By Bob Seidenberg

rseiden914@gmail.com

The Evanston City Council cleared the way Monday for a one-year pilot Pathway to Wellness program that aims to improve health outcomes for some of the city’s most vulnerable populations.

Council members voted 9-0 in support of Fifth Ward Council Member Bobby Burns’ recommendation to approve the $400 000 funding allocation, using federal American Rescue Plan Act funds.

Several members, however, raised concerns about the program continuing beyond the one year the federal money is funding it for.

“I think the worst outcome would be that this proves successful and there’s no plan for funding it on an ongoing basis,” Council Member Tom Suffredin (6th Ward) said during discussion.

The program focuses on census tract 8092, which encompasses much of the city’s Fifth Ward, where data from the Evanston Project for the Local Assessment of Needs in 2022 showed severe health disparities from other wards.

Over one-third of residents there had been diagnosed with hypertension, significantly higher than the Evanston area overall, Health and Human Services Director Ike Ogbo wrote in a memo.

Socioeconomically, the tract stood out too, with a high poverty rate, particularly affecting Black and Hispanic/Latino residents. That, in turn, “impacts their access to health care and healthy lifestyle opportunities. The poverty rates for Black and Hispanic/Latino residents in this area stand at 18% and 19%, respectively, much higher than Evanston’s overall poverty rate of 11%. This socioeconomic disparity significantly contributes to the lower life expectancy in this tract, which is up to 13 years less than in more affluent neighborhoods in Evanston,” Ogbo noted.

Priority for the program will also be given to census tracts 8096 and 8102 in southeast Evanston, where high proportions of vulnerable residents also live.

Other criteria include a low income level (at or below 250% of the federal poverty line) and a diagnosis of hypertension, Ogob said in his memo. Also, participants must complete a health survey, he said.

150 total participants

The Evanston Pathway to Wellness program will operate for a year and will be divided into two groups (running simultaneously), each consisting of 75 residents, Ogbo said.

Participants in the control group will receive remote patient monitoring and access to healthy food options tailored to their dietary needs, he said.

Participants in the second group,  the intervention group, will receive comprehensive wraparound support in addition to the benefits provided to the control group, he said.

“This includes in-person fitness classes, food preparation courses, nutrition education, nurse checkups, referrals, personalized medical support, and medication management,” Ogbo said in his memo.

“Onda Collective will collaborate with the city to design and implement aspects of the program,” he reported, “such as food and nutrition, leveraging its expertise in community-based intervention and engagement.”

“The effectiveness of the Evanston Pathway to Wellness program will be rigorously evaluated through a comparative study of health outcomes between the control and intervention groups,” he said.

In order for the program to continue to be funded, Ogbo said, “you have to show there was the kind of rigorous scientifically sound investigation of the intervention, so in the end we can say that not only did people get get healthier, but we know it’s because of the intervention that took place.”

Endeavor Health, Erie Health Services interest

In addition, Neticia Waldron, a health administrator, told council members that “what we have done over the past couple years in designing Pathways to Wellness is we have been at the table with community organizations that feel that this work is valuable.

“The reason we focus on hypertension,” she went on, “is because right now it is the leading focus of the NorthShore University HealthSystem,” now known as Endeavor Health. That group’s lead researcher sits on Pathways’ advisory board, Waldron said.

Pathway to Wellness also has Erie Health as a partner, she said, “and we are positioning ourselves to bill insurances for the people that are insured, so that we can have reimbursement back into the program,” she told council members. While “we don’t have any like firm commitments for future funding, we have a lot of reasonable prospects,” she said.

In further discussion, Council Member Devon Reid (8th Ward), said he agreed with Suffredin “in that it would be a terrible thing if this were successful and we didn’t have funding to push it forward. And so I think if these interventions are successful, it almost gives us a mandate to continue to fund this and find partners that might offset the costs.“

Council Member Krissie Harris (2nd Ward), who serves on the Human Services Committee that backed the proposal, recalled that “the last time we met, I remember a much higher dollar amount” ($883,700 in ARPA funds, for a two-year program).

Waldron said since then Pathways to Wellness conducted data walks, arriving at a comprehensive program that is going to serve the people in Evanston that are most vulnerable with health inequities.

“Of course, we want to serve many more, but we have been able to reallocate funds, make some reductions, get some items donated – as far as man-hours, human resources – and so we’ve been able to identify some partnerships; that is going to make it possible for us to do more with less,” she said.

Council Member Eleanor Revelle (7th Ward), who also serves on the Human Services Committee, said, “I’m really delighted about the research component. Dr. Lynch is involved in a similar program in Chicago … working with the kind of population that I think we’re targeting here in Evanston,” she said. “So this program has gone through multiple, multiple discussions and I think it’s in a good place.”

Council Member Jonathan Nieuwsma (4th Ward), noted the 13-year disparity in life expectancy in the particular geographic region compared with other neighborhoods located minutes away.

“That is a glaring example of historic inequity,” he said, “and I’m really glad that the city has identified this problem and is responding to it by allocating some resources and involving partners in a collaborative approach here. So I certainly hope that this one-year program will lead to some ongoing funding, ongoing resources from whatever source we can come up with, until that 13-year discrepancy is down to zero.”

Waldron thanked Nieuwsma for acknowledging that point, and paused in her presentation, her voice breaking.

“That very health disparity has impacted my family,” she told council members.

Her grandmother died two years shy of her 60th birthday, she said. “My mother died July 20 of chronic illness – things that were preventable.”

“This is preventable,” she said, “but it’s also ingrained in our culture. We literally live this, and so generationally, my children are impacted. There are other individuals who are also impacted. I can just up line up our team and show that there are several individuals that have that same story … they have family members that are not here, and we just want to change that.”