WHILE I had a great time on a recent trip to Miami, I realized how cool our own city is. Philadelphia really is a great place to live, with its historic landmarks, great museums, abundant arts and culture, fabulous restaurants, shopping, Fairmount Park, and plenty of pedestrian-friendly spaces.
Do you think you know everything about our great city? You might be surprised to discover that Philadelphia really is "the place that loves you back" and Greater Philadelphia Health Action Inc., is a stellar example of it. I learned about GPHA about a year ago when I was asked to participate in training sessions for its innovative Centering Pregnancy Program. However, it wasn't until recently that I discovered the historical significance and magnitude of this great community health organization. The late African-American activist Carl Moore and other South Philadelphia community leaders were the pioneers and courageous visionaries who saw the need for affordable and accessible health care. From the fruits of their labor, Greater Philadelphia Health Action was founded in 1970.
Since its inception, GPHA has been dedicated to providing health care to every member of the community, regardless of income or coverage by health insurance. Its goal is simple: encourage prevention while simultaneously offering the very best care, diagnosis and treatment when clients are sick.
Today, GPHA has grown into a major health care provider, serving up to 60,000 patients in the Delaware Valley. This nonprofit, community-based health care organization offers comprehensive primary care services, behavioral health care, health education, human services, child development services, and innovative programs like the Asthma Center of Excellence, the Centering Pregnancy Program, and maternal care through the Midwifery Group and Obstetrician Care Programs.
Beginning Sunday, GPHA is joining other community health centers nationwide in celebrating National Health Center Week. GPHA will host open houses at several of its centers, offer free blood pressure screenings and provide CPR training to those who want to learn this life-saving skill. A town meeting to discuss the racial and economic disparities in health care is scheduled for Aug. 10 at St. Joseph's Hospital, 16th Street and Girard Avenue. Community health centers provide vital services to underserved communities and Philadelphia is fortunate to have the dedicated team of medical and administrative professionals who make up Greater Philadelphia Health Action.
Hear it from an expertDr. Janet E. Young, a Harvard University graduate who specializes in internal medicine, is the medical director for Greater Philadelphia Health Action. Daily News fitness columnist Kimberly Garrison talked to her last week about her work, the mission of GPHA and the importance of lifestyle decisions in protecting health.
Q. What was your motivation to study medicine and then focus on community health?
A. I was more of an artistic person - an artist, musician and writer. My family was really surprised when I decided to pursue medicine. I really think it had to do with my family members in rural Virginia and the paucity of health care resources there and the poor quality of care they were receiving that influenced me more than anything else. And so at that point I had made my mind up and never looked back to the music.
Q. How did you get to GPHA?
A. A friend of mine in college told me about Greater Philadelphia Health Action Inc.
Q. When was that?
A. Back in 1985.
Q. You have been here since 1985?
A. Yes, and it was exactly what I wanted to do. I knew when I was in residency that I wanted to work in underserved communities. So, it was a perfect fit.
Q. Who does GPHA serve? What are the demographics?
A. In the city of Philadelphia, we reach out to patients in all parts of the city. We're in North Philadelphia, the Northeast, West Philadelphia and South Philadelphia. We serve all ages, all ethnic groups, and we reach out to patients that speak multiple languages. The purpose of this organization is to provide quality health and behavioral services to patients in need of such services and we don't have any particular criteria. They don't even have to live in Philadelphia. They could come from Delaware or New Jersey. We have patients from other states and there are no insurance requirements. You don't have to have Medicaid or Medicare, private insurance, or any insurance. So our patient population is very diverse.
Q. What can the average Philadelphian do to live a more healthy life?
A. I think the list is pretty well known but not so easy to follow. It has to do with lifestyle and knowing what your personal risks are and knowing how to manage personal risks. Everyone comes with a family history and it's important to know what that is. Especially those who have histories of metabolic conditions, cancer, or heart disease. It's important for individuals to not smoke cigarettes and not to use drugs, to not drink to excess, and to exercise regularly and to eat healthy foods. Those are the basics. Accessing health care and getting screening tests are also important in order to catch things in the early stages.
Q. Are there any immunizations that adults should be aware of?
A. In general adults need a tetanus booster every 10 years. A lot of people don't think about tetanus until they are in an accident. They step on something, something falls on them, they are in a car accident. But tetanus is a ubiquitous organism that's all around us. So getting a booster every 10 years protects you from any accident that may occur. So that's across the board for all adults. Then there are also vaccines based on individual particular needs.
Q. Is there a link between our health and spirituality?
A. That's a good question but I guess it depends on how you define your spirituality. Because a person cannot be divided into parts and pieces. When treating someone you have to take the entire individual into account. Not just their lab test, not just their age - what is their family history, what is their home life, their working conditions and spirituality or intellectual ability or religious beliefs (which is actually different from spirituality). Also how the person takes care of themselves, the image the person has of him or herself, and the standards they set for themselves.
Q. Can you give me an example of what you typically see based on the above?
A. Unfortunately, what I see is a lot of individuals that don't value themselves enough. I see this as a spiritual problem. It is not an intellectual problem and it's not a mental health problem. It is just not caring enough about your life and therefore taking chances with things that you shouldn't take chances with. Be it unprotected sex, or experimenting with drugs, smoking, putting oneself in harm's way hanging out with gangs, getting piercing and tattoos (which are associated with viral hepatitis).
Q. What is happening in Philadelphia concerning AIDS?
A. Like all the major cities we are seeing a spread of HIV among young people and heterosexual people. The spread of HIV has not stopped. Because we have treatment many people have become complacent. We still encourage people to get tested, and avoid behaviors known to increase risk of HIV.
Q. What about heart disease and diabetes. Are we seeing any reduction in those numbers?
A. Treatment for heart disease has improved dramatically. Death from heart disease has gone down but the cases are not going down. We have an obesity epidemic. Philadelphia was named one of the fattest cities. Diabetes is a huge concern. Diabetes links to heart disease and stroke. With this increase in obesity among children, adolescents, and adults we're looking at a future of more cardiovascular disease. Obesity shortens life span. It breaks my heart. This was practically unheard of 20 to 30 years ago.
Q.There are those that advocate fat acceptance and say you can be healthy and overweight or obese. Is it possible to be both healthy and significantly overweight?
A. I think it's important to have the right perspective on weight. There's a range of healthy weights. There is not one weight for a given height. Bone structure makes a difference. There is a reason for the range and that means if you're not in the range you are at increased risk. And this is just a fact of life. I empathize with individuals that want to wish this away. If you are over the range you have increased health risk for diabetes, cancer, high blood pressure, heart disease and stroke. We can't make that go away because they have an image of "I can be overweight and healthy."
Q. I hear a lot of controversy about this issue and especially from African-American women. A lot of sisters feel the charts do not apply to them. Many of us think the BMI (Body Mass Index) does not really apply to black folks.
A. Of course it does and I would encourage a comparison with our brothers and sisters in Africa who don't seem to having a problem with their BMIs. And we are having problems with the foods we eat and lack of exercise.
Q. What's your recommendation for exercise?
A. Pick something you like, preferably more than one activity so you have variety, and make sure it's vigorous. One thing many people do is pick something that's not vigorous and then they are wondering why they're not making progress with weight or blood pressure. Activity should be pleasurable and not drudgery. The gym is not for everyone. I encourage people to try out something different that seems interesting and fun - yoga, tai chi, Tae Bo, Pilates, kick-boxing. Something will be to your liking. It's the activity and the regularity.
Q. Does racism play a role in the health disparities between races that we see today?
A. Because the problems stem back so long ago, I think that racism gets buried a bit. In some cases I think the community has internalized the racism. Then there are expectations. It doesn't come so much about "liking" the patient but there can be condescending attitudes, information that's omitted, or services that are not offered. This is how a person does not get state-of-the art treatment.
Q. How can a person get good health care?
A. I'd say in 2006 and moving forward people need to be knowledgeable. It is better to know than not to know.