It Really Does Take a Village: How Memphis is Fixing Healthcare
Photo Credit: Shutterstock.com/ Rob Marmion
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“First and foremost, I give honor to God.”
Carole Dickens, a registered nurse, stood before the black congregation at Lakeview Community Temple in Memphis, Tenn., urging them to get a mammogram. Anyone who’s uninsured, she said, might be eligible for a free screening.
“African-American women do not have breast cancer as often, as prevalent, as Caucasian or white women,” she said. But, “we are so late going for an early detection that by the time we get there, it is at a stage that your prognosis is really, really poor.”
“You don’t want anybody to know your business? You will be dead and everybody will know it.”
Dickens, who has light brown skin and wavy silver hair, told her audience that she also belongs to a Church of God in Christ church, a predominantly black Pentecostal denomination with Memphis roots. After she spoke, she passed around a form and women began signing up.
The pastor approached the pulpit and affirmed Dickens’ message. “When we get through dancin’, and we get through shoutin’, we still have to live.”
Preventing and treating chronic disease for low-income patients is one of the most vexing and expensive public health problems in this country. Factors like poor diet and education, distrust of authorities and lack of access to primary care contribute to high rates of conditions that, once they arise, require decades of care.
We can’t calculate the cost in joy and fulfillment of premature death and disease. And the financial toll approaches similarly metaphysical heights. In 2011, taxpayers covered an estimated $414 billion in spending on Medicaid, the government health program for low-income Americans. That price tag excludes direct and indirect including major portions of care for low-income veterans and seniors.
In the middle of the last decade, Methodist Le Bonheur Healthcare, Memphis’s largest hospital system, began teaming up with churches to address the city’s abysmal health situation and reduce the cost of care. This collaboration has grown into the Congregational Health Network, which has received attention in national public health circles, and from the Obama administration, for reducing the costs of care and improving outcomes for low-income patients. The Memphis method offers lessons to hospitals nationwide wrestling with similar problems. But successfully replicating the program will depend on hospitals’ ability to rethink their function in the communities they serve. Could the answer really be as simple as a woman testifying in church about the importance of mammograms?
As the pastor preached, Dickens, the nurse, and Dorothy Seawood, her point woman at the church, stepped outside to talk shop. They made plans, and caught up on news, but the conversation kept returning to their mission: how to engage congregation members in their own health.
“People don’t want you to know they’ve got high blood pressure,” Dickens said. “It’s already a silent killer. By the time they go and get the test to even identify, they’re at stage four.”
“A lot of people think that when God heals he don’t send a doctor,” Seawood, whose pure white outfit indicated her status as church missionary, said. “He does it that way sometimes, with the laying on of hands or by your faith. But God also has doctors out there. He’s also got nurses out there. He’s also got medication out there. I thank God for all of it. Some people think it ain’t God.”
“A whole lot of it is misinterpretation of scripture,” Dickens said.
“They don’t want anybody to know that they’re taking pills,” as if, she added, “that’s a signal that ‘I’m not trusting God.’”