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The east side neighborhood of San Antonio (63.2% Latino) struggles with socioeconomic hardships, health disparities, and a lack of access to quality healthcare. In the past few years, the nonprofit Eastside Promise Neighborhood (EPN) has sought ways to improve conditions for residents in the city’s east side.
To solve the gap in the availability of healthcare options in the area and fight health disparities, the EPN partnered with a provider, CommuniCare Health Partners, to open a new health clinic in the area.
Latinos in need in San Antonio
San Antonio’s historic east side neighborhood is home to 17,955 residents (mostly Latino), more than 200 private businesses, and six schools on 3.5 square miles bounded by Interstate 37 to the west, Fort Sam Houston to the north, AT&T Center Parkway to the east and East Commerce Street to the south.
However, it’s also home to critical health and socioeconomic disparities. Nearly 72% of the area’s population is in poverty and less than 40% have obtained a high school diploma.
A lack of access to quality healthcare is particularly pronounced.
EPN, a nonprofit group that unites institutional and resident stakeholders to leverage and strengthen the neighborhood’s assets and resources to benefit local families, so that children and families are inspired to stay, grow, graduate, and stay, sought a way to address this.
“There are a number of health concerns in this area,” said Noemi Villarreal, health and wellness manager for EPN. “Childhood obesity, diabetes, and asthma are really among the major concerns we have here and it is something we continually address.”
The community served by EPN is largely Latino, and several cultural barriers also prevent this population from getting the proper healthcare that they need, Villarreal said.
These issues include many not having health insurance—Latinos are currently the largest uninsured racial/ethnic group in the United States—and a language barrier.
This has often been a problem for many of the people in our area,” Villarreal said. “Simply being unable to discuss a health problem or be able to relate to it in their language often causes a lot of mistrust. It’s a serious problem and a real barrier that is difficult to overcome. Building trust with someone takes time.”
Increased access = better healthcare
Part of the EPN’s plan to address socioeconomic and cultural barriers to health was to partner with other organizations to cover gaps in healthcare.
CommuniCare Health Centers was one of the partners that took up the challenge.
CommuniCare provides primary healthcare—including pediatric care, family medicine, senior care, women’s health, dental, behavioral health, minor surgery clinic, WIC services, and vision care—in multiple clinic locations in San Antonio (and across Bexar, Kendall and Hays counties).
In the mid-2000s, EPN and CommuniCare started to conceptualize a clinic in the eastside neighborhood.
Members of the community had been vocal about the need for a clinic for some time, said Dr. Carlos Moreno, vice president and chief of clinical affairs for.
“In the past, our mission has been to place centers…in areas in which the population has the least access to general healthcare needs,” Moreno said. “By creating continuative care, we are creating in a sense a medical team for the patients. There’s an establishment of trust with them, which has often been a barrier in the past for Latinos and healthcare.”
Moreno said their clinics aim to impact three main outcomes.
“First, is to increase access to patients,” Moreno said. “Second, save money on non-duplicating, inefficient systems, to make it cost-effective for people to actually come here. And, third is patient outcomes, how they rate the services that they get. If we can do well on those three things then we are fulfilling our mission here.”
The need for a primary care clinic in the eastside neighborhood was clear.
However, EPN and CommuniCare knew primary care was only part of the equation—education about prevention and continuous care would play a big part in the success of a new clinic.
They would have to consider what kind of services would best deliver both care and education to residents, as well as how to tailor that education and services in a mostly Latino area that struggles with certain health conditions, such as diabetes.
“Diabetes is a key area of concern for this community and it is an area of particular focus for us,” said Marisol Cortez, chief development officer at CommuniCare. “Most times patients see diabetes as a sentence to a bad life. We really make an effort to bring education…to our patients and to all the residents of the community.”
Putting a plan into action
To meet the needs of the eastside neighborhood, CommuniCare planned to offer a variety of health services, including general medicine, women’s health, pediatrics, behavioral health, dental surgery, and senior care.
But they also started planning ways they could tailor these services—along with education and outreach—to the culture and language of the community.
“You can have the best services in the world, but they have to be tailored to the community,” Moreno said. “So, you have to understand your community, align your services, and then align your align your message and your education to them.”
The team decided to:
• Bring in health educators to work with clinicians who can then provide “one-on-one health education” to patients;
• Employ patient navigators and we have outreach eligibility workers who work with patients in their search for enrollment [for health insurance] as part of the Affordable Care Act; and
• Contract with translation services via telephone in every exam room, given that many local residents come from Central and South America and don’t speak English.
“We are eliminating as many excuses as we can that preclude people from using our services,” Moreno said.
CommuniCare opened a new clinic, The Dr. Frank Bryant Health Center, in the eastside neighborhood (located at 3066 E. Commerce St.) in 2007 and started treating hundreds of patients a month.
Patient care combined with education and community outreach are the main goals of the clinic and they main way they plan to positively impact their residents in the long run, Moreno said.
“Our clinic is open doors to everyone,” Moreno said. “A great deal of our population is Hispanic, but we really are inclusive to everyone in our community. Whether it’s for breast cancer awareness month or the diabetes outreach, we want to help everyone.”
Bringing the Clinic to the People
The Dr. Frank Bryant Health Center has grown in the number of patients received and treated each year since its opening.
The center also has become a big part of the community’s revitalization.
“Right now, the east side is undergoing dramatic changes as new housing developments are being constructed and slowly this community is being revitalized,” Moreno said. “This clinic has been a stabilizing presence and a benevolent influence on the community, especially for those families who wouldn’t normally have had resources available to them.”
Equity: The staff and personnel at the Dr. Frank Bryant Health Center have become fixtures in the eastside neighborhood, not just by providing much-needed health services but also by offering events throughout the year, including festivals, immunization drives, blood drives, and food drives.
“We listen and we look for events in our community that will help us maintain that contact with our residents so we can better understand their needs,” Cortez said. “We want them to know we are here for them.”
This has led to increasing health equity and reduced health disparities in the area, officials say.
“We really make an effort to tailor our effort to meet the community’s needs,” Cortez said. “The majority of the people we see are hardworking people and taking a day off for healthcare needs often times means going a day without pay. And many times, they wait until their health condition is too late to prevent or sufficiently take care of.”
The clinic has become ingrained in the community and they are committed to continually evolving and growing to meet their patients’ needs. Becoming partners with area groups and organizations as well as fostering an atmosphere of continued care is among the main priorities of the staff.
“Our current success is the staff we employ here,” Moreno said. “We are recognized as one of the top companies to work for and our clinic here in particular invests heavily on making a culture that people want to be a part of. Our clinicians and staff are here because they love what they do, they love where they work, and they love this community.”
By The Numbers
This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.
The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.