According to a UCSF study, obesity rates have dropped in Caucasian and Asian children and leveled out for Hispanic/Latino children for the first time in 30 years. Though this may point out successes in recent public health campaigns aimed at reaching youth it also highlights the fact that campaigns are not reaching all children: obesity rates in African American and Native American children continue to rise.

The study states that 20 percent of California schoolchildren were obese and 3.6 percent were severely obese as of 2008. Severely obese children are at high risk of experiencing life-threatening health complications such as diabetes and hypertension.

At St. Anthony Free Medical Clinic we now have an obesity treatment and management program for our pediatric patients and their families in response to the growing number of overweight children in our community. Diet and nutrition are crucial in healthy childhood development; limited access to nutritious food and poor education on how to make healthy food choices leave many in our community at a disadvantage.

Clinicians here at St. Anthony Free Medical Clinic have begun focusing care on children who qualify as overweight and obese in order to medically manage their health and weight-loss plans. We recognize that children are impacted by the health of their family members, thus families of overweight children are also enrolled in the obesity management program. We believe treating families holistically so that all who are involved in a child’s life receive the tools necessary to make healthy lifestyle choices, such as nutrition education and weight management education, is vital to successful weight management for our low income, uninsured pediatric patients.

Asthma in the Tenderloin
The Tenderloin has the highest citywide rate for ambulatory hospitalizations associated with COPD (Chronic obstructive pulmonary disease) and the second highest rate for asthma. According to a 2007 UCLA Health Policy Research Brief, one in six of California’s 2.8 million residents with active asthma live below poverty level. In addition to having poorer overall health, low-income residents also miss more school and work because of asthma, visit the emergency department for asthma care more often, and experience more frequent symptoms.

“Tenderloin residents live in old, poorly maintained buildings whose dust, mold, and other environmental factors dramatically increase asthma incidents.” noted St. Anthony Free Medical Clinic Director, Dr. Ana Valdés. “We try to address those factors through education, active medical care, and asthma management techniques.”

St. Anthony Free Medical Clinic
Established in 1956, the St. Anthony Free Medical Clinic is the first Free Medical Clinic in the United States. The clinic provides 12,000 patient care visits annually, nearly 3,000 of which are chronic care visits, Asthmatic patient account for about 9% of total visits.

The San Francisco General Hospital in partnership with the Avon Foundation were on-site here at St. Anthony Foundation administering mammograms for St. Anthony Free Medical Clinic patients  through the Comprehensive Breast Care Center. This “mammo-mobile” provides vital screening services to undeserved women around San Francisco in an effort to prevent breast cancer through early detection.

Women who receive primary care at St. Anthony Free Medical Clinic are given clinical breast exams as part of routine health exams and are signed up for yearly mammogram screenings through the Comprehensive Breast Care Center.

Since its inception in 2004, the Avon Comprehensive Breast Care Center has provided over 34,000 breast screenings and more than 2,000 breast health procedures. Diagnostic procedures include digital mammography, ultrasound-guided biopsy, stereotactic biopsy, localization procedures, as well as clinical, health education and case coordination services.

The “mammo-mobile” will be making monthly on-site visits to St. Anthony Free Medical Clinic to ensure  patients have ccess to these life saving services. It is community partnerships like these  strengthen the safety net and make health care available to all.

There are those who charge that services in the Tenderloin attract poor people to the Tenderloin. They think this makes the problems of the Tenderloin worse. But there are so many ways that St. Anthony’s and our partners in crime are good for the neighborhood and the city at large. Take the St. Anthony Free Medical Clinic, for example.

The Institute of Medicine estimates that lack of health insurance leads to more than 18,000 deaths a year. According to a study done by the Commonwealth Fund, this makes lack of insurance the sixth-leading cause of death among people ages 25 to 64—less than cancer, heart disease, injuries, and suicide, but more than HIV/AIDS or diabetes.

Without primary care, low-income, uninsured patients are less likely to discover medical problems early and more likely to delay seeking help until the problem is severe and requires emergency attention. Even if an illness doesn’t need emergency help, the emergency room is where most low-income people go when they’re sick or hurt. One study by the Commonwealth Fund found that of 2 million emergency room visits a year, 33% were for health conditions that did not require immediate care or could have been treated during a physician visit.

St. Anthony Free Medical Clinic provides those physicians. A doctors’ care at the Clinic helps relieve pressure on San Francisco’s ER facilities and reduces the state and county reimbursements for these costs, which are constantly up for reduction anyway in a state that continues to struggle with debt subsidies.

All of our full time doctors provide primary care: annual adult and well-child checkups, adult and pediatric immunizations, GYN visits for women, nutrition counseling, preventative health education, adult and pediatric lab tests, medication counseling, and evaluation for referrals to specialists.

We provide annual physicals necessary for our adult patients to get job clearance and for our pediatric patients to get school clearance. We help them take better care of themselves and manage their own health between visits. We empower patients, providing them with the primary care they need to stay healthy and offering healthcare support in times when they are not, all free of charge.

We think that’s good for the neighborhood and for the city. It’s surely good for the people who live here.

A big thanks to the kind folks at the Bryant Street Sports Basement! They’ve generously donated $500 in gift cards to St. Anthony Free Medical Clinic to promote healthy, active living among patient families. Their gift will provide low-income parents and their children with access to shoes and equipment as part of our Clinic’s ongoing effort to prevent obesity and diabetes.

For over 10 years, Sports Basement has actively reached out to the San Francisco community by sponsoring local nonprofits, fundraising for health and wellness causes, and holding in-house clinics and events that support healthy living for all in the Bay Area. Their dedication to the community is present in all that they do – Sports Basement routinely opens its doors to host local events, club gatherings, and community based organizations. We are so grateful for the generosity and partnership of this San Francisco based business. Thank you, Sports Basement!

This week is National Women’s Health Week, a week long health observance coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health. At St. Anthony Free Medical Clinic we are celebrating women’s health and wellness by hosting a Women’s Health Day next Friday.

Over half the patients seen at St. Anthony Free Medical Clinic are women. They are our mothers, daughters, sisters, and wives here in the Tenderloin. These women nurture their families and tie the community together, and are more than deserving of special attention to their health and well-being.

During our Women’s Health Day, staff will focus on the women of the Tenderloin and provide exercise and nutrition education, free women’s health screenings, free harm reduction classes to prevent at-risk behaviors, and mental health sessions.

Alongside the nationwide campaign, we are doing our part to give women in our community the healthcare support necessary to encourage them to take simple steps for a longer, healthier, and happier life.

I saw an article today about the inherent need for health care for the poor and uninsured and was stuck by the similarities between a group of Tennessee-based health care providers who opened shop in the Los Angeles Sports Arena and our own clinicians here at St. Anthony Free Medical Clinic. The LA group, known as Remote Area Medical, is comprised of hundreds of hundreds of doctors, dentists, and other medical professionals who historically have focused on caring for impoverished rural populations. As we know here in the Tenderloin, the demand for health care for the underserved in big cities continues to grow and now the RAM doctors have taken to the busy streets in an effort to meet healthcare needs, much like we do every day here at St. Anthony Free Medical Clinic.

As Health Care Reform continues to move forward, I find myself feeling hopeful for the future of American health care – even if major changes won’t be entirely evident until 2014.  However, here in the Tenderloin we see the need for health care TODAY, the need for services for working  adults  and families and children right outside the St. Anthony Free Medical Clinic doors. We provide care to more than 3,100 poor and uninsured patients a year and many of whom will not be eligible for government health care coverage when it becomes available. We will be here, as we are today, providing those in need with the comprehensive healthcare they deserve.

Today at St. Anthony Free Medical Clinic we’re holding our first Asthma Outliers Day. Now, what’s an outlier? An “outlier” is a patient in our chronic disease management program who has not been in for important medical visits such as medication adjustments, mental health counseling, or asthma education in over 6 months.

In an effort to help patients who might find it difficult to schedule an appointment we call these patients for Outliers Days where all clinic staff focuses on managing patients with one type of chronic disease for an entire afternoon. This way, patients see clinicians to get caught up on all dimensions of their health care needs all in one afternoon. For some of our diabetic and asthmatic patients this is more effective than attending a variety of appointments over time as they’re already overbooked trying to maintain living, food, and transportation needs.

Our chronic care program is tailored to the needs of our low income patients. We’ve seen improvement in our diabetic patients who have attended our Diabetes Outliers Days over the past year in lowering blood sugar levels. Through the care and guidance of clinic staff, patients gain a sense of ownership and empowerment in managing their own health. These events take place once a quarter and will continue as we continue to combat chronic disease in the Tenderloin.

219 to 212. A slim margin of victory, but even seven votes make a difference for the millions of uninsured who will now have the chance to receive the medical care that they previously couldn’t afford. On Sunday evening the House of Representatives passed the health care reform bill. The bill entails a sweeping transformation of the nation’s health care system, including offering insurance to tens of millions currently not able to afford health services.

The bill estimates expanding health insurance coverage to 32 million people, adds 16 million to Medicaid rolls, subsidizes coverage for the low-income and reduces federal budget deficits by 143 billion in the next ten years. Insurance companies can no longer drop coverage when people become ill and cannot deny coverage to children with medical problems.

After a year of back and forth between people and parties, the House approved the bill already approved by the Senate with a package of revisions. The President plans on signing the legislation Tuesday, making it law.

Although 32 million will be covered under the insurance umbrella, they will not receive coverage immediately and 23 million will remain uninsured, a third of these immigrants. However, the bill will expand  health care to many who were denied this civil right for so long and marks a historic point in American history.