Improving access to cardiovascular preventive health care for the uninsured Polish population in the greater Chicago area- Experience from the Polish American Atherosclerosis Risk Factor Modification (POLAARIS) project

Background. Healthcare system in United States is faced with a unique challenge of catering to a population that is racially, culturally and linguistically diverse. Efforts to provide health care appropriate to each of such populations are a part of the national health care agenda. Yet, certain locally diverse minorities might be neglected due to their confined location in a part of the country. The Polish community is one such linguistically and culturally unique population in the Chicago area, within the county of Cook in the state of Illinois. The Cook County Health System provides health care for the un- and under insured population in the county, but specific language and cultural barriers exist for the uninsured Polish population.;Objective. To improve access to cardiovascular preventive health-care for the uninsured Polish population in Chicago area by analyzing barriers and devising effective and sustainable solutions.;Methods. Efforts were made to establish community collaboration in order to assess needs and devise effective solutions towards breaking the barriers to provide health care to the Polish population. Care was provided at a geographically proximate health center. Screening using a non-lab based cardiovascular risk assessment tool identified individuals at high risk of adverse cardiovascular outcomes. Such screening was offered in health fairs at community gatherings (a Polish cultural festival and a local community church). Individuals with no access to health care providers were given follow-up appointments at a nearby county health clinic. As needed, all these individuals received continuity care with primary care physician and/or a cardiologist.;Results. Strong collaboration was established between the health care facility and a community organization named Polish American Association. Apart from providing insight into the barriers faced by the Polish population in accessing health care facilities, this organization identified effective venues for health screening, created necessary publicity and also facilitated Polish translation services at the local health clinic, the Logan square health center.;A total of 125 patients were screened. 63 of them were identified as high risk and not having access to a provider. All these individuals were given appointments for a clinic visit at the Logan square health center, a geographically proximate health clinic. 54% of those screened had >20% risk of a 5 year adverse cardiovascular outcome. 34 of the 68 have been seen in follow-up clinic till date. 56% of them had a new medication prescribed in their first clinic visit while 38% had an investigation ordered. All were provided with a primary care physician while 38% needed follow-up with a cardiologist.;Discussion. Health care organizations need to be aware of any linguistically and culturally unique populations being served. Collaboration with established community organizations and reallocation of resources within the health system could be an effective way to cater to the needs of such populations.