Health policy conversations often revolve around access to health insurance, often as to how health insurance can be reformed to be made more affordable or assessing the quality of health care. However, health insurance isn’t universally accessible in the United States. In 2019, 10.9 percent of the nonelderly population was uninsured. That is 28.9 million individuals who did not have health coverage, oftentimes foregoing or delaying access to health care providers when needed.
I started working on this project to gain exposure to a free clinic serving a need in rural North Carolina. Hope Clinic is a free and charitable clinic serving the uninsured and underinsured in the county. The opportunity to work on a project for this clinic has allowed me to get exposure into how to actually expand access to health services and essential care at the community level for one of the most vulnerable populations in this country.
The opportunity to continue engaging with Hope Clinic has been extremely rewarding in terms of how to expand health care access. As I have not engaged with a free and charitable clinic in my previous experience, it was eye-opening to see the services that this clinic is able to provide given their resource constraints. Hope Clinic staff work tirelessly to fill a need in their community. And during a pandemic, no less, their services were crucial.
The main purpose of this project was to provide diabetic patients at the clinic with opportunities to help them manage their diabetes. This project uncovered that even at the most basic level of chronic care management, peer and community support is crucial. Just providing patients with opportunities to engage with and support one another can go a long way. When an individual is living with and managing a chronic condition on a daily basis, it can be tiresome to keep up with their demanding health needs. Having a peer or community member to rely on for support when times get tough is invaluable.
The main legacy of this project in my mind has been to connect Hope Clinic with other organizations and resources in the county that their patients would benefit from. Even though Pamlico is rural and the resources that exist are scattered in the county, there are so many people willing to help in any way they can. For example, a community task force has started during the COVID-19 pandemic to serve as a resource for community members. The COVID-19 Community Task Force (CCTF) has been an effective volunteer effort over the past year, connecting Pamlico residents to resources and supports when needed as well as disseminating resources on the importance of masking, vaccine dissemination efforts, and other COVID019 related topics. Never underestimate the power of volunteers.
The more services that are offered through the clinic, the more the topic of long-term sustainability comes up. One of the long-term goals that came from this project was the idea of implementing Community Health Workers (CHWs) in Pamlico County. CHWs health workers that are recruited from the community to aid their community members in a variety of things such as health education, support, and mentoring, to name a few. CHWs often bridge the gap between formal health care providers and patients, providing patients with an opportunity for more-frequent care. In a rural community like Pamlico, they can also address access to transportation by conducting home visits for patients. For a resource-constrained organization like Hope Clinic, it would be beneficial to have health extension workers out in the community, providing ongoing support to patients in need.
While I do not have the answer at this time as to how to bring CHWs to Pamlico County, this is an effort that others in Pamlico are going to continue to explore and hope to carry out. CHWs are an innovative form of health care that should be explored in other settings as well, particularly in rural areas of the country where the hope is to expand access to care but where there are limited resources. My hope for Hope Clinic, and the future of this project, moving forward is that they will continue to utilize the network of willing volunteers in the county to assist their patients in their journey to managing their chronic conditions.