Baylor Treats Illness "Clusters" Around Town

On Houston's north side, diabetes is a major health problem. On the east side, asthma frequently causes children to miss school. Childhood obesity is becoming more common on the city's southwest side.

To help manage these chronic diseases, Baylor College of Medicine physicians began implementing their Community Health Program July 1. Physicians from Baylor's Department of Family and Community Medicine committed $40,000 to the program in addition to their initial $40,000 contribution for the program's study and preparation phase, which began in 2000. The program is based at six of the Harris County Hospital District's Community Health Centers.

"These physicians work among the most vulnerable citizens in our community, many of whom have chronic conditions that need continuous management," said Dr. Stephen J. Spann, chairman of Baylor's Department of Family and Community Medicine. "The strategies our faculty are implementing will make a significant difference in the health of the people who live in the neighborhoods surrounding the community health centers."

Baylor researchers studied patient records and demographic information and found that certain illnesses clustered in specific areas. From what they discovered, they developed treatment plans for patients who most often suffer from chronic diseases.

Diabetes management is the focus at Aldine, Casa de Amigos and Northwest Community Health Centers in the northern part of Houston. Northwest Community Health Center is using a group-to-group approach to manage diabetes, in which subspecialists interact with patients. Patients at the Casa de Amigos Community Health Center also are treated by subspecialists and consult with a case manager to keep their diabetes care on track. Aldine Community Health Center uses both approaches.

Pediatric obesity is the target at Peoples Community Health Center on the city's southwest side. Physicians closely track the health of a select group of patients, ages 10 to 17. Each patient participates in nutrition and exercise classes and a behavior modification program that uses positive reinforcements, such as a family boat/vacation prize package.

"Our goal is to help these youths make the kind of lifestyle changes that not only improve their health, but also improve their quality of life," said Dr. Blanca Azios, an assistant professor of family and community medicine at Baylor.

Congestive heart failure is the most common chronic condition at Martin Luther King Community Health Center, near the University of Houston. Patients receive scales and weigh themselves daily. A nurse contacts the patients every two weeks and asks about their weight, symptoms, daily activities and general health.

Asthma is a major health concern in the area surrounding Strawberry Community Health Center in Pasadena. Physicians developed a school-based disease-management program at Cloverleaf Elementary in Galena Park. They have created a screening questionnaire to monitor patient symptoms, school absenteeism, parental absences from work and emergency care. Physicians will use this information to develop treatment plans for patients and their parents.

Through the program, each community health center sets aside $10,000 for neighborhood improvement grants, such as patient-to-patient tutoring at Peoples Community Health Center and a breast cancer awareness walk sponsored by Martin Luther King Community Health Center.

"Health care providers have to look at the community as a whole and determine what its problems are," said Jennifer Markesino Roberts, coordinator of the grant program. "They may not always be health related, but they need to be addressed."

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©2006 Texas Medical Center

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