Johnny Johnson and Anthony Taylor are a made-in-Hartford tag team. Upon first meeting, it can take a moment to tell these two men apart. Both are 52 years old and sport short, salt and pepper hair. Both share the same shorter stature and wear bright, welcoming faces. Today this likely pair is going door to door to get their neighbors to complete a short health survey for Community Solutions.
Johnny, a man with palpable passion for his hometown, naturally plays the role of the charismatic opener. A handful of times each week he can be found pounding the pavement around the Northeast Hartford neighborhood and appealing to residents' personal stake in the larger community's needs. Once good relations have been established, Anthony is right there to step in with a more analytical approach. With a tablet computer in hand, he diligently takes his neighbors through a set of survey questions aimed at teasing out their experiences and needs around unemployment, public safety, and health care services. And, it is both men that make sure there is a carefully kept record of who they've gotten the chance to talk to in this community of about 10,000.
Anecdotally, neighborhood residents have been on the same page for a long time - Northeast Hartford needs change. In 2004, the closing of the Swift gold leafing factory tipped off what has now been a little more than a decade of debilitating unemployment-- an unending rash of joblessness that has dealt blow after blow to this once vibrant community.
This story about the unraveling of opportunity in Northeast Hartford is told by more than just residents. Data from the state of Connecticut, Medicare, and Medicaid reveals the neighborhood as an outlier along multiple indices. Apart from an unemployment rate more than twice the national average, the community's population has the most diminished life expectancy in the larger Hartford area.
But history makes clear that it doesn’t have to be this way, and in Northeast Hartford, there are still plenty of residents who remember a time when local fortunes were better. Through our Northeast Hartford Partnership, Community Solutions is coordinating a complex effort to help these residents and their neighbors turn the hardships of their community around.
The comprehensive survey is a starting point in that effort. It takes about 15 to 20 minutes to administer, and Johnny, Anthony and their co-workers hope to persuade a random sample of at least 300 of their neighbors to fill it out. Because lack of favorable health outcomes has emerged as one of the community’s most pressing issues, the most important survey questions deal with individuals' interactions with doctors and visits to hospitals and clinics. Yet, the survey also layers in other kinds of inquiries in order to take into account factors such as employment and housing that so often play pivotal roles in creating and perpetuating residents' vulnerable health outcomes.
Early work conducted by our team around reducing emergency room visits has born out this approach. Among a pilot group of the neighborhood’s most frequent ER visitors, social interventions such as connecting individuals with routine primary care and providing tools to apply for relevant benefits reduced emergency visits by a dramatic 57%. This reduction has also brought impressive costs savings at nearby St. Francis Hospital.
At the heart of our work is a dedication to challenging entrenched conditions by tailoring systems level solutions to the specific needs of neighborhoods. To accomplish this, we focus our attention on bringing together local leaders with the right outside knowledge, skills, and funding.
In Northeast Hartford’s case, the Cigna Foundation has come to the table as a key ally. For Cigna, Northeast Hartford is important for two reasons: first, the health of local residents is suffering badly and the company is equipped to assist; and second, Cigna is a also a neighbor, a national corporation based in the State of Connecticut. The company’s help is invaluable because of its deep experience in evaluating health related behaviors and outcomes and identifying the most salient patterns and holes in care that need to be addressed. Cigna’s team is helping to ensure that the information that Johnny and Anthony gather from their neighbors can help guide intelligent efforts around job creation, improving healthy food access, and reducing ER visits.
But long before that can happen, Johnny, Anthony, and the rest of the surveying team have a job to do. Their door-to-door effort is a step toward directly engaging residents and gathering the raw information needed to define not just what the problems are and how the social and health care systems in place can be improved, but also what people want and need to revitalize their own community.