The Global Coalition on Aging (GCOA) has teamed up with local leaders to launch a community health initiative in Baltimore focused on addressing cardiovascular disease.
Dubbed engAGE with Heart, the program claims to be the first of its kind and leverages six community partners in east and west Baltimore—four churches and two senior centers. Supported by Novartis, it is focused on reducing health inequities through community-led programming including health education, healthy food and preventive cardiovascular screening.
The program will offer free community-based screenings conducted by Johns Hopkins University School of Nursing students that will evaluate and provide education on cardiovascular health indicators. The program has begun to employ and train community health ambassadors recruited from within their communities to serve as a resource for their neighbors throughout the program.
GCOA is also partnering with the Black Church Food Security Network and Hungry Harvest to offer fresh food, encourage healthy food decisions and feature healthy food demonstrations to promote nutritional resilience within the community.
“The Community Health Ambassador is the centerpiece of our program,” Michael Hodin, CEO of GCOA, said in a press release. “By training and deploying local, trusted advocates, health access can become more tangible for citizens who may not regularly interact with the formal healthcare system and who may also be suffering from or at risk of chronic conditions like cardiovascular diseases.”
CVD a leading killer in Baltimore
Age-friendly cities, a World Health Organization concept, are where infrastructure helps ensure healthy aging. When planning this initiative, GCOA considered the needs of multiple cities before eventually landing on Baltimore.
Cardiovascular disease is the city’s leading killer, accounting for a quarter of all deaths in 2017 (PDF). It disproportionately impacts the city’s Black community, according to the partners. Nationally, Black people have a 30% higher likelihood of dying from heart disease than white people.
The average life expectancy of residents in the predominantly white neighborhood of Greater Roland Park is 84. By stark comparison, that of residents in the majority-Black neighborhood of Druid Heights is 68.
Lifestyle is more greatly associated with cardiovascular disease risk than genetics. To that end, engAGE with Heart aims to help Baltimore residents build sustainable healthy habits.
“We want to make sure that that prospect of living longer, healthier lives is achievable for everyone,” Melissa Mitchell, executive director of GCOA, told Fierce Healthcare.
“If we are not addressing cardiovascular disease from a preventive point of view,” she added, “we thwart our efforts on the topic of healthy aging.”
To track progress, the program will be measuring engagement in church events, purchases of healthy foods, to what degree residents feel empowered to enact change in their lives, knowledge of cardiovascular disease and healthy aging, referrals to the healthcare system and clinical improvements as well.
'This is a no-lose'
The program kicked off at Liberty Grace Church of God on Sunday, Oct. 29, with Mayor Brandon Scott, Sen. Ben Cardin, D-Maryland, and other community leaders present. The event included a church service, a discussion of the program, a meeting with program staff and a shared meal among all those involved and church congregants.
“My administration has made tackling health inequities and overcoming the decades of disinvestment a top priority, and tackling the disproportionate impact of heart disease in our communities is central to that work,” Scott said in a press release. “We know that public health initiatives focused on equity and the specific needs of communities make a real impact, improving and even saving lives. That’s why we’re so proud to be working with initiatives like engAGE with Heart.”
One of the program’s key partners is Terris King, pastor at Liberty Grace Church of God and former senior executive at the Centers for Medicare & Medicaid Services who helped establish the Office of Minority Health.
Among King’s goals is to restore trust in the healthcare system, which he said Black Baltimoreans are rightfully distrustful of.
“Baltimore is the model for what you can do wrong,” King told Fierce Healthcare. “Historically, this is the city that invented redlining.”
This is an opportunity to engage in a community-based, participatory process to bring interventions to people and to have bidirectional conversations with them about their needs.
The program extends beyond cardiovascular disease prevention by offering a variety of vaccinations and preventive screenings, like for diabetes and cholesterol, for free within churches. Test results will be sent automatically to a person’s provider or payer to help them better understand the populations they serve. Community health ambassadors will help connect people to care, regardless of insurance status, and help enroll them in insurance as needed.
“This is not a process that is an island off the shore of the healthcare ecosystem. It is part of that system,” King said.
King hopes that in the long run, this will continue to be supported by the city. Thus far, the response from the community has been resounding. “This is a no-lose. I don't even have to sell this program,” King said.
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