National Center for Health in Public Housing Presentation - May 2012

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The National Center for Health in Public Housing recently sponsored the 2012 Health Care for Residents of Public Housing National Training Conference on May 1 -3 at the Westin Hotel in Alexandria, Virginia.
The Citywide Advisory Board Health Planning Committee presented a workshop entitled: Improving Health among Public Housing Residents in the District: A Resident Driven Process. The panel consisted of DCHA resident leader, Kenneth Council, who chairs this committee, and Committee members, Diana Lapp, Deputy Chief Medical Director of Unity Health Care; Robert Grom, Chief Development Office and Deputy Director of the DC Cancer Consortium; and Charles Debnam, Director of Health Education Services at Breathe DC. Julian Wilson of the Office of Resident Services moderated the panel discussion.
Panelists shared highlights of the committee’s work, including:
• Residents partnering with DCHA, the DC Department of Health and many other District health-related organizations to implement a resident-driven community health needs assessment
• Collaboration on efforts to address the District’s high rates of cancer and tobacco-related health issues.
• Coordination of data collection and reporting on specific health challenges facing DCHA public housing residents;
• Dissemination of information on health screenings and support services
• Collaboration with UDC as the lead applicant in the development of a grant application to HUD for improvement of asthma management
• Introduction of the Langston Gardening Club (LGC) to program managers at DOH which enabled LGC to make a grant application to expand its efforts and introduce community gardening to other public housing and low-income communities
• Because of the particular severity of health problems in Wards 7 and 8, partners have met with senior officials at both the Children’s National Medical Center and the United Medical Center (UMC) in an effort to coordinate services
Panelists were united in their agreement that much more work must be done to improve the health of DC’s public housing residents. Participants gained valuable knowledge to take back to their own comes
Based upon pre- and post- session testing, attendees reported that they found the workshop very useful and gave it a most favorable evaluation.

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National Center for Health in Public Housing Presentation - May 2012

  1. 1. Graphic from U.S. Department of Health & Human Services, Office of Minority Health, ACT NOW program.
  2. 2. Improving Health Among PublicHousing Residents In The District: A Resident Driven Process PANEL Kenneth Council, Resident Leader Charles Debnam, Director of Health Education Services, Breathe DC Robert M. Grom, Deputy Director, DC Cancer Consortium Diana Lapp, M.D., Deputy Medical Officer, Unity Health Care, Inc. MODERATOR Julian C. Wilson, Jr. Resident Services Specialist, District of Columbia Housing Authority
  3. 3. Citywide Advisory Board Health Committee OBJECTIVEConduct a series of Health and Wellness Workshops to educateresidents on the concept of health inequities and the effects on theirhealth outcomes. Use these workshops as a vehicle to motivateresidents to take more personal and collective action to improve theirhealth and that of other residents. STRATEGYDevelop resource network of community health providers to includelocal government agencies, hospitals, universities, community healthclinics, and nonprofit organizations that offer services and advocacy toreduce health inequities.
  4. 4. Citywide Advisory Board Health CommitteeFollowing a meeting in December 2010, experts worked to helpresidents develop a community health needs assessment tool tobe administered to all public housing properties.Residents presented the assessment plan to the ExecutiveDirector to solicit support to implement the assessment, whichthey hoped to perform with help from the Department ofHealth, ORS staff and other partners with requisite research andcommunity health expertise.
  5. 5. Health Needs Assessment
  6. 6. Health Needs Assessment
  7. 7. Citywide Advisory Board Health Committee
  8. 8. Citywide Advisory Board Health Committee Initiatives DCHA staff has worked closely with several partners to launch initiatives to improve health among public housing residents. These efforts included:• Collaboration with DC Breathe to support a grant application to the DC Department of Health to support a tobacco cessation project at DCHA to develop a pilot effort designed to reduce smoking behavior at selected housing developments. Because of DCHA involvement, the design for this project includes resident empowerment and will enlist leadership for the CWAB to help determine which developments can best advance tobacco cessation effort in DC public housing.• Collaboration with UDC as the lead applicant in the development of a grant application to HUD for improvement of asthma management in public housing.
  9. 9. Citywide Advisory Board Health Committee Initiatives• Introduction of the Langston Gardening Club (LGC) to program managers at DOH has enabled LGC to make a grant application to expand its efforts and introduce community gardening to other public housing and low-income communities.• Because of the particular severity of health problems in Wards 7 and 8, staff has met with senior officials at both the Children’s National Medical Center and the United Medical Center (UMC) where the Emergency ward of Children’s National Medical Center is housed. Staff has connected both medical institutions to the CWAB to coordinate balanced services of projects to all properties located in these two wards.• Breathe DC won a competitive grant with support and technical guidance from ORS to provide education on the dangers of smoking and second hand smoke in public housing and to offer smoking cessation classes to public housing residents. The grant is funded under an HHS grant to the District Department of Health.
  10. 10. CANCER ISSUES IN THE DISTRICT• Each year 2,700 District residents are diagnosed with cancer; each year 1,100 die• The District has the nation’s highest death rates for breast, prostate, and colorectal cancer• Access to cancer specialists for DC’s low-income population remains a persistent challenge… despite one of the nation’s highest insured populations and some of the country’s best hospitals
  11. 11. CANCER ISSUES IN THE DISTRICT• DC’s income gap is rising, and disparities in cancer death rates and access to care persist among DC’s most prosperous and poorest wards• Insufficient Medicaid reimbursement rates – which continue to fall – result in more and more physicians refusing to treat the District’s most vulnerable residents
  12. 12. CANCER ISSUES IN THE DISTRICT• Persons with lower socioeconomic status (SES) have higher cancer mortality rates than those with higher (SES) regardless of race/ethnicity.• Uninsured persons are more likely to be diagnosed with cancer at later stages and less likely to receive standard treatment.• Racial and ethnic minorities tend to receive lower quality health care even when income and insurance status are controlled.• Social inequalities, including discrimination, persist and have a negative impact on cancer treatment outcomes. Source: American Cancer Society, Cancer Facts and Figures, 2012
  13. 13. CANCER ISSUES IN THE DISTRICT• Efforts toward social justice, defined as equitable distribution of social, economic, and political resources, opportunities, and responsibilities and their consequences will promote prevention and improve treatment and survival outcomes of persons living with cancer.* Extracted from 2011-2016 DC Cancer Control Plan Health Equity: Christopher J. King, FACHE *Source: Braveman, P. & Gruskin, S. (2003). Defining Equity in Health. Journal of Epidemiology and Community Health. 57, 254-258.
  14. 14. CANCER ISSUES IN THE DISTRICT• More than 60% of the District’s residents are racial/ethnic minorities, 12.5% are foreign born, and 14.2% do not speak English as a primary language.• Approximately 17% of its 601,723 residents live in poverty – many of whom are concentrated in communities east of the Anacostia.* Extracted from 2011-2016 DC Cancer Control Plan Health Equity: Christopher J. King, FACHE * Source: Ward, E., Jemal, A. & Cokkinides, V. (March/April 2004). Cancer Disparities by Race/Ethnicity and Socioeconomic Status. Cancer Disparities. 54(2), 78-93.
  15. 15. TOBACCO ISSUES IN THE DISTRICT• In the US, cigarette smoking and exposure to secondhand smoke causes approximately 443,000 deaths each year.• When states are ranked for mortality rates, DC ranks highest for deaths from all smoking-related cancers for both men and women.• In the District, black males are at the highest risk for smoking- related cancers.• Survival rates from smoking-related cancers are poor.
  16. 16. TOBACCO ISSUES IN THE DISTRICTIn the District of Columbia, 16.2% of adults are current cigarette smokers, over 77,000individuals, compared to the national median of 18.4%. This figure places the District 10 thamong states for smoking; however DC ranks highest for deaths from all smoking-relatedcancers, for both men and women. Among adult District residents who smoke, thefollowing demographic characteristics have been documented:• More men than women smoke (19.2% compared to 13.7%, respectively)• Education appears to be a factor, with 27.2% of smokers having less than high school education compared to 12.5% of those with more than high school degree• Smoking appears to decrease with age with 23.8% of those 18-24 reporting they are smokers, compared to 14.9% for 25-44 year olds; 19.8% for 45-64 year olds; and 10.6% for those 65 and older• Racially, more African Americans (23.3%) and Hispanics (13.4%) are smokers than whites (9.1%) Source: Centers for Disease Control and Prevention, Tobacco Control State Highlights 2010
  17. 17. TOBACCO ISSUES IN THE DISTRICT• DC is one of only 5 states to spend nothing on tobacco programs• The District currently spends ZERO local dollars on cancer or tobacco programs and 0% of tobacco tax collections are re- invested to fight the health burdens caused by those products.• Tobacco-related health costs alone top $600 million each year in DC
  18. 18. Smoke Free PublicHousingWorking with communityleaders to empower residentsto quit smoking!
  19. 19. Breathe DC Smoke Free Public HousingIn March 2011 Breathe DC was awarded $150K by the DCDepartment of Health’s Community Putting Prevention toWork project to collaborate with four selected publichousing developments to bring awareness to the dangersof tobacco and to prepare the over 1000 residents for apolicy change that would make the public housingdevelopment they reside in totally smoke free in their unitsand on campus.
  20. 20. Program Outline Identify existing leadership within 4 public housing developments and assist them with assembling a team of individuals committed to empowering fellow residents to quit smoking Help Leadership Teams engage the community and educate smokers about the program
  21. 21. Program Outline Conduct 2 four week group sessions per development focusing on how to successfully quit smoking, the dangers of second-hand smoke, and community engagement Empower residents who completed the program to fight for smoke free environments
  22. 22. DC Public Housing Developments Langston Dwellings – 274 Units – Ward 5 Green Leaf – 242 Units and  Green Leaf Senior Bldg. – 215 Units - Ward 6 Benning Terrace – 274 Units – Ward 7 Knox Hill – 122 Units – Ward 8
  23. 23. Collaboration/Partners ANC’s DC Department of Health – Tobacco Control Dept. DC Public Housing Authority DC City Wide Advisory Board DC City Wide Advisory Board Health Committee Resident Council Members Catalyst Grantees Clergy
  24. 24. Accomplishments Conducted 6 four week cessation groups 216 participants completed All residents received quitline cards 5 Secondhand Smoke Exposure presentations 2 Brown bag trainings conducted in other wards 5 Resident Leader Teams developed Presented Public Housing Webinar with Boston Housing Authority
  25. 25. CONTACT INFORMATIONMODERATOR JULIAN C. WILSON District of Columbia Housing Authority Office of Resident Services | Resident Services Specialist jcwilson@dchousing.orgPANEL Kenneth Council District of Columbia Citywide Advisory Board | Vice President Fort Dupont Resident Council | President 202-575-3601 vze3swjc@verizon.net Charles Debnam, BA, CACII, CTTS Breathe DC | Director, Health Education Services 202-574-6920 charles@breathedc.org Robert M. Grom DC Cancer Consortium | Deputy Director and Chief Development Officer 202-821-1933 rgrom@dccanceranswers.org Fay J. Van Hook District of Columbia Department of Health | Public Health Analyst Cardiovascular Health Program fay.vanhook@dc.gov Diana Lapp, MD Unity Health Care, Inc| Deputy Chief Medical Officer dlapp@unityhealthcare.org 202-715-7931
  26. 26. Graphic from U.S. Department of Health & Human Services, Office of Minority Health, ACT NOW program. 27

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