By William Bole
In what appears to be a growing trend, hospitals around the country are performing radical surgery not just on their patients, but on their communities as well. Consider these recent developments:
--In Washington, D.C., a local hospital system has taken over and refurbished apartment houses owned by absentee landlords, triggering a wave of housing development and renovation in the city's poorest neighborhoods.
-- In Detroit, hospitals are supporting an effort to plant community gardens in formerly vacant lots and teach inner-city youngsters how to grow vegetables and sell them to local markets.
-- In Pueblo, Colo., hospitals have launched a "family strengthening" campaign that involves visits by nurses into the homes of mothers considered at risk of abusing their children or themselves with drugs.
None of this would seem to be exactly what the doctor ordered. But more and more, hospitals are looking to improve the health of locals by improving the quality of community life, according to health officials and others involved in the efforts.
"A lot of things that have nothing to do with medical care nonetheless have a direct impact on health and wellness. And that's why the hospitals are reaching out," said Tyler Norris, an independent consultant who helps hospitals set up community action programs. Decent housing providing a sanitary environment for children, neighborhood gardens yielding fresh produce and nutritious meals, home visits helping keep young mothers and children out of the hospital -- these are but a few of the initiatives that have come out of the Healthy Communities movement.
Since 1989, the movement has spread to 350 communities nationwide, according to the National Civic League, a private non-profit association that helped launch the campaigns that include hospitals with diverse local groups in community revitalization.
The housing problems help illustrate why many hospitals are getting involved. "We continually see children who suffer from respiratory ailments because they live in housing where there is lead paint on the walls, poor ventilation, roaches and rodents in the apartments, bad plumbing and other unhealthy conditions," said Jacquelyn Lendsey, vice president of corporate and community development for the Greater Southeast Healthcare System in the District of Columbia.
For a long time, hospitals in the city's southeast quadrant simply treated the children for their asthma attacks and sent them back into the substandard housing. Not surprisingly, the youngsters returned again and again -- often for costly emergency room visits paid for by the hospitals.
But then, a few years ago, one of the two community hospitals that make up Greater Southeast decided to go to the root of the problem by getting into the business of housing rehabilitation.
The system bought a 200-unit apartment complex that had fallen into disrepair across the street from Greater Southeast Community Hospital. After renovations, the system handed the property over to a community development corporation but still owns a day care center for 65 children at the complex.
This project has spawned other community efforts to upgrade housing. The most ambitious is a plan to renovate 10 large housing complexes in the quadrant that includes the high-poverty Anacostia section of Washington.
"Normally you wouldn't think of hospitals getting into this. But we have to," said Lendsey, noting that children who live in the improved housing now have less need of emergency care than before.
Few would likewise think of hospitals getting seriously into horticulture. But in Detroit, health care leaders and other concerned citizens recently began asking, "How do we get at some basic health issues, like obesity?" said Denise Pike, coordinator of the new coalition Healthy Detroit.
One answer was to start cultivating community gardens and teaching children how to not only grow the vegetables but cook them -- "and not the way their grandparents did, with all the butter and fat," she added.
No one seems to object strongly to hospitals engaging more deeply in community action, but some think they aren't doing nearly enough.
"A lot of the healthy community stuff is window dressing -- getting a few yuppies to do a lot more push-ups. Hospitals tend to shy away from the more intractable problems, like poverty, environmental toxins, guns and violence," said Emily Friedman, an independent health policy analyst in Chicago.
It also takes a long time to see results from these projects, one reason for the hesitancy of hospitals, Friedman noted, adding: "You've gotto be in it for 10 or 20 or 30 years, which means an organizational commitment." Yet she and others nonetheless think hospitals will continue to expand their mission in communities, largely because of wider changes in the health care system and methods of reimbursement.
"They want to keep you out of the hospital, which means they want to keep you healthy in the first place," said Norris, who helped launch the movement in the late 1980s while at the National Civic League in Denver. "Keeping communities healthy is going to be a growing piece of that."
Copyright ©1997 American News Service
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