Researchers Target Bootheel Health Disparity

11/15/2019

Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders Fellowship Chooses SLU, One Heart - Many Hands to Improve Rural Health

ST. LOUIS -- Two Saint Louis University faculty members and their community partner are working to improve the health of rural Missourians as they participate in the Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders Fellowship.

Elizabeth Baker, Ph.D., professor of the Department of Behavioral Science and Health Education at SLU’s College for Public Health and Social Justice; Carissa van den Berk-Clark, Ph.D., assistant professor in the Department of Family and Community Medicine at SLU’s School of Medicine; and Janice Ballard, MPH, vice president of community health and executive director of Health in the Heartland, an initiative of One Heart - Many Hands; will collaborate to improve access to health care in Missouri’s Bootheel.

Their project will receive $350,000 over the next three years and is among eight interdisciplinary research initiatives recently funded by the prestigious Robert Wood Johnson Foundation aimed at finding real-world solutions to improve health equity.

Rural communities in the southeastern corner of Missouri, referred to as the Bootheel, experience health and socioeconomic challenges that result in some of the worst health outcomes and poorest access to health and social services in the state. 

• Countyhealthrankings.org ranks Pemiscot County 115 and Mississippi County 112 – among the least healthy of Missouri’s 115 counties.
• Both counties are designated “Health Professional Shortage Areas” with fewer than 30 primary care providers per 100,000, compared to 84 per 100,000 for the state as a whole.
• These two counties have fewer mental health providers – 108 in Pemiscot and 21 in Mississippi, compared to 170 per 100,000 for the state of Missouri.
• Approximately 25% of the residents of both counties have reported that they do not receive medical care when they need it.

SLU and One Heart - Many Hands have spent the last 18 months working with community members and providers from clinical and social service agencies to understand the root causes that impede people’s  access to services. Among the barriers they found are: 

• Cost of health care
• Inadequate interagency networks
• Lack of providers, transportation and information about service
• Lack of trust in providers and the delivery system
• Lack of understanding of cultural differences among providers and cultural adaptations among agencies
• Poor health literacy
• Racism and classism

“These findings underscore the importance of helping individuals overcome the barriers they face, while simultaneously using collaborative approaches to eliminate the barriers themselves,” Ballard said.

Their three-year project, “Building Blocks and Tearing Down Fences,” will address how to overcome obstacles that prevent residents of Pemiscot and Mississippi counties from accessing critical services to improve their health. In a nutshell, community health navigators and advocates will work with residents and a network of clinical and social service organizations to address existing barriers (building blocks) as well as make systemic, structural, and policy changes to eliminate these barriers (tearing down fences), the team explained.

The three leaders will receive intensive support from the Robert Wood Johnson Foundation through training, hands-on mentoring and national assemblies. As part of the Interdisciplinary Research Leaders Fellowship, they will connect with other leaders from across the country as they learn from, and work with one another to create more just and thriving communities. 

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Founded in 1818, Saint Louis University is one of the nation’s oldest and most prestigious Catholic institutions. Rooted in Jesuit values and its pioneering history as the first university west of the Mississippi River, SLU offers nearly 13,000 students a rigorous, transformative education of the whole person. At the core of the University’s diverse community of scholars is SLU’s service-focused mission, which challenges and prepares students to make the world a better, more just place. For more information, visit slu.edu.

Elizabeth Baker Ph.D., Carissa van den Berk-Clark, Ph.D., and Janice Ballard, MPH are fellows in Interdisciplinary Research Leaders, a national leadership program, supported by the Robert Wood Johnson Foundation to equip teams of researchers and community partners in applying research to solve real community challenges. The project described in this article is supported by the program. The views expressed here do not necessarily reflect the views of the Foundation.