Public Health Partnerships in Diverse Settings
Who was the population of interest at that moment in time? In the article by Carthon, the African-American population in Philadelphia was in focus. At the turn of the last century, 1900, the statistics clearly showed that a much higher percentage of African-Americans ("blacks" is used in the references) were dying due to tuberculosis (TB) than Caucasians ("whites") (Carthon, 2011, 32). In fact the statistics showed that about 447 blacks per 100,000 were dying (from TB) at that time compared with just 197.3 whites per 100,000, Carthon explains.
What was the environmental context within which the population lived at that time? Why were blacks more susceptible to TV than whites in the early 20th century? Carthon suggests that blacks tended to have jobs that had a "high exposure to dust, such as marble, stone, plaster, wood, and textile work." Clearly the black worker exposed to these elements was more likely to be a candidate for TB than teachers, bookkeepers and others in the middle class whose employment did not include unhealthy environments.
What was the main problem/focus concerning this population at that moment in time? Making the problem more severe was the fact that blacks (for a number of reasons) did not feel comfortable traveling to sanitariums or entering hospitals. Why? For a "…sick man traveling without civil rights," not sure where he would stay, having a weakened body, fearing "mistreatment" and other unknowns, he preferred in many instances to "…remain at home with his family and trust God for the rest" (Carthon, 35). On page 36 Carthon explains that when the University of Pennsylvania took over the Henry Phipps Institute (HPI), improving the facilities considerably, it was perhaps...
Blacks were "…more disposed to help themselves," the author continues. In 1922 there were 427 black patients with TB in the HPI; the number of white patients was 1,541, demonstrating that whites were far more willing to seek treatment than blacks (Carthon, 36). This unbalanced number of patients held true despite the fact that blacks were "more prone to tuberculosis" than white people (Carthon, 36).
After the Whittier Centre funded a black nurse (Elizabeth Tyler) to reach out to the black community, the number of blacks visiting HPI increased "rapidly," which was a positive approach to getting more blacks with TB into proper care.
How were the stages (as presented in the CCAT, formation, maintenance and institutionalization) exemplified between 1900 and 1930? The Community Coalition Action Theory is based on cooperation through a coming together of several groups, all of which are seeking solutions to community problems. "…Holistic approaches can deal successfully with problems where fragmented approaches cannot" (CCAT, 238). In the case of blacks and TB, the resources needed to help lower the death rates for TB sufferers were greatly enhanced through the joint efforts of HPI, the Whittier Centre, and the University of Pennsylvania.
The first stage begins before the building of the coalition can be identified; several civic groups gave consideration to "…alternative methods to prevent the disease and attract black patients to clinics," Carthon writes (30). The CCAT points to the "community context" in which "specific factors" enhance (or "inhibit") the development of a coalition; the community context in…
