For years the South Dallas neighborhood, located near the Texas city's downtown, has ranked as one of the leaders in Dallas County in all the wrong categories.
The predominantly African-American population has consistently experienced one of the county's highest rates of unemployment, poverty and lack of health insurance.
The area also has had one the county's highest rates of death from breast cancer. Nearly 40% of area women with breast cancer received their diagnosis in a late-stage of their disease, according to a 2015 Susan G. Komen study.
The disparities set off alarm bells at Parkland Health & Hospital System, which is putting money and time into addressing the area's poor health outcomes.
“We really need to address the social determinants of health and move upstream to try to postpone the onset of disease and eventually prevent disease if we're going to be successful,” said Dr. Esmaeil Porsa, Parkland Health's executive vice president and chief strategy and integration officer. In breast cancer care alone, the health system receives roughly 20% of the county's cases. “At some point we're going to be drowned by the number of folks who are going to be needing treatment of the illnesses,” Porsa said.
Parkland has partnered with the CMS since 2017 as part of a five-year, $4 million initiative aimed at finding ways to better connect patients identified as having unmet social needs with community resources.
That work led the system to focus on breast cancer broadly, and in September it was one of 10 health systems selected to take part in a yearlong initiative being led by the American Hospital Association.
Dr. Jay Bhatt, senior vice president and chief medical officer for the AHA, said the project's goal is to study the participating hospitals' various approaches toward improving health equity and to share information and develop a blueprint that other healthcare providers can one day adopt.
“We hope that there will be not only results that will improve outcomes and lower costs, but we hope that we will have strengthened hospital community partnerships not just for a moment but for the long term,” Bhatt said.
Other participants in what is known as the Hospital Community Cooperative include University of Vermont Medical Center, Holy Name Medical Center in Teaneck, N.J., and Tacoma, Wash.-based MultiCare Health System.
Each participating hospital receives $10,000 and guidance from subject matter experts and technical support, and will file a report on their findings near the end of the year. The Aetna Foundation provided financial support. In studying breast cancer care and access, Porsa said, the AHA initiative will provide the tools that will allow Parkland to address the other health inequities that exist throughout the community.
“If we were trying to be simplistic about this we would just send a couple of mobile mammography units and that would take care of the problem,” Porsa said. “But I really think the issue is much deeper.”