Discussion

300 Presentation FAITH-BASED HEALTH NEEDS ASSESSMENT: IMPLICATIONS FOR EMPOWERMENT OF THE FAITH COMMUNITY THE REVEREND CES' COOK Faith-Based Center of Excellence Abstract: Churches are often caught in the middle of the struggle between health care institutions and managed care organizations. A faith-based center of excellence model is proposed that would establish a middle ground between the secular and "sacred" aspects of health care. Such a model would focus on using the faith community to influence the behavior and lifestyle of persons within the organized public health model, thus providing a new model of ministry. This process can increase an understanding of the tools needed for the clergy to be better caregivers, more influential co-change agents, and more informed about data-driven outcome ministry. This integrated process is aiticalfor real change in health outcomes, for the improvement of primary prevention, and for reducing disease mortality. Key words: Health promotion, public health, preventive care The questions that everybody has been asking today are, What can we do about increasing the use of the church as a site for preventive health care, and how can we do it in a systematic way? I have completed a faith-based health needs assessment in several local churches in Nashville. All too often, churches are caught in the middle of health promotion initiatives. Most of these programs are results oriented and private sector driven, and the focus is on the bottom line—money. The presentations today suggest that we can get it done, and as a pastor trained in public health, I feel strongly that we can. We can achieve a collaboration between the church and health care marketplace by having a working model in place that allows the pastor to understand how best to engage in the process. To do this, I propose a modd often used in the academic community called a "center of excellence," where direct services, Journal of Health Care for the Poor and Underserved · Vol. 8, No. 3 · 1997 Cook 301 research, and (interdisciplinary) collaboration are emphasized. We used such a model at the Ennix Jones Center, a church-based outreach center at the historic First Baptist Church, Capitol Hill, in Nashville, Tennessee. The difference , however, is that the center used a community organizing approach to be more inclusive in its program development. The approach was found to be a wonderful way of bringing public health, the private sector, and the faith community in line with the reality of health problems within our communities. Such faith-based centers of excellence provide a model of caring in which the pastor can take a more active part in public health initiatives by administering the care necessary to heal both body and soul. The current system of managed care looks at public health from the results-oriented quantitative standpoint. One thing it has not done is affect lifestyle and behavior changes. On the other side of the equation is the qualitative approach, which can involve the church. The church can affect a wide range of behaviors, and thereby reduce some of the risk fartors assodated with problems like heart disease. Such a model would provide a continuum of preventive care, so that once physidans and other health professionals come to the church and convey health messages, their work continues long after they leave. This kind of community organizing model must be formalized so that one can track the extent to which one has made a difference. Last, but not least, is the research aspect of such a model. The current changes in our health care system have created what I call the "herd effect." The poor, the disabled, and those receiving Medicaid support are being herded into a managed care system, what is known in Tennessee as TennCare. The effects of such a system were not tested by the business or political community. The public health community knows how to assess the effects of such a system extremely well. We know we can start with health status and look at various ways to track this population. In that cycle of events, we can measure everything that takes place. I am suggesting that the faith community, using the community organizing approach...