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A Life-Changing Prescription for Homeless Oregon Teens

Dr. Tanya Page gives a routine health exam to a young patient in Outside In's mobile health van. Photo courtesy of Kelly Anderson.
Dr. Tanya Page gives a routine health exam to a young patient in Outside In's mobile health van. Photo courtesy of Kelly Anderson.
August 10, 2012

PORTLAND, Ore. – Oregon may be working to transform its health care delivery system, but one Community Health Center has been transforming young lives for more than 40 years. "Outside In" serves the Portland homeless population, with a special emphasis on teens.

For National Health Center Week, it's a reminder that there's a lot more to good health than seeing a doctor. John Duke, Outside In's clinic and health services director, says social factors - from income and insurance, to housing and upbringing - can affect anyone's ability to live a healthy lifestyle or manage a chronic illness.

"Ten percent of a person's health is determined by the care that's delivered. And the other 90 percent of a person's health comes from the social determinants of health - and a large portion of that is in the patient's control."

As Oregon moves toward a system of Coordinated Care Organizations, where people get medical, dental and mental health needs met in one place, Duke is convinced that it's an improvement over the current health care delivery system.

As part of the changes, Oregon recently received a federal waiver that allows providers more flexibility in how Medicaid dollars are used.

Community Health Centers are one-stop care providers, and Outside In takes the concept much further. For young people who would otherwise be living on the street, it provides transitional housing, meals, an alternative school, and counseling. Duke says the clinic's role is as much about life lessons as it is about medicine - which also requires that the patient take some responsibility for their outcome.

"It's about educating and empowering them to take control of their lives. So, it's not that we deliver a cure - 'here's your cure, you're fixed and you're well.' It's giving them the strength and the skills and the desire to support their own health."

A study by the Stanford University School of Medicine compared federally-funded Community Health Centers with doctors' private practices around the country and found the centers matched or outperformed the treatment standards of the private doctors.

Chris Thomas, Public News Service - OR