Graciela Alvarez
Graciela Alvarez reads a book to Azaria Abernathy, the 1-year-old daughter of one of her patients. | Photo: Lisa DeJong
I’ve been at Cleveland Clinic for over 12 years now, working in different departments, but I’ve always been drawn to community work. Before this role, I did cancer screening education — mainly for our Hispanic population, since I speak Spanish — and through that I got very involved with the community. I’m part of the Mexican Committee of Cleveland and work with other organizations that support the Hispanic community. So when the Center for Infant and Maternal Health was about to open, I reached out to learn more. The director — whom I’d worked with before — said, “You’d be perfect for this.” And here I am.
My work focuses on women’s health. Our goal is to lower infant and maternal mortality, especially among underserved patients. When a pregnant woman is referred to us, we meet with her every month until the baby is born and then every month during the first year of the baby’s life.
We want to make sure that they have a safe and good delivery, and that mom and baby both get what they need: proper immunizations, pediatric care, education about safe sleep, car seats, potential signs of emergency. We meet them wherever they are. Sometimes in clinics, sometimes in their homes, sometimes even in a park.
One of the biggest barriers is transportation. Some patients don’t know that their insurance covers rides to appointments or how to use the app to schedule them. If someone doesn’t have insurance, they can get a ride through our department’s Uber Health account — because getting to an appointment can be the difference between a healthy pregnancy and one that’s not.
Here’s an example of some of the other kinds of support we offer: I met an unhoused woman named Charzay, and I began visiting her at the shelter where she was staying. She eventually got housing, and I helped her get a playpen for the baby, plus furniture through a grant we had with a local furniture bank. From there, she just took off! Daycare, a job, a car. She did so much on her own. I just connected her to what was out there. That’s what I love most about this job: when I see someone take those steps and build a better life.
Another family I helped had twin baby girls, but she and her husband didn’t know what resources were available to them. I took them to WIC (Women, Infants and Children, a federal nutrition program), helped translate documents and even went to the grocery store to show them how to use the scanner to find which foods were covered.
Many people just need help navigating social and government programming, and we try to teach them to handle these kinds of things on their own. I always tell my patients, “I’ll show you once, but you’ve got to take it from there.” And when I see them do it, it’s the best feeling.
Brinase Merritt
Brinase Merritt, right, checks in with patient Gennie Wallace at the Langston Hughes Center. | Photo: Matt Kohlmann
Everyone calls me “Miss B.” I’ve been with Cleveland Clinic for over 10 years, starting as an environmental services supervisor. I came across this position through a colleague who knew I had a desire to give back to my community.
The role of community health workers is to recognize the needs of the community — and understand that many individuals don’t have equal access to healthcare. These factors make it difficult for them to properly care for themselves, and that’s where Cleveland Clinic CHWs, working with doctors and nurses, become advocates for the community.
Increasing access to care is essential, as our community faces health, social, economic, political and cultural challenges. These social drivers of health are exactly what we aim to address and ultimately eliminate.
I see many patients with chronic illnesses, the most common being hypertension. Some are retired and raising their grandchildren. As much as they want to improve their health, stresses such as being a single grandparent or parent, losing a spouse or being employed again after retiring can adversely affect their health. CHWs are here to encourage and motivate, serving as the voice for patients to create a bridge to wellness. These are the people I am fighting for.
One of the programs we are most proud of is our six-week chronic disease self-management workshop, held at Langston Hughes Community Health and Education Center. We’ve completed seven workshops where our patients, mostly seniors, acquire tools to better manage their chronic illnesses. We provide transportation to these classes, which erases a frequent barrier.
I get to know the ins and outs of my patients’ lives. Let’s say someone has high blood pressure. I’ll sit down with them and address the issue. I help them learn to set goals, develop action plans, read food labels, deep breathing exercises, meditation and how to live safer at home by taking steps such as removing throw rugs to keep them from tripping and falling. By stepping into our patients’ lives, we have the opportunity to rebuild the trust that many have lost in the healthcare system.
I have one patient, Gennie Wallace, who came in as a hypertension patient. She received medically tailored meals for three months, and we talked about action plans, setting goals, things of that nature, to help her situation and maybe bring her blood pressure down. Then she decided she wanted to join our chronic disease self-management workshop, and now she wants to join the gym to work on her balance and overall wellness. She’s 81 years old!
As we advocate for our patients, we become the change agents needed to make a difference in their lives and restore hope within the community by eliminating barriers so they can thrive, not just survive. Each day, CHWs are “boots on the ground,” connecting one person at a time to healthy life alternatives.
Martrina Jackson
Martrina Jackson, left, rewards Naomi Robinson with a sticker during a lead screening/lead testing event at a childcare center in Cleveland. | Photo: Lisa JeDong
To a lot of families, I’m “the lead lady.” My job is to help kids and families deal with the dangers of lead in their homes. It’s not glamorous work but it’s very important.
I’ve been with Cleveland Clinic for 13 years, mostly in administrative roles. But I wanted more. I wanted to be out in the community, making a difference. So one day I typed “community” into the internal job search, and this position for the Lead Safe Child Care program popped up.
Most people still don’t realize how dangerous lead is. If your home was built before 1978, chances are it has some form of lead — usually in the paint or the windowsills or even the dust. But it’s also in places you wouldn’t expect: old toys, mini-blinds, even the soil in your yard. A child doesn’t have to eat paint chips to be affected; they can inhale lead particles or absorb it through their skin. And because their brains are still developing, kids under 6 are especially vulnerable.
The way I get involved is pretty straightforward. When a child at Cleveland Clinic tests with a blood lead level over 10 micrograms per deciliter, I’m notified. I reach out to the family, talk them through what the results mean and help them get a home inspection through their city’s health department. If lead is found, I help them apply for remediation grants, although due to red tape, repairs can take months. In the meantime, I teach them how to clean safely, what foods help lower lead absorption and how to keep their children away from high-risk areas.
Also, our program has recently partnered with local childcare centers, registering children under age 6 with their legal guardian’s consent to have their blood checked for lead. Building trust is a big part of the job. When I started, I had 93 kids on my list, and most parents didn’t want me in their homes. They thought I was just another voice telling them what to do. Over time, they started to open up. I’m currently working with 38 families, and I’m often helping with more than just lead — things like food insecurity, transportation, beds for kids, even job training referrals.
I’ve seen real results. More than half of the kids I work with have seen their lead levels go down, some significantly. One family stands out: The little boy has special needs and used to put many things into his mouth. His levels dropped after his parents followed the cleaning tips and nutritional changes I shared. They’re now just a couple months away from getting their home fully repaired.
I still plan on finishing nursing school, but for now I’m proud to be doing this work. Because every child deserves a safe place to grow up. And if I can be part of that, even in a small way, I’m all in!
A PRESCRIPTION FOR RURAL HEALTH
When Teagan Hayes, DO, talks about community health, she doesn’t speak in abstractions. She talks about people she knows in Lake County, Ohio, a patchwork quilt of suburbia and farmland roughly 30 miles from Cleveland. Patients who struggle to find a doctor. Families who can’t afford fresh produce. Parents worried about their children’s future. And now, thanks to a leadership gift from Mark and Shelly Saltzman, Dr. Hayes is in a position to address these challenges and others head-on.
She was recently appointed Cleveland Clinic’s Medical Officer for Community Health Outcomes in the East Submarket of Northeast Ohio. This new role was created through the Saltzmans’ gift to establish the Lake County Community Health Accelerator Fund. Their generosity also supports Cleveland Clinic Mentor Hospital, where a new pavilion bears the Saltzman family name.
“Our focus is more chronic disease management,” Dr. Hayes says. “In Lake County, we’re seeing diabetes, obesity, cardiovascular disease and a lack of cancer screenings.”
Dr. Hayes is no stranger to the area. A family medicine physician, she practices in Madison, Ohio, and lives with her own family in nearby Ashtabula County. She has spent years working in rural and underserved communities.
Her latest challenge? Build a community health model that works for Lake County’s diverse population. To this end, Dr. Hayes and her team are rolling out a three-part plan:- Bring health education and screenings directly to communities.
- Help residents navigate local resources.
- Improve access to primary care, the gateway to long-term wellness.
At one listening session, several attendees brought up the issue of food insecurity. “We’re learning that it’s a bigger problem than we realized,” says Dr. Hayes. “It’s clearly something people are struggling with. We’re looking at programs elsewhere to see what’s working and how we can bring those ideas here.”
With philanthropy as the spark, Dr. Hayes is helping Cleveland Clinic build a model of care grounded in partnership, prevention and trust — one community at a time.