Local officials released a plan to help address health disparities across Dallas County after a report published in October identified five ZIP codes in southern part of the county as the most unhealthy.
Parkland Health and Hospital System and Dallas County Health and Human Services worked together on the report.
"The finding is undisputable,” Parkland president and CEO Fred Cerise said. “In many instances, your ZIP code is a better predictor of your mortality than your genetic code, and that certainly is what you see playing out."
More than 300 health officials, Dallas County Commissioners, members of the board of managers for Parkland, plus other city officials, discussed solutions at a public event Thursday morning.
The five ZIP codes identified in the assessment as having the most significant health disparities are: 75210, 75215, 75216, 75217 and 75241.
“As we’re looking at this from a health care perspective, we’re taking this in manageable bites,” Cerise said during the talk.
He said the plan will be a multipronged collaboration with partners across the community in areas like education, transportation and criminal justice.
The treatment plan outlined by health officials was more topical than geographic, addressing issues like maternal mortality, diabetes, STDs and a lack of health literacy and trust.
During the talk, Cerise said the plan will work to address the gaps in treatment for issues that disproportionately affect communities of color, like maternal mortality.
“I’ll give you an example of a structural gap: Medicaid covers most of the women in our system in prenatal care for 60 days postpartum,” he said. “But at the end of the day, 62% of the deaths happen between 60 days and a year, so there’s a gap there.”
He said part of the solution was expanding targeted outreach and monitoring women for up to a year after childbirth for diabetes, hypertension, postpartum depression and other complications.
Philip Huang, Dallas County Health and Human Services director, said health literacy is key to addressing illnesses like diabetes in these at-risk areas.
“For people to make the healthy choice the easy choice, health literacy is certainly one aspect of that, and also the built environment, the access to healthy foods in the environment,” he said. “All those things that compliment the clinical pieces for diabetes care.”
Cerise said complicated illnesses like diabetes need to be addressed with programs rather than a few visits to the doctor.
“I can tell you when I walk through the hospital, and I see somebody in the bed and their foot’s up and it’s wrapped, you can pretty much predict that’s somebody with diabetes who has had an amputation,” he said. “And that happens too frequently.”
Cerise told the audience these kinds of amputations can be avoided with preventive care and improved education. He also emphasized a balance between seeking out new patients and monitoring current ones.
“It’s a combination of identifying the undiagnosed disease and getting it in care,” he said. “And for those who are getting into care, we’ve got to make sure those are optimally managed to prevent any complications.”
A key topic of discussion was also the lack of trust in underserved communities. Cerise said health officials could begin to address this issue by working with community partners, recounting the Mexican Consul's health fair that drew a line of people two blocks long. He attributed the high turnout at that event to “an environment of trust” where community members felt at ease.
In an opinion piece published by The Dallas Morning News, Cerise said the plan would also create new physical locations for clinics, the use of telehealth services for consultations and outreach, and a data-driven approach to identify under-resourced populations.
Syeda Hasan contributed to this report.
