engaged even when it is difficult or stressful for them. There has also been a reduced cost to the state’s Medicaid program and decreased emergency room use and hospitalization of students with asthma (Adams and Johnson, 2000).

As important as these program-based figures are, Johnson likes to measure success one child and one family at a time. Among the examples she cited were the ability to detect a brain tumor in a third-grader while it was in the early stage and treatable, the early detection of a genitourinary deformity in a 9-year-old child that was successfully corrected, and early detection and intervention of children with chronic illnesses such as asthma and diabetes.

In addition, through onsite counseling and support, the program has facilitated the recovery of many emotionally troubled children. This, Johnson noted, is probably the most important aspect of the program as far as improving the outcomes for children. Unless you adjust the emotional aspect of the health of people, she said, you will not be able to make improvements in their physical health.

In meeting needs and bridging gaps, Johnson concluded, the program has been able to increase access to health care, improve health outcomes for children and their families, decrease health care costs, and improve school attendance and academic performance.

ACCOUNTABLE COMMUNITIES: HEALTHY TOGETHER

Atlanta, Georgia is divided into 25 neighborhood planning units (NPU). The NPU system was established by Mayor Jackson in 1974 to ensure that citizens, particularly those who have been historically disenfranchised, would have a voice in the structure and development of their community. Accountable Communities: Healthy Together (ACHT) is a community-based, participatory research effort that Kreuter and colleagues are conducting in NPU-V (letter V). ACHT is funded by a grant from the National Center on Minority Health and Health Disparities (NCMHD), which supports a collaboration between the NPU-V community leadership and the Georgia State Institute of Public Health, the Centers for Black Women’s Wellness, the Atlanta Regional Health Forum, the Fulton County Department of Health and Wellness, and the Southside Medical Center. The ACHT program, Kreuter explained, engages the community in identifying their health issues, providing them with the methods, activities, and data to do so, and then identifying pilot programs to take action on those health problems.

The neighborhood data advisory group (NDAG), composed of local residents, developed a profile of NPU-V in 2004. The NDAG identified an unambiguous pattern of health, social, and environmental disparities in



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement