She looked healthy and felt healthy, but when Cordelia Hill was diagnosed with breast cancer last fall she decided it was finally time to start listening to her body.
First, after intensive treatment and therapy, she beat the cancer. Now free of that, the 47-year-old Oklahoma City resident is among the first to enroll in a new prevention and wellness program offered by the Oklahoma City-County Health Department.
Funded in part by money allocated through the new federal health care law, “My Heart, My Health, My Family” is part of the department's effort to reduce the steep costs of poor health and treatment with a heavy focus on key preventive measures.
“You get so accustomed to do what you want to do and eat like you like, so it's a mindset thing,” Hill said after her fifth in a series of wellness classes offered as part of the program. “When I got that cancer it kind of scared me — I want to help raise my grandchildren.”
Lesson plans, taught by department specialists with the help of volunteers from the local health care community, are different each session. Hill and other participants spent a recent morning learning about healthy eating habits, from proper portion sizes to the benefits of substituting water or tea for sugary drinks like fountain sodas.
In exchange, participants are rewarded with access to free regular clinical checkups four times a year — including free medication — and to a wealth of information aimed at keeping them out of the emergency room.
Hill's is a story Michael Bailey hopes can be repeated hundreds of times over the five-year course of the $3.5 million grant.
A 22-year health inspector for the department, Bailey recently switched jobs and assumed the role of community liaison for wellness. Now a foot soldier in the local fight against diabetes and cardiovascular disease, he works daily to recruit new program participants from one of the city's most vulnerable neighborhoods.
Stretching north-south from NE 78 to NE 16 and east-west from N Kelley to N Bryant, the 73111 ZIP code is one of the poorest — and, not coincidentally, unhealthiest — in Oklahoma County. Matching actual health data of the neighborhood's residents with other determinant factors, such as access to fresh fruits and vegetables, access to health care providers, income and education levels, the department has honed in on the area as a pilot study for what could ultimately be rolled out countywide.
Here, in a predominantly black area in the middle of the city, infant mortality rates are twice that of the county's healthiest ZIP code, 73151, in far northeast Oklahoma City.
Cancer diagnoses are 31 percent higher in 73111 than in 73151, and deaths from cardiovascular disease are 10 times higher. About 9 percent of people in 73151 live below the poverty level; in 73111 that number rockets up to 30 percent.
Bailey said he sees the problem walking the streets of 73111 every day.
“You won't find a lot of people here that buy groceries once a month — most buy them every day because they don't know if they're going to have money enough to buy groceries next week,” he said. “For a lot of these people, putting a roof over your head, having gas in your car, having a car to drive at all — these things come first, so you're eating whatever you can.”
Following Tuesday's wellness class, Bailey made his first rounds of the week, dropping off stacks of program fliers and asking community leaders to join him in recruiting additional participants.
On the 1400 block of NE 23, restaurant owner Florence Jones Kemp said her customers just don't want to hear about healthy options.
Florence's, a soul food cafe with a southern flair, is known for its fried chicken and cornbread muffins, cooked to order by Jones Kemp.
“We tell them all the time, ‘Eat lots of salad and vegetables,' and we try serving them fresh vegetables, or pinto beans,” she told Bailey. “But they do listen at me, so when I tell them to go see about this they're going to go.”
Next door, barbershop manager David Antwine told Bailey many of his customers complain of heart disease and diabetes.
“It's lack of information and lack of insurance,” Antwine explained.
Awareness and access are two of the greatest obstacles to a healthy community, said Gary Cox, director of the city-county department.
As many as 70 percent of the county's premature deaths are because of an unhealthy lifestyle, poor diet or the use of tobacco, alcohol or other substances, he said. There's a human cost, but also an economic one: Oklahoma County spends as much as $920 million annually treating its residents for chronic disease.
“If you can keep them well then you can keep them out of the emergency rooms and doctors' offices and specialists' offices,” Cox said. “It's not only to save the person from disease, illness and death, but it also has a very firm underpinning in economics.”
Lack of access is compounded by difficulty in persuading elected officials to pass more stringent health policies, he said. Though he doesn't see political support in Oklahoma for limiting soda sizes, as was recently adopted in New York City, he said he would like to see the Legislature adopt rule changes that would allow cities and towns to enact more stringent nonsmoking policies.
His was one of 61 health departments nationwide to receive the federal funding, which in addition to the cardiovascular program will also support nearly a dozen or so obesity-specific health initiatives adopted by the joint city-county Wellness Now Coalition.
Among others: A campaign to reduce consumption of sugary beverages, expanded walking and biking trails, wellness classes and a push to refocus public school cafeterias on healthy menu options.
In the 73111 ZIP code, construction is progressing on a $17 million wellness center that will house neighborhood health care and awareness programs in two buildings, with outdoor fitness amenities on the 54-acre campus to include walking trails and recreation fields.
“It's a comprehensive effort, really, to improve health using all the funding sources we can get our hands on,” Cox said.
The state's Republican leadership has turned away federal health care money in the past, but Oklahoma City Mayor Mick Cornett, a Republican, said this campaign is worth supporting.
Cornett said Oklahoma City will supplement the federal health care funds with revenue from city and school bond issues, sales tax proceeds and private sector investment to finance hundreds of new miles of sidewalks and develop new gyms at inner-city schools.
Next, the city will bring in a national polling agency to see how the programming and direction can better be tailored to the region's specific needs, he said.
It's not about forcing people to be healthy, he said, but giving them the tools they need to make that decision for themselves.
“By creating a city that has catered itself to the automobile like we have done is irrational,” he said. “We're redesigning this city to be built for people. Five years ago we were on the list of fattest cities in America, so there's anecdotal information out there that we're doing good but we've still got to do better.”
Bailey, glad to be distributing good news to his community now instead of filing health violations, said he's excited to see the initiative spread. Already 15 pounds lighter himself, he said just talking about ways to be healthy can be contagious.
“People are losing weight, they are being diagnosed, and many of them have no idea that they're prediabetic or diabetic or have high blood pressure — they're finding this out for the first time now,” he said. “If you're trying to improve the health of the whole county it just makes sense that you start at the worst and move out from there.”