Today I paid a visit to the Kaiser Family Foundation (KFF) headquarters off Sand Hill Rd. here in Menlo Park. Having developed good friendships at the orientation for the Kaiser Media Internship in Health Reporting, I was excited to see familiar faces of the other interns, Penny, and Deirdre, and also learn about children’s health in California. Upon arrival, I was taken on a tour of the beautiful resort-like office of the KFF office complete with floor to ceiling sized wall art and a gorgeous view of the city all the way to Stanford’s Hoover tower. I definitely wouldn’t mind working there!
The morning briefing was a presentation on how to effectively use kidsdata.org, a comprehensive website pulling from over 35 data sources such as California surveys and the Census to compile data on hundreds of indicators of children’s health. This project was created and is still maintained by the Lucile Packard Foundation for Children’s Health. Using the site, one can easily search for statistics on children’s health customized by year, ethnicity, and age, among others, all stratified by city, county, or school district. We were shown how to use “Eligibility for free or reduced price school lunch” as a measurement of poverty level. (Family income must be below 130% of the federal poverty guidelines ($28,665 for a family of four in 2010) for free meal eligibility, or below 185% of the federal poverty guidelines (or $40,793 for a family of four in 2010) for reduced-cost meal eligibility). If you ever need data on kids health or if you are simply interested in perusing some statistics, I would recommend looking at some of the indicators on this site. They even have an “Abstinence: Teens who have not had sex” indicator, which put the California abstinence statistic at 80.8% (in which case, I wonder if the parents were in the room when these surveys were administered…).
After a delicious lunch and failed attempt to eat outside due to killer bees that wouldn’t leave us alone, we all headed over to Ravenswood Family Health Center for a site visit. I have often heard of Ravenswood because at Arbor Free Clinic we refer San Mateo County primary care patients there. The mission of this clinic is to serve the community by delivering culturally competent, high quality care to everyone regardless of financial or immigration status. Their patient profile in 2010 was 12% African American, 73% Latino/Hispanic, 9% Pacific Islander, and 4% Caucasian, and 2% other. A large majority of the staff are Spanish-speakers, African American, or Pacific Islander, and many of them grew up right in East Palo Alto, so they know their patient population quite well. After I toured the adult and pediatric clinics, we crossed the street to tour the new dental facility which opened a little more than a year ago. I could note a hint of pride as Luisa Buada, the CEO of Ravenswood, took us around the facility; understandably so, as this dental facility integrates dental care with primary care and provides health services that are desperately needed in this community. At the end of the tour, we met with Will Cerrato, the chronic disease manager at Ravenswood, a recent dental patient, and her patient navigator to hear their stories.
Justine* had been in her normal state of health when one day she felt intense pain stabbing her face from the area right under her earlobe to her chin. The electric-like spasms came and went in attacks, and severely affected her ability to carry out simple daily tasks. She came into the Ravenswood Dental Clinic, where one of the nurses happened to have seen a case of trigeminal neuralgia in the past, and recognized the symptoms. With the help of her patient navigator, who paved the way for our patient through all the administrative red tape involved with getting care, Justine was able to have a consult with a Stanford neurologist, subsequent surgery to relieve pressure on the nerve at Stanford, and medications to keep her pain at a minimum. My head spun just hearing about all the paperwork that needed to be filled out and people who needed to approve transfers of care. As Will Cerrato pointed out, education and literacy levels are challenges to providing care in this patient population. I felt very touched hearing about the role of patient navigators, who are truly dedicated to getting these patients the help that they need from the beginning of their interaction with doctors at Ravenswood to obtaining the medication needed after the procedures.
Another one of Ravenswood’s services is health education. One of the nurses told us about the nutrition classes she was putting on for moms in the area. With Collective Roots, the nurses were having shopping field trips and cooking classes to teach moms how to provide healthy meals for their families. She explained how she was teaching parents to use turkey meat for tacos instead of beef, and how to choose organic produce in reduced price farmers’ markets. “Each of our patients is my family,” she explained to us. “I grew up in East Palo Alto, and each patient I see is one of my family members.” Hearing her words, I began to realize just how important a role Ravenswood plays in the lives of its patients. The clinic does more than provide healthcare. Ravenswood takes patients in and welcomes them into a family, a home of sorts, that goes above and beyond just health check-ups. The clinic takes on a holistic approach to healthcare, where patients are supported in every aspect of their lives. Patients here feel like they really matter, and that the doctors and nurses actually care on a personal level about their health outcomes. How lucky we are to have a clinic like Ravenswood here; I think all doctors should rotate through sites like these to learn how to transform hospitals into a community.
*name changed to protect patient privacy