Unmasking inequities: The role of community health workers in elevating and addressing neighborhood health needs that are masked by zip code

Issues: The Western Addition (WA), once known as the “Harlem of the West” has the second highest density of African Americans in San Francisco. The WA shares the 94115 zip code with bordering affluent neighborhoods. Aggregate data based on zip code misrepresents the neighborhood as well resourced, thus the community has experienced declining allocation of city resources. Yet within the WA are some of the city's highest rates of unemployment, uninsured residents, and sexually transmitted infections. Description: The Western Addition Health Training (WAHT) program was created at the Women's Community Clinic, to address the health and economic inequities created by the geographic isolation of the WA. The activities of WAHT are facilitated by WAHT Fellows, young WA community members who have firsthand experience with the health, economic, and trauma inequities tied to the legacy of redevelopment in the WA. WAHT Fellows are trained as health workers through an intensive health fellowship. Lessons Learned: WAHT Fellows are trained to take leadership roles in health clinics and organizations in San Francisco to elevate the assets and address the unique needs of marginalized African American residents in the WA. WAHT provides health and wellness education and clinical services to a significant number of community residents annually, and has drafted a WA needs assessment to be used as an advocacy tool. Recommendations: The Affordable Care Act provides an important opportunity for WAHT to expand its role in community outreach and education with a focus on the enrollment of uninsured WA residents.