When the heart stops: Community health workers raising cardiovascular disease awareness in public housing

African Americans are disproportionately affected by heart disease. A report released by the Urban Institute in 2007 demonstrated that residents of public housing are at higher risk of heart disease than other populations.1 The Charlotte Housing Authority (CHA) has a total of 19,286 predominantly African American residents in subsidized housing with an average income of $8,059 annually. The CHA used Community Health Workers (CHW's) to educate residents about the risk factors of heart disease. Residents were trained on the use of the “With Every Heartbeat is Life” manual to educate other residents on cardiovascular disease, its risk factors and ways to make heart healthy choices. Before conducting education classes, CHWs surveyed the community and identified the following self reported risk factors among public housing residents: High blood pressure 46.6%, High blood cholesterol 23.3%, Physical inactivity 11.0%, Obesity 31.5%, Diabetes 16.0% and Cigarette smoking 34.7%. The CHW's educated 31 residents (84% female, mean age 51) through two ten week education sessions between the January and July 2010. CHW's also assisted participants with securing primary care physicians and scheduling appointments. Nine residents were identified as not having a medical home and subsequently referred to a medical home. Five residents did not have insurance and were set up on a sliding payment scale with the health center. Using the WEHL program suggest that CHWs influenced health outcomes in public housing communities through their ability to increase awareness and provide follow-up support needed by residents to engage in heart healthy activities.