Community Health Leader Fights Disparities With Pipeline Program

    • October 27, 2011

It has been a big year for Robert Wood Johnson Foundation (RWJF) Community Health Leader alumna Cheryl Holder, MD. She has spent most of 2011 receiving awards for her heroic efforts to improve community health in Miami's Dade County, an area where more than 17 percent of the residents live below the poverty level and have difficulties receiving needed medical care. "It's nice to be recognized," Holder says. "It helps me in my work and planning my next steps. I am grateful."

It seems Holder's community is grateful to her as well. In September, the St. John Community Development Corporation gave Holder their Chairman's Award for outstanding medical service. In March, she received the National Medical Association's Community Advocate of the Year Award for her missionary work in Haiti and the Dade County Medical Association awarded her their Spirit of Excellence Award. Last, New Washington Heights Community Development, Inc., a Florida-based organization, lauded her community work in honor of Women's History Month.

A Clinician Focused on Community

Since winning a Robert Wood Johnson Foundation (RWJF) Community Health Leader Award (CHL) in 1995, Holder has maintained a passion for grassroots work, even after becoming an associate professor in the Division of Family of Medicine at Florida International University (FIU) in 2009. Her approach to solving health problems in underserved communities has changed a bit, but her schedule is still loaded with community projects. "Before I was out there in the community sounding the alarm," says the Jamaican-born physician. "These days, I'm trying to get at the big, root causes of health disparities."

Holder is referring to her latest project, the Pipeline Program. She created the Pipeline educational initiative—which is part of the Green Family Foundation Neighborhood Help Program (GFFNHELP) because, "research shows that the higher the educational attainment of the population, the higher the health status," Holder says. Pipeline volunteers are medical, nursing and college undergraduate students who go into Dade County households to mentor and tutor young people in the areas of math and science to prepare them for, Holder hopes, careers in health and medicine. Every household in the program also receives materials listing and explaining a variety of health careers. "Even if they don't choose such paths," Holder says, "they will still be better equipped to do well in school and graduate." The program's goal is important in an ethnically diverse area of Miami where high school graduation rates are 74 percent for Hispanic students and 64 percent for Black students.

"To make the program work, we're leveraging resources from all over and bringing them to the community. The goal is to improve health by improving educational attainment and empowerment," Holder explains.

Holder believes, like many health experts, that reducing disparities in the medical workforce means helping future generations to become more competitive. "You've got to be interested in science to have a health career," Holder says. "We eliminate these options from a lot of kids because we don't expose them to it. So that's where I'm going to begin."

"In 2012, all the components of the Pipeline Program will be in place—assessment, referral, mentoring, tutoring, community activities—and will be monitored systematically as part of a research project," Holder says. She is also working with a writer to help narrate the journey, as writing is yet another part of her approach to teaching people about living healthy.

Reaching Across Borders

Holder also recently co-wrote a children's book called Pumpkin Soup is for Sunday (Educa Vision, $10). It tells the story of young Haitian girl, Gigi, who cooks pumpkin soup with her grandmother and learns about vegetables, colors, shapes and her Haitian culture. She is hoping schools will pick up the book to use as a fun, teaching tool. Proceeds from the sales go to an orphanage in Haiti, where Holder travels to teach residents about health and nutrition. She also partners with a nursing school in Haiti to share information about testing for and identifying sickle cell disease, an illness that Holder says is often misunderstood in the Caribbean country. "If anybody's going to tackle sickle cell, it should be Black physicians," she says. "It's another way to get people in Haiti into care."

In the Caribbean and in the United States, Holder thinks that, "a more diverse medical community is important to improve patient health," adding that Black doctors are not quite four percent of the physician population in the United States. "Health is more than a diagnosis. It's the ability to communicate your passion in a legitimate way that people will understand. I can help them because I know the barriers they're facing in their lives. I understand their culture."

Amazingly, in addition to her community work here and abroad, Holder devotes 16 hours a week to direct patient care, in addition to teaching. People who know her cannot understand how she does it all, but they appreciate her efforts. "She's such a very unselfish person," says Dazelle Simpson, treasurer of the James Wilson Bridges, MD, Medical Society (Holder is the society's current president). The society was named for Bridges, the first black senior resident at Jackson Memorial Hospital in Florida and the first Black president of the Dade County Medical Association. "She's always trying to promote other African-American doctors in Dade County. She never wants credit herself."

Drawing on Her Early Work

With all that she has achieved since becoming a Community Health Leader in 1995, Holder says she is still thankful for the role the RWJF award has played in her journey.

"First, getting the award helped community members and other people listen to me a little bit more," says Holder, who still attends the annual CHL conferences to 'recharge.' "I've gotten lots of support and gained a constant connection with other Community Health Leaders. It has truly been a Godsend."

Back in 1995, Holder used part of her $100,000 CHL Award to further her work taking on the HIV/AIDS epidemic with a program she created called Project CARE or Community AIDS Reduction through Education. Teams of Project CARE workers traveled to bars, beauty salons, coffee shops—community hangouts—to train local business owners to be HIV/AIDS educators who would then pass on HIV/AIDS prevention information to their customers. "Something had to be done, so I became motivated," Holder says. "I got tired of going to funerals, tired of seeing the same statistics."

With the remaining funds, she attended a leadership institute at Harvard University and championed teen health issues with an outreach campaign and opened an in-house diabetes clinic at the North Dade Health Center in Miami, Fla. where she was once medical director. These days, Holder still believes in all of these causes, but says she is addressing community health from a different angle. "Change really begins at home," she says, "so with the Pipeline Program, I've taken my career back to its foundation."

Each year, the Robert Wood Johnson Foundation selects 10 Community Health Leaders to receive an award. The winners are outstanding and otherwise unrecognized individuals who overcome daunting odds to expand access to health care and social services to underserved populations in communities across the United States. The program aims to elevate the work of these unsung heroes through enhanced recognition, technical assistance and leadership development opportunities.