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AARP Public Policy Institute
Bringing Health Services Straight to the People
First came the gritty Philadelphia neighborhood where she grew up. Then on to the tough areas of Newark, New Jersey, where she delved into her life’s work. And finally, to Los Angeles—where a gem of an idea blossomed.
Early life and professional experiences gave Gloria McNeal a passion for health care, and serving the underserved. And wherever her life path took her, she drew the same conclusion: Where you live, learn, work, and play determine not just your life course; these variables determine your very health.
All while gaining this wisdom, McNeal acquired an impressive resume of formal expertise, including a Ph.D. in Higher Education Administration and Master of Science in Nursing from the University of Pennsylvania as well as several pre- and post-doctoral fellowships.
Solutions to big issues, of course, don’t come easily. McNeal knew that to reach people in need, she would have to bring health care to the residents of a given community. She began those efforts with mobile health van initiatives in Philadelphia and Newark. That was a start (in fact, a highly innovative idea of another time), but delivering health services from inside a van is far from ideal.
“We had to coax people to come into the van,” McNeal says. “They didn’t trust us right away.”
In short, a “drive-by” mobile van did not enable the initiative to become a part of the community. Ideally, health services would be a destination within the community. They would provide care in places clients already frequent.
McNeal took those experiences and some percolating ideas to Los Angeles, home to many of the same urban health problems she knew so well. In the city’s Watts neighborhood, the average life expectancy is significantly lower than that of neighboring areas. It was there that McNeal came up with the idea that transcended the mobile health service challenges.
Working with community-based organizations willing to collaborate by providing space, McNeal, the dean of the School of Health and Human Services at Los Angeles’s National University, established nurse-managed clinics right on site at locations including churches, community centers, and the Salvation Army. A second phase of the initiative also reaches clients literally where they live—that is, via telehealth services for patient-provider interactions that do not require in-person visits.
The initiative even features an innovative means of staffing the clinics in a cost-effective way: National University nursing students provide the services. In addition, a multidisciplinary team of health professionals—including those in informatics, public health, and other allied health professions—contribute to the design and implementation of the initiative.
Thus, good ideas build on good ideas. And with thought leaders like McNeal at the helm, yesterday’s solutions are often set aside for something better still.
“The mobile clinic was great when we started 20 years ago,” she says, “but it was time to improve on the model and disrupt the way care was delivered.”
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