Laura Montoya, left, and Veronica Ocana, center, receive dental information from Jefferson Dental community manager Dely Acosta, right, during a health and safety fair at Pleasant Grove Christian Church in Dallas, Jan. 25, 2020. The fair hosted a variety of health and safety information, as well as free flu shots by the Dallas County Health Department, and free lab tests checking cholesterol, STDs, thyroid, diabetes and glucose levels. Ben Torres/Special Contributor(Ben Torres / Special Contributor)
Dallas Health Officials identified Five Zip Codes as the Most Unhealthy. Here’s How They Plan to Fix it.
January 30, 2020 | Nic Garcia
| The Dallas Morning News
Three months ago, health officials diagnosed five zip codes in southern Dallas as the most unhealthy in the county. Today, the public gets its first look at treatment options.
Health leaders are set to brief more than 300 health care professionals, elected officials and community activists on their plan that they hope will reverse historic inequities and improve the county’s overall well-being.
The presentation from Parkland Health & Hospital System and the Dallas County health department is a response to a tome of data the two groups published in October that put a heavy emphasis on five zip codes – 75210, 75215, 75216, 75217 and 75241.
The response, however, focuses less on neighborhoods and more on specific chronic illnesses and other ailments such as pediatric asthma, breast cancer and mental health.
The plan builds on a shift at Parkland in recent years to provide more services away from its main campus in northwest Dallas, said Frederick Cerise, the hospital’s president and CEO. And while there isn’t a detailed list of interventions for each zip code, the strategies the hospital plans to put in place will have a strong and early focus on south and southeast Dallas.
“We have to do more upstream,” he said. “Dallas is a big city. There are inequities that are pretty broad. And so the approach that we’re taking is: ‘Where can we make an impact?’ We’re gonna have to take this thing in bite-size pieces.”
The plan, which is federally mandated by the Affordable Care Act and often referred to as a community health needs assessment, is still being fine-tuned. The hospital plans to include specific measurable goals next month and will regularly brief the Parkland board and county commissioners.
“I hope everyone does hold us all accountable for this,” said Dr. Philip Huang, director of the county’s health department, which will play a critical role in data collection and prevention of sexually transmitted infections, including HIV.
Some of the strategies Parkland and the health department plan to adopt as part of their plan:
Develop a partnership with Dallas Independent School District to share data in order to better identify and track children with asthma.
Increase the number of mammograms performed in zip codes 75216 and 75217, which includes Pleasant Grove, where there was a concentration of late-term diagnoses.
Increase the number of mental health experts at Parkland community health centers.
Provide a year’s worth of services such as nurse home visits to new mothers in southeast Dallas.
Expand a team of social workers, paramedics and police officers to respond to 911 calls involving people who may benefit from mental health services rather than a trip to the hospital or jail.
In an interview previewing the plan, Parkland officials suggested the work they’re about to do exceeds the federal mandate.
But that isn’t hard to do, said Kevin Barnett, a researcher at the Public Health Institute who has studied hundreds of community health needs assessments.
Federal standards for these surveys and plans are lax and hospitals usually spend too much time on data collection – something he suggested can be accomplished more easily than in the past – and not on solutions.
Barnett suggested that if Parkland and the health department are serious about ending inequities in specific zip codes, a goal he applauded, they would provide as much real-time data as possible and work to drive down the number of preventable emergency room visits for chronic illnesses such as diabetes.
"If your focus is on compliance, you're not being serious,” he said. “We have to go far beyond that. Your commitment ought to be about improving equality.”
Since October, health officials have stressed both a commitment to reversing stubborn inequities and the need for a countywide response that goes beyond what any hospital can do.
Community members and leaders echoed that call for partnership and holistic change.
Dorothy Hopkins, president and CEO of Frazier Revitalization, a nonprofit that is working to improve the neighborhood southeast of Fair Park, said Parkland and other elected officials must find the “political will” to improve the city’s forgotten neighborhoods.
“Of course every child over here has asthma because they all live in houses built in the 1920s,” said Hopkins, who plans to attend Thursday’s event. And while treatment is welcomed, addressing the underlying causes of asthma is paramount, she said.
Kevin Barnett is a Senior Investigator at the Public Health Institute.