The legacy of racism and neglect hangs heavily over health discussions in these congregations. Often, the name of the infamous Tuskegee experiment is raised. The pastors acknowledge that their congregants do not trust doctors, and that is a barrier to getting timely medical care and following prescribed treatment.
“There is such a huge trust issue,” Pastor Christian told doctors and other healthcare providers at a regional health summit in 2016. “People are fearful. They remember what happened to their grandmother, to their sister, their next-door neighbor.”
At the same time, the clinicians expressed frustration at having some of their African Americans patients not adhere to their medication regimen, indeed, who follow a relative’s lead instead of what is prescribed.
The project has created safe spaces for clinicians, particularly doctors, to interact with faith leaders, through its annual health summit. The exchanges provided insights not easily gained anywhere else, raising awareness among clinicians of the history and culture of African Americans, with the goal of informing all levels of healthcare, from the treatment of individual patients to how a health system treats a community.
These meetings have already led to tangible results. At one, the ACC/AHA Cardiovascular Risk calculator was introduced to the healthcare providers, many of whom said they were unfamiliar with it. The online calculator estimates the risk of the patient having a heart attack or stroke depending on a variety of factors, including race. African American patients face a significantly higher risk. On the spot, many doctors expressed an interest in beginning to use it. Furthermore, these community-clinical linkages have resulted in doctors volunteering to help the health ministries — doctors are sharing their knowledge in meetings, trainings and other health events organized by the churches.
The project’s data are still being collected, however, the pastors regularly share stories of individuals understanding their risk, losing weight, increasing medication adherence. We believe that the data will show improved health outcomes.
All the churches participating in the project have formed a learning community. Their pastors and their health ministry leaders come together once a month to get an update on the project and to share experiences and best practices.
This is significant because the churches are from various denominations and can have starkly different histories, economic resources, size and type of congregation and leadership. Yet they have come together to help improve their congregants’ health, and are willing to help each other.
The Southeastern San Diego project supports an approach to developing health-enhancing programs, called Community-Based Participatory Research. According to the Institute of Medicine, this approach not only increases the knowledge base for public health but also promises to identify interventions that are ready for dissemination and are sustainable because they have been developed with community engagement – and there is trust.
This project is showing how this approach works and can serve as a national model. Project organizers, led by Ms. Bustos and Rev. Brown, developed a relationship of a key community partner, the faith organizations, and encouraged them to own their heart-healthy plans. As a result, the pastors are raising awareness of cardiovascular disease from the pulpit and the congregants are taking steps to reduce their disease risk. What’s more, the project organizers brought the community together with health practitioners, who become more aware of African Americans’ history and their concerns.