Can Clinics utilize Community Organizing to Improve Health Outcomes?

Background Residents of South Los Angeles experience some of the worst health outcomes in California, and are among its most disenfranchised. South Los Angeles, with over 1 million residents, has 8.5 liquor stores per square mile, the highest rate of HIV/AIDS mortality, gonorrhea, adult obesity, heart disease, cancer, diabetes and stroke mortality in the County. It has only 1 remaining full-scale Trauma Center in an almost 100 square mile radius, and 30% of its adult population is uninsured. As medical care adjusts to health reform regulations and opportunities, little is known about the role of community engagement in health care transformation.

Project Description The Right to Health Committees (RHCs) grew out of the desire of St. John's Well Child and Family Centers, a local community clinic network and its partners to engage with patients to improve community health. The RHCs mobilize patients as health care constituents within clinic catchment areas in order to create an advocacy infrastructure and impact the clinic's scope of practice. Participatory design and implementation of RHCs will to help the community to advocate, participate, develop and implement health care delivery systems while improving individual health outcomes.

Methods Using evidence-based organizing methods, participants are recruited from general patient clinic population; and the surrounding community. Participants engage in activities including narrative-based organizing, assessment of health-related community relationships and resources, participatory decision-making and development of a resident-driven strategy to address local health priorities.

Results Preliminary outcomes demonstrate improvements in self-reported health status and health services utilization, improvements in patient self efficacy; and increased knowledge and engagement in health-related community organizing efforts. Clinic-based community organizing and mobilization efforts represent an important, underutilized tool in improving individual and population-level health status.