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VCU Clinic For Low-Income Seniors Aims To Alleviate Health Disparities

VCU Nursing Faculty member Ana Diallo and patient Leslie Harris
VCU Nursing Faculty member Ana Diallo talks with Leslie Harris before he works with student practitioners. (Photo: Crixell Matthews/VPM)

In a rec room at Church Hill House, about a dozen students and staff from VCU’s Richmond Health and Wellness Program greet residents. 

More than 100 low-income seniors live in the five-story red brick building. One of them is 76-year-old Leslie Harris. He’s meeting with Clinic Coordinator Ashley Stanley who asks him about the health goals he’s been working on with the students.

“Since I’ve been in a wheelchair, I’ve been doing exercises. I work on my legs, my arms, all of that,” Harris tells Stanley.

After having his weight and blood pressure checked, Harris is sent back to a team of nursing and social work students. They talk to him about any recent falls or hospital visits.

“All I do is go back behind that screen and they check me out, see that I’m falling apart,” he jokes.

Harris says he lives mostly off social security. He’s been in a wheelchair since having a stroke about 10 years ago. But at 76, Harris has already lived longer than the typical resident in Richmond’s East End. 

A 2015 study by VCU found that in Church Hill the average life expectancy is 67. Compare that to the average resident of the Museum District who lives to 77.

Babies born within 5 miles of downtown Richmond face up to a 20-year difference in life expectancy.

 

Closing that health gap was the motivation behind the Richmond Health and Wellness Program, said VCU’s Dr. Pam Parsons. The team of students and staff hold these free wellness check ups in five low-income senior communities throughout Richmond.

“The entire concept is: What is the area of the city that has a higher rate of poverty and more health inequity,” Parsons said. “And how can we go out and be an outreach to the community?” 

Parsons, who is now the Associate Dean for Practice and Community Engagement at the VCU School of Nursing, conceived the program while working with patients as a nurse practitioner. She finally got grant funding in 2012, and they began working out of a downtown senior high rise called Dominion Place.

“The local administration said to us, ‘The ambulance is outside of our building every day,’” she said. “Something is going on in that building that’s making that happen.” 

One of the key goals early on was reducing hospital visits. In a yet-to-be published paper, VCU researchers found an 8% drop in hospital admissions for program participants.

Preparing Medicine
VCU Pharmacy student Menaka Seshadri reviews Leslie Harris' medications for the coming week. (Photo: Crixell Matthews/VPM)

Parsons says the program is effective because they are addressing what are called social determinants of health.  Those include things like access to medical services and knowledge about healthy eating and exercise.

Students and staff from VCU arrange rides to the doctor’s office or pharmacy for those without transportation. They also help review prescriptions and provide access to fresh fruits and vegetables.

The Richmond Health and Wellness Program also tries to address social isolation, which research shows can lead to a higher risk of heart disease and cognitive decline.

After meeting with the wellness staff, residents are encouraged to return for a lunch provided by Feed More. While residents can get their meals to go, program volunteers hope they stay. They want residents to interact with the students and each other to build a sense of community. 

Stanley, the clinic coordinator, said the intergenerational dialogue is important to the residents.

“During our breaks, sometimes we don’t have students and we see a decline in people who come. People just look forward to talking with the students.” 

And the program is just as important to students.

VCU Students
Instructor Jody Winship reviews patient testing procedures with some of the clinic's student care providers. (Photo: Crixell Matthews/VPM)

Heather Allmon, a student nurse practitioner, recently took time away from her residency in the ICU to help staff a Richmond Health and Wellness Program clinic. She said spending time with patients where they live has been eye opening. Through the program, she’s learned to ask her patients better questions to understand the lived experiences of low-income residents.

“We don’t really go for like ‘Where is your house and your access to a car and your access to medications,’ Allmon said. “I think that sometimes it’s just forgotten in the acute setting.”

In May, VCU is expanding the program into the new health hub at the Market at 25th. They want to provide similar services to seniors living in their own homes.

Researchers also plan to collect more data on health outcomes for participants. Parsons said that could allow them to get the program covered by insurance companies that are starting to think differently about what healthcare really is.

“The whole shift is toward value based care,” she said. “How many MRI’s or how many CT scans or labs you did, isn’t how you are going to be compensated. It’s did you address holistically what an individual needs?”

With no other programs like it in the commonwealth, Parsons said she hopes the Richmond Health and Wellness Program can serve as a model for universities engaging with their communities and for disrupting health disparities.