The National Center for Health in Public Housing recently sponsored the 2012 Health Care for Residents of Public Housing National Training Conference on May 1 -3 at the Westin Hotel in Alexandria, Virginia. The Citywide Advisory Board Health Planning Committee presented a workshop entitled: Improving Health among Public Housing Residents in the District: A Resident Driven Process. The panel consisted of DCHA resident leader, Kenneth Council, who chairs this committee, and Committee members, Diana Lapp, Deputy Chief Medical Director of Unity Health Care; Robert Grom, Chief Development Office and Deputy Director of the DC Cancer Consortium; and Charles Debnam, Director of Health Education Services at Breathe DC. Julian Wilson of the Office of Resident Services moderated the panel discussion. Panelists shared highlights of the committee’s work, including: • Residents partnering with DCHA, the DC Department of Health and many other District health-related organizations to implement a resident-driven community health needs assessment • Collaboration on efforts to address the District’s high rates of cancer and tobacco-related health issues. • Coordination of data collection and reporting on specific health challenges facing DCHA public housing residents; • Dissemination of information on health screenings and support services • Collaboration with UDC as the lead applicant in the development of a grant application to HUD for improvement of asthma management • Introduction of the Langston Gardening Club (LGC) to program managers at DOH which enabled LGC to make a grant application to expand its efforts and introduce community gardening to other public housing and low-income communities • Because of the particular severity of health problems in Wards 7 and 8, partners have met with senior officials at both the Children’s National Medical Center and the United Medical Center (UMC) in an effort to coordinate services Panelists were united in their agreement that much more work must be done to improve the health of DC’s public housing residents. Participants gained valuable knowledge to take back to their own comes Based upon pre- and post- session testing, attendees reported that they found the workshop very useful and gave it a most favorable evaluation.

1. Graphic from U.S. Department of Health & Human Services, Office of Minority Health, ACT NOW program.

2. Improving Health Among Public
Housing Residents In The District:
A Resident Driven Process
PANEL
Kenneth Council, Resident Leader
Charles Debnam, Director of Health Education Services, Breathe DC
Robert M. Grom, Deputy Director, DC Cancer Consortium
Diana Lapp, M.D., Deputy Medical Officer, Unity Health Care, Inc.
MODERATOR
Julian C. Wilson, Jr.
Resident Services Specialist, District of Columbia Housing Authority

3. Citywide Advisory Board
Health Committee
OBJECTIVE
Conduct a series of Health and Wellness Workshops to educate
residents on the concept of health inequities and the effects on their
health outcomes. Use these workshops as a vehicle to motivate
residents to take more personal and collective action to improve their
health and that of other residents.
STRATEGY
Develop resource network of community health providers to include
local government agencies, hospitals, universities, community health
clinics, and nonprofit organizations that offer services and advocacy to
reduce health inequities.

4. Citywide Advisory Board
Health Committee
Following a meeting in December 2010, experts worked to help
residents develop a community health needs assessment tool to
be administered to all public housing properties.
Residents presented the assessment plan to the Executive
Director to solicit support to implement the assessment, which
they hoped to perform with help from the Department of
Health, ORS staff and other partners with requisite research and
community health expertise.

5. Health Needs Assessment

6. Health Needs Assessment

7. Citywide Advisory Board
Health Committee

9. Citywide Advisory Board
Health Committee Initiatives
DCHA staff has worked closely with several partners to launch initiatives to
improve health among public housing residents.
These efforts included:
• Collaboration with DC Breathe to support a grant application to the DC
Department of Health to support a tobacco cessation project at DCHA to
develop a pilot effort designed to reduce smoking behavior at selected
housing developments. Because of DCHA involvement, the design for this
project includes resident empowerment and will enlist leadership for the
CWAB to help determine which developments can best advance tobacco
cessation effort in DC public housing.
• Collaboration with UDC as the lead applicant in the development of a
grant application to HUD for improvement of asthma management in
public housing.

10. Citywide Advisory Board
Health Committee Initiatives
• Introduction of the Langston Gardening Club (LGC) to program managers at DOH
has enabled LGC to make a grant application to expand its efforts and introduce
community gardening to other public housing and low-income communities.
• Because of the particular severity of health problems in Wards 7 and 8, staff has
met with senior officials at both the Children’s National Medical Center and the
United Medical Center (UMC) where the Emergency ward of Children’s National
Medical Center is housed. Staff has connected both medical institutions to the
CWAB to coordinate balanced services of projects to all properties located in these
two wards.
• Breathe DC won a competitive grant with support and technical guidance from
ORS to provide education on the dangers of smoking and second hand smoke in
public housing and to offer smoking cessation classes to public housing residents.
The grant is funded under an HHS grant to the District Department of Health.

11. CANCER ISSUES IN THE DISTRICT
• Each year 2,700 District residents are diagnosed with cancer;
each year 1,100 die
• The District has the nation’s highest death rates for breast,
prostate, and colorectal cancer
• Access to cancer specialists for DC’s low-income population
remains a persistent challenge… despite one of the nation’s
highest insured populations and some of the country’s best
hospitals

12. CANCER ISSUES IN THE DISTRICT
• DC’s income gap is rising, and disparities in cancer death rates
and access to care persist among DC’s most prosperous and
poorest wards
• Insufficient Medicaid reimbursement rates – which continue
to fall – result in more and more physicians refusing to treat
the District’s most vulnerable residents

13. CANCER ISSUES IN THE DISTRICT
• Persons with lower socioeconomic status (SES) have higher cancer
mortality rates than those with higher (SES) regardless of race/ethnicity.
• Uninsured persons are more likely to be diagnosed with cancer at later
stages and less likely to receive standard treatment.
• Racial and ethnic minorities tend to receive lower quality health care even
when income and insurance status are controlled.
• Social inequalities, including discrimination, persist and have a negative
impact on cancer treatment outcomes.
Source: American Cancer Society, Cancer Facts and Figures, 2012

14. CANCER ISSUES IN THE DISTRICT
• Efforts toward social justice, defined as equitable distribution
of social, economic, and political resources, opportunities, and
responsibilities and their consequences will promote
prevention and improve treatment and survival outcomes of
persons living with cancer.*
Extracted from 2011-2016 DC Cancer Control Plan
Health Equity: Christopher J. King, FACHE
*Source: Braveman, P. & Gruskin, S. (2003). Defining Equity in Health.
Journal of Epidemiology and Community Health. 57, 254-258.

15. CANCER ISSUES IN THE DISTRICT
• More than 60% of the District’s residents are racial/ethnic
minorities, 12.5% are foreign born, and 14.2% do not speak
English as a primary language.
• Approximately 17% of its 601,723 residents live in poverty –
many of whom are concentrated in communities east of the
Anacostia.*
Extracted from 2011-2016 DC Cancer Control Plan
Health Equity: Christopher J. King, FACHE
* Source: Ward, E., Jemal, A. & Cokkinides, V. (March/April 2004). Cancer Disparities by
Race/Ethnicity and Socioeconomic Status. Cancer Disparities. 54(2), 78-93.

16. TOBACCO ISSUES IN THE DISTRICT
• In the US, cigarette smoking and exposure to secondhand
smoke causes approximately 443,000 deaths each year.
• When states are ranked for mortality rates, DC ranks highest
for deaths from all smoking-related cancers for both men and
women.
• In the District, black males are at the highest risk for smoking-
related cancers.
• Survival rates from smoking-related cancers are poor.

17. TOBACCO ISSUES IN THE DISTRICT
In the District of Columbia, 16.2% of adults are current cigarette smokers, over 77,000
individuals, compared to the national median of 18.4%. This figure places the District 10 th
among states for smoking; however DC ranks highest for deaths from all smoking-related
cancers, for both men and women. Among adult District residents who smoke, the
following demographic characteristics have been documented:
• More men than women smoke (19.2% compared to 13.7%, respectively)
• Education appears to be a factor, with 27.2% of smokers having less than high
school education compared to 12.5% of those with more than high school degree
• Smoking appears to decrease with age with 23.8% of those 18-24 reporting they
are smokers, compared to 14.9% for 25-44 year olds; 19.8% for 45-64 year olds;
and 10.6% for those 65 and older
• Racially, more African Americans (23.3%) and Hispanics (13.4%) are smokers than
whites (9.1%)
Source: Centers for Disease Control and Prevention, Tobacco Control State Highlights 2010

18. TOBACCO ISSUES IN THE DISTRICT
• DC is one of only 5 states to spend nothing on tobacco
programs
• The District currently spends ZERO local dollars on cancer or
tobacco programs and 0% of tobacco tax collections are re-
invested to fight the health burdens caused by those
products.
• Tobacco-related health costs alone top $600 million each year
in DC

19. Smoke Free Public
Housing
Working with community
leaders to empower residents
to quit smoking!

20. Breathe DC
Smoke Free Public Housing
In March 2011 Breathe DC was awarded $150K by the DC
Department of Health’s Community Putting Prevention to
Work project to collaborate with four selected public
housing developments to bring awareness to the dangers
of tobacco and to prepare the over 1000 residents for a
policy change that would make the public housing
development they reside in totally smoke free in their units
and on campus.

21. Program Outline
 Identify existing leadership
within 4 public housing
developments and assist them
with assembling a team of
individuals committed to
empowering fellow residents to
quit smoking
 Help Leadership Teams engage
the community and educate
smokers about the program

22. Program Outline
 Conduct 2 four week group
sessions per development
focusing on how to successfully
quit smoking, the dangers of
second-hand smoke, and
community engagement
 Empower residents who
completed the program to fight
for smoke free environments

23. DC Public Housing Developments
 Langston Dwellings – 274 Units – Ward 5
 Green Leaf – 242 Units and
 Green Leaf Senior Bldg. – 215 Units - Ward 6
 Benning Terrace – 274 Units – Ward 7
 Knox Hill – 122 Units – Ward 8

24. Collaboration/Partners
 ANC’s
 DC Department of Health – Tobacco Control Dept.
 DC Public Housing Authority
 DC City Wide Advisory Board
 DC City Wide Advisory Board Health Committee
 Resident Council Members
 Catalyst Grantees
 Clergy

25. Accomplishments
 Conducted 6 four week cessation groups
 216 participants completed
 All residents received quitline cards
 5 Secondhand Smoke Exposure presentations
 2 Brown bag trainings conducted in other wards
 5 Resident Leader Teams developed
 Presented Public Housing Webinar with Boston
Housing Authority

26. CONTACT INFORMATION
MODERATOR JULIAN C. WILSON
District of Columbia Housing Authority Office of Resident Services | Resident Services Specialist
jcwilson@dchousing.org
PANEL Kenneth Council
District of Columbia Citywide Advisory Board | Vice President
Fort Dupont Resident Council | President
202-575-3601
vze3swjc@verizon.net
Charles Debnam, BA, CACII, CTTS
Breathe DC | Director, Health Education Services
202-574-6920
charles@breathedc.org
Robert M. Grom
DC Cancer Consortium | Deputy Director and Chief Development Officer
202-821-1933
rgrom@dccanceranswers.org
Fay J. Van Hook
District of Columbia Department of Health | Public Health Analyst
Cardiovascular Health Program
fay.vanhook@dc.gov
Diana Lapp, MD
Unity Health Care, Inc| Deputy Chief Medical Officer
dlapp@unityhealthcare.org
202-715-7931

27. Graphic from U.S. Department of Health & Human Services, Office of Minority Health, ACT NOW program.
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