Addressing Health Equity in a Rural County- Kershaw County, SC

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Addressing Health Equity in a Rural County

Rationale

From data gathered in meetings and through online surveys, LiveWell Kershaw discovered a health crisis occurring in the northeastern part of the county. This is an underpopulated rural region of our county that includes six major zip codes. Through this study, the Community Medical Clinic (CMC) learned that the key determinant of a person’s health is where they live or their zip code. People get sick from the social circles in which they travel and the physical environments they visit during their day-to-day activities. Categorizing the data by zip code uncovered areas of concern and identified strategies that could be implemented. 

Goal

To make Kershaw County the healthiest county in South Carolina, based on the County Health Rankings compiled annually by the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin. 

Project Summary

After conducting a county-wide health assessment LiveWell Kershaw, in collaboration with the University of South Carolina and the state health and human services department, developed a health improvement plan.  

LiveWell Kershaw employed three strategies to improve the health outcomes of the residents living in the northeastern area of Kershaw County. Each strategy has an effect on improving health, while helping to reduce the health costs for this population sector. The strategies are as follows: 

• A school-based health center (SBHC) that provided individual counseling, mentoring parent sessions, consultations and support groups. A nurse practitioner and certified medical assistant saw middle and high school students at the high school four days a week. 
• Care Coordination– Satellite health care locations, identified based on a high number of emergency room visits, were created to provide personal coaching, medical treatment, mental health counseling and enrollment in other social assistance programs. 
• Organizational and Community Capacity- Training about population health and health equity has been added within the staff and in the county. Training has included quarterly staff and board training, community meetings, and a county-wide population health summit with over 100 attendees. 

Engagement Strategies

The clinic has utilized community surveys, conferences and educational forums to identify the community’s healthcare needs. One of the most significant and impactful programs is the health equity bus tours, which focuses on community health statistics, patient challenges and successes, and health care service expansions.  

CMC has been inviting community leaders to be a part of the wellness rider bus tour with the goal to facilitate a discussion about population health in Kershaw County. Their mission for the tours is for the riders to: 

• Have a deeper understanding and awareness of health in our community
• Recognize differences between the 13 zip codes in our county that contribute positively or negatively to one’s quality of life and longevity
• To appreciate the complexity of one’s health

These tours not only showcase CMC’s efforts to impact population health in Kershaw County, but they emphasize the critical healthcare needs the county faces. Participants become an integral part of developing innovative solutions to empower county residents to live healthier lives. A Wellness Rider reunion was held at a local farm for a facilitated focus group to address system changes based on what they saw on the tour. 

Outcomes

Between May 2014 and May 2017, a total of 2,471 students and adults received assistance, totaling 4,749 encounters. Fifty-six percent of the uninsured population in the northeastern part of the county received services, equating to 1,812 residents. 

LiveWell Kershaw was such a success that the CMC has expanded their mission and vision to not only care for the uninsured of Kershaw County but all underserved populations. One of the six strategies in the Clinic’s 2016-2018 strategic plan is to be the recognized leader in population health in Kershaw County through community outreach and engagement. In addition to joining the 100 Million Healthier Lives Campaign and the Pathway to Pacesetter program funded through the Robert Wood Johnson Program, LiveWell Kershaw has been honored as one of the five SC communities to receive Duke Endowment funding for increased capacity building through Healthy People, Healthy Carolinas grant. The Community Medical Clinic of Kershaw County has positioned itself as a local and state leader for the execution of population health strategies through the adoption of local and national tools and practices that can be scaled throughout the entire county. 

Timeline of Project: Since 2014
Initiator:  Community Medical Clinic (CMC)
Additional Resources:
Community Medical Clinic of Kershaw County Website
Kershaw County, SC– 2018 AAC Winner: Presentation
Local Contact:
Susan Witkowski, CHCQM
CEO- Community Medical Clinic of Kershaw County
 803-713-0806