The HEALing Community Center: Reaching Out to the Underserved in the U.S.A.

Charles E. Moore, MD, for the Diversity Committee The health of many Americans has improved during the past few decades and tremendous scientific advancements have been made. However, the reality is that many homeless, uninsured, and low-income minorities are not benefitting from these advancements, nor are they receiving important health screenings and preventative primary medical care. A critical issue is that a lack of financial resources often plays an important role in access to care. African Americans are diagnosed with some form of cancer at 44 diagnoses per 100,000 individuals more than Caucasians. Additionally, the death rate is 33-percent higher for African Americans than it is for Caucasians. We know that for most disease processes early detection means a better chance of more effective treatment. We also know that early detection is less common among African Americans. In Fulton County, GA the increasing health disparity between Caucasians and African-Americans has cost 28,022 years of potential life lost due to premature death in African-Americans. This number is more than double the number of years lost in neighboring DeKalb County and is drastically higher than any of Georgia’s 159 other counties. When considering oral cavity and oropharyngeal cancers in particular, it is seen that it will destroy 14,000 to 15,000 lives annually (www.nccn.org, www.cancer.gov). Additionally, 50,000 people will develop head and neck cancer this year. Of those who develop cancer of the oral cavity, nearly 75 percent of the cases of squamous cell cancer of the oral cavity involve only 10 percent of the mucosal surfaces of the mouth. This is an area that can be easily identified and monitored by health professionals. Also, it can be easily taught to lay people to examine in the home or community setting for signs of abnormality. In my current practice in the Department of Otolaryngology at Emory University at Grady Health System, I saw numerous patients who sought medical care only after their cancer had progressed to the point where they had limited treatment options. When I continued to see such patients on an almost daily basis, I decided I could do more to increase awareness of head and neck cancers. I identified the three zip codes that represented the highest percentages of head and neck cancers that I saw in my clinic. All three of these zip codes were in medically underserved areas. I later focused my attention on creating a facility in the area that had the highest percentage of head and neck cancers identified with outreach to the other areas. Poverty, high crime rates, limited access to healthcare and joblessness make this area a real-life study in the social determinants of health. Accordingly, I decided to develop a strategic approach to care that encompasses not only design, but delivery. From a community needs assessment, it was determined that cancer education was of primary importance. I developed the concept for the HEALing Community Center (www.HEALingOurCommunities.org), a free medical facility that would provide health education and primary and specialty care in the zip codes that need them most. Through collaborations with multiple medical, faith-based, community, and academic organizations, the center provides direct services in a medically underserved inner-city area in Atlanta. The facility addresses the increasing health disparities among minorities and uninsured individuals in poverty. In July of 2009, the Healing Community Center began providing primary care, cancer screenings and mental health services in three small rooms at a community-based organization. On June 25, 2011 the construction was completed on an 8,000-square feet facility that focuses on health education while providing comprehensive, integrated care. Since then, the need has increased exponentially necessitating the expansion to a larger facility to accommodate the requests of the community and other potential collaborators. The creation of this new facility will allow the center to further expand its services to provide comprehensive, integrated care to address the social determinants of health faced by people in poverty. From the initial screenings, I saw firsthand the extent of medical issues that were not being addressed in the community. Education of the public is of paramount importance to empower our patients to address critical health issues. In this manner, together we can strive to decentralize the delivery of healthcare by providing critical information not only from bench to bedside, but from bench to bedside to curbside. Donations to the HEALing Community Center can be addressed to HEAL Inc, PO Box 7522, Atlanta, Ga 30357 or completed online at www.HEALingOurCommunities.org.