Ella Barnes-Williams is dealing with a lot right now.

For starters, her government-subsidized house in Northeast Washington, D.C., leaks when it rains. She points at a big brown splotch on the ceiling.

"It's like mold, mold, mold all over," she says. "I've got to clean that now 'cause that just came back."

Barnes-Williams is 54 and lives with her 30-year-old daughter and three young grandchildren. All three grandkids have severe asthma, which makes the mold a serious problem. And she and her daughter are diabetic.

On top of the housing and health problems, Barnes-Williams hasn't had steady work for more than a decade. At the end of most months, the family runs out of food.

As if all that weren't enough, their house was recently robbed — twice. "They, like, went shopping in my house," Barnes-Williams says. "They even stole the kids' school uniforms."

But she isn't the type of person to give up. Though she dropped out of high school as a teenager, she went back to school and got her diploma at age 46. She now attends community college, attends career training workshops and volunteers on political campaigns.

There's also a steady stream of visitors to her house because she's a notary public. She receives $2 per stamped document, which she says helps with small costs around the house.

But, despite being hardworking and well-connected in her community, Barnes-Williams didn't know about a wide range of social programs that are available to help her family — until she met a young man named Phung Tran.

Tran grew up in Washington, D.C., and is a senior at the University of Maryland. Two days a week, he comes to a small office in the Children's National Medical Center to make phone calls through a program called Health Leads.

"I connect low-income families at the hospital with different resources in the area," Tran says.

He first started working with Barnes-Williams a few months ago. She had about 10 specific needs, he discovered — many related to food, clothing and housing. "It was kind of overwhelming at first," he says.

So they made a list and started working through the items, one by one. Her top priority was food; Tran referred her to a local food pantry that now provides the family with free groceries once a month.

Next was furniture: Tran found an organization that gave Barnes-Williams a couch, shelves, lamps, a drawing board and puzzles for the grandkids.

Now he's helping address the mold problem, by connecting Barnes-Williams with an organization called Breathe DC, which provides air purifiers, vacuum cleaners and specific advice on how to stop mold.

Phung Tran is an advocate with Health Leads, based at the Children's National Medical Center in Washington, D.C.

Phung Tran is an advocate with Health Leads, based at the Children's National Medical Center in Washington, D.C.

Anders Kelto/NPR

Tran is also lining up summer activities for Barnes-Williams' grandkids, including a camp geared toward kids with asthma.

Health Leads operates in seven cities across the U.S. and has more than a thousand volunteer advocates, the vast majority of whom are college students. It was founded by Rebecca Onie. Now the organization's CEO (and recipient of a MacArthur Foundation Fellowship in 2009) Onie came up with the idea as a college sophomore in the 1990s. While volunteering at a hospital in Boston, she often asked doctors this question: If you had unlimited resources, what's the one thing you would give your patients?

The answer that came back over and over again, she says, was food, transportation, or a better place to live, because those were the real problems — and the underlying cause of many patients' health problems.

This led Onie to imagine an entirely different kind of health care system — "one in which a physician or nurse could prescribe basic resources that a patient needs to be healthy, like heat in the winter or access to healthy food," she says.

And that's exactly what Health Leads does. It trains doctors to ask patients about their social needs and then connects patients with organizations that can meet those needs.

Onie says the long-term goal is to show that providing patients with better food, housing, transportation and so on not only improves patients' health, but also reduces the cost of health care. She and her team are collecting data to try to make that case.

"Then we can work closely with health care systems across the country," she says, "to really make [addressing social needs] an integral part of how they deliver care."

Since Ella Barnes-Williams began working with Health Leads a few months ago, she has been making regular trips to Martha's Table, a food pantry in Washington, D.C. She had no idea how much help was out there, she says. She just needed someone to help her find it.


This story is part of the NPR series, What Shapes Health? The series explores social and environmental factors that affect health throughout life. It is inspired, in part, by findings in a recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

Most Americans understand their health as an issue that goes way beyond medicine. A survey finds many Americans link social factors to their health. By social factors, they mean obvious issues like food and also less obvious factors like housing and unemployment.

STEVE INSKEEP, HOST:

It can all affect people's health according to that survey by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. Social factors can hurt your health when you do not know how to connect with people and programs to improve your situation. And as part of our series What Shapes Health, NPR's Anders Kelto profiles volunteers who help to make the connection.

ANDERS KELTO, BYLINE: Ella Barnes-Williams is dealing with a lot right now. For starters, her government-subsidized house in northeast Washington, D.C., leaks when it rains. She points some brown patches of mold on the ceiling.

ELLA BARNES-WILLIAMS: (Laughter). I got to clean that now 'cause that just came back. It's like mold, mold, mold all over, so I've been cleaning.

KELTO: Barnes-Williams is 54 and lives with her 30-year-old daughter and three young grandchildren. She and her daughter are both diabetic and all three grandkids have severe asthma, which makes the mold a serious problem. She pulls out a big plastic basket.

BARNES-WILLIAMS: This is all medicine for allergy and asthma. My daily life is a grandmother trying to make sure all the kids are taken care of.

KELTO: On top of these health problems, Barnes-Williams hasn't had steady work for over a decade. At the end of most months, the family runs out of food. And if all that weren't enough...

BARNES-WILLIAMS: My house was robbed twice. They, like, went shopping in my house. They even stole the kids' uniforms for school. I know I heard everything, but take the kids' uniforms so they can't go to school?

KELTO: But let me give you a sense of the kind of person that Ella Barnes-Williams is. After dropping out of high school, she went back and got her diploma when she was 46. She attends community college and volunteers on political campaigns. She keeps the family's paperwork in a neatly organized binder.

BARNES-WILLIAMS: Birth certificate and health records - see me stacked up? Look at this.

KELTO: And people are constantly stopping by her house.

(SOUNDBITE OF DOOR KNOCKING)

BARNES-WILLIAMS: Hi, baby.

UNIDENTIFIED WOMAN #1: Can you do something for me?

BARNES-WILLIAMS: Sure.

KELTO: Because Ella Barnes-Williams is also a notary and she takes the job seriously, even the oath.

BARNES-WILLIAMS: Is everything true to your knowledge of the document you just signed?

UNIDENTIFIED WOMAN #1: Yes.

BARNES-WILLIAMS: Is it complete without error as far as you know?

UNIDENTIFIED WOMAN #1: Yes.

KELTO: But despite being well-connected in her community, Barnes-Williams didn't know about her organizations that could help her family - until she met a young man named Phung Tran.

PHUNG TRAN: Hey, Ms. Barnes-Williams. Hi, how are you?

KELTO: Tran is a senior at the University of Maryland. And two days a week, he comes to a small office in the Children's National Medical Center in Washington, D.C., and makes phone calls as part of a program called Health Leads.

TRAN: So I connect different families here at the hospital, more specifically the low-income families, to different resources in the area.

KELTO: He started working with Ella Barnes-Williams a few months ago.

TRAN: It was kind of overwhelming at first because there were a bunch of needs. There were, like, nine or 10 specific needs that she needed - food, clothing, some housing resources.

KELTO: So they made a list and started working through these needs one by one. First, he referred her to a food pantry. Then he connected her with an organization that gave her a couch, shelves, lamps and even a drawing board and puzzles for the grandkids. Now he's helping her with the mold problem and lining up summer activities for the kids.

TRAN: So in regards to the summer camps, there's also one that's catered for kids with asthma.

KELTO: Health Leads is in seven cities across the U.S. and has more than a thousand student volunteers. It was founded by a woman named Rebecca Onie when she was a college student back in the '90s. She was volunteering at a hospital in Boston at the time, a hospital that was stretched pretty thin. And she would go up to doctors there and ask this question...

REBECCA ONIE: If you had unlimited resources, what's the one thing you would give your patients?

KELTO: And the answer that came back over and over was this - I'd give my patients food or transportation or a better place to live because that's the real problem. This got Onie picturing an entirely different kind of health care system, one in which...

ONIE: The physician or nurse can prescribe the basic resources that a patient needs to be healthy, like heat in the winter or access to healthy food, the same way that she could prescribe medication.

KELTO: And that's basically what Health Leads does. It trains doctors to ask patients about their social needs, and it connects those patients with organizations that can help. Onie says the long-term goal is to prove that better access to food, housing, transportation and so on not only improves patients' health, it reduces the cost of health care.

ONIE: And then we can work closely with health care systems across the country to really make this an integral part of how they deliver care.

KELTO: Health Leads is now collecting data to make that case.

BARNES-WILLIAMS: Hello, ma'am.

UNIDENTIFIED WOMAN #2: Hi, how are you?

BARNES-WILLIAMS: I'm fine, how you doing today?

UNIDENTIFIED WOMAN #2: I am doing well.

BARNES-WILLIAMS: Yes, ma'am.

UNIDENTIFIED WOMAN #2: Come on in. Let's do some shopping.

BARNES-WILLIAMS: Yes, ma'am.

KELTO: Since Ella Barnes-Williams connected with Health Leads a few months ago, she's been making regular trips to Martha's Table food pantry in Washington, D.C. She often brings her 11-year-old grandson, Malachi.

UNIDENTIFIED WOMAN #2: So, Malachi, you get to choose four different vegetables today.

MALACHI: Sweet peas.

UNIDENTIFIED WOMAN #2: Sweet peas, OK.

MALACHI: Green beans.

UNIDENTIFIED WOMAN #2: Green beans.

KELTO: Barnes-Williams says all this food really helps, and she says she didn't know how much help was out there. She just needed someone to help her find it. Anders Kelto, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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