SPRINGFIELD – “We have a lot of work to do. Our job is keeping people healthy, not dealing with them when they are in an unhealthy situation only,” said Doreen Fadus, executive director of community health and well being at Mercy Medical Center.
The hospital’s parent organization, Trinity Health, recently awarded Mercy a $2.5 million grant, allocated over five years, to continue its work with Live Well Springfield in assisting the city’s low-income children and adults to have healthier lives. This may mean more staff to support existing programs, or to run focus groups, do training or examine related policy issues.
The initiative will also make several million dollars available in low- or no-interest loans for proposed projects, like a supermarket in Mason Square, and coordination will be through a coalition of organizations already working on health-related issues.
“There are all these things that are churning and I don’t know how they are all going to come together but they are definitely going to play off of each other because the group working on these things is working very nicely together and that is important to know and all the hospitals are involved too,” Fadus said.
According to a large national study on income and longevity published in the Journal of the American Medical Association and featured, by geographical regions, on the website of the New York Times, the wealthy in Hampden County can expect to live about seven years longer than the area’s low income residents.
The survey’s good news for low-income residents in the Springfield area is that their life expectancy has increased by three years since 2001. This is one year more than the national average, which generally stayed flat for poor people, and means that 40-year-olds with household incomes of $28,000 can expect to live 79.4 years.
However, this is more than a year less than their counterparts in Hampshire and Franklin counties, and three years less than Springfield area residents making $57,000, who are projected to live 83.7 years, and residents making $150,000 who are expected to live 87.9 years.
According to the survey, Hampden County has lower median home values, fewer college graduates, as well as fewer immigrants, compared to national averages. Immigrants, at least initially, are considered to be more active and consume diets lower in fat and processed foods than the native born.
The survey also found the county has a higher percentage of the poor who smoke, are obese and do not exercise.
Fadus added that tobacco and obesity are what Trinity Health, one of the largest tax-exempt Catholic health care systems, is also targeting both in its directives to its 91 hospitals as well as in its innovative Transforming Communities Initiative into which it is investing about $80 million in grants, loans, community match dollars and services in six communities over the next five years.
“The 90 hospitals under Trinity Health are coming together to have some semblance of same goals throughout the nation and Trinity has chosen tobacco and obesity as the same goals at this point. What the system is trying to do as a whole is have a definite move-the-needle influence on these hospitals and their community on these issue” Fadus said.
“We have so many challenges here in Springfield, whether it is heroin, poverty, housing but when you look at people who have lifestyles of smoking and obesity, it makes sense,”
Fadus said for the past 10 years various groups have been engaged in a “constant groundswell of some advocacy work” within the city “looking at social determinants” (conditions in a person’s long-term environment).
“They may even not have used that language that much 10 years ago, but that manifested itself in improving the bike path, mobile markets, fresh fruits and vegetables and policies such as EBT (government-issued) cards at mobile markets,” Fadus said.
Mercy has had long-term programs that early on assisted the families of refugees from the Vietnam War, as well as the homeless of Franklin, Hampshire and Hampden counties access health care services and benefits.
More recently, the hospital is looking at what Fadus calls “high end users” — individuals who frequently use the hospital’s emergency department for conditions that may not be acute. It is also doing what Fadus termed a faith communities nursing program in which the hospital provides a Mercy registered nurse for parishes of any Christian denomination that want “to start a health ministry within their parish.”
“It could be something as simple as a walking club, participating in a health fair, doing presentations,” Fadus said. “We would provide some training and some materials. We can provide some medical liability for the nurse who wants to be part of the program, but they control what they want to do within their own parish.”.
“We also have a community health van which we call the van ministry.”
Fadus said the van was donated and is staffed by mostly volunteers who take it to farmer’s markets and other venues to dispense health information and to also provide services, such as first aid at such events as road races.
Internally, Fadus said the Trinity Health directive has prompted Mercy’s Cancer Center to do a video on smoking as well as on obesity, and to re-evaluate meals served in is cafeteria and to look at expanded ways the hospital can do outreach.
The $500,000 a year grant from Trinity, Fadus said, will help Mercy’s Live Well partners address issues of obesity and tobacco use, and Mercy will work with Partners for a Healthier Community in bringing coalition members together.
“Martin Luther King Family Services is going to work on tobacco issues with teens using a peer-to-peer model. HAP Housing is also going to work on tobacco with people in subsidized housing but in private management. Maybe looking at getting four to five private managers to have smoke-free buildings,” Fadus said.
“Square One will work on nutrition and obesity issues, both with the children in their programs and with the mothers, whether it is healthy living, groceries, mobile markets. Pioneer Valley Planning Commission has just finished a study on safe streets, part of the resources will be to support them in that effort, whether it be signage, paved curbings, walking paths, cleaning them up. The Springfield Food Policy Council will work on some of the initiatives that they have been trying to do with breakfast in the classroom and also working with Sodexo on working with local farms for fruits and vegetables.”
Fadus said a manager will oversee the initiative, whose first year begins July 1, and there will be national evaluations. She said there will also be opportunities to meet with the other communities funded by the Trinity grant to share experiences.
“Also tied into this,” Fadus said, “is $40 million of capital loans, low interest and no interest loans, that will be available through Trinity. There is an effort to put a grocery store in Mason Square. It could be used for that, or to enter into a conversation with Sodexo to help them utilize the fresh fruits of the valley. There is someone who has a greenhouse that will be hiring low-income workers. They could use some of that capital money. Those are just the three who have already said they would be interested in it.”
Fadus said there is possibility of a large media campaign with Partnership with Healthier America to promote the consumption of fruits and vegetables.
Fadus cited other similar initiatives in the city including the BUILD Health Challenge in the city’s Old Hill area which last year received a planning challenge grant of $75,000. Fadus said that initiative is now moving into a “$100,000 implementation.”
Fadus hopes the targeted population of all these initiatives will be “open to the education.”
“I would be hoping thatthey are not thinking we are trying to control what people do. We are just making the thought, the suggestion. The (NYT’s) article suggested that you could still be in pretty good shape at 40. These lifestyle challenges of smoking and unhealthy eating and activity don’t kick in until way after that. I hope they would be willing to listen.”
She added that ongoing coalition efforts have ensured “that we are listening to them as well.”
“The other part of this is that we have focus groups. We listen to the community. We can talk about healthy eating forever, but if they have to take two buses to a grocery store then we are wasting air,” Fadus said.
“We had a focus group in the Brookings School in the Old Hill neighborhood and they talked about safety on the streets in terms of their children walking to school, safe parks, them walking in their neighborhood. . . You have to get to that social determinant. The why. Why don’t you have housing, why are you running out of food stamps. It is not just about focusing on what is in front of you which maybe the Cheetos and Coke for breakfast.”
“We will,” Fadus added, “be learning as we go along.”