Veronica Clarke: ‘The divide is undeniable. But we can close it.’

Community Voices interview with Veronica Clarke, Chief Executive Officer of TCA Health, a federally qualified health center on Chicago’s Far South Side

Many people aren’t familiar with federally qualified health centers. What are they and what do they do?

Federally qualified health centers, or FQHCs, are funded by the Health Resources and Services Administration. They are the primary federal agency charged with improving access to healthcare for people who are medically underserved. We are also known as community health centers. FQHCs like TCA Health are vital because we provide comprehensive primary and preventive healthcare, dental and behavioral health services. We also have case management, care coordination, and offer a long list of support services.

FQHCs are in areas of high need and we see everyone regardless of their insurance status and their ability to pay. In Illinois alone, there are 45 FQHCs with over 300 locations, serving more than 1.3 million patients.

TCA Health has three community-based primary care locations and a mobile medical van. Two are in Chicago’s Riverdale community and one is in Chatham. Our health centers are in some of Chicago’s largest food and transportation deserts. One of our communities, Riverdale, also has extensive air and soil pollution.

What are the biggest challenges that you face as a healthcare provider?

We strive to meet many of the basic needs of our patients and community members. What comes to mind is psychologist Abraham Maslow’s idea of hierarchy of needs. Our basic human needs are for air, food, water, safety, and so on, and the people we serve struggle to have those basic needs met.

When basic needs are not met, they often lead to health disparities and what we call social determinants of health. So we need to focus on the basic life challenges, like poverty, educational attainment, employment, and housing so patients can take care of their health. When one of our doctors walks into an examination room and asks the patient, ‘What’s your primary concern today?’, it’s a list of seven to 10 different issues, not just one.

Other challenges include lack of grocery stores and transportation. In Riverdale, there are absolutely no grocery stores within four miles of our health center. Zero. Also, there’s no direct transportation to food. Residents have to take multiple buses to get to a store. Imagine a mom living here with three children. If she doesn’t own a car, she has to ask someone for a ride or take public transportation, which is limited here. So, TCA works with community partners, including local farmers, to bring food into the community.

Now COVID-19 is in the picture.

TCA Health’s communities have been hard-hit by COVID deaths. Now more than ever, we rely on partnerships and funding opportunities to further serve our communities.

FQHCs have banded together to provide an even more robust care model that now includes telehealth and COVID-19-related services including vaccine administration.

TCA offers free COVID testing at our health centers, too. We use our mobile health van to provide testing through our partner network of churches, community-based organizations, food pantries and local businesses.

How do community disadvantages translate into poor health?

It goes back to what I said about social determinants of health. Health is not the No. 1 priority for people who don’t have food or a job or feel safe. This means they are sicker by the time they seek care because they do not lead healthy lifestyles or get preventive services. For example, we see a large number of patients who suffer from obesity because it is easier for them to find junk food than something healthy and nutritious. And obesity frequently leads to diabetes. Many also have depression and anxiety due to the psychological stress they live with.

Maternal and child health is also at risk because several hospitals closest to us providing those services are no longer open. We have more infant deaths per 1,000 lives—10 times more on the South Side compared to the North Side. The divide is undeniable. But we can close it.

What needs to happen to bring about health equity?

People are now faced with acknowledging social injustices and racial inequality. So, there’s no hiding, there’s no denial. And to bring about health equity, healthcare professionals must acknowledge and address that race and racism factor into healthcare. Achieving health equity must be a shared vision and community members must be part of the conversation.

Achieving health equity must be a shared vision and community members must be part of the conversation.

With that realization, I’d like our legislators to allocate more funding to the South Side. I’d like to see more funding to help people better manage their care so healthcare providers can better coordinate our patients’ care. We want to hire more specialists because it’s hard to refer patients when they’re uninsured or on Medicaid.

Someone once asked me: How will you know when health equity is achieved? My response was: It will mean that South Side residents have the same life expectancy as those living on the North Side. Right now, we’ve got up to a 17-year gap between some south and north side neighborhoods.

What’s already underway that has you feeling hopeful?

Mayor Lightfoot has put together a racial equity rapid response workgroup, and TCA actively participates in this group, recognizing that racism is a public health crisis. We’re talking and planning every week about how we can work together to close the racial and health equity divide.

As the chair of the South Side Healthcare Collaborative (SSHC), I’d be remiss if I did not mention the collective work that is occurring on the South Side. SSHC is a network of FQHCs, safety net hospitals, and the University of Chicago Medical Center. This network aims to improve access to care and care coordination so patients can get basic and preventive care through primary care providers, versus the emergency room.

What’s also good is that local hospitals and FQHCs are talking. We’re making sure our collective resources are being used efficiently and that we understand what each entity does really well. We share best practices, identify gaps in services, and collaboratively work to fill the gaps.

We don’t have all the answers yet. But what’s important is that we’re communicating and we’re listening to each other. And most importantly, the community is involved. We cannot create long-term sustainable change without getting buy-in and input from the residents of the South Side of Chicago.

How does being a dietitian influence your thinking as CEO?

Much of my passion is around food because we are what we eat. I want to make sure people have access to healthy food. As a former dietitian, I want to meet the holistic needs of our community, patients and staff.

I’ve worked hand-in-hand with community members to make health and wellness a priority. For over 10 years, TCA has collaborated to bring fresh food resources to our community, and from there, we go on to educate community members about nutrition and healthy cooking.

For example, TCA Health sponsors 10 community gardens. We teach children how to grow their own fruits and vegetables. We teach children and their parents how to cook with different foods. It’s amazing when a child gets to plant a tomato seed, goes back and harvests it and then sees it put into a recipe that they ultimately enjoy. Even if that child has never had a tomato at home, just that process alone makes that kid want to try it.

I have a passion for what I do. I want to see people benefit and become healthier from the services TCA Health and our fellow FQHCs provide.

This interview originally appeared in the Chicago Tribune's Community Voices column. It was conducted by independent health writer Deborah Shelton on behalf of UChicago Medicine. Neither the Tribune newsroom nor the Editorial Board was involved in producing the content.