Louisville Medicine Volume 71, Issue 10 | Page 11

INTENTIONAL EMPOWERMENT
citizens have what they need to be as healthy as possible . In order to achieve full health potential , people must have convenient access to good health care . The challenge has been to overcome unhealthy lifestyles and poor trust in medical care amongst the West Louisville population .
Historically , medical reforms in urban America have been insular and narrowed by siloed funding , competing hospital systems or politics . Recent attempts in Louisville have gained momentum , but remain local and have limited vision . Often , those trying to improve health are not on the same page . For example , the city may focus more on issues on the streets , proposing a “ community care campus ” and safe outdoor space for unhoused residents . Community Ministries and West End churches have always provided places of worship , and have banded together to provide social services and mental health interventions for those in their neighborhoods . Local health departments are attempting policies and guidance across the entire city and cannot always manage what is needed in the disadvantaged neighborhoods . Various medical offices such as the Family Health Center try their utmost in providing primary care , but lack a continuum to meet all health care needs . It is evident that medical access is a higher-level need and considered a “ choice ” by many , as opposed to a basic human requirement for survival . Plus , any of those who need us most , choose not to seek medical care for various reasons – unable to leave their jobs to seek care , unable to get transport , lack of funds or just fear of finding out what might be wrong .
In the hundreds of listening sessions held in West neighborhoods , it became clear as to why access to health care is so difficult . Mr . Cox noted that the usual concerns over transportation , parking and child care came up . But the biggest realization was the difficult “ front door ” conversations that keep patients in need away . “ Many have limited or no health insurance and perceive they are unable to pay for care .” They feel ashamed or stigmatized just coming in the clinic door , being presented with forms and myriad questions concerning ability to pay . Many are not aware of the financial assistance policies that help lower financial barriers . But they are wary and stay away for fear of shame . By not addressing their chronic needs , they suffer acute deterioration forcing emergency medical services or hospital admission : so the cycle continues . 2
In June 2020 , Norton established The Institute of Health Equity to address these health and racial inequities in West Louisville and pull together services in these vulnerable neighborhoods . Adding physician practices , mobile units and deploying community health workers have all been a help , but community leaders realized that to truly make a difference in health outcomes in West Louisville , a hospital in the community would need to be built .
As noted by Dr . Kevin Cosby , Senior Pastor of St . Stephen Baptist Church , “ You need to plant your mailbox in concrete ,” emphasizing that changing attitudes would require the community-based permanency of a new hospital . In an interview with Mr . Cox in January 2024 , he spoke to me with personal passion and emphasized the importance of collaboration with existing community groups and coalitions . “ Partnerships are key in growing new development in the West End , and our surveys kept pointing back to the need for permanent access to health care .” Working with church leaders , the Urban League and Goodwill Industries supported the success of long-term relationships in the community . “ In order to build trust , we must always be there . It is very hard to build trust in a transient situation or with a mobile unit .”
Enlightened by these survey findings , the collaboration focused on the need to develop trust and overcome confusion about health literacy . As Mr . Cox noted , “ The community wants to know when are you going to be available ? Are there doctors here ? We need access after-hours and to specialty services .” Mental health care , especially among children and adolescents , is a critical need . The desire was for privacy and being seen in person , not just via telehealth . Here the roles of the community health workers become essential in building knowledge of services and connecting patients directly to services they need . “ Just getting residents on the phone and signing them up for financial assistance in advance of needing care can make a huge difference !”
A committed workforce is now being recruited to serve these needs . “ We are looking for clinicians with a servant ’ s heart ” and want to care for this population . Caregivers will be provided with specific training in developing trust in this skeptical community . Navigation will be key .
There is a strong belief that this new hospital will strengthen health equity throughout Louisville by providing close access to medical services in West Louisville . The facility will have an emergency department , specialty care and primary care for adults and children – even a stand-alone pharmacy . It will also be a concrete location to educate and build health literacy , provide needed medical services and navigate patients through an often-confusing maze of modern medical care . Economic development ( and tax revenue ) will follow . The collaborative team noted , “ We will try a lot of things , and learn as we go ,” in hopes of evolving meaningful solutions . What is clear is that building in the community brings care closer to home , and develops ownership in the most stressed Louisville neighborhoods and communities . The permanency of the Norton West Louisville Hospital will provide a new “ medical front door ” and eliminate a major barrier so that all residents in our city can lead a healthy and prosperous life . November 2024 is only a few months away , so stay tuned !
Visit nortonhealthcare . com / locations / west-louisville / for more information and news on completion .
References :
1
2017 Health Equity Report : Uncovering the Root Causes of Our Health , Center for Health Equity and Louisville Health Department
2
Nortonhealthcare . com – West Louisville survey results
Dr . Wernert is the Executive Medical Director of Norton Medical Group and practices with Norton Behavioral Medicine .
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