Building a Healthy and Equitable Community for People with Diverse Abilities

The objective of our initiative in Freehold Borough, Improving Patient Access, is to remove barriers to health care experienced by people with disabilities and address other social determinants of health. Three community partners are undertaking the project: the Borough of Freehold, the nonprofit Neighborhood Connections to Health, and the Freehold Family Health Center, a Federally Qualified Health Center (FQHC). Our IHC grant helped us build a platform for important conversations with the disability community, leading to meaningful relationships and change.

Health care access can be a significant challenge for the disability community. Freehold recognizes this and is making a change. Through a series of focus groups, personal interviews, and community events, we are learning from people with disabilities, their caregivers, and service providers. The safe space created here allows people to open up about their needs as well as their barriers. Some reoccurring themes we are learning about are:

• Caregiver support is vital. Having a safe sharing space to open up about daily struggles can lead to improvements in mental health outcomes. It is not easy having to mask emotions to get through the day. One parent told us: “This is what happens with my son, and I have to step in and attend or manage situations at the last moment. I am grateful for your understanding as well as this important opportunity to share our lived experience in this fractured and splintered system of care we are mending.”

• The cost of accessing care (medical appointments, therapies, medications, in-home services, etc.) is a constant challenge. The things needed to maintain good quality of life are often the hardest things to obtain.

It’s important to note that disability is only one of many issues in Freehold Borough affecting social determinants of health. Other health-related stressors include affordable housing, food security, transportation, and safety. Consider, for example, that:

• 30% of Freehold Borough’s population is uninsured compared to 9.6% in Monmouth County

• Childhood poverty is rising rapidly, currently estimated at 24%

• 79% of students are enrolled in the free or reduced lunch program.

These challenges are reflected in health outcomes:

• WIC data in Freehold Borough shows obesity rates of 62% for women and 27% for children ages 2-4

• The prevalence of diabetes in Freehold is 9.8%, 21% higher than national benchmarks

• In the local Freehold hospital, admissions for hypertension are 93.85/100,000 compared to a national rate of 61.4/100,000

This is why our initiative is so vital to the community.

Improving Patient Access also involves raising awareness about community health services. In March 2023, for example, we hosted our Family Health Day: Possibilities for Diverse Abilities. The event offered free health services designed specifically for people with disabilities. Held at the ADA-compliant Freehold Family Health Center, programs ranged across the lifespan from early childhood to adulthood. Local groups offered hearing screenings, fitness programing for people with disabilities, flu and COVID-19 vaccines, lead poisoning screenings, and cancer screenings. An ASL interpreter was available. For people with mobility issues, we offered vaccinations in their vehicles. To address food insecurity, a mobile food pantry with fresh produce, meat, dairy, and herbs was available, and all attendees were offered a free on-site meal.

In addition, our local FQHC partner, Freehold Family Health Center, offered tours of the facility to highlight how preventive, primary, and specialty care services are all offered under one roof. This unique style of providing services is something our IHC project is raising awareness about in the community. Families can receive quality care at one medical home where communication among providers is seamless.

The work is not done when our current initiative ends. With the insight gained from participants, we are compiling a report and an implementation plan to take this project further into the community. If awarded future funding, we have ideas that include making physical changes to the Freehold Family Health Center, making our respective websites and social media platforms ADA accessible, conducting trainings for health care providers and staff members, and implementing policy changes.

If you’re part of the Freehold community and you would like to take part, there are plenty of opportunities to get involved:

• Provide written testimony to our team about how barriers to health care access for people with disabilities has affected you, your loved one, or those you serve, particularly in Freehold.

• Take part in personal interviews with our team to highlight your health care needs and barriers to care. Issues might include medical insurance coverage, transportation to appointments, cost of or access to medication or specialized services. Our goal is to help Freehold Family Health Center consider these challenges and look for areas of improvement.

• Become a leader on our Patient & Family Advisory Council. Meetings are held regularly to discuss the systems, patient needs, and best practices for people with disabilities at Freehold Family Health Center. If you are a patient at the Center who would like more information about this Council, or a resident of the Freehold area interested in joining a focus group, offering written testimony, or being interviewed, please contact: Jenna Sistad at 732-589-0259 or ncthnj@gmail.com.

The Freehold community is thankful to have the support of the Inclusive Healthy Communities program sponsored by New Jersey’s Department of Human Services, Division of Disability Services to make this work possible.