Parkland Hospital Is Hiring Community Health Workers to Fix Health Disparities

It's part of a plan to address widespread health disparities in southern Dallas.
It's part of a plan to address widespread health disparities in southern Dallas. Adam Jones / Wikimedia
For months, Parkland Hospital administrators have been touting a new focus on tackling health disparities in Dallas' poorest ZIP codes.

Now, they've released details about how they'll do it.

The hospital is hiring community health workers and plans to deploy them in southern Dallas to help fight heightened mortality rates, particularly among black residents. It's one of an array of new strategies the hospital promises to implement by 2022.

Michael Malaise, a senior vice president at the hospital, said the plan is part of a larger effort to direct more of the hospital's resources beyond its walls. "We wanted to make that public, so that the public could follow along with whether we're making progress," he said.

The program is outlined in the hospital's "implementation plan" for the federally mandated Community Health Needs Assessment released last year. Besides hiring community health workers, the plan outlines dozens of actions the hospital will take to address the disparities outlined in the assessment, from new screening programs to additional mobile health clinics. It was published online earlier this month.

The numbers in last year's assessment were sobering. The expected life span of someone living in South Dallas' ZIP code is 23 years shorter than someone living in Uptown's. Black men fared worst, with life expectancy over five years shorter than average.

But addressing that disparity, Malaise stressed, is going to be a long-term effort. "You're not going to solve that in three years," he said.

Still, the hospital is taking a variety of immediate actions. It will assign a top executive to improve the hospital's "cultural competency," launch new screening programs for heart disease, cancer and diabetes, and hire a dozen community health workers in southern Dallas.

"You can't solve health disparities unless you start tackling economic disparity." — Michael Malaise

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"The value of these community health workers is their relationship to the community," Malaise said. "That's really an imperative if you're looking how to get beyond our hospital walls." They will be tasked with connecting difficult-to-reach patients with healthcare services.

A federal task force concluded that there's strong evidence that such programs are effective. Baylor Scott & White Health has already hired more than 100, and Parkland plans to train at least a dozen.

For months, Parkland administrators have been working to raise awareness and garner support for their efforts. "This communitywide problem requires a communitywide response and some nontraditional thinking from Dallas County’s public health system," wrote the hospital's CEO, Dr. Fred Cerise, in an op-ed last month.

The efforts stem from pressure — both internally and externally — on the hospital to take a leadership role in addressing the issue.

Jeff Tillotson, a Dallas trial lawyer and hospital board member, said he was taken aback by some of the statistics reported in last year's assessment.

"It was very jarring to realize there's that big of a gap, you know, in a matter of a few miles," Tillotson said. "What I was focused on as a board member, and what I think the hospital's focused on, is what can we do better than before to really attack the problem?"

But he said he's very happy with the plan proposed by the hospital's leadership, and particularly the inclusion of metrics that will track the hospital's progress.

Tillotson called these metrics a "scorecard" that leadership can use to figure out what's working and what's not, and also a way for the board to hold the hospital accountable.

But Parkland administrators stress that all of the blame does not fall on them. "You can't solve health disparities unless you start tackling economic disparity," Malaise said. They've promised to work closely with the county, which has pledged — among many things enumerated in the plan — to enact policies to improve access to health foods and physical activities.

At a community meeting last month, which the hospital plans to repeat annually, Cerise was joined on the stage by the county's top health official, Dr. Philip Huang.

"Fire me in four years if we don’t make any progress," Huang reportedly said.

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Lucas Manfield is an editorial fellow at the Observer. He's a former software developer and a recent graduate of Columbia Journalism School.
Contact: Lucas Manfield