Resident Orientation
Welcome to Practicing Medicine
in Springfield, Illinois
Congratulations and welcome to the residency program at SIU School of Medicine!
The years ahead will be busy but satisfying as you care for and improve health outcomes of the residents in and around Springfield. As a medical community located in Sangamon County, Springfield is the hub of healthcare for central and southern Illinois. It is also a center for education, research and excellence in innovation made possible through partnerships between the Southern Illinois University School of Medicine, SIU Medicine, Memorial Medical Center and St. John’s Hospital. As a medical professional training in our community, you will not only develop the skills to provide excellent patient care, you can help shape the future of health care!
Social determinants of health (SDH) play an important role in influencing the overall health of all people, and as an anti-racist institution, SIU Medicine continues to work toward identifying health disparities and achieving health equity. Making oneself familiar with the social determinants of health and understanding the challenges that affect your patients is one important step in providing the best care possible. SIU School of Medicine continues to expand SDH education for residents and clinical faculty with a variety of interventions. This Google site, along with an upcoming virtual tour of Springfield, is one way to help familiarize you with our city and the people you will serve.
The information on this site was compiled to help orient you to the SDH that influence the patients you will see. Participation in the upcoming tour and use of the resources available here will increase basic knowledge of Springfield’s geographic, socioeconomic, racial, and other healthcare disparities. Additionally, knowledge of the resources in the community will better equip you to assist patients by utilizing a wide range of services available for improving health outcomes for Springfield residents.
We hope you find this site helpful, and encourage you to refer back to it throughout your residency as you interact with our wonderful Springfield residents and future patients.
Quick Review of Social Determinants of Health and Health Inequalities
As a physician, you can directly impact the quality of care your patients receive. However, we know that healthcare only determines about 20% of an individual patient's health outcomes (see diagram to the left). You can help influence the other 80% by increasing your awareness of how SDH affect your patients, your work in the community, and by serving as an advocate for your patients and their community.
Understanding these social factors and practicing through a lens of population health will equip you to provide the best care possible.
Social Needs vs Social Determinants
Maslow's hierarchy of needs is a theory of motivation which states that five categories of human needs dictate an individual's behavior. Those needs are physiological needs, safety needs, love and belonging needs, esteem needs, and self-actualization needs.
Springfield Demographics
Click here to read article from Natalie Pierre, State Journal-Register, 5/12/21 "Springfield's equity gap: By the numbers".
Understanding SDH Specific to Springfield
The Basics: Springfield is the capital of the U.S. state of Illinois and the county seat and largest city of Sangamon County. The city's population was 114,394 at the 2020 U.S. Census, which makes it the state's sixth most-populous city, the second largest outside of the Chicago metropolitan area, and the largest in central Illinois.
Well-known History: Settlement of the area began in 1820 when John Kelly built a cabin on what is now the corner of Second and Jefferson streets. Abraham Lincoln moved to Springfield from New Salem on April 15, 1837, and lived there until he became president in 1861. Springfield had a population of less than 3,000 when it was chosen as the state capital in 1837. The city has several historical sites associated with President Lincoln.
Springfield’s economy grew in the mid-19th century with the arrival of the railroad. An agricultural center, Springfield became known for coal mining at the turn of the 20th century. The city is a wholesale and retail center for a rich farming area producing corn (maize), soybeans, and livestock. It is the site of the Illinois State Fair, held annually since 1853. Principal manufactures include agricultural equipment, electric meters and electronic equipment, chemicals, and building materials. Tourism is an economic asset and the city is the national headquarters of several insurance companies. Several college and universities are located in Springfield (cited directly from source)
Not-so-known History: The Springfield community has lived through traumatic events which have influenced the city and residents. The Springfield race riot of 1908, along with the trials and aftermath, are said to be one of the most well-documented examples of the complex intersection of race, class, and criminal justice in the United States. As a result of the rioting, many black citizens left the area and a long history of racism remains. According to Springfield's National Association for the Advancement of Colored People (NAACP) website, the 1908 Race Riots in Springfield was a major factor which led to the establishment of the NAACP.
Redlining in Springfield
Redlining practices in Springfield have contributed to inequalities residents of Springfield have experienced throughout the years.
Click here to read article from Natalie Pierre, State Journal-Register, 5/12/21 "Springfield's longstanding equity gap has created 'whole different world' on the east side".
Why does Springfield’s history matter in addressing social determinants of health and health disparities for our patients?
Disparities: Racial disparities and residential segregation between black and white Springfield residents significantly affect the wellness and health outcomes of people in Springfield and the surrounding areas. Although SIU School of Medicine and our partners throughout the city continue to tackle the barriers to equity, the progress made is no where near where it needs to be. According to an article published in the State Journal Register, differences between median black and white incomes is greater in Springfield than any other metro area nationally.
Second only to income, education is a another major determinant in health outcomes. Springfield School District 186 encompasses 32 schools. The most recent Illinois State Board of Education report card shows the chronic absenteeism rate for the district is 34%, the graduation rate is 72%, and secondary enrollment following graduation is 60%, each of which trail their comparable state percentages. Three of the five schools rated "underperforming" are physically located in neighborhoods east of downtown Springfield.
The Robert Wood Johnson Foundation (RWJF) reported that although Sangamon County ranks 2nd for clinical care, the county ranks 82 out of the 102 counties in Illinois for overall health outcomes. Worsening trends include obesity, sexually transmitted infections, and children in poverty. Please take a look at the details regarding Sangamon County's 2019 ranking here.
COVID-19 is a recent example of how populations with health outcomes already negatively impacted by SDH are further disproportionately affected by the coronavirus pandemic. In Sangamon County, 31% of coronavirus infections were among black residents, despite making up 12.9% of the population (as of May 2020).
What Can Be Done?
Information gleaned from the Community Health Needs Assessments (CHNA) conducted by our partnering hospitals continually shape SIU Medicine's efforts and work in the community. To learn more about the priorities and implementation plans developed by St. John's and Memorial Medical Center, visit the links below.
https://www.st-johns.org/Hospital-Information/About-Us/Community-Health-Needs-Assessment
https://www.choosememorial.org/Community-Health-Needs-Assessment
COVID-19 and Its Effects
Use Your Position to Make an Impact!
Linkage to a Community Health Workers
After screening for social needs, the SIU Community Health Workers (CHW) task list can be accessed through the EHR to refer patients for assistance from a CHW.
Additional Considerations in Sangamon County
The map on the right shows the medical campus in the heart of Springfield and its surrounding neighborhoods.
Community & Neighborhoods Matter
Where your patient lives within Springfield plays a large role in how well and how long they will live. Despite our many physician providers, the residents of neighborhoods that border the medical campus are significantly impacted by SDH that influence their health outcomes.
To address this, many of the most frequently used resources are also located near the medical campus and around town.
Access to Healthy Food & Healthcare
One variable affecting wellness is access to healthy food choices, and several areas in Springfield lack grocery stores and co-ops providing healthy food choices. Below is a picture of the only grocery store located near the neighborhoods of Enos Park, Pillsbury, and Pioneer Park. It is imperative to know access to fresh, nutrient dense food is limited for many patients you will see.
In addition, lack of transportation forces many patients to rely on public transportation for shopping and/or transport to healthcare facilities. Oftentimes, patients have to navigate several bus exchanges to get from their residence to a doctor appointment, pharmacy, or the Sangamon County Department of Public Health for WIC services.
For patients who rely on public transportation, planning a visit to a medical or resource facility is often tasking and confusing. The pictures below provide a scenario of a mother who attempts to use the trip planner available through the SMTD website to travel from an address within Pioneer Park neighborhood to the Sangamon County Health Department which houses the WIC office.
SMTD utilizes a trip planner on their website which is powered by Google maps. The picture above shows a first attempt to get from an address in Pioneer Park neighborhood to the Sangamon County Health Department for WIC services.
The first attempt routed the patient from their home to an address in Columbus, Ohio, requiring the patient to go through the process again making sure they have placed the city and state behind both their to and from addresses.
For the second attempt at the trip planner, patient correctly entered city and state for both locations (above). The time of departure was set at 8:00 AM. Map results (middle) depict the possible routes for the patient to take and the mode of transportation necessary for each.
However, further route instructions (right) do not provide the location of the bus stops, do not reflect the set departure time of 8AM, require more intense planning on the part of the patient.
Click here to read article from Dean Olsen, State Journal-Register, 4/27/21 "Gov. JB Pritzker signs sweeping health care equity reform bill at Memorial Medical Center".
Improving Outcomes by Partnering with Community Service Agencies
The Sangamon County Department of Public Health provides personal and environmental health services which emphasize health promotion and the prevention of illness and disease. It is the 10th largest health department in the state with an annual budget of $8.4 million serving a population of over 200,000.
Office: 2833 S. Grand Ave. East
Hours: 8:00AM-4:30PM Monday-Friday
Phone: 217-535-3100
The Sangamon County Department of Community Resources strives to improve the quality of life for people through department programs, services and referrals that promise economic stability and/or self-motivation.
Office: 2833 S. Grand Ave. East, Suite C100
Hours: 8:30AM-5:00PM Monday-Friday
Phone: 217-535-3120
https://co.sangamon.il.us/departments/a-c/community-resources
The Springfield Urban League works to assist individuals and communities in reaching their fullest potential through empowerment in the following areas: civic engagement and social justice, economic and workforce, education and youth, and health and quality of life.
Office: 100 N. Eleventh Street
Hours: 8:30AM-5:00PM Monday-Friday
Phone: 217-789-0830
Mental Health Service Agencies
Memorial Behavior Health clinicians include licensed professional counselors and social workers who provide comprehensive mental health and treatment services.
Closest location is 710 N. 8th Street, walk-ins welcome from 8:30 am - 4:30 pm
Phone: 217-525-1064
Lincoln Prairie has a clinically skilled multidisciplinary team which provides youth with mental health and psychiatric treatment.
Office: 5230 S. Sixth Street, walk-ins welcome 24 hours a day
Phone: 217-585-1180
Springfield Shelters
Contact Ministries
365 day emergency shelter from 5 pm - 8 am
A transitional shelter for moms and children, including boys until age of 13.
Helping Hands of Springfield
https://www.helpinghandsofspringfield.org/
Shelter for males 18+ years, must arrive no later than 5 pm
Eligibility, basic rules and guidelines for overnight shelter
Inner City Mission
http://innercitymission.net/
Provides shelter to children and parents and single women.
Catholic Charities
Provides legal services, crisis assistance, intact family services, food/mobile food pantry, daily breadline and referral assistance.
Washington St. Mission
https://www.washingtonstreetmission.org/ Transition home for men in recovery and returning to work
M.E.R.C.Y Communities, Inc.
https://www.mercycommunities.org/
Provides housing and support to homeless or at-risk women and children
Supports for Youth
The Outlet
https://www.theoutletillinois.org
Giving young boys from single parent homes the opportunity to learn & grow from positive, male role-models.
Located at:
2525 S. 12th Street, Springfield
Boys & Girls Club
Inspiring boys and girls to be the best that they can be.
Located at:
300 S. 15th Street, Springfield
YMCA
https://www.springfieldymca.org/new-downtown-y/
Providing healthy experiences for youth of all ages.
Located at:
601 N. 4th Street, Springfield
Additional Efforts
Collaborative Projects
Recognizing that access to care was a priority for both hospitals serving Springfield and Sangamon County residents, SIU Center for Family Medicine joined with Memorial Medical Center and HSHS St. John's hospital to further a joint project improving access for lower income families. Focus groups on "Access to Care" revealed that a community health worker (CHW) model might be effective, so SIU Center for Family Medicine created a CHW program for Enos Park neighborhood.
The program exceeded expectations and received an American Hospital Association 2018 NOVA Award for collaboration on looking beyond physical ailments to address economic and social barriers to care.
In addition, the Department of Family and Community Medicine (FCM), in partnership with Land of Lincoln Legal Aid, provides free legal assistance to low-income patients with health-harming legal needs, that typically address the social determinants of health. For more information, contact Carolyn Pointer, JD, at 217-545-4391.
Thank you for participating in this orientation activity.
We hope it enhances your ability to effectively treat and interact with patients during your residency.
This module is for educational purposes only.