CVS Health announced earlier this year that Sinai Chicago was one of three initial partners of a new initiative to address barriers to care in underserved communities across the country.
As part of the initiative, CVS will provide funding to each institution for local initiatives that expand the community health worker workforce. Sinai will use those funds to recruit residents in local neighborhoods to become community health workers through a program that trains individuals to connect residents with critical health information and resources.
The collaboration is just one way the Chicago-based health system works to address health disparities within the city’s south and west sides, said Debra Wesley, president of the Sinai Community Institute, which supports programs in those communities.
She recently spoke with Health News Illinois about the collaboration and its goals, and what challenges remain to achieve health equity. Edited excerpts are below.
HNI: How did this collaboration come about?
DW: There are block leaders that literally go door to door and know each person that lives in those households. And it helps them to get a better understanding of who they are and what they need. So one of the ideas that we had is: ‘Can we train those block leaders to become community health workers?’
So that when this platform really goes live — which we are planning to pilot — we will have a workforce that is embedded in the community, if you will, that will help our community members actually get the services and identify the resources that they need to be healthy and address their concerns. That is something that CVS was very much interested in and got excited about from a workforce point of view, but also from a community point of view, to train trusted members of the community to really be navigators of what the future for our community can look like.
That’s how we got involved with them and partnered and it was just great to be able to be brought resources. We’re planning a very intensive training program that’s operated by Sinai Urban Health Institute, which is a research entity within Sinai that is working on this space, looking at what are the best practices as it relates to a community health workforce. They are in the planning process … We’re starting with 11 block club leaders, who will then have a skill set that will enable them to actually do some other things in their lives.
HNI: What are some of the goals Sinai hopes to achieve?
DW: If you look at the history of our communities in Chicago, they’ve been pretty segregated, isolated — particularly those communities that Sinai serves — and unfortunately have faced a lot of the challenges where the root cause is around racism. There are serious concerns in the community around gentrification, and then we also talk about the violence that is impacting our community.
That being said, there’s a sense of isolation, so folks are in their own space, if you will, and they don’t come out. The best way I’ve put it is oftentimes life gets in the way when … you get almost into a survivalist mode, where you don’t necessarily take care of yourself. You’re trying to take care of others and raise your family, make sure the kids get to school, all those things, and you don’t pay attention to signs and symptoms that are critical in terms of being healthy.
So for example, when we do the health risk assessment, we’re going to ask if there are certain thresholds in terms of when one should have a mammogram done and if have you had a colonoscopy. And if you haven’t, then our job as community health workers is to say, ‘We can help you get that done because that’s important’ … These folks literally live in the community so they understand and they don’t have to be punitive to someone not getting care in time. They will be compassionate: ‘I understand that this is a lot on you, but we’re going to take a moment where we’re going to focus on you, because it is not normal for you to have ABC symptoms. That’s a risk factor that’s going on.’
We’re going to look at obesity, which is a creative critical indicator. I know that, particularly nowadays, people should be comfortable in their own skin or whatever size they are, but we do know that there are health concerns that come along with if you are five feet and you weigh 400 pounds. That’s a risk factor for everything. And so what we want to do is do these community health workers because there’s an understanding, as well as we can communicate with the various providers.
HNI: What’s the timeline for this work?
DW: They’re working on developing the schedule right now. So I believe that training is going to take two months to do. Due to the gracious support of CVS, we have been able to hire — but he doesn’t start until the end of March — an evaluator, because we want to make sure that we can we can really look very closely at what the outcomes are, how do we build success, how do we replicate this and other communities. What are the lessons learned? The other thing is, because I’ve been in the front end of this, I needed a project manager. So I’ve found someone who is going to work with me on a work plan of updating our work plan and a timeline.
I envision hopefully by mid-summer that we can begin to pilot this. One of the challenges that we have that we are addressing now is, in the community of North Lawndale, there’s a digital divide. So we’re trying to understand and plan for how do we address that it is not a barrier. And that’s a lesson that we learned during the pandemic in terms of children not having that connectivity to study.
HNI: What more can policymakers do to support this work?
DW: It’s the same approach that we took years ago. My organization, in June, will be celebrating 30 years, which I’m excited about. But it’s important for organizations to know that we cannot operate in a vacuum, that we have to be willing to bring different voices to the table to address very complex issues, particularly when you talk about root causes.
I learned some years ago, the term of the ugly baby, that you have to really name the ugly baby and be OK with saying, ‘There’s an ugly baby in the room.’ There’s racism. There are other things that are larger than just this issue itself that we’re trying to overcome. But we have to collectively work together to address it. So everyone has a stake in making those changes. Where there are policies that are contributing to the ugly baby not getting pretty, if you will, then that’s where it needs to be named and then needs to be changed.