For the rural elderly, it can take a village

In Kern County, where pregnancy-related mortality rates are more than double the California average and Black mothers face life-threatening complications at nearly three times the rate of white women, community doulas are working to bridge the gap between patients and the medical system. Since California expanded Medi-Cal coverage to include doula services in January 2023, more than 1,400 doulas have enrolled statewide, with active training pipelines building the workforce locally.

GoodVision trains local technicians to produce glasses made with flexible spring steel wire and shatterproof plastic lenses that are manufactured locally with hand-powered machines that don’t require electricity. They then distribute the glasses in their own communities, pricing them at 2-3 days' local wages (about $5-6 USD). Since 2012, the initiative has provided glasses to over 1 million people across 11 countries, employing approximately 600 people.

North Carolina has expanded a network of peer-run mental health programs, including peer cafes, respite houses, and support hotlines, staffed by people with lived experience of mental health and substance use challenges. These spaces offer free activities, crisis support, and community connection as alternatives to clinical settings. Research found that peer programs reduce emergency department visits by more than 40% over a three year span.

In 2017, residents of Kabuga Aisami in Kano built their own maternal and child health hospital to address maternal mortality rates and improve access to care. Led by the Kabuga Aisami Community Initiative (KACI), community members pooled resources to construct the facility, which includes two labor rooms, three wards with 40 beds, four laboratories, a pharmacy, 25 toilets, and three self-contained flats for doctors to enable 24-hour care. Patient volume has since increased by over 250%, and the hospital has expanded to serve 10 surrounding communities, as well.

Cycling Without Age addresses social isolation among elderly people through a volunteer-run program using electric three-wheeled bicycles with two front seats, so elders can enjoy a ride without the physical toll. Founded in Copenhagen in 2012, the program has expanded to 3,600+ chapters across 41 countries with 50,000 volunteers.

The National Council for Mental Wellbeing's Mental Health First Aid for Rural Communities trains local residents to recognize mental health warning signs and provide critical support until professional help arrives. The program equips non-medical community members with skills to spot crises, have supportive conversations, and navigate people to appropriate resources. In central New York alone, more than 6,000 people have been trained across 10 rural counties, providing life-saving interventions, particularly in areas where emergency services are hard to access.

Over the past several years, Lithuania has implemented a comprehensive national strategy to combat high suicide rates by shifting from a medicalized approach to community-based support. One such strategy is Sidabrinė Linija, or Silver Line, a nonprofit offering free support to isolated seniors by matching them with a “befriender” who shares some of their interests. Since its inception, Silver Line has befriended 6,000 seniors. As a result of combined efforts from multiple initiatives, Lithuania’s suicide rate has dropped from 44 per 100,000 residents in 2004 to 19.5 per 100,000 today.

The Network of TB Champions in Kenya works with volunteer TB survivors to go door-to-door, screen people in public spaces, provide treatment support, trace contacts and link patients to nutritional assistance. Volunteers complete a two-day "Tuberculosis 101" course and then work under the supervision of local health facilities, using their lived experience with TB to build trust and overcome stigma in hard-to-reach populations.

The Mamacare Foundation has trained over 860 traditional birth attendants (TBAs) in hygiene, safe delivery practices, danger-sign recognition, and timely referral systems over the past decade to improve maternal care in the region. The program pairs each TBA with a supervising midwife, creating a collaborative bridge between traditional and modern maternal care. The training has increased referrals from TBAs to clinics by 40%, and district hospitals report fewer emergency cases arriving in critical condition since the Foundation has formed.

Priya Living is an elder-living community focused on Indian culture. Priya Living has four locations throughout the state and is planning to expand in Michigan and Texas. Rent in the condo-style units ranges from $2,000 to $3,000 a month and currently serves over 530 people. This culture-focused community helps the aging population fight loneliness and find a sense of community with people they can relate to through activities and programming like yoga, movie screenings and down time to chat.