Even though UC San Diego (UCSD) Health Sciences has a long history of commitment to the underserved and has numerous projects specifically focused on helping at-risk communities, it isn’t enough. We realized several years ago that we needed to take our community partnerships to a new level to benefit both at-risk communities and our organization.
UCSD Health Sciences has been serving the San Diego and Imperial County region for more than 40 years. We are the region’s only medical school, school of pharmacy, and academic health system.
As an academic medical center and a disproportionate share hospital (DSH), we care for a large number of patients who otherwise have limited health care options. As such, we are in integral part of the health care safety net.
Determining Community Needs
Beginning in 2010, we spent six months meeting face-to-face with over 150 leaders in South Bay and southeast San Diego to conduct a needs assessment. South Bay and southeast San Diego are diverse, historically underserved regions with approximately 600,000 residents.
This was no ordinary needs assessment. Rather than simply collecting data and reporting it out, this effort was focused on listening intently and redesigning interventions to help elevate and empower communities to achieve their desired outcomes.
After those six months of listening, many ideas emerged focused around health care access, health education and workforce development, and reducing health and education disparities.
We brought the community’s ideas back and aligned them with our tripartite mission as an academic medical center.
The HERE Initiative was the result.
Health and Education Disparities
So what are the problems facing the communities of South Bay and southeast San Diego?
To illustrate some of their challenges, let’s look at the community of San Ysidro, an area that straddles the border with Mexico.
In San Ysidro, more than 50 percent of residents never graduate from high school; 28 percent of San Ysidro residents live below the poverty level.
Access to health care and educational services is challenging.
Only 3 percent of San Ysidro residents work in the health care field. To see why that is, let’s look at San Ysidro High School.
San Ysidro High School has seen low performance in English, math and science testing—key areas for anyone seeking to pursue college or training for a career in the health care field.
This school had an existing medical career pathway; a program that grouped students interested in medical careers, gave them special instruction, and guided them towards their goal. These are often referred to as pipeline programs.
But despite dedicated teachers and willing students, the program had major challenges.
There were few resources to support the program. There were limited connections to health care providers. Student transitions to college or training programs were difficult.
For many who claim to have pipeline programs, what they actually have are segments of pipe that are disconnected. The same can be said about the health care system. The segments of pipe often don’t fit.
For instance, Joselin is a student in this pathway program at San Ysidro High School. We met Joselin when she was just a freshman. Joselin comes from a family that is lower socioeconomic status. Although she had a dream to work in health care in her community, and considered possibly becoming a pharmacist, those prospects were limited.
Brainstorming Next Steps
So we asked ourselves: What can we do for this young woman and her fellow students? How can we help her better define and achieve her dream of helping a community known for low health access, workforce training and recruiting challenges, and long term disparities in health and education outcomes?
And how can our health system meet its own need for a diverse, culturally competent workforce?
We knew that in order to do this, we had to be innovative and align those segments of pipe by connecting the community with the health industry. We also knew that UCSD was uniquely positioned to do just that as a provider of health care services, educational opportunity and health workforce training, and an internationally renowned research organization.