New program puts community health workers at ground level

Establishing roots

Community health worker Kaye Barnes sports a purple SIU Medicine T-shirt to complement her green thumb as she works in Springfield’s community gardens. A native of the city’s north side, she feels at home both tilling the soil or working in the trenches for her clients in the school of medicine’s Office of Community Care (OCC). 

Barnes is a diabetes lifestyle educator, a nationally certified nutrition coach and has a master’s degree in library science. In the summer of 2023, she created and launched Operation Taproot, a new program she hopes will grow and flourish across Springfield’s neighborhoods. The plan is to provide easy access to fresh, locally produced foods while also raising awareness of nutrition and health services available within the community. 

Throughout the growing season, Barnes and other community health workers (CHWs) spend a few hours each week in three Springfield community gardens, cultivating plots filled with vegetables, herbs and fruit. 

The community health workers’ presence in the gardens gives them time to chat with and get to know the residents, and subtly discuss concepts like healthy eating and social connectedness. The hope is that seeds planted in conversations may grow into relationships with far-reaching benefits. 

Operation Taproot is the newest addition to a nationally recognized community health program that began in 2015. The Enos Park Access to Care Collaborative targeted the underserved populations who had difficulty navigating the on-ramps to Springfield’s health care system. HSHS St. John’s Hospital and Springfield Memorial Hospital allocated $500,000 to support the program, working in collaboration with SIU’s Center for Family Medicine.

The ambitious project was crafted in response to the Sangamon County Health Needs Assessment, in which area residents at public forums identified the region’s top health priorities. The goal was to use CHWs to improve conditions for those who were becoming marginalized within their own neighborhoods. The program’s metrics included connection to primary care providers and insurance programs, an ability to manage one’s appointments and achievement of basic needs (food, housing and income). The CHWs focused on the residents’ social determinants of health – the factors outside the doctor’s office that affect well-being – and tried to remove any barriers to accessing medical care.

Out of the gate, the program exceeded everyone’s expectations. Employment, health outcomes, safety measures and government relations were all improved. Visits to emergency departments were reduced, replaced by regular appointments with primary care providers.

Branching out 

At the end of its first funding cycle, the hospitals encouraged SIU to expand the program’s scope and range. An adjacent neighborhood on the medical district’s north edge, Pillsbury Mills, was a logical choice. 

Pillsbury Mills presented a more challenging environment. Nearly 80 percent rental properties, it has a largely transient population. At its center is an 18-acre industrial site, a former Pillsbury processing facility that closed in 2001. Over two decades, it was a prominent emblem for a neighborhood that felt abandoned by business interests and municipal officials. 

To date, the hospitals have spent $1.5 million to support the Access to Care program, but there is still much work to be done. The University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation’s annual County Health Rankings highlight health disparities in the region. Despite Springfield being a downstate medical hub, Sangamon County “health outcomes” rank persistently in the middle of Illinois’ 102 counties.  

The area population has a 31% obesity rate, a 17% adult smoking rate and rates above the state average for sexually transmitted infections, poor mental health days and physical inactivity. The middling rankings indicate that not everyone takes advantage of the city’s available medical resources.  

It’s a barrier Kaye Barnes wants to erase. In addition to her CHW credentials, in her previous career she worked for 20 years as a reference librarian in a small town in Michigan. 

“I know it can take a lot for people who are just getting by, who are a flat tire away from complete disaster,” Barnes says. “That’s why all of this is so important.” 

At the library she frequently helped patrons who were searching for reputable diet information following their doctors’ suggestion. It led her to read up on nutrition, and take an interest in the studies that explored similarities between concentrations of healthy octogenarians around the world. 

Research showed the long-lived populations had several factors in common: good genes, they kept active, ate a healthy diet rich in fruits and vegetables and embraced a sense of community.  

After virtually reconnecting with an old friend (now her husband), Barnes decided to shift careers, return to her hometown and make a difference. 

“I knew I didn’t want to be in a library or a lab. I wanted to do my small part to make my community better... with boots on the ground.”

Barnes has dubbed her effort Operation Taproot based on the concept of growing deep roots to rejuvenate soil – or neighborhoods – with “social permaculture,” creating groups that work together toward sustainable living. She views gardening as a natural and public way of integrating with a neighborhood and establishing trust. 

“You’re not extracting anything out of the community. You’re putting something into it,” she says. “They see my purple SIU shirt and gear, and I’ll say hi and ask them if they want some snow peas and some kale, and then I keep on doing my chores. We are being a visible presence for health care, someone here whom they can ask questions.” 

The program pairs well with SIU Medicine’s demographic and with Barnes’ background. Before starting her current job at SIU, she spent a year working in retail, earning $16,000. It was barely enough to live on, but just enough to disqualify her for government assistance. 

“I know it can take a lot for people who are just getting by, who are a flat tire away from complete disaster,” she says. “That’s why all of this is so important.” 

The nonprofit Enos Park Neighborhood Gardens were created in 2012. It’s owned and operated as a partnership between the Enos Park Neighborhood Improvement Association and Kumler Outreach Ministries, with support from the Community Foundation for the Land of Lincoln, Dominican Sisters of Springfield and SIU School of Medicine. 

About 1,300 people visited or volunteered in the communal garden last year, says manager Carey Smith. There’s a free farmers market from 10 to 11 a.m. every Saturday during the growing season. 

The repurposed land use was a logical development that checked all the boxes, says Michelle Ownbey, past president of the EP Neighborhood Improvement Association. “You’re providing fresh food, socialization and a sense of community.” Educational opportunities for children and adults also contribute towards the overall health and well-being of the area. “We’re very excited about adding Operation Taproot, too,” she says. 

SIU’s community health workers “are a real boon for our neighborhood,” Smith says. Barnes is good at engaging with visitors, volunteers and gardeners who want to talk. Smith knows of at least one gardener who talked with Barnes about a health-related issue. 

In addition to her handy garden tools, “I always have my laptop with me,” Barnes says. “I can start the process while we’re here talking. They don’t have to wait. It’s reducing a barrier to access, that gets them what they need quickly.” 

And from small things, bigger and healthier things can grow.