Using Community Health Mapping to promote Cognitive Health in West Philadelphia

Tobi Akindoju

SUMR Scholar

Mentors

Jason Karlawish and Tigist Hailu

The Penn Healthy Brain Research Center A CDC Healthy Brain Research Network Member

Outline

´ Project Overview and Significance

´ Aims of Project

´ Methods

´ Findings

´ Recommendations and Next Steps

´ Lessons Learned

Project Overview and Significance

´ Goal: Promote cognitive health in West Philadelphia

´ Components of Age-Friendly Communities ´ Access to parks

´ Healthy food options

´ Transportation

´ Social engagement

Significance

´ The elderly population in the U.S., and particularly in Philadelphia, is growing at a rapid pace, but the amenities in place are not enough to handle this demographic shift

Trends of the U.S. Elderly Population

Source: U.S. Census Bureau, 2012 Population Estimates and 2012 National Projections

Significance

´ The lack of resources particularly in low-income and minority populations, is leading to poor cognitive health outcomes

´ Environmental factors, like poor infrastructure and low socioeconomic status, have a negative impact on health outcomes ´ Social-ecological approach

Specific Aims

´ Create visualizations that show the available amenities associated with cognitive health in the neighborhood surrounding First Corinthian Baptist Church

´ Engage older community members in discussion on what needs to be changed in their community

´ Generate recommendations for neighborhood based on findings

Project Overview ´  Create a health map showing different amenities around First

Corinthian that promote cognitive health

´ Google Maps

´ WHO Age-Friendly Guidelines

´ Division of Nutrition, Physical Activity, and Obesity

´  Conduct Focus Groups with local community members to understand their attitudes towards cognitive health, and record what changes they see as necessary

´ Guided discussion sections with older (60+) members of community

´  Recommendations for healthcare providers and community leaders on creating more Age-Friendly community

Why West Philly?

´ Zip Code of interest: 19143 ´ Total population: 64,849

´ People 65 and older: 8652 (13.3 % of population)

´ Problems associated with low SES ´ Low access to fresh food

´ Poor local infrastructure

´ Few options for physical exercise

All of these factors lead to poor cognitive health in individuals

´ Partnership with First Corinthian Baptist Church

First Corinthian Baptist Church

Community Health Map

Considerations for an Age-Friendly Park

Safety Accessibility

Design Services

Malcolm X Park Safety:

´  Try to create separate bike and pedestrian paths or restrict access to bikers at certain times, in order to protect the park’s walking population.

´  Increase number of foot patrols in the area to prevent crime

´  Have more clearly labeled, elevated crosswalks to increase pedestrian visibility and prevent speeding in those areas

Accessibility

´  Clear obstructions from sidewalk, try to limit construction during peak pedestrian hours (early morning and late afternoon)

´  Address issues of uneven curbs by repaving sidewalks

Malcolm X Park

Design

´  Create a designated pick up and drop off area for the park

´  Increase available parking around the park premises

´  Increase fencing around pedestrian heavy parts of the park

Services

´  Provide signage for designated spots within the park where animals can be leased

´  Build more shelters for bus stops around the park

Area of Interest

Demographics

Modified Retail Food Environmental Index

Focus Group Methods

´ We conducted a focus group with West Philadelphia residents, who attend First Corinthian Baptist Church and are 60 and older

´  Using the WHO Age-Friendly Cities Methodology, we discussed the following: ´ General feeling about their neighborhood ´ Access to parks and physical exercise

´  Transportation and mobility ´ Ability to purchase fresh food ´ Access to health services (clinics, pharmacies, etc.) ´ Engagement in social activities

Quotes from Participants

´  “We have to walk in the street, because of the pavement. There are trees that grow underneath the pavement and make it difficult to walk”

´  “The quality of food offered at some of the local markets is just terrible”

´  “The markets are either too expensive or do not accept some of the vouchers that we are offered.”

´  “A lot of the older seniors do not have transportation, and cannot carry things from place to place on public transportation”

´  “On New Year’s Eve, the neighbors’ kids had a party and when I returned, someone had been shot in the street and had died. I couldn’t get into my house. There was a situation where someone threw a fire bomb in my neighbor’s home – I don’t feel safe.”

Recommendations

Access to Parks and Physical Exercise Healthy Food Options

Ease of Transportation Opportunities for Social Engagement

Healthy Communities

Parks & Recreation

´  Increase the number of recreational activities specifically designated for seniors, and publish activity guides so that seniors know about such activities

´ Make sure that parks are well maintained, clean, and safe for patrons

´  Include more benches and shaded areas for seating in and around the park

´  Improve sidewalks near the park, paying particular attention to the trees that grow underneath the sidewalk and cause it to be elevated

Healthy Food

´  Increase number of fresh grocers, food retail, and agricultural options available in the areas surrounding the church and communities where elders live

´ Government entities should subsidize small business owners, particularly grocers, who want to move into the area and start selling their wares

´ Utilize government services, such as the Supplemental Nutrition Assistance Program (SNAP) and associated retailers, to reach areas of greatest need and engage community members on healthy food choice, cost, and other food related issues

Transportation

´ Greater utilization of ride-sharing technology (Uber, Lyft, etc.) , by and for community stakeholders and members, could allow for more consistent and reliable transportation for older persons in the community

´ Make area more accessible to older citizens by increasing number of bus stops and shaded bench areas

´ Ensure that all sidewalks have adequate curb cuts and can be traversed by senior citizens easily

Social Engagement

´ Work with FCBC to set up weekly social events for elder churchgoers, or to invest in a garden so that older members of the church can participate in social activity.

´ Bolster educational, vocational, and leisurely pursuits for older adults in the neighborhood

´ Promote multigenerational interaction and dialogue

Next Steps

´ Utilize the recommendations and feedback to create compelling presentations for community stakeholders

´ Coordinate with other local organizations concerned with the health of the elderly population

´ Generate changes in the local neighborhood to make it more age-friendly

Lessons Learned

´  Qualitative research techniques (i.e. surveys, focus groups, etc.)

´  Collaboration with large teams of academics

´  The importance of cognitive health in the aging process

´  Research Writing

Thank You!

´  Jason Karlawish

´  Tigist Hailu

´  Ms. Elsie Shelton

´  Members of FCBC

´  Joanne Levy, Safa Browne, the Leonard Davis Institute and the SUMR Program