discuss the most recent topics regarding public housing and public housing primary care, including Envision Centers, Smoke Free Public Housing, Chronic Disease Management and Integrated Care, and PHPC trends. PHPC leaders offer new perspectives and solutions to improve the health status of public housing residents.
HUD’s Smoke Free Rule: What Health Centers and Public Housing Agencies Need to Know
The HUD’s rule banning smoking in public housing is an excellent opportunity for Health Centers and PHAS to forge collaborations and address the health care needs of those living in public housing. During this session, we will be expolore best practices and challenges PHAs faced to implement the rule as well as smoking cessation services provided by Health Center programs, and the opportunities to collaborate across agencies.
Kids, E-Cigarettes, Vaping, and New Tobacco Products
E-cigarettes and vaping devices have become an almost ubiquitous – and dangerous – trend among youth that has reached epidemic proportions. Over the past several years, e-cigarettes were the most commonly used tobacco product by youth. In fact, more than 2 million middle and high school students were current users of e-cigarettes in 2017. Health Centers and community organizations will have to develop campaigns and put resources to educate youth that using e-cigarettes, just like cigarettes, puts them at risk for addiction and other health consequences because nicotine can rewire the brain to crave more nicotine, particularly because adolescent brains are still developing. In addition, e-cigarettes, among other things, can contain dangerous chemicals such as: acrolein, a chemical that can cause irreversible lung damage; formaldehyde, a cancer-causing chemical; and toxic metal particles, like chromium, lead and nickel, which can be inhaled into the lungs.
Management, Education and Support, Nutrition, Physical Activity, Smoking Cessation, and Psychosocial Issues
Residents of public housing are particularly at risk of developing diabetes and diabetes-related complications due to the many social factors that impact their health. A recent HUD publication indicates that HUD-assisted adults have the highest prevalence of diabetes diagnosis, with 17.6% reporting ever having been told they had diabetes. During this session NCHPH explored ways to manage diabetes through programs that address education and support, nutrition, physical activity, smoking cessation, and psychosocial issues.
Microvascular Complications and Foot Care
The importance of protecting the body from hyperglycemia cannot be overstated; the direct and indirect effects on the human vascular tree are the major source of morbidity and mortality in both type 1 and type 2 diabetes. Diabetes complications are divided into microvascular (due to damage to small blood vessels) and macrovascular (due to damage to larger blood vessels). In this session, we discuss diabetes barriers to care and best practices to address microvascular complications among diabetic patients.
Nonadherence and Behavior Change: How are You Helping your Patients?
Research studies indicate that diabetes affects around 9% of the U.S. population, and it is a leading cause of heart disease, stroke, kidney failure, lower limb amputations, and blindness among U.S. adults. A recent CDC publication estimated direct medical costs attributable to this disease were $116 billion, and the number of patients with diabetes will more than double by 2050. Thus, diabetes is a highly prevalent disease that is important for both public health and public policy reasons.
Smoking Cessation
Public housing residents are more likely to smoke and suffer from health conditions that are exacerbated by smoking and secondhand smoke exposure, such as asthma, diabetes, and COPD, compared to the general adult population. The National Center for Health in Public Housing (NCHPH) hosted a call as part of its learning collaborative on improving access to smoking cessation services for public housing residents. Participants discussed needs, challenges faced by PHAs during the implementation process and HCs shared smoking cessation services and best practices.
Strategies for Diabetes Awareness, Prevention and Control: Focusing on Prediabetes
Increasing awareness and risk stratification of individuals with prediabetes may help physicians understand potential interventions that my help decrease the percentage of patients in their communities in whom diabetes develops. During this session NCHPH discussed strategies for diabetes awareness, prevention and control with a focus on Prediabetes.
Violence and Opioid Abuse in Public Housing Communities
During this presentation, NCHPH highlighted the problems, solutions and opioid overdose training related to public housing residents. An overview of the likelihood of opioid abuse and the long-term effects on children due to violent experiences was provided in addition to a detailed description of the methodology behind NCHPH’s case study on Addressing Violence in Public Housing Communities. NCHPH also presented on case examples on what health centers are doing to mitigate the effects of violence and opioid abuse in public housing communities.
Women’s Health Program: San Ysidro Community Health Center
Women’s Health Programs provide an excellent opportunity to counsel patients about preventive care and to provide or refer for recommended services. These assessments should include screening, evaluation and counseling, and immunizations based on age and risk factors. In this interview, San Ysidro Community Health Center shares the activities that are part of their Women’s Health Program.
Women’s Health Program: South Boston Community Health Center
Women’s Health Programs provide an excellent opportunity to counsel patients about preventive care and to provide or refer for recommended services. These assessments should include screening, evaluation and counseling, and immunizations based on age and risk factors. In this interview, South Boston Community Health Center shares the activities that are part of their Women’s Health Program.