Memphis ZIP code 38109, a neighborhood called Riverview-Kansas, is affected by severe health inequities—more so than any other part of the city. High rates of chronic illness, hospital stays, emergency room visits, and use of charitable services in 38109 led Methodist Le Bonheur Healthcare to develop a community-driven program in response.

Joy Sharp, a certified trainer of Bridges to Health and Healthcare, says of the project, “We knew the use of services was inflated due to the environment of daily instability our patients live in. And we knew we needed a community program that addressed the health gap using core constructs from Bridges to Health and Healthcare.”

Building on relationships established through the Congregational Health Network, Methodist held a series of community conversations with residents of the neighborhood so they could express their healthcare needs. Of the 6,296 people who live in Riverview-Kansas, 98% are African American, 32% are unemployed, and 79% of single mothers with children under 5 live in poverty. The median household income is around $17,000 per year.

These conversations resulted in two new initiatives. Once a month “Wellness Without Walls” transforms the Riverview Kansas Community Center into a one-stop shop for residents’ needs. Help with health insurance claims, basic needs (food, housing, etc.), and health education and assessments (blood pressure, glucose levels, vision, dental, mammography, etc.) are all offered free of charge.

The “Familiar Faces” program targets patients who use the emergency department the most. Healthcare navigators trained in Bridges to Health and Healthcare are notified via text when Familiar Faces clients are coming to the emergency room. The navigators meet the patients at the hospital and build relationships that encourage preventive care and sound healthcare decision making.

Both programs link patients to community resources, identify and eliminate barriers, coordinate care, tailor health information to patient needs, and motivate them to make healthy choices. Initial results of the community-driven program are promising, and Methodist hopes to expand the program in the future.

If you’d like to learn more about implementing Bridges to Health and Healthcare in your community, consider Bridges to Health and Healthcare Trainer Certification from aha! Process.

Terie Dreuessi-Smith, M.A.Ed. has been an author/consultant with aha! Process since 1997 and is experienced in bringing diverse audiences to new understandings and paradigms with practical knowledge, humor, and sincerity. She presents an average of 70 days per year. Terie has years of both direct and midlevel management experience working with youth and adults in poverty. Her areas of expertise are health and wellness initiatives, K–12 education, higher education, alcohol and other drug prevention, community youth development, and community wellness. She lives in Greenville, South Carolina. Click to learn more about Terie Dreussi-Smith.