Crossroad Health Center - OTR

Alexander Drinnan, Summer 2019

Crossroad Health Center is a federally qualified health center that serves the Over-the-Rhine community. The patient population is largely African-American and low-income. There is also a significant Hispanic population, and I was able to practice speaking Spanish with patients while interning. This summer Kati and I worked on a study that is being done by the Centers for Medicare and Medicaid Services (CMS). We administered a survey to patients about health-related social needs which covered the following categories: housing issues, food insecurity, transportation issues, and domestic violence. Because not all patients qualified for navigation services through the CMS study, we compiled a list of community resources that we used to refer patients to appropriate services. We also created a “Guide to Community Resources” pamphlet in both English and Spanish that is currently being worked on by the graphic designer at Crossroad. We hope it can be available in the waiting room and administered to patients as needed.

For our UHP project, we compiled the data from the first year of surveys at Crossroad which included 378 adult patients. We were interested in looking at patient demographics, survey results, patient qualification for navigation, and associations between comorbidities and positive screenings. What we found was that about 60% of patients had at least one social need and the top three social needs were food insecurity, housing issues, and lack of reliable transportation. Of those patients with at least one social need, only about 24% qualified for navigation with a community health workers through the CMS study. The qualifications for navigation are 2 or more ER visits in the past year and being a Medicare or Medicaid beneficiary. And lastly, there was an association between a history of depression and a positive screening, which is not very surprising.

This experience gave me an insight into the challenges faced by those in our poorest communities. I spoke with a woman who was having difficulty making the rent due to recent high medical costs and was in danger of being evicted. She was in tears talking to me about how hard it was to obtain affordable housing in the area due to the shortage of low-income housing. She also was having problems with her car, making it difficult to get to appointments. Barriers like these make it extremely difficult for people affected by poverty to achieve wellness. Because of this experience, I have a better understanding of the importance of addressing social determinants of health in a health care setting and the importance of appropriate referrals. Although health inequity won't be solved without addressing systemic and institutional factors, an awareness of a patient's social needs is a small step in the right direction.

Download Alexander & Kati's poster (.pptx)