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What Can Health Care Professionals Do About Poverty?

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A colleague of mine, Cheryl, has been trying to help a solo physician address a thorny issue. Through the use of How's Your Health, an amazing Web-based suite of health and practice tools, the physician realized that many of her patients struggled with maintaining an adequate income. Cheryl went looking for some ideas for the physician, and she came across this: Health Providers Against Poverty, an Ontario-based group that has a toolkit to help primary care' professionals address poverty issues.

Poverty is a simple, yet complex issue that is a major determinant of health. Not taking action to address it is like ignoring any other symptom or risk factor.  Like so many things in primary care, it seems overwhelming. What's a provider to do?

First: Screen for income issues.  I liked this simple screening question from the unpublished work of Vanessa Brcic and Caroline Eberdt: "Do you ever have difficulty making ends meet at the end of the month?"  (It's 98 percent sensitive and 64 percent specific for those of you working on the basis of Spin and Snout.)

Second: Know what you can do about it. Dr. Gary Bloch, in a presentation created for the Family Medicine Forum this month in Vancouver, British Columbia, recommends adjusting risk based on what you know about income level as the first step in making a difference.  After that, it's time to intervene directly and through others.  Here are Dr. Bloch's ideas (which will need a bit of translating for American readers, but the principles are the same):

  1. Complete disability applications, welfare supplement and tax credit forms.
  2. Advise patients to complete their income tax, as most benefits are calculated from that.
  3. Inquire about other income supplementation for which they might be eligible.
  4. Know where to refer patients to obtain assistance.

Since Cheryl and the doctor she is working with aren't in Ottawa, Cheryl has been working to create specific tools for the Vancouver area.

What can you do to reduce poverty for the people you serve?

 

More Blog Posts by Connie Davis

author bio

Connie Davis MN, ARNP is a geriatric nurse practitioner, health care consultant and William Ziff Fellow at the Center for Advancing Health. This blog was originally posted on Connie’s website where she blogs about improving the patient experience. You can read Connie’s blogs and subscribe to her RSS feed here and follow her on twitter at @ConnieLDavis.


Tags for this article:
Health Care Access   Connie Davis   Communicate with your Doctors   Pay for your Health Care   Minority Health and Health Disparities   Inside Healthcare  


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Tweets that mention Prepared Patient Forum: What Can Health Care Professionals Do About Poverty? « CFAH PPF Blog -- Topsy.com says
October 20, 2010 at 7:03 PM

[...] This post was mentioned on Twitter by luke buckmaster and Melissa Sweet, Jessie Gruman. Jessie Gruman said: From CFAH: Should clinicians screen for poverty and if so, what next?: http://tinyurl.com/22m47so [...]

Goldie Pyka says
November 1, 2010 at 3:54 PM

Related Content:

Case Study: Montefiore Medical Center: Integrated Care Delivery for Vulnerable Populations.
http://tinyurl.com/2cg58a4

Montefiore Medical Center, an academic medical center in New York City, has created an integrated system of care for its primarily low-income patients. This patient-centered system of hospitals, community clinics, and school-based clinics uses innovative practices for managing chronic disease, provides access to high-quality specialty hospital care, and employs targeted care management and robust health information technology in support of integrated care. Although close to 80 percent of its payer mix is Medicaid and Medicare, Montefiore has been able to achieve financial and organizational sustainability. Factors that contribute to this success include: care management that allows for integration across the system; building successful primary care that combines traditional and new models; and medical systems that focus on population health and community accountability.

John Piescik says
November 13, 2013 at 12:17 PM

You may be interested to check out the work of Matrix Human Services in Detroit and its president, Marcella Wilson, Ph.D., who advocates treating poverty as a disease. She has been developing and applying a comprehensive treatment model, called the Transition to Success, with model development support from the Kellogg Foundation.

The crux of the approach is to treat poverty as a disease, with a coordinated care plan that addresses first the most acute symptoms (joblessness, malnutrition, homelessness, lack of transportation, drug dependency, stress and environmental related illnesses, etc.) and then progressively moves each person upwards on scales that measure their health, employment, transportation, literacy, and other indicators of personal well-being.

Dr. Wilson has developed a radically simple, nuts-and-bolts set of models for training health and human services staff and volunteers, marshaling existing resources (and even reducing the cost of some programs), using clients’ dreams as motivators for educational attainment and employment advancement, and actualizing the potential of clients as volunteers themselves.