Nutrition, access to care impact health of Klondike Smokey City

Regional One Health’s Guthrie Primary Care clinic provides services to the Klondike Smokey City community as Church Health’s future presence at Crosstown Concourse could have a local impact. But the neighborhood’s healthcare needs go beyond what services are provided.
It wouldn’t be correct to refer to Klondike Smokey City as a health care desert. That term better defines rural communities where medical providers are scarce or limited in scope.
Regional One Health’s satellite Guthrie Primary Care provides primary care services in the heart of Klondike Smokey City. A range of doctor’s offices are just a few miles away in various Midtown and Medical District locations. And Church Health is consolidating all of its services in the nearby Crosstown Concourse.
So, no, Klondike Smokey City isn’t a health care desert. But maybe it is a health and wellness desert.
Limited grocery access in a neighborhood where roughly half the households live below the poverty level often means health care and nutrition are pushed down the list of priorities. The Klondike Smokey City’s income disparity is clear, according to U.S. Census data. The median household income in 2014 was $16,033, compared to $37,099 for Memphis and $46,213 for all of Shelby County.

Dearia Milon chats with Dr. Garnett Miller, a family nurse practitioner, at the Guthrie Primary Care Clinic in Smokey City.
Guthrie Primary Care is the lone health care provider that calls the Klondike Smokey City community home. It sits at the corner of Chelsea Avenue and Breedlove Street where the two neighborhoods of Klondike and Smokey City come together. Brenda Buckley is a nurse and manager of Guthrie, and she said she sees patients often faced with decisions about their health that are driven by food access, household income and location.
“I may teach you about diet and nutrition but when you go to prepare your meal, if what you get at the corner store isn’t as good of product you get at a major chain, you’re not eating what I need you to eat to maintain your plan and manage your health care needs at home,” she said.
“It is always a struggle and continues to be a circle because access to things they need to manage health care issues that are predominantly cardiac problems, high blood pressure and diabetes, they’re limited in their abilities to do it themselves.”
There technically isn’t a grocery inside the Klondike Smokey City neighborhoods although locally-owned Gordon’s Butcher Shop sits just across the neighborhood boundary on the south side of Jackson Avenue. The closest Kroger is at Cleveland Street and Poplar Avenue, a journey that takes multiple bus routes for those who use public transportation.

The nurses and support staff gather around the nursing station at the Guthrie Primary Care Clinic in Smokey City.
“It takes not only education but the resources,” said Ryan Haywood, clinical director of ambulatory services for Regional One Health. “We take fresh fruits and vegetables for granted, but there isn’t much available in their area. We hope to provide the education to our patients on a grand scale so that when they are in position where they can make a choice they know what the right choice is.”
So in many ways, residents already face challenges to good nutrition. Guthrie Primary Care is there to do its part for the neighborhood.
On average, Guthrie Primary Care sees about 500 patients per month. Patients range from children getting immunizations to adults dealing with hypertension, diabetes and other heart conditions. Buckley said it’s not uncommon to see teen girls who haven’t been in since early childhood annual checkups.
The cause for a return visit? Pregnancy or contraction of sexually-transmitted diseases. It’s also not uncommon for teenagers to visit the clinic already dealing with hypertension because of stress and pressures they feel at school or in the neighborhood.
Roughly 90 percent of the patients who visit Guthrie live within the immediate area. Buckley said many people come in by word of mouth or just happen in by chance.

The staff at the Guthrie Primary Care Clinic in Smokey City includes physicians and nurse practitioners for both adult and pediatric patients.
Guthrie Primary Care is one of Regional One’s four primary care offices. The others are Hollywood Primary Care, South Third Primary Care and Harbor of Health in Harbor Town. All of the locations focus on many of the same services which include wellness and sick visits for adults and children with focuses on primary and preventative care and maintenance of chronic disease.

If patients need further care they are referred to other services within the Regional One system including appointments with specialists and tests or imaging services.
At one time, there were 10 similar health clinics that operated in conjunction with the Memphis and Shelby County Health Department. Four of those serviced North Memphis, but now only Guthrie and Hollywood Primary Care remain.
North Memphis population shifts surely play a role; Klondike Smokey City’s estimated 2014 population was 4,765, which is down 36 percent from the 7,486 residents in 2000. Nearby Springdale Hollywood was 2,314 in 2014 which is down 35 percent from the 3,545 residents in 2000.
“This is what I call a generational clinic,” Buckley said. “We see patients from newborn into later in life. We’ve had some patients hit 100.”
Guthrie does treat patients from beyond the nearby community. In fact, some patients as they move out of the neighborhood return to Guthrie for their primary care.

Irma Jones hugs Brenda Buckley, the practice manager at the Guthrie Primary Care Clinic in Smokey City, on her way out of the clinic.
As the only service provider in the neighborhood, Buckley said Guthrie’s staff is able to get to know patients on a more personal basis. As people move out of the neighborhood, Guthrie keeps that identity as a personal clinic people want to return to.
The importance of neighborhood care might be more pronounced in Klondike Smokey City where only 75 percent of residents drive, which creates a heavier reliance on public transportation. The Memphis Area Transit Authority has four bus lines that touch the neighborhood including the Chelsea line that passes by the Guthrie Primary Care facility. The Jackson line also provides access to Methodist North Hospital.
Not in the neighborhood but within sight is Church Health. The organization will consolidate all of its services at Crosstown Concourse except for Perea Preschool which calls Klondike home.
Part of the work that comes with moving to Crosstown Concourse will be an increased effort to focus health care services on the North Memphis communities of Klondike, Smokey City, New Chicago and Speedway Terrace.
Church Health provides affordable health care, including clinical, dental and vision services, to uninsured working Memphians and their families. The move to Crosstown Concourse will enable the medical clinic to grow its capacity by 77 percent.

Christine Jones, 17, and her mother Irma walk down the hall toward an exam room while being seen at the Guthrie Primary Care Clinic in Smokey City.
Part of what Church Health will do in Crosstown Concourse is collaborate with partners in ways that focus on a model for healthy living.
One example is in the realm of nutrition with partnerships that include Tulane College of Medicine to license a culinary arts program. A partnership with Memphis Tilth includes the use of a commercial kitchen at Crosstown Concourse to train people on how to use locally sourced and healthy food. Another partnership with Juice Plus will use that company’s garden greenhouse at the Concourse building.
And Church Health also partners with the Crosstown YMCA to offer fitness services.
It’s not an immediate fix to the health concerns in greater North Memphis, but it’s a start. Long term, the idea is that Church Health will learn from residents and community leaders what is most needed to bring health connectivity to the central part of Memphis.
“If there is something we hope to encourage everybody in Klondike Smokey City it’s not just to come to our community classes. It goes beyond that,” said Ann Langston, senior director of strategic partnerships and opportunities at Church Health.
“We want people to have access to healthy, affordable food. Nutrition is probably the biggest growth area in terms of partnerships. It’s an important part of a healthy life.”
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