Frontier hospital in Idaho takes unique approach to bridging the gap between medical care and food insecurity

Frontier hospital in Idaho takes unique approach to bridging the gap between medical care and food insecurity

By Cody Wilkinson, St. Mary’s and Clearwater Valley Hospitals and Clinics

At St. Mary’s and Clearwater Valley Hospitals and Clinics (SMH-CVHC), we are seeking to change the way care is delivered in northcentral Idaho.   In addition to eight primary care clinics throughout our expansive service area, we also have a highly motivated team of Community Health Workers (CHWs) that travel deeper into those “hard to reach” places within our service area to expand our reach.  They provide free medical screenings, distribute health information, and connect individuals to medical resources.

The SMH-CVHC Bridging the Gap (BTG) Team has pursued a more proactive approach to community health and addressing chronic medical conditions like diabetes by exploring a relationship with the Idaho Food Bank.  The Idaho Food Bank is well-established in the same communities that we serve and they provide direct support to many of the food distribution sites.  It took one conversation to realize that we shared a common goal of improving the health of our communities, and that marrying our work was an obvious first step.

                Our team of CHWs and I met with each of the food distribution sites in our three-county catchment area to explore the feasibility of co-locating our services.  Although all of the sites were open to the idea of having CHWs on site, we needed to work closely with food distribution volunteers to talk more about why healthcare and food banks could work together.  Furthermore, the logistics of hosting a co-located outreach event proved to be a limiting factor.  Some of the sites were located in small buildings with very little space, while others were simply pullouts along the side of the road with no electricity.  Some of the sites were drive-up pantries, where boxes were loaded directly into cars.  As we piloted a few co-location events, we learned that individuals were not interested in the services we had to offer.  They wanted to collect their food and leave.

                Our BTG team and CHWS quickly learned that we could not connect with our community by simply setting up our services next to the food pantries and waiting for people to volunteer to eat healthier.  That is the old way of thinking where hospital staff wait for patients to present to the emergency room in a health crisis.  We needed to build foundational relationships with the Idaho Food Bank, food pantry volunteers and community members.  We also needed to learn more about what could help our community partners and stakeholders to see the value in partnership with a healthcare organization.

                As the summer progressed, we continued to host co-located events.  However, we also embarked on a mission to make our presence more meaningful to everyone we encountered.  Our CHWs approached every vehicle with recipes and measuring spoons, with the hope they would eventually agree to participate in our health screening activities that can link residents back to primary care and follow up on specific social needs.  We worked alongside volunteers and community members to select food items, fill boxes, and load cars with supplies.  Our dietitian and benefits counselors were also present to offer free resources and information.  Anything we could do to help, we did it!  Additionally, we had an amazing opportunity to have a third-party researcher embed himself into our work.  Isaiah Sommers, a medical student from the University of Chicago, spent the summer researching the CHWs and our work with the Idaho Food Bank to offer insight and possible recommendations to guide future work.  He interviewed CHWs, community members who coordinate local food distribution, and administrators at SMH-CVHC and at the Idaho Food Bank to learn what parts of the co-location worked well, and what needed to change. His preliminary results show that individuals who use the food distribution services often have high rates of social and medical needs and face significant barriers to healthcare access, which highlights the value of having CHWs available at food distribution sites. Furthermore, it was thought that food distribution users would be unlikely to attend screenings at other community events, suggesting that co-located health screenings may be the only opportunity for CHWs to reach some members of the community. To effectively engage these populations, CHWs must overcome a deep distrust in the healthcare system by painstakingly cultivating personal relationships with each member of the community. 

As I reflect on our work this past year with the Idaho Food Bank, I am very satisfied with the foundation that we have built.  Relationship-building has been the key to our success and it will undoubtedly be crucial to the success of our work moving forward.  This winter we will sit down with the Idaho Food Bank team and evaluate our work more closely.  We will use the data and experiences we collected, Isaiah’s CHW and food bank partner research, and resources through BTG to expand our work to address food insecurity in our region.  Our relationship with the Idaho Food Bank will allow us to have a greater impact and offer more comprehensive health solutions to the communities we serve.