Law & Public Policy Blog

Treating a Sneeze Could be as Easy as ABC and 123

Araesia King, Law & Public Policy Scholar, JD Anticipated May 2021

Philadelphia was the location of the nation’s first hospital, and it is now a national hub for medical education and care. One sixth of the physicians in the United States have trained in Philadelphia. The city has thirteen acute care hospitals, three children’s hospitals, two cancer hospitals, one eye hospital, and one Veteran Affairs hospital. The number of acute care hospital beds per capita exceeds both the national average and the average for the state of Pennsylvania. There are nine city health centers operated by the city’s Department of Public Health, and the City also has five medical schools. With all of these facilities and its rich history of medical advancement, one would think that the City of Philadelphia would be a shining example of healthcare in the country. This is not the case.

Philadelphia has a higher rate of HIV transmission than other major cities within the United States. It also has high rates of premature death, infant mortality, and child mortality. All of these issues can be addressed and possibly lessened by the existence of a better primary care system in the city. Even though there is more than the national average number of acute care hospital beds per capita in Philadelphia, parts of the city are in what can only be called a “primary care desert.” This means that there are expansive areas of the city where people have little to no access to primary care services.

The solution to this issue is not to build another hospital, but to increase the number of primary care providers in the hospitals and health centers around the city. Eight of the nine city health centers provide primary care services. However, the wait time for primary care at one of the centers was over six months—entirely too long for anyone to wait for medical care. It is enough time for a young child’s cough to turn into pneumonia or for a young woman’s urinary tract infection to turn into a life-threatening kidney infection.

A possible solution to Philadelphia’s primary care shortage might come from a place you would least expect: your local neighborhood public school. For those of us that grew up going to public school and remember our interactions with the school nurse, this proposal might seem absurd. But the idea would not be to utilize a school nurse. Using public schools as a way to address Philadelphia’s primary care deserts should be based on the “Community Schools” movement. Community schools are a partnership between public schools and other community resources. The idea is to use local public schools as a hub for resources for the community. This movement has a series of multifaceted objectives, with a prime one being the improvement of a student’s capacity to succeed academically by strengthening the community where they live. By ensuring that students are healthy and safe outside of school walls, the community schools movement helps to nurture and develop success within the school walls.

A great model of this movement is Broughal Middle School in Bethlehem, Pennsylvania. In Bethlehem, the Department of Parks and Recreation, Lehigh University, St. Luke’s hospital, Temple University’s medical school campus at St. Luke’s, the United Way of the Greater Lehigh Valley, and a locally-owned corporate sponsor (Just Born, Inc.) have formed a partnership using Broughal as a hub. The partnership includes multiple initiatives. As a part of the community health initiative, students are provided with healthier food options; the school now has an afterschool organic gardening club where they can help grow healthy food items that the school cafeteria can use to make breakfast and lunch. There is even a fitness center that is open both before and after school.

In addition to promoting good nutritional practices, the partnership also works to address the medical needs of the community. St. Luke’s Hospital sends a dentist to the school twice a month. The dentist is able to perform basic procedures like extractions and fillings on the school’s campus. Additionally, at least once a month, Broughal provides the space for students from Temple’s Bethlehem-based medical school to set up a clinic to serve uninsured and under-insured families. Undergraduate students for Lehigh University who are interested in entering the medical field serve as “medical coaches” at the clinics. These student partners provide additional help to these families by taking them to pick up prescriptions and teaching them practical health skills like how to use a blood pressure cuff.

There is no reason that a similar partnership cannot be successful just an hour away in Philadelphia. With its abundance of health care resources, Philadelphia is an ideal location for the community schools movement. In fact, there are already twenty schools identified as community schools in the city. This solution focuses on utilizing the resources and infrastructure that Philadelphia already has in place to improve the city’s health outcomes. It is time that the City of Philadelphia start taking the health needs of its citizens seriously, and the community school model provides a practical solution to Philadelphia’s primary care problem.