Healthcare access and obesity in Bella Vista, Pennsylvania

Community/Organization of Interest:

Health and medical services in Bella Vista, PA, a South Philadelphia neighborhood

The cultural perspective

Bella Vista, PA, a South Philadelphia neighborhood, is a largely Italian-American ethnic enclave dominated by white, working-class residents. Although recent scholarly literature has focused upon the deficit of healthcare knowledge and services in lower-income nonwhite populations, deficits in knowledge and willingness and ability to access vital resources to improve their health still persist across population groups. For example, one study of non-Hispanic and Hispanics found that there were high levels of systemic barriers to obtain colorectal screening, including: scheduling and financial barriers; fear of diagnosis and pain; and lack of motivation amongst all study participants (Green et al. 2008). Culturally and psychologically in many communities, there is often an unwillingness to seek medical treatment in the form of screening. Even though Bella Vista is not a poor community cultural attitudes towards healthcare can still be significant.

Politics and economy: Effects upon healthcare

Enhanced physical and economic access to healthcare is critical to enhancing residents' ability to fully enjoy healthcare services: "one of the most important community determinants of access is the magnitude of the geographic area's population that tends to rely on the health care safety net, such as community clinics, public hospitals and clinics, and teaching hospitals" (Brown et al. 2004). Bella Vista currently boasts access to a number of large community hospitals, including Greater Philadelphia Action which can enhance usage of critical services.

Bureaucracy

Creating a more effective healthcare bureaucratic system to deal with healthcare needs is essential. The recently-passed Affordable Care Act (ACA) has tried to increase reimbursements to Medicare providers as well as Medicaid providers (Breen 2013). For elderly residents this can be a critical spur to take a more active approach to healthcare and self-care.

Organizational culture

One organization within the area dedicated to providing assistance to residents is Greater Philadelphia Action. GPHA advertises itself as a nonprofit organization offering a wide array of "primary, dental and behavioral healthcare" with a focus on preventative medicine (GPHA, 2014). The organizational culture and vision stresses the need to provide "compassionate and affordable healthcare for families" and is one of "the largest and most effective providers of primary healthcare in the area-serving over 85,000 patients" (GPHA, 2014). Comprehensive healthcare in a 'one-stop shopping' facility can enhance willingness to access primary care and encourage users to avail themselves of a wider array of healthcare resources.

Organizational structure

GPHA makes use of a 'case management' approach which treats the 'whole person.' "GPHA is committed to helping patients break down any healthcare barriers they may face by offering medical case management services. Provided for patients with debilitating problems, which may range from a lack of resources and housing to drug and/or mental problems, all of which can negatively affect a patient's health, our medical case managers serve as a lifeline" (Medical case management, 2014, GPHA).

Ways in which your community/organization works with immigrants and refugees

Culturally-based attitudes can often determine willingness to access healthcare services, regardless of income level (Hochhausen & Perry 2011). Bella Vista continues to attract a high percentage of recent Italian immigrants to the area: "of the top twenty tracts for Italians, three are in the Marconi Plaza/Packer Park neighborhood, including tract 47, where those born in Italy made up over 9% of the population, the city's highest. The Wharton/Hawthorne/Bella Vista area contained three tracts with large proportions of Italians, Girard Estates had three tracts, and South Philadelphia had two tracts" (Patusky & Ceffalio 2004: 34). However, given that this immigrant pattern is somewhat different from that of the larger Philadelphia region, language-sensitive assistance (including healthcare services) has not been as proactive as it has been with other communities: "the Philadelphia metropolitan region attracts a larger share of immigration from India, Southeast Asia, China, and parts of Eastern Europe than the national average" overall (Patusky & Cephalic 2004: 5). This highlights the need for local organizations to fill in the gaps: "local organizations may be mainstream, those serving much broader populations than refugees and immigrants. Examples include county departments of social services, hospitals, schools, and counseling agencies. They may also be ethnic, those private agencies targeting the needs of refugees, immigrants, or other designated ethnic populations" (Kirst-Ashman & Hull 2011: 125).