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Community Health Centers: Taking the Clinic to the Patient

Dr. Tuckson's guest is Dr. Charlotte Gay Stites, founder and pediatrician at Smoketown Family Wellness Center.
Season 14 Episode 6 Length 27:20 Premiere: 11/11/18

Community Health Centers: Taking the Clinic to the Patient

The concept of community health centers is a holistic one that begins by addressing the needs of children in the surrounding area, starting at an early age and involving parents and caregivers every step of the way. It’s an innovative approach with the long-term vision of transforming public health outcomes in the community, and a new organization in Louisville is testing it out, with encouraging early results.

In this episode of Kentucky Health, host Dr. Wayne Tuckson speaks with the founder of Smoketown Family Wellness Center about the nonprofit’s mission and resources and about the ways community health centers successfully reach and treat previously underserved populations.
 

Dr. Charlotte Gay Stites, MD, is a pediatrician and founder of the Smoketown Family Wellness Center. The center, nearly six years in the making, opened in March 2018, and is located on the ground floor of the old Presbyterian Community Center in the Smoketown neighborhood in downtown Louisville. The newly renovated building served as a community center for decades and was one of the first gyms Muhammad Ali trained in when starting his legendary boxing career.

Stites says parents know that raising a healthy child requires much more than just making regular visits to the doctor. But many communities do not have the resources necessary to support children as they grow up – such as groceries that offer fresh and healthy food, recreational opportunities, counseling services, and so on.

“What we’re trying to do, for families who have difficulty in achieving these additional pieces, is to put everything right there together,” Stites says. “To improve access to all the other pieces, other than the clinical care, so that every family has access and the ability to successfully raise their child to be healthy.”

A Public Health Model That Starts with the Child
Stites says that as a pediatrician she has seen how decisions made early in life are important to a person’s overall health as one ages. She also points out that treating children gives her an opportunity to advise parents and caregivers about their own health choices, making an emphasis on how their habits can affect the child.

Take adult tobacco use, for example. “When you’re caring for a child with asthma, and the caregiver is a smoker, it’s very important to talk with the family member about smoking cessation and how they’re able to either quit or certainly decrease exposure for their child,” Stites says. “And so without providing direct medical services for that adult, we’re able to support the family to improve the health outcome for the child as well as that caregiver.”

Stites’ idea for opening a community health center started when she was working on a project with the Louisville Public Health Department. For the first time in her career, she focused on macro-level issues – the health of large populations, inequities in health access and provider care, economic and educational factors – rather than just treating patients in a clinic, one-to-one. That inspired her to think about creating an organization that engaged families with young children early in order to achieve long-term public health improvements for the community.

“…if we can look back and practice primary prevention – to prevent these diseases from ever happening – then that’s really where we can effect maximum change,” she says.

The Smoketown Family Wellness Center is organized as a nonprofit, and Stites says that medical reimbursements will cover approximately 60 percent of its operating costs – the clinical care that the center provides. As for the myriad other resources Smoketown offers, Stites says that she, her staff, and the board of directors have tapped into Louisville’s expansive network of nonprofit organizations to create partnerships and secure grants to meet the community’s needs.

An infographic from the Greater Louisville Project details those needs. According to its research, only 20 percent of Louisville’s health outcomes are caused by decisions made in the doctor’s office, clinic, or hospital. Roughly 40 percent are caused by social and economic factors (education, employment, housing), 30 percent are caused by a person’s health behaviors (smoking, drug and alcohol use, eating and exercise habits) and 10 percent from the physical environment in the community (air/water quality, crime).

The Smoketown Family Wellness Center aims to address 100 percent of these factors in a centralized location, Stites says. “And if we can address all of these together, and help families establish healthy habits, success in school, and deal with these adverse childhood experiences, then we really think we can start to impact change and decrease some of these chronic diseases, and start to incorporate all of the pieces of health care together in one setting.”

Creating Programs to Promote Wellness
Stites says that the renovated building on Hancock Street that once used to house the Presbyterian Community Center is once again serving as a hub for the Smoketown neighborhood. The Smoketown Family Wellness Center has a busy schedule, and holds a number of events in conjunction with other nearby nonprofit organizations. According to Stites, “the Wellness Center isn’t about reinventing the wheel. What we’re interested in doing is collaborating with other organizations doing important work.”

One of those events occurred earlier this year: an outdoor celebration of the Wellness Center that included music, performance, other activities, and food and drink were served. It was part of Give for Good Day, a 24-hour donation day that involved over 500 Louisville nonprofits.

Another outdoor event at the Wellness Center is part of the “Satur-play” program and was held in fall 2017 and spring 2018. The program offers activities for school-age kids on Saturdays. The Wellness Center partnered with Dare to Care food bank and the YMCA for “Satur-plays,” and pediatric residents from the PUSH (Pediatricians Urging Safety and Health) Group also participated.

Stites says that the Wellness Center is open to working with a wide variety of partners in developing programs for the Smoketown neighborhood. For example, the Center promotes music as a source for relationship building and mental wellness by holding a “beats-making” class in association with the AMPED youth music organization. Stites says that the Wellness Center aims to develop a strong collaboration with Jefferson County Public Schools in the months and years ahead.

The Smoketown Family Wellness Center features an open space for large community events. It holds Tai chi and yoga classes, and has a literacy section with reading resources. A three-year grant from the Lift for Life Foundation has enabled Stites to hire a family coach, who will integrate behavioral health services as a component of the center’s overall wellness plan.

And the Wellness Center features a popular learning kitchen, where food classes are taught in partnership with Dare to Care, Louisville’s Bates Community Development Corporation, and the American Heart Association. Recently, the center hired a professional chef with the title of 365 Fresh Food Coordinator. “Smoketown is a ‘food desert,’ and everybody knows that food is a really important piece of our health and well-being,” Stites says. “This position allows us to look at how we bring fresh, healthy foods into the community.”

The Smoketown Family Wellness Center is off to a successful start, and Stites believes that its comprehensive menu of services can be, and should be, extended to other neighborhoods in Louisville. Further, she believes that similar community health centers would work just as well out in Kentucky’s rural communities.

“Our goal is to be a scalable model,” she says. “And the reason we have set this up as a nonprofit organization is so that it is not a practice start-up for a physician, but that there is structure and a format to be able to pull all these pieces together.”

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Season 14 Episodes

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S14 E25 Length 26:47 Premiere Date 05/12/19

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S14 E13 Length 26:34 Premiere Date 01/27/19

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S14 E9 Length 26:57 Premiere Date 12/16/18

Cancer and Immunotherapy

S14 E8 Length 27:10 Premiere Date 12/09/18

Intestinal Biome: We're in This Gut Together

S14 E7 Length 27:47 Premiere Date 11/18/18

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S14 E6 Length 27:20 Premiere Date 11/11/18

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S14 E5 Length 26:58 Premiere Date 11/04/18

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S14 E4 Length 27:21 Premiere Date 10/28/18

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S14 E1 Length 25:23 Premiere Date 10/07/18

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