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DHI makes Durham medical care accessible to those in need

Living in a low-income neighborhood can have a negative effect on overall health, but Durham Health Innovations has a plan to reduce this issue in the Durham community.

Dr. Robert Califf, vice chancellor for clinical research and director of the Duke Translational Medicine Institute, is researching low-income neighborhoods’ correlation with national epidemics and has found that health issues such as heart disease, cancer, stroke, respiratory disease and hypertension are more pronounced in poorer neighborhoods. Califf also serves as co-chair of Durham Health Innovations oversight committee, and through the work of DHI, is encouraging those in Durham to use many health resources the city offers.

“Health in America is going in the wrong direction, and there needs to be an effort to turn it around,” Califf said.

With North Carolina falling to the bottom 20 percent nationally in life expectancy, Durham County has become a target area for health improvements. DHI, a partnership between Duke Medicine and Durham County, has recently funded 10 teams to work on projects that can improve the overall health of Durham residents. These projects, ranging from obesity work to adolescent health, encourage residents to keep track of their health and to attend the eight health clinics located in Durham on a regular basis.

“There was a view that clinics would be better, so people wouldn’t be forced to get transportation to the Duke Hospital and work their way through the mazes of all these people here,” Califf said. “We think these clinics have been very successful”.

Grendel Burrell, the chief of strategic communications at Duke Translational Medicine Institute, said clinics are smaller and create a cozier environment for Durham residents. They are also more available, making it easier for the elderly who may have trouble navigating Duke’s medical facilities.

Although community-based clinics such as CAARE, Inc. and the American Health Center are free and open to the public, Duke-funded clinics such as the Duke Outpatient Clinic, Durham Medical Center and Duke Family Medicine charge fees for their services.

CAARE Executive Director Sharon Elliot-Bynum said CAARE focuses on the five health disparities that affect people of low income: cancer, hypertension, diabetes, obesity, HIV and AIDS. Elliot-Bynum said CAARE works to ensure that the community is taking advantage of its services.

“Even though we are a community based organization, we don’t expect our communities to come to us,” Elliot-Bynum said. “Every day we are doing health fairs and other events [to reach out to the community].”

During health fairs, CAARE performs health screenings on factors that contribute to the five major health disparities such as blood pressure, cholesterol, BMI, blood sugar and HIV. If people have abnormal readings or results, CAARE refers them to their doctor or the organization will follow up with them personally. The nonprofit also offers exercise and cooking classes in direct response to the obesity problem in Durham.

“People go to the doctor and are told they are overweight, but it is not enough to just tell them,” Elliot-Bynum said. “It may be they are eating the wrong foods... or don’t have a place to exercise, so we provide these services.”

Kristin Thomas, project leader of Check it, Change it—a program sponsored by DHI and the American Heart Association to curb high blood pressure—listed hypertension as another major health problem in Durham. The program’s personnel works with providers of the clinics to follow patients for six months to manage their medication and provide education on behavioral modifications to improve their blood pressure.

“By getting people’s blood pressure under control you are going to prevent strokes and heart attacks,” Thomas said. “Checking residents’ blood pressure [also] has economic benefits, in that it saves the patient and hospital money, but also improves the quality of life.”

Califf said exercise and access to affordable and nutritious foods are particularly challenging in low-income neighborhoods. He also noted the safety risk people face in low-income neighborhoods to get through their daily lives as a contributing factor to health-related issues.

“If you have more than one job, you are rushing from one place to another and are probably going to eat fast food,” he said. “If you live out in nicer parts of Durham, you have open spaces to walk.... It’s safer.”

Despite clinics in Durham each providing specific services to increase overall community health, Thomas said the collective goal is to limit all the health risks that can lead to long-term problems.

“We want people to enjoy a better quality of life, that’s the most important thing,” she said.


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