Community Engagement Institute Livestream with Interactive Presentations & Dialogue

The USA Center for Healthy Communities in partnership with the USA Office of Research Development & Learning will host a livestream of the 4th Annual Community Engagement Institute “Community Health from Engagement and Environmental Renewal (CHEER) for Civil Inclusion & Empowerment.” The event will take place in the Faculty Club of the University of South Alabama on October 6, 2017, from 8:00 am to 2:00 pm. The keynote presentations will be broadcast from Birmingham with onsite presentations and discussions related to the inclusion of community members in research.

Keynote speakers: Crook 100

Errol D. Crook, M.D., Physician & Director of the Center for Healthy Communities,  USA College of Medicine


Diane Bell McKoy,  President and CEO of Associated Black Charities-Maryland


A continental breakfast and lunch will be provided.

Space is limited so register today.

Download the event flier.


New Publication: Consolidating the Academic End of a Community-Based Participatory Research Venture to Address Health Disparities

A recent article published in the Journal of Higher Education Outreach and Engagement explores the development of the Health Disparities Research Group (HDRG) at the University of South Alabama.  Written by a team led by Dr. Martha Arrieta, the article discusses

  • the formation process of the HDRG
  • Activities leading to the promotion of group identity and permanence
  • Activities to Foster Health Disparities Research Capacity
  • Activities Leading to Engagement in Participatory Research
  • Activities Leading to the Dissemination of CBPR Principles and Practice
  • Keys to Success in the Consolidation of HDRG
  • Challenges Encountered and Responses Devised

Read the full article.

Why Medicaid Is The Platform Best Suited For Addressing Both Health Care And Social Needs

The following excerpt comes from the article by Katharine Witgert published September 7, 2017 on the Health Affairs Blog.

...The Medicaid program provides a plausible platform upon which to build a health infrastructure that incorporates the social determinants of health. Medicaid could provide a common entry point that links individuals and families not just to health care services, but also to social services that affect their health. Indeed, state Medicaid leaders have long embraced this concept and are experienced in building bridges that link health and social programs to meet the comprehensive needs of their citizens.

Where Medicaid Leads In Addressing Social Determinants

Medicaid programs have long been leaders in addressing social determinants of health. A range of innovations for incorporating social determinants of health have been tested in Medicaid programs across the country. State Medicaid programs make referrals to social services, directly connect individuals to needed services, align systems to share goals, and invest future savings to the health care system into social services programs. For example:

  • In Pennsylvania, the online health and human services programs eligibility system known as COMPASS allows individuals and families to simultaneously apply for Medicaid, the Children’s Health Insurance Program (CHIP), and the health insurance marketplace, together with programs that administer food stamps, school lunches, child care assistance, and other benefits. There is evidence from a range of social programs that transaction costs—the difficulty of applying—significantly influence take-up rates. Single applications can facilitate access.
  • Colorado’s Medicaid program divides the state into seven Regional Care Collaborative Organizations, each of which connects beneficiaries to health care providers as well as social and community services. The goal is to link every beneficiary with a primary care provider who not only serves as a central point of contact for medical care, but also assesses a person’s nonmedical needs.
  • Louisiana, meanwhile, has embedded permanent supportive housing into Medicaid home- and community-based services, allowing for better integrated care for individuals who are homeless or at risk of homelessness.
  • Recognizing the mutually reinforcing roles of health and education—health status influences a child’s ability to learn, for instance—Oregon began aligning its health care and early education systems around 2011. The Medicaid program and early learning systems share goals, staffing, and funding.

Additionally, Massachusetts, New York, Oregon, Utah, and Vermont are all testing strategies not only to link Medicaid and social services, but also to use Medicaid funds to actually deliver supportive services that affect social determinants of health. These value-based delivery system reforms include the creation of accountable care organizations, health homes, community health teams, and accountable communities for health.

Most recently, the Centers for Medicare and Medicaid Services (CMS) launched an initiative called Accountable Health Communities to better manage the health-related social needs of Medicare and Medicaid enrollees. The initiative will test whether systematically identifying and addressing the social determinants of health through screening, referral, and community navigation services will impact health care costs and reduce health care utilization. Over the next five years, the model will provide support to community organizations that link enrollees to services that address housing instability, food insecurity, utility needs, interpersonal violence, and transportation needs. As CMS begins to test this model, there is reason for optimism, given Medicaid’s track record of integrating health care and social services.

Read the full article.

Reducing Racial and Ethnic Disparities in Access to Care: Has the Affordable Care Act Made a Difference?

The following excerpt comes from the Issue Brief written by Susan L. Hayes, Pamela Riley, David Radley, and Douglas McCarthy.  It was originally posted to the Commonwealth Fund website on August 24, 2017.

Historically, in the United States, there has been a wide gulf between whites and members of minority groups in terms of health insurance coverage and access. Proponents of the Affordable Care Act (ACA) hoped that law’s major insurance coverage expansions and reforms would begin to bridge those gaps.

Evidence suggests that uninsured rates have declined among blacks and Hispanics under the ACA, but have these coverage gains reduced disparities between whites and ethnic and racial minorities? This brief seeks to answer that question and to examine if disparities in access to coverage and care are different in states that expanded Medicaid and states that did not.

We compared national averages between 2013 and 2015 for white, black, and Hispanic adults on three key measures of health care access to determine the effect of the ACA’s major coverage expansions on disparities:

  • the share of uninsured working-age adults ages 19 to 64
  • the share of adults age 18 and older who went without care because of costs in the past year
  • the share of adults age 18 and older without a usual source of care.

These measures align with those reported in the Commonwealth Fund Scorecard on State Health System Performance, 2017 Edition.

Additionally, we sought to determine if there were differences in disparities in states that chose to expand their Medicaid programs under the ACA and states that did not. For each indicator, we calculated the average rate for white, black, and Hispanic individuals in 2013 and in 2015 in two groups of states: the group of 27 states that, along with the District of Columbia, expanded their Medicaid programs under the ACA between January 1, 2014, and January 1, 2015, and the group of 23 states that had not expanded Medicaid as of that time.

As the current administration and Congress weigh how to move forward after the recent failed attempt to repeal and replace the ACA, it is useful to examine how successful the law has been in making health care available to racial and ethnic groups that have historically been left out.

Findings include:

  • Racial and Ethnic Disparities in Adult Uninsured Rates Narrowed After the ACA’s Major Coverage Expansions
  • Racial and Ethnic Disparities in Rates of Adults Who Went Without Care Because of Costs Narrowed After the ACA’s Major Coverage Expansions
  • Racial and Ethnic Disparities in Rates of Adults Without a Usual Source of Care Narrowed After the ACA’s Major Coverage Expansions
  • Disparities Between Hispanic and White Adult Uninsured Rates in Medicaid Expansion States vs. Nonexpansion States, 2013–2015
  • Disparities Between Black and White Adult Uninsured Rates in Medicaid Expansion States vs. Nonexpansion States, 2013–2015
  • Disparities Between Hispanic and White Adults Who Went Without Care Because of Costs in Expansion States vs. Nonexpansion States, 2013–2015
  • Disparities Between Black and White Adults Who Went Without Care Because of Costs in Expansion States vs. Nonexpansion States, 2013–2015
  • Disparities Between Hispanic and White Adults Without a Usual Source of Care in Medicaid Expansion States vs. Nonexpansion States, 2013–2015

Download the full issue brief.

UAB to launch statewide genetics initiative for better health for all Alabama residents

The following is an excerpt of the article by Bob Shepard Posted on UAB News.

The University of Alabama at Birmingham — Alabama’s leading provider of genomic and precision medicine — has launched the Alabama Genomic Health Initiative in partnership with HudsonAlpha Institute for Biotechnology to better meet health needs across the state.

The project, funded by a $2 million appropriation from the Alabama legislature to UAB, supports one of the nation’s first statewide efforts to harness the power of genomic analysis to help identify those at high risk for a genetic disease, and provide a basis for continuing research into genetic contributors to health and disease.

“This initiative could be transformative for the state of Alabama,” said Selwyn M. Vickers, M.D., senior vice president for Medicine and dean of the UAB School of Medicine. “We will use the knowledge gained from the AGHI to begin to uncover more undiagnosed diseases, and will potentially rewrite our understanding of the burden of disease on our population. This project can have tremendous impact on the residents of Alabama and stimulate economic development in the state.”

The AGHI will recruit a diverse group of participants from every county in Alabama and provide genomic analysis and interpretation to this group free of charge. For some, the results will indicate an increased risk of a disease for which preventive or treatment strategies exist. Those participants will receive genetic counseling and be linked to appropriate medical care. The initiative will also feature a public education campaign about genomic medicine and create a DNA biobank for research.

In the first year, the initiative plans on recruiting 2,000 individuals who will provide a DNA sample from a simple blood draw. Over a five-year period, the goal will be to increase the database to include genetic information from more than 10,000 persons.

“Since the Human Genome Project was completed in 2003, we’ve learned a tremendous amount about the roles of genes in disease,” said Bruce R. Korf, M.D., Ph.D., chair of the UAB Department of Genetics and co-director of the AGHI. “This project will result in immediate health benefits to some participants, and in the long term will help to address problems of chronic disease and rising health care costs in the state. It will also position Alabama as a leader at the forefront of 21st century medicine.”

The AGHI will engage citizens throughout the state and their health providers in the use of genomic information to guide medical care.

“This initiative advances the tremendous work already being done in genomics at HudsonAlpha and at UAB,” said Richard M. Myers, Ph.D., president and science director of HudsonAlpha Institute for Biotechnology. “Genomics is dependent on several factors, data being one of them. Undoubtedly, individuals will benefit from the AGHI; additionally, the initiative could lead to identification of new genetic diseases and new treatments for those conditions that will benefit Alabamians and the rest of the world. Through the AGHI, we can help make our citizens healthier, and demonstrate the value and power of genomic medicine in creating a new paradigm for health care. HudsonAlpha is proud to partner with UAB for this groundbreaking initiative.”

Read the full article.


Closing Ceremony of the 2017 STARS and STRIPES Summer Program

On July 21st, the CHC Center of Excellence hosted a closing ceremony to recognize twenty-five (25) high school students for their successful completion of the STARS and  STRIPES. Summer Enrichment program. The 13 Student Training for Academic Reinforcement in the Sciences (STARS), and the 12 Special Training to Raise Interest and Prepare for Entry into the Sciences (STRIPES) participants included students from 7 local high schools.

Dr. Errol D. Crook, Director and Principal Investigator of the Center of Excellence, opened the program by giving a brief overview of the program, welcoming all in attendance and congratulating the students on a successful summer.  He then recognized Dr. Hattie M. Myles, retired Co-cor

e Director of Community Outreach, for her outstanding legacy of service to the Center, the University of South Alabama and the community. Dr. Myles presented the Keynote in which she provided a heartfelt, “real talk” message of perseverance, dedication, and hard work. Finally, four former STRIPES graduates who participated in 2017 CHC Undergraduate Research Program, spoke on their undertaking of various research projects and gave the student participants a glimpse into college life.

Funded as a part of the NIMHD Center for Excellence, the STARS and STRIPES program activities  include:

  • Academic enrichment sessions during the summer
  • Participation in community service activities and health advocacy
  • An eight-week internship in a health care provision site or a medical research facility upon high school graduation

Read more about the STARS and STRIPES program

Stars and Stripes ceremony


2017 CHA Led Projects: Reaching the Community to Improve Health

This June, five Community Health Advocates(CHAs), submitted applications to the Center for Healthy Communities to implement short term, limited scope community projects addressing nutrition, health literacy, family health, and mental health. These projects are:

Nutrition through Gardening: CHA Lead, Sheena Billingsley
Starting in July, Sheena and her partners planned four health and nutrition awareness events at community gardens in the area. These events focused on educating community members on healthy eating and healthy living. Each consisted of

  • Hands on gardening activities
  • Healthy cooking demonstrations
  • Sustainable gardening techniques
  • Conversations with volunteer health professionals

As an incentive for participation, participants received personal growing space in the community garden located in their zip code.

Community Garden at Ridge Manor: CHA Lead, Frewin Osteen
The goal of this project is to increase and enhance home-based and community centered gardening though the construction of a Hoop House to demonstrate the feasibility of a new gardening method suited to small, protected areas.

Smart Grocery Shopping Workshop: CHA Lead, Barbara Hodnett
Through this workshop which was held in June, Ms. Hodnett offered an educational program designed to help participants develop shopping skills to save money while buying healthy foods. The workshop topics included:

  • Learning the typical layout of a grocery store
  • Arranging your pantry and food storage areas to maximize healthy choices
  • Reading labels to determine whether a product is a sound nutritional choice
  • Creating a healthy weekly meal plan

Workshop participants also participated in a walking field trip to practice applying the information they had learned.

Hearts to HEAL (Health Education and Literacy): CHA Lead, Porsche Blount
This five-day summer enrichment program aims to improve the health knowledge and literacy, reduce associated stigmas, improve self-self esteem, and help to create a positive self-image among adolescent girls aged 12 to 18. The topics addressed in the program are

  • Health literacy
  • Nutrition
  • Family Health
  • Mental Health

A pre/post test design will be used to measure the knowledge gained by participants in the program. Also, the final day of the enrichment experience will be an opportunity for the girls to give presentations about what they have learned.

Black Mental Health Matters: CHA Lead,  Zionne Williams
Through this two part project, Zionne and her partners hope to “break the stigma associated with mental health in minority communities and to bring much-needed awareness to the issues associated with mental health.” Part one of the project consists of a family-friendly community event to raise awareness of the importance of recognizing when someone may need help and how to connect those in need with the correct resource. The event included fun kid’s activities, food and entertainment, and presentations from mental health professionals.

The second part of the project is the development of a mental health awareness campaign through an online platform to promote health literacy, create an open dialogue with the community, and encourage potentially affected individuals to seek and complete treatment. To accomplish the goal, individuals will be invited to share their personal stories through visual, written and audio documentation that will be shared online.

These CHA led projects provide an important mechanism for the Center for Healthy Communities to support the CHAs in applying the knowledge they gain through CHC supported trainings to target health issues that are of greatest concern to them.  Through these projects they provide information in culturally relevant formats to improve the health of their neighbors.

Learn more about the CHA program.

Meet the Community Advisory Board of the Sentinel Surveillance Project

The Sentinel Surveillance to Monitor Progress toward Health Equity project of the CHC’s Center for Excellence aims “to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations.” Members of the Community Advisory Board (CAB) are community leaders who work in the research focus areas target by the project. Since the inception of the project in 2011, CAB members have provided the research team with important insight for choosing data collection sites and guidance in interpreting and understanding the collected data. The CAB members include:

Click on the links above to read more about the experiences of each of the CAB members in working with a multi-year research project.

Pipeline Students Present at Medical Student Research Day

On July 28, 2017, participants in the Medical Student Summer Research program presented on their projects. Among the eight oral and 55 poster presentations, five students were participants in the Center for Healthy Communities Undergraduate Research Program and two were undergraduate medical students who have multi-year connections to the CHC.  

Ms. Destini Smith, a second year USA Medical student, gave an oral presentation entitled “Access to Employer Provided Health Insurance in Low Income Communities.” Her work was sponsored by Dr. Kenneth Hudson of the Department of Sociology, Anthropology, and Social’ Work, and Dr. Errol Crook, Abraham A. Mitchell Chair and Professor Department of Internal Medicine and Director-Principal Investigator of the Center for Healthy Communities.poster collage

The poster presentations included:

  • Treatment of Hepatitis C Infection in HIV Infected Patients in Inner City Clinics, presented by Verlisa Kennedy, a first year USA medical student was sponsored by Dr. Eduardo Calderon, Division of Infectious Disease.
  • Health Policy and Child Poverty: An Illustration of the Social Determinants of Health presented by Aryne Hudson, a junior at Montevallo University was sponsored by Dr. Errol Crook, and Shannon M. Shelley-Tremblay, from the Center for Healthy Communities
  • Access to Employer Provided Health Insurance in Low Income Communities presented by Jasmine Mabry, sponsored by Dr. Kenneth Hudson of the Department of Sociology, Anthropology, and Social’ Work, and Dr. Errol Crook, Abraham A. Mitchell Chair and Professor Department of Internal Medicine and Director-Principal Investigator of the Center for Healthy Communities.
  • CASPASE-1 Levels are Elevated in Diabetic Patients Residing in Health Care Disparity Areas of Mobile County presented by Andrew Spriggs, a sophomore at UAB was sponsored by Diego Alvarez, M.D., Ph.D., Department of Physiology and Cell Biology, Center for Lung Biology and Center for Healthy Communities, University of South Alabama College of Medicine, Mobile, AL.  
  • Telehealth Enhanced Education for Patients Living with Diabetes in Rural Alabama, presented by Elizabeth Torrance, sponsored by Jessica Hardy of the Alabama Public Health Department in Montgomery and Dr. Alethea Hill of the College of Nursing.
  • A Mouse Model To Test The Cytotoxic Immune Response To Intracellular Antigens presented by Raven Walker, sponsored by Dr.  Victor Solodushko and Dr. Brian Fouty, Departments of Pharmacology and Internal Medicine in the College of Medicine.
  • College Student Obesity Prevention Program: Pilot Study, presented by Christen Carter, Sponsored by Sharon Fruh, Ph.D., RN, FNP-BC, Rebecca J. Graves, Ph.D., Heather Hall, Ph.D., Debra Swanzy, DNP, Theresa Wright, DNP, College of Nursing.

The summer program included 9-weeks of hands on research and a seminar program focused on various scientific and clinical topics.

See the full list of abstracts from the Medical Student Research Day.

poster collage


Center for Healthy Communities Congratulates Dr. Bobbie Holt-Ragler

Holt-ragler blueThe Center for Healthy Communities is pleased at the news that Dr. Bobbie Holt-Ragler, a long-serving Community Health Advocate (CHA), will receive the Lillian B. Smith Award at the Annual Convention of the Alabama State Nurses Association (ASNA) in October. Named for a long serving executive director of the ASNA, the Lillian B. Smith Award recognizes association members demonstrating long-term commitment both by service in the organization and in their communities.

Dr. Holt-Ragler received her Doctorate in Nursing Practice in 2007 and served for 30 years in the University of South Alabama hospital system. She also worked as a worked as a nurse educator at Mobile Infirmary Hospital. Now retired and a CHA, Dr. Holt-Ragler uses her knowledge and expertise in helping people gain important information about disease, disease prevention, and how to access medical assistance.