An NCI-designated Comprehensive Cancer Center
By Maxine Nunes | February 6, 2020
Last year, City of Hope convened all of the nonprofit hospitals in California's San Gabriel Valley — Emanate Health, Huntington Hospital, Kaiser Permanente Baldwin Park, Methodist Hospital of Southern California and Pomona Valley Hospital Medical Center — to do something they’d never done before.
For the very first time, instead of doing separate assessments, they pooled their resources to produce "The Greater San Gabriel Valley Health Snapshot," a comprehensive report on health issues in the area, with a pathway to more effective action.
The cooperative, a subcommittee of the Health Consortium of Greater San Gabriel Valley, was spearheaded by Nancy Clifton-Hawkins, M.P.H., M.C.H.E.S., senior manager of Community Benefit at City of Hope.
“We’ve been putting Band-Aids on the same problems year after year,” she said, “and it’s time to take a deeper dive into what’s truly causing the barriers to health care.”
The first step toward significant change was a February 6 symposium, held at City of Hope’s Cooper Auditorium. About 300 people — representing hospitals, government, school districts and members of the community — met to explore the issues and identify measures that will truly make a difference.

Report Tells a Powerful Story

The story of health care disparities is not a new one — poverty, housing insecurity, ethnic and racial discrimination, cultural and language barriers, the lack of affordable healthcare and more — but the report brings new depth and clarity to the issues.
“We really stepped back and took a hard look at why, for example, there’s a 10-year difference in life expectancy between Maria in one ZIP code and Debbie in another,” said Clifton-Hawkins.
The economic causes are clear. In El Monte, for example, almost a quarter of the population lives below the federal poverty level, while in Sierra Madre only 5% do.
What’s more, one out of three adults in the Greater San Gabriel Valley area delayed medical care because of cost or lack of insurance, and 42% were unable to pay for basic necessities because of medical debt.
Economic insecurity — whether people are homeless or working three jobs just to survive — also means that people may not be able to afford healthy foods or have the time or facilities needed to prepare healthy meals. As a result, they rely on cheap fast foods and an excess of sugar, which can lead to serious illnesses like cancer and diabetes.
The San Gabriel Valley is also an area of great ethnic diversity. In South El Monte, 67% of residents speak Spanish at home, while in Rosemead, 56% speak an Asian language at home. And cultural, racial and linguistic differences can also create major barriers to health care.
One of the harshest revelations in the report was that 45% of African Americans diagnosed with cancer will die of the disease, compared to 35% of whites.
And one problem, related to all of the above, stood out above the rest.
“The question of mental health had been bubbling up to the surface for a while,” said Clifton-Hawkins, “You can't ignore mental health anymore.”
Mental health, the report found, is not only a major underlying cause of substance abuse and homelessness, but is frequently caused by economic insecurity, racial trauma and cultural barriers.
This clear-eyed assessment of the problems is, of course, just the starting point. The next step is doing something about it.

Part of a Community

“An individual hospital alone can’t do anything about the deep, underlying issues — but collectively we can move the needle,” said Clifton-Hawkins.
The report makes clear that the idea of healthcare must expand to encompass such basic needs as emergency housing, food pantries and child care for working families and integrated health care for the economically insecure.
“City of Hope may not be able to build houses, but we can support existing infrastructures that make a difference,” said Clifton-Hawkins. “For example, through a grant program, we are funding housing organizations that provide services to the homeless.”
Several City of Hope projects can also serve as models for other hospitals in the collective. These projects include the farmers market at La Primaria Elementary School in El Monte, which provides affordable produce to one of the poorest areas; the “Wonderfully Made” program at the Second Baptist Church in Monrovia, which addresses health care disparities in the African American community; and a cancer education program for Chinese-speaking residents conducted entirely in their language.
Other initiatives in the works are bias training for healthcare workers and enlisting the help of legislators who can press for better health care policy.

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