Medical Clinics Expanding Care To Needy

Wow, what a concept. Charitable, volunteer medical assistance.
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December 25, 2007

Medical Clinics Expanding Care to Needy

By LAURAN NEERGAARD

AP Medical Writer

WASHINGTON (AP) -
An out-of-work David Thomas walked into a Milwaukee food pantry just
seeking groceries. Thomas learned he was a stroke waiting to happen and
got blood pressure medicine along with his bread.
Food pantries have long aimed to help heal hunger. A new project aims to
see how well they can help heal high blood pressure, diabetes and other
ailments, too.

It's part of a growing movement to offer medical care for the poor and
uninsured in the places where they regularly gather.
"We're taking a window of opportunity approach," says Bill Solberg,
director of community services for Columbia St. Mary's Hospital in
Milwaukee, which co-founded the food pantry project. "We know we can see
these people once a month."

Despite an increasing number of free medical clinics, treatment is hard
for the needy to track down. That's especially true for the nation's top
health problems - high blood pressure, diabetes and high cholesterol -
that require ongoing care even when the person feels no symptoms if
they're to avoid heart attacks, strokes, kidney failure and amputations.

Clinics require a special trip, a long wait, perhaps a baby sitter,
annoyances for the well-to-do but huge obstacles for someone who must
take three buses to reach the doctor or who loses a day of pay for the
time off.

Consequently, "they only come when they're out of medicines or have
symptoms. It's so frustrating," says Dr. Jim Sanders of the Medical
College of Wisconsin.

So specialists increasingly are seeking other ways to address glaring
disparities in U.S. health care, by taking care directly to where the
people who need it most hang out.

Churches nationwide are offering blood pressure screening days and
health fairs. Projects in numerous states are teaching barbers and
beauticians how to teach their customers about stroke symptoms or to
encourage a mammogram while giving a haircut.

Baltimore health officials are debating expanding the concept, with a
proposal to offer blood pressure testing in 100 hair salons and
barbershops in neighborhoods with high rates of heart disease.

In Milwaukee, Columbia St. Mary's and the medical college aim to provide
scientific evidence that "chronic disease management" - ongoing wellness
care - can significantly improve food pantry users' health in nine
months.

The targets: High blood pressure, diabetes, high cholesterol, obesity
and smoking. The plan: Nurses will screen users of three food pantries
for those health conditions when they come in for free groceries. Those
with problems can get treated on the spot, with ongoing care as needed.

And because four of those conditions are diet-related, patients also
will get nutrition education: Cooking classes in the pantry's kitchen
and tips to make the often carbohydrate- and salt-heavy food-bank
staples a little healthier. Medical students will be sent shopping with
patients, helping with things like label-checking for salt.

Sadly, high-carb and high-fat foods tend to be a lot cheaper than fresh
produce, and many of these families feed four for a month on $250,
Sanders says. "Try to talk them into a head of broccoli. It's going to
be an eye-opener."

Thomas, 47, learned his blood pressure was a sky-high 194 over 124 while
visiting the project's initial food pantry clinic. A nurse told him he
was at high risk for a stroke, and he agreed to treatment. Her warnings
really sank in days later, when a meatpacking plant checked his health
as part of a job interview, and said he'd be hired only after his
hypertension was controlled.

Five days after starting pantry-provided pills, Thomas' blood pressure
was dropping fast.

"This clinic is going to bring joy to the whole neighborhood," he said.

The program, which aims to treat 2,500 patients over three years, is
funded by a $450,000 grant from a charity, but patients are expected to
contribute for medications if at all possible. Sanders predicts that for
$4 or $5, a month's supply of generic hypertension or cholesterol
medicine will be adequate for most. The seriously ill will be sent out
for more advanced care, and nurses will enroll patients who qualify into
Medicaid or other health programs.

"This is definitely an innovative program," says Dr. Jada Bussey-Jones,
a preventive health expert at Emory University.

It's not the first time food banks and medical clinics have teamed up,
notes Dr. Georges Benjamin of the American Public Health Association,
pointing to a long-standing collaboration in the nation's capitol.

But there's little data showing how well this kind of nurse-led
community project works, or that it can be cost-effective, Sanders says.

"The most important principle here is going where the people are,"
Benjamin says. "There no reason you can't do immunizations there, no
reason you can't do nutritional counseling there. ... It makes a lot of
sense."
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EDITOR's NOTE - Lauran Neergaard covers health and medical issues for
The Associated Press in Washington.
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