Journal of Health Care for the Poor and Underserved

Accessing comprehensive and timely health care services in the U.S. continues to be a significant problem, particularly for low-income and socially marginalized groups in urban environments. To begin to address these problems, the Northern Manhattan Community Voices partners have turned to health priority specialists (HPSs) and community health workers (CHWs) to help reduce emergency department visits for care that would better be delivered in clinics or provider offices. This paper examines data collected from an emergency department (ED) diversion program between January 2003 and December 2004 and examines the effects of interventions by HPSs and CHWs in relationship to ED usage among 711 patients. At 6-month assessment, 3 interventions were significantly correlated with decreased ED usage: providing health education (pearson correlation = .299; p = .000; N = 177; mean = .02), teaching patients how to use the health care system (pearson correlation = .259; p = .001; N = 177; mean = .01), and providing counseling on social/emotional issues (pearson correlation = .408; p = .000; N = 177; mean = .01). This paper presents data that reflect the operations in a real-life clinical setting working with economically, socially, and linguistically marginalized populations.