A Faith- Based Movement to Transform Health Disparities

Transcription

1 A Faith- Based Movement to Transform Health Disparities Rev. Tyrone Pitts Co- Chair, Interfaith and Diversity Workgroup TheCTAC.org July 9, 2015

2 The Big Picture People often don t receive the care that they want and need during advanced illness. Closing this gap will require, according to the IOM report, Dying in America (2014) Broad engagement of actors in the health care field, social and supporting services sector, as well as the organizations and institutions on which Americans rely for practical assistance, spiritual support, information, and advice...

3 C-TAC s Vision All Americans with advanced illness, especially the sickest and most vulnerable, receive comprehensive, high-quality, person-and family-centered care that is consistent with their goals and values and honors their dignity.

4 About C-TAC National, non-partisan, non-profit coalition of 120+ organizations and leaders Achieve our mission by empowering consumers, changing the health care delivery system, improving public and private policies, and enhancing provider capacity.

5 Community Action Project: Practical Collaborations, Built on Trust

6 The impact of interventions to reduce disparities for advanced illness is limited (Johnson K, J Palliative Med., 2013) No problem can be solved from the same level of consciousness that created the problem -Albert Einstein

7 The people in the community don t know C-TAC. They don t even like the local hospital. They re going to enroll in care only if we [clergy] encourage them. Fewer American Africans are going to church, but whenever they have a problem or a crisis like someone s sick, they call us. -C-TAC Listening Session Participants (May-April 2014)

8 Addressing Disparities How We Started: Listening to the Community (2014) With Aetna Foundation support, C-TAC conducted listening sessions in 7 regions: Washington, DC; Detroit, MI; New York, NY; Oakland, CA; San Diego, CA; Portland, OR; Providence, RI. Participants included (oversampled for American Africans): Places of worship, health-systems, patients, family caregivers, and Workgroups (Clinical, etc.) of C-TAC. Key question: Even if you have a seat at the table, do you have a say in the care for your community, as part of the health system?

9 Listening Sessions: High Level Findings There are latent, underused resources that are not well linked between communities and providers Systematic linkage (integrating clinical and community models) would yield outcomes aligned with patient goals (e.g., reduced unwanted hospitalizations) American Africans identified their faith-based organization (FBO) as a trusted resource FBOs need training and partners to serve as a link between health system and community.

10 What We Did: Launched Community Action Project Objectives: Foster a partnership between health systems and faith community organizations to fill critical gaps in care delivery Give each partner tools and knowledge Help extend existing advanced illness management programs to reach underserved people Pilots of this model are underway in Alameda County California (in partnership with Kaiser Permanente), Detroit (MI) and Washington (DC).

11 What We Learned: 6 Practical Insights 1. Advanced Illness is already a priority 2. Language is extremely important 3. It s about the money but it s not about the money 4. Like health-systems, churches/communities have their own systems 5. It s intergenerational. 6. Principle of Ubuntu. Interconnectivity.

12 1 Advanced Illness is already a priority Surprisingly, given their workload, it s on the top 10 list of clergy, but they need ideas to start and capacity (training, information, staff) to keep going. We hold meetings for clergy, but no one comes -Clinician Participant, San Diego We want to be at the table. But the meetings don t happen where we live. When we get what we need I think we re going to be surprised about the resources out there to help us. -Clergy Participant, San Diego

13 2 Language is extremely important Clergy Person v s Healing v s Vulnerable v s Beginning of Life v s Clinicians Patient Curing Sickest of the Sick End of Life I tried to explain what advanced illness care is to our regional group of pastors. They had no idea what I was talking about until I explained it was serving many of the same folks as the sick and shut in ministry. Detroit Participant

14 3 It s about the money, but it s also not about the money: Start with Commitment to Help. We re pastors. We re used to making bricks from straw. Of course we need financial support but our people are perishing from lack of basic information. Oakland Participant

15 4 Faith-based organizations have their own systems - Engage the community, not just one partner - E.g., A survey of 6,000 churches showed that 70% had health services that included those outside of that particular church (National Council of Churches, 2005) - Understand the power dynamics/system of each community within the community Historically, health and healing went together for places of worship. DC Participant

16 5 It s Intergenerational Grandparents are caring for grandchildren, but grandchildren are also caring for grandparents End of life is a reality for our young people. Drugs have taken such a toll on some of the young that they re walking around in bodies that are 70 years old. They need support and caregiving as well. -Oakland Participant

17 6 Ultimately, Shared Decision-Making is based on the South African Principle of Ubuntu: I am because community is; and community is because I am part of community If clergy and clinicians can come to the table in true appreciation of each other, we can learn from each other. -Portland, OR, Participant

18 No one can do this on their own. Good thing no one has to.