Walking the Talk
Tackling the Social Barriers to Good Health

Many people find doctor visits stressful. But for people like Frank — a longtime resident of Stockton, California — just getting a ride to a doctor's appointment used to be an ordeal in itself.

Frank deals with a number of daily health issues, including diabetes. In order to manage his conditions, he has multiple doctors' appointments each week. When family and friends were unavailable to take him, he often spent up to three hours a day roundtrip using public transportation. Or on some days, he missed appointments, which posed potential risks for his health.

Factors in our everyday lives that impact our health — such as Frank's lack of access to reliable transportation — are known as the social determinants of health (SDOHs). They include access to healthcare and education, the environment, economic opportunity, and social factors such as social support and discrimination.

These social and economic barriers to health are closely linked to health inequalities, as well. For example, research shows that low-income communities in the US are more likely to have unhealthy diets or limited access to quality healthcare — which leads to lower life expectancy among low-income citizens, compared to those with higher incomes.

As communities worldwide face the growing threat of chronic disease, they must find a way to tackle these barriers to good health. Chronic diseases, also known as noncommunicable diseases (NCDs), are one of the greatest challenges to global health, today and in the future. These diseases include diabetes, cardiovascular disease, respiratory disease and cancers, and they accounted for 71 percent of deaths globally and 88 percent of deaths in the US.

Our Future Well Communities program aims to fight chronic diseases by addressing the social and economic barriers to good health. We're launching the program in Stockton, working in close collaboration with local government, leading institutions and community groups. Efforts focus on addressing the diabetes epidemic in Stockton — nearly 60 percent of adults have diabetes or prediabetes and 33 percent are obese.

Stockton is no stranger to challenges. Today, this city of 310,000 is considered one of the most fiscally healthy cities in the state — a big change from 2012, when Stockton was forced to file for bankruptcy. Since exiting bankruptcy in 2015, Stockton has focused on revitalization under the leadership of Mayor Michael Tubbs, who at 26 became the country's youngest-ever mayor of a major city. Today, local government, a coalition of community organizations and residents across the city are guided by a singular focus: Reinventing Stockton. Through Future Well Communities, we hope to help advance this important work by supporting community efforts to address diabetes and improve health.

Community-driven change

Future Well Communities is based on a simple, but powerful idea: empowering communities to break down social and economic barriers can improve health outcomes. Through strategic partnerships with Mayor Tubbs and a number of Stockton-area community groups, Future Well Communities is helping residents address the primary challenges to good health in the city — including access to health, education and economic opportunity.

Here's a brief summary of the components to this unique program:

Image credit: Abbott

Medical transportation services

Successfully managing a chronic illness such as diabetes often means frequent doctors’ appointments. Many in Stockton, including Frank, face gaps in public transportation; when available, ride-sharing services or taxis are expensive and often unpredictable. Future Well Communities is supporting local nonprofit El Concilio's medical transportation program by purchasing vans that provide free, door-to-door, non-emergency medical transportation to ensure people can more easily access medical care.

"Despite a critical and growing need right here in Stockton, most patients are unable to find reliable transportation and drivers who understand their needs. The Abbott Fund-El Concilio Medical Transportation Service is filling that gap," said Seidy Ayala, MTS Coordinator for El Concilio. "We launched the program in July, and it has been gaining momentum with the community because it is a reliable service for people whose very lives depend on making their medical appointments."

Group medical visits

Type 2 diabetes isn’t easy to manage. Community Medical Centers (CMC), a Stockton medical clinic, offers shared medical appointments to people who have uncontrolled type 2 diabetes. This program is one part medical visit, one part health class and one part support group. Participants attend multiple sessions with the same group over time to make sure they have consistency in managing their diabetes. With support from Future Well Communities, CMC is expanding the program into more locations in Stockton to help reach additional patients who need help managing their condition.

Healthy Families

Future Well Communities supports El Concilio’s Healthy Families program, which encourages families to focus on their health. Participants attend six sessions — led by community health workers known as promotores — that provide education and guidance on healthy eating, shopping and cooking; exercising, diabetes, and cardiovascular and oral health.

The Healthy Families program also teaches them that chronic diseases run in families. According to the American Journal of Preventive Medicine, if your parents have type 2 diabetes, your chance of getting diabetes increases by fourfold. To prevent diabetes in future generations, families must educate themselves to reduce their risk and get healthy by eating more nutritious meals and exercising regularly.

Healthcare worker pipeline

To address a growing shortage of healthcare providers, Future Well Communities is collaborating with the University of the Pacific to create two new educational programs: a new diabetes certificate program to help community health workers gain a concentrated diabetes focus, and a diabetes track for graduate-degree programs in nursing and social work. And to help ensure the new programs meet local workforce needs, the Abbott Fund is awarding scholarships to a select group of community health students if they agree to work in Stockton after completing their education.

Urban farming

According to research from UC Davis, the San Joaquin Valley is the most productive agricultural region in the world, growing more than 250 crops — but many neighborhoods in Stockton don't have access to grocery stores with fresh produce. We're creating economic opportunities for local farmers that expand access to fresh, healthy produce in food deserts through a partnership with PUENTES — an urban farming community located in one of the most underserved areas of Stockton.

Having a lasting impact

Through Future Well Communities, Frank now has access to reliable transportation. He can schedule a free van to pick him up at his home and take him directly to his healthcare appointments. He is just one example of how addressing everyday barriers can make a huge impact.

Looking ahead, we will continue to rely on collaboration and community partnership to outsmart chronic disease in Stockton and make a lasting impact across the community. By working together, we believe that we can all help build a healthier future.

For more information on Future Well Communities, see our fact sheet. For more information on our broader work to fight NCDs, visit abbott.com/FutureWell.