Grameen VidaSana (GVS), the health initiative of Grameen PrimaCare (GPC), opened in September 2014 and currently offers Grameen America (GA) members and other women from the community. Based on a comprehensive program that incorporates an enhanced primary care practice and peer group meetings for health promotion, we hope to improve the health and well-being of hard working, low-income women in immigrant communities.
GVS Peer Group Meetings for Health Promotion
- GVS health promotion takes a comprehensive approach to health education and promotion, covering a range of topics including: nutrition, physical activity, mental health, sexual/reproductive health, prenatal care, parenting, health literacy, domestic violence, disease prevention, and chronic disease management.
- As part of the GVS program, members are encouraged to attend group-based health and wellness education sessions in groups of 15 women.
- Interspersed throughout the year are workshops, seminars, and group activities (cooking demonstrations, guest speakers on various health topics, fitness classes), as well as support groups that may arise organically through GVS participation (diabetes groups, walking groups).
- GVS health coaches facilitate health and wellness education sessions.
- All sessions are designed to be experiential learning that is interactive and discussion-based.
GVS Enhanced Primary Care Health Center
- Participants pay $49 per month as a membership fee, which provides unlimited access to health consults in the GVS Health and Wellness Center.
- GVS opened in September 2014, at 82-11 37th Avenue, Jackson Heights, Queens, 11372.
- Bilingual staff consists of an MD, RN, nurse practitioner, social worker and health coaches.
- Offers traditional primary care services through a comprehensive health care team.
- All members receive access to other essential services and referrals to various discounted services offered by partner community organizations and other health care providers.
- In January 2008, GA opened its first Branch in Jackson Heights, Queens.
- Today, GA Branches are in 12 major cities including New York City, Charlotte, Indianapolis, Los Angeles, Omaha, San Jose, San Francisco, Boston, Austin, Union City, and San Juan, Puerto Rico. GA recently expanded to Newark, NJ opened in November, 2016 and will continue to expand to Miami, FL this year.
- To date there are 89,580 GA members in the US.
- A GA Branch is made up of many Centers: each Center is generally comprised of 3-6 Groups (5 borrowers per Group).
- To date, GA marketing of its microcredit program is almost exclusively done through “word of mouth,” with no other advertising or promotion.
- There are 46,235 members within the New York City branches, which is the largest and most successful.
Grameen America Loan Process
- A woman can take a loan from GA if she brings 4 friends together to form a Group.
- To form a Group, GA members must live no more than 5 minutes walking distance from each other.
- Each Center will meet weekly to begin loan repayment.
- At each weekly Center meeting, the member will repay a portion of the loan (with interest) and make a small payment to a savings account.
- First-time loans to GA members are capped at $1,500, typically with 6-month terms.
- Interest rate is approximately 15%.
- A GA loan can only be used for an income-producing business.
- A typical GA entrepreneurship is self-employment, such as renting a chair at a hair salon or nail salon, selling desserts in restaurants, buying equipment for house-cleaning, daycare center at home, cosmetic sales, clothing and jewelry sales, health products, and food carts.
iorahealth, Our Health Care Partner
- A venture-backed health care services firm founded in December 2010 in Cambridge, MA, to build a new scalable model of primary care.
- To date, Iora has 12 practices across 9 major cities, including Las Vegas (NV), Phoenix (AZ), Seattle (WN), Denver (CO), New York City (NY), Boston (MA), Hanover (NH), Hartford (CT), Boston (MA). GVS was the 7th practice to open.
- Business model has moved away from a transaction-based model to one based on care where helping the patient is more important than what the system deems reimbursable.
- The GVS staff consists of 1 medical provider, 1 Nurse Practitioner (NP), and 2 health coaches.
- Health coaches make deep connections with each patient to better understand their health goals and support them on their health needs.
- It has its proprietary IT/EMR system to track all patients in the practice more efficiently.
- From early data, high acuity practice suggests patients truly engage with care team: 94% patients have had at least 1 appointment, 96% patients rated provider >7 on 1-10 scale.
- 50% reductions in Emergency Room visits and Hospital Admissions.
Jackson Heights GA Member Demographics
Based on our health needs assessments in Jackson Heights/Elmhurst
- 100% Latina (Note: the entire GA population is not 100% Latina, but largely Latina)
- Long-term immigrants (14 years on average in the US)
- Ages range from 19-51, with an average age of 41
- 80% have 2 or more children
- 80% uninsured
- 75% have less than a high-school education
- 96% live under NYC poverty threshold
- 55% have an annual income of less than $10,000
Jackson Heights GA Member Health Statistics
Based on our health needs assessments in Jackson Heights/Elmhurst
- Medical Care Access:
- 69% do not have a regular medical provider
- 50% do not go to a doctor on a regular basis
- Medical Cost:
- 26% stopped paying other bills to cover medical expenses
- 21% lost more than 1 month of work due to illness/injury
- 62% had at least one ER visit in the past year and 35% owe on average $654 for their visit
- 87% of members were overweight (33%) or obese (54%)
- Women’s Health:
- 36% did not have a pap smear in the last two years
- Almost all have been pregnant at least once, yet two-thirds reported unintentional pregnancies
- Mental health:
- 51% of members reported feelings of depression
- 59% reported feelings of anxiety
- Domestic Violence:
- 22% had to go to a doctor as a result of domestic violence-related incident
- Social Support:
- 33% self-report having no support
- Technology Use:
- Almost all have cell phones and two-thirds smart phones; however, less than one-quarter use the phone to the full functionality
Immigrants in NYC/USA
- 3 million of the 8.3 million people (37%) in NYC are foreign-born, compared to the US average of 13%.
- NYC has almost 8% of all foreign-born individuals in the US.
- Of the foreign-born in NYC:
- 32% Latin America
- 20% Caribbean
- 28% Asia
- Of the foreign-born in NYC, about 500,000 are undocumented (11.7 million undocumented in the US).
- On the economic front, immigrants comprised 47% of all employed residents, in all major industries.
- Ethnic groups of the lowest median household income include Dominican Republic, Mexican, Ecuadoran, and El Salvadoran; ironically, these are also the groups who have the lowest public assistance recipiency.
Immigrants in Queens
- Of all boroughs, Queens has the highest percentage of immigrants, with 36% of all foreign-born.
- Much of the Queens immigrant population is clustered along the number 7 Subway train (aka the “International Express”) that runs across northwest Queens.
- Elmhurst, Corona and Jackson Heights all sit along this route and have the highest percentage of immigrants within Queens.
- Queens has the highest percentage (and largest number) of population not proficient in English.
- About a third of the population in Queens are low-income.
Healthcare in Queens
- There are 2 public (HHC) hospitals in Queens – Elmhurst Hospital and Queens Hospital.
- 2 charity hospitals recently closed due to financial difficulties, creating a heavier burden on the remaining hospitals.
- 50% of Elmhurst Hospital’s ambulatory care patients are undocumented.
- There are 3 Federally Qualified Health Centers (FQHC) that take Medicaid patients as well as uninsured (no questions asked), with the closest one to Jackson Heights being in Corona.
- Small-scale clinics are “sprinkled” in the borough; GA members are not known to access these resources on a regular basis.
- Compared to the other boroughs, there is a disproportionally low number of federally funded primary care service sites in Queens, by about one-quarter. These sites serve about 84,000 individuals, about 11.8% of Queen’s low-income population.
- Another indication of the lack of adequate coverage is that Queens is currently 6% of NYC total health center patient population but 27.4% of NYC’s total population.