New York borrows a health care idea from Africa

The United States now has a variety of federally-supported nutrition programs, but the health care system remains disconnected from the social determinants of health. Many doctors simply lack the resources to provide the comprehensive care proven to have greater impact on health than strictly medical treatment. A group called Health Leads is training young volunteers to treat the social factors, like poor nutrition and housing needs.

Hidalgo Medical Services is a nonprofit public health clinic that has set out to develop a model for delivering quality, affordable health care to rural communities through a comprehensive approach that addresses multiple patient needs at once.

New mothers who live in poverty are faced with fewer resources to help them with their physical and mental health as well as the health of their babies. In New York City, the Nurse-Family partnership matches nurses with economically poor first-time mothers. Different studies have shown that women in the program have healthier pregnancies and children.

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.

Three hospitals throughout Mississippi rank at the top for having the lowest number of C-sections in first-time, full-term pregnancies. The hospitals achieved this by making midwife care a regular part of the birthing experience, despite not having a midwifery certification program in the state.

Promotoras de salud is a term that describe lay Latina community members who have been trained to provide health education to community members, and it's a concept that has helped eliminate barriers and improve health outcomes in Montana. Now, as the coronavirus pandemic spreads throughout the state, these part-time community health workers are helping their communities navigate the barriers to navigating the complex health care system.

Promotoras is a model used in Latin America since the 1950s, where respected community members perform health outreach and host events to answer questions about healthcare access and treatments. The program seeks to ensure that Latinx communities are not prevented from receiving quality healthcare because of traditional obstacles such as distrust, lack of transportation, lack of insurance, or language barriers. Research and surveys consistently show that this model achieves success by improving access to health services for the majority of people they interact with.

Patient navigation, which uses community members as health care informants, is helping to break down social and cultural barriers to accessing care in a community in North Carolina. The navigators are "population-focused," meaning they work in the communities they are passionate about and can relate to in order "to provide culturally appropriate assistance." Since the implementation of the program, doctors at Wake Forest Baptist Health Comprehensive Cancer Center have reported that more patients are seeking care proactively.

After accompanying trans people to their doctors appointments, and answering their medical questions, Kale Edmindson founded Trans Buddy in 2013. “Transgender people can call a hotline and get a trained “buddy” to answer their questions, refer them to a trans-friendly provider, or accompany them when seeing a doctor.” Since then, hundreds of people have been served and the model was replicated by the Kentucky Health Justice Network.

An emerging health care model, in Tennessee, has expanded to about 50 counties under a federal innovation program aimed at trying to give better care at lower prices.