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MEDICAL AND MENTAL HEALTH UPDATE
On this Saturday as we continue our conversation about racial justice and health, I wanted to spotlight my dear friend Kelly McShane who is doing amazing work in our community and for our most vulnerable citizens.
Kelly is the CEO of Community of Hope, a DC non-profit whose mission is to improve the health of its residents and to end family homelessness in the city. In 2019, Community of Hope provided medical, dental, and behavioral health services at three health centers in DC to about 13,850 patients and prevented or ended homelessness for about 1,250 families.
Here is her important insight on how COVID-19 is operating through pre-existing inequalities within society:
The pandemic has highlighted the huge inequities in health outcomes for people of color. And the pandemic is only making things harder, as people lose jobs, live doubled up with relatives in housing that is otherwise unaffordable, and struggle to support their kids in distance learning with limited wifi, data, and technology.
I have worked with under-resourced families, most of whom are African American, in Washington DC for almost 30 years. I have been continually inspired by the strength and hope of the families that I have known over the years, as well as by the amazing commitment and skills of my staff. The families we serve at Community of Hope are almost all people of color, and 82% of staff are people of color.
Even in Washington, DC, which has some of the highest rates of health insurance in the country, there have continued to be great disparities in health outcomes. The average life expectancy for a neighborhood in NW DC, whose residents are predominantly white, is 89 years, versus only 68 years for a neighborhood in Ward 8, whose residents are predominantly African American. That’s a difference of 21 years of life. That’s a lot. People of color, especially African Americans, in DC have less access to healthy foods, less access to mental health supports or dentists, a higher percentage of children living in poverty, etc. The list goes on.
At the end of 2019, Community of Hope created a new strategic plan with ambitious goals. The goals include: to improve health and eliminate inequities in health outcomes in under-resourced communities in DC; to end homelessness for families in Washington, DC; and to innovate, collaborate and better integrate our work.
Then COVID-19 hit. People with underlying chronic health conditions are more vulnerable. Those with more exposures are more vulnerable—including those working in low-wage essential jobs or people having to take public transportation or people living in overcrowded housing. As a result, the disparities in health just continue.
Community of Hope has remained open and fully operational throughout the pandemic, though we now deliver services in a very different way. While managing all the change is difficult, I have also found this to be a time of great innovation. A perfect example is the use of telehealth. Rather than taking the next five years to slowly transition to telehealth, we had to switch everything in five days. Regulations were changed overnight to allow for full reimbursement by Medicaid for telehealth. There are still many things that we need to see people in person for (such as immunizations, prenatal care, lab tests, etc.), but telehealth will now always be a part of how we work. Telehealth has been particularly important for people who need a therapist or a counselor to talk to about their worries. Now we just need to make sure that the changes made will continue after the public health emergency ends.
I know that our world will never look the same as it did in February 2020, but I still have hope we can use this time to make things better, particularly improving the health outcomes of some of our most vulnerable fellow citizens.