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Collaboration Brings More Equitable Access to Healthcare in Chester County

CCH community health
Leadership and Empowerment for Access to Programs (LEAP) member Clayton Kellum joined James Logan, Coatesville City Manager, and Jermaine Thomas, LEAP organizer, at the LEAP for Coatesville Run in May. Kellum suggested the run as the initiative's inauguration to the community it serves.

Coatesville, Pa., is a special place. Not only has the city recently gained national recognition as the production base of HBO’s Mare of Easttown, it also has deep rooted history in America’s industrial revolution. Unfortunately, due to centuries of inequities, residents of Coatesville on average are disadvantaged in both wealth and health compared to some other communities in Chester County, the state’s wealthiest county. Chester County Hospital is working to bridge the gap in health found in this community, thanks to partnerships with its local businesses and residents.

Community partnerships are essential to a hospital because they help create a clearer picture of residents’ needs. An analysis like a community health needs assessment can identify and help the hospital prioritize where outreach and attention would be most vital. For example, the assessment may show that hospitalizations for hypertension are especially high in a particular community, but it doesn’t necessarily explain why. Is it a result of a lack of awareness or of access to screenings? Community partnerships can bridge those gaps by helping hospitals decide how to develop plans and design programs that support the communities and neighborhoods they serve.

What’s more, these partnerships can also help foster trust among residents, some of whom may be wary or distrustful of the hospital for a variety of reasons, including personal experience.

In 2019, Chester County Hospital (CCH) joined with their Penn Medicine colleagues in Philadelphia and other local city and suburban hospitals and health systems to develop the first-ever Southeastern Pennsylvania Community Health Needs Assessment. Going forward, the assessment will be completed on a triannual basis. In response, while Penn Medicine’s city hospitals developed a strategy for Philadelphia’s community health needs, CCH developed its own Community Health Implementation Plan, a strategy specific to the hospital that addresses the most pressing concerns outlined in the assessment for Chester County in particular. Chief among those was improving access to affordable primary, specialty, and preventive care in Chester County’s underserved communities.

One of the first steps in this process, which began in fiscal year 2020 and continues through the current fiscal year 2022, involved forming more partnerships with organizations and influencers in these neighborhoods. While CCH has many longstanding community partnerships across the county, there have been historically fewer collaborators in neighborhoods with larger minority populations, including Coatesville, where 75 percent of residents are people of color and the median household income is $45,000 — less than half of what it is across the rest of Chester County.

Nurturing a Reliable Presence in Coatesville

When the Food and Drug Administration granted emergency use authorization to the Moderna and Pfizer-BioNTech COVID-19 vaccines in late 2020, CCH embarked on a grassroots campaign to ensure equitable access to vaccines. The vaccine effort, which was spearheaded by Timmy Nelson, a member of the hospital’s Board of Directors, was formally commended by the Pennsylvania Department of Health.

Nelson, among others at the hospital, employed one of the strategies originally intended to address the disparities outlined in the community health needs assessment — personally reaching out to influential people and organizations in Chester County’s underserved communities. They asked them for help hosting a vaccination clinic or recruiting people to come to the hospital to be vaccinated.

In February, early in the campaign, Jermaine Thomas, a barber and marketer in Coatesville, and a group of fellow community leaders from Coatesville, met with Nelson and Michele Francis, MS, RD, CDCES, LDN, director of the hospital’s Community Health & Wellness Services. Thomas immediately moved into action, and arrived at the hospital with several friends for vaccinations the next week.

“There was real synergy throughout that meeting. Jermaine and his colleagues had a lot of ideas, and they were eager to put them into action,” Francis says. “That was when we really decided we needed to do more in Coatesville.”

From that informal session grew a new organization called Leadership and Empowerment for Access to Programs, or LEAP. Comprised of Coatesville business owners (including Thomas), council people, and residents, the intent of LEAP is to “promote high-quality health care, wellness, and educational, health-focused services in the Coatesville area,” Nelson says.

LEAP introduced itself to Coatesville in May with a two-mile run and walk. The event was sponsored by the hospital through a Penn Medicine CAREs Grant. In June, LEAP hosted a meet-and-greet that drew about 50 people. It is important to note, Nelson says, that while the hospital is a member of LEAP, both events were presented by the organization, not the hospital.

“I think one of the main reasons business owners and government officials in Coatesville have been so receptive to us so far is because we’re not coming in and trying to take over,” Nelson says.

In fact, Nelson and Francis haven’t limited community outreach to LEAP. This summer, they also met with the West Chester Ministerial Alliance and Minnie McNeil, director of the W.C. Atkinson Memorial Community Services Center in Coatesville. They also engaged local church groups, which ultimately enabled the hospital to stage two large vaccination clinics in Coatesville.

Clinics like those helped facilitate the progress that has been made this summer, Nelson says.

“Through the vaccine clinics, we proved to the community — and ourselves — that, working together, we can make things happen,” he says.

While the early results are encouraging, there’s still much work to be done. For his part, Nelson says he’s focused on actions. “A consistent presence is how we’re going to continue to build trust in Coatesville, but it’s not a one-way street. We’ll keep listening and meeting the needs as they’re expressed to us, but we need the residents of Coatesville to show up for our programs and screenings. That’s how this becomes a true collaboration,” Nelson says.

Francis emphasized the “our part” of the sentiment. She notes that there are at least 70 service agencies operating in Coatesville.

“With that in mind, it really is all about collaboration,” Francis says. “We’re here to support those existing organizations and do whatever is asked of us to improve awareness of and access to programs that improve the health and well-being of Coatesville residents.”


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