Bus stops. Parks. Libraries. The county jail. Barbershops.
These are some of the places the City Mission of Schenectady's health ambassadors go when they're looking for people who might need to see a doctor.
"I try to remember where I used to be, when I was trying to figure out food and clothing and shelter," Eddie Polanco told me, when I met with him at the City Mission. "I introduce myself and start a conversation. ... When you're homeless, a smile and a hello go a long way."
As one of the Mission's three health ambassadors, Polanco works to connect people in need to the health care system.
The cheerful 38-year-old spends more time on the street than in traditional health care settings, talking to people, finding out what they need and offering to help.
His background, which includes addiction and prison time, is an asset, enabling him to understand and relate to men and women who might otherwise be wary of a system that can be complex and difficult to navigate, especially if poor.
"When (Eddie) started he went out and engaged so many people," recalled Erin Simao, who serves as program manager for the Mission's Empower Health initiative. "We couldn't believe how effective he was."
How to improve health outcomes for the poor is a question that's receiving a lot more attention from local non-profit organizations that provide housing and food to the needy.
There's a growing sense, among people I've spoken with in the non-profit community, that helping people get back on their feet requires making sure they're not suffering unnecessarily from chronic illnesses, injuries and other health ailments.
The research indicates that there's a lot of work to do be done.
According to a report from the New Jersey-based Robert Wood Johnson Foundation released earlier this year, Schenectady County is the 53rd healthiest county in the state, placing it not far from the bottom of New York's 62 counties.
That's bad news, and it calls for innovative new programs to improve health outcomes.
Empower Health, which oversees the health ambassadors, is one such program, as is a similar initiative sponsored by the anti-poverty organization Bethesda House that I wrote about over the summer.
The key to making these efforts successful is being prepared to help people meet other needs.
If someone doesn't have a place to stay, a health ambassador might start by helping them find housing. If they're hungry, they might bring them a meal. If they need clothes, they might get them some.
"We know that health is never a priority when people have all these other competing needs," Simao said.
Unfortunately, neglecting your health can have expensive, long-term consequences.
"People get sick at a younger age," Simao said. "It's costly if you're always in the hospital at a younger age. You wonder if these things could have been prevented or better managed along the way."
Polanco said that his clients are in "survival mode" — so focused on just getting by that health gets short shrift.
One pioneering project that Empower Health will undertake is tracking down people who haven't been to the doctor in a while, have health issues that need to be addressed and trying to convince them to seek medical care. The names of patients will be provided by local insurance companies, and could number between 100 to 400 a month, according to Simao.
"Me sitting in an office and making a phone call to someone is not going to be as effective as someone from the (health ambassador) team going out and finding someone," Simao said.
This is almost certainly true.
The health ambassadors are likable, charismatic and patient. They're friendly, easy to talk to and eager to help the community.
"I'm from the community, and I utilize a lot of resources from the community, so people trust me," said health ambassador Keisha Dunson, 50. "I'm just like them."
Dunson does outreach at Schenectady's Hometown Health Centers, which provides health care to low income people. People visiting the clinic to meet with a healthcare provider can talk to her about whatever else is going on.
"I ask them, 'How are you?' and some people are having housing issues, some are having behavioral issues," Dunson said. "Some people need help with substance abuse. Some people need better jobs, or transportation. A lot of times they're having trouble with their medications."
"We use everything to our advantage, whether it's our ethnicity or our upbringing," Polanco said. "We know the struggle and challenges that being in poverty brings. It's helpful that we sound and look like our audience. We didn't learn all this stuff from a book."
There's nothing wrong with learning stuff from a book, but the health ambassadors bring to the job compassion, a sense of purpose and the insights gained from lived experience. That's a special — and highly effective — combination.
The health ambassadors are doing good work.
If anything, we need more of them.
Reach Sara Foss at [email protected]