Prescription for change

Closing the gap on healthcare disparities in north Tulsa

Driving to Crossover Health Services from midtown Tulsa feels like venturing to a frontier outpost in the uncharted desert. Wide, acre-lot-size blotches of brown grass flank either side of the nondescript white building where the clinic operates. The isolated area almost feels rural, but it’s heavily populated.

The drive to Crossover’s location at 36th Street North gives you some idea of what it must be like to travel miles for basic care. Just imagine if you didn’t have a car, and had to rely on a bus or your own two feet. Now imagine you’re traveling with sick children.

For years that was north Tulsans’ everyday reality. For many it still is. Since 2014, Crossover Health Services has tried to fix that, by offering family medical services at 940 E. 36th St. N, the Hawthorne neighborhood. The clinic is part of Crossover Bible Church and its affiliated nonprofit organization, Crossover Community Impact.

Executive director Justin Pickard is a graduate of the University of Tulsa who also holds a master’s degree in urban development from Harvard University. Crossover Community Impact was born thanks to Pickard and Rev. Philip Abode’s shared vision. Rev. Abode is also a TU graduate, as well as a former Golden Hurricane football player, who is pastor of Crossover Church. They have been joined by numerous others who grew weary of watching their fellow human beings suffer in silence.

For the Crossover team, this clinic is personal. Instead of commuting to work from different parts of the Tulsa metro, they have built their lives and are raising their families in north Tulsa.

“All of us live out here. This is our community too. It means something to us,” said Louise Whitley, Crossover’s RN, DSN. “We’re not just coming in and working and leaving. This is us.”

“I’m one of the patients. My family is the patient. You can’t treat me any differently than anyone else,” said Angelia Barnett, Crossover’s administrative manager.

Being both patient and provider gives the team a grassroots perspective when it comes to serving a patient’s needs. With people’s lives on the line, the providers don’t fret about customer service or patient experience, and will prescribe a heavy dose of tough love.

“Sugar and salt are both white, so you might not get what you expect, but you’ll always get what you need,” Barnett said. She has called patients every hour on the hour just to make sure they pick up their prescriptions. “That’s the family aspect of it. It’s getting what you need, not always what you expect.”

Like a family, the Crossover team is united by stronger bonds than you find in most workplaces. Chatting with Pickard, Barnett, and Whitley is like watching a play with overlapping dialogue or sitting around the family dinner table, as the three expand on each other’s thoughts.

“Nobody thought we could do this,” said Whitley.

“No. Everybody told us [you can’t do this],” said Barnett. “Executives told us this would not be a profitable venture.”

“Well, they were right about that!” said Pickard.

“We make enough,” said Whitley.

“We’re not federally funded,” said Barnett. “We’re not swinging from the chandeliers. But we’re making it.”

“This is what I think medicine should be,” said Whitley. “But it’s turned into a business. It shouldn’t be a business, but it has, I feel like. Ours is not a business.”

“Our doctors work for way less,” said Pickard. He credits this for keeping the clinic afloat. While Pickard says that Crossover’s healthcare providers are able to make a living and feed their families, they each work for a fraction of what they would make elsewhere. This allows the clinic to serve a patient population that would otherwise fall through the cracks.

The national debate over healthcare justice has been with us for generations. Every election cycle brings with it another round of arguments between advocates for universal, single-payer coverage and more market-based reforms. In the meantime, the status quo remains. Working within the confines of our current system, Crossover Health Services finds its purpose in the Bible. The organization’s symbol is the lion and its mission is unapologetically scriptural.

“This wouldn’t be here at all if it weren’t for the Christian mission,” Pickard said. “The people willing to come over here and work and invest in it, they wouldn’t do it without the Christian mission.”

“For your ordinary person, that makes no sense, ‘Yeah I’ll go make half what I can make elsewhere.’ That’s where the Christian mission makes [our clinic] present here where it just wouldn’t exist otherwise,” said Pickard. “We can take as many SoonerCare patients who come through our door and other places literally don’t do that. That’s an example of injustice in our city that affects health outcomes. They just flat out won’t take the people because of the money.”

A structural problem

Systemic issues like this put places like north Tulsa at an inherent and what at times seems like an insurmountable disadvantage. When a community is afflicted, every man, woman, and child who lives there suffers. Mayor GT Bynum shined a light on this nearly two years ago in his statement following Police Officer Betty Shelby’s acquital for the shooting death of Terence Crutcher: “We have a long way to go as a city when there is a 10-year life expectancy disparity between the most predominant African-American part of our city and the rest of our city.”

The racial disparity that Mayor Bynum called “the great moral issue of our time in Tulsa” is the result of a perfect storm of plight.

“Healthcare is a problem. Poverty is a problem. Then there’s segregation by race that we have in north Tulsa that is a problem,” Pickard said. “You can be poor in another part of town, but you have access to services because of the wealthier people around you. It’s the isolation over here … that leaves you with this space without a whole lot of services. Poverty is an issue. It’s a real issue. The broken healthcare system is an issue. But we have stacked on top of those this geographical issue that leads to that health disparity.”

The dearth of primary care providers in an area with north Tulsa’s population is disturbing, and is the side effect of the system as it now stands. While it’s a huge part of the disparity, a healthy population needs more than hospitals and clinics; they need quality food. Greasy spoons and fast food joints abound, but grocery stores, or even places to buy fresh fruit and vegetables, are nearly nonexistent. North Tulsa’s status as a food desert contributes to the obesity, type-II diabetes, and high blood pressure which plague residents and shorten lives.

“There’s a two-mile radius to even get to a grocery store,” said Barnett. “You try walking two miles with groceries. It’s not going to happen.”

Compassion against the odds

As insurmountable as the odds may seem to those on the outside, the Crossover staff does not think the battle is lost. Quite the opposite. Patient by patient, day by day, they are seeing the difference they are making in people’s lives.

“The Tulsa Health Department opening up that branch [at 5635 M.L.K. Jr. Blvd] is a good move. [OU Wayman Tisdale Specialty Health Clinic] is a good move…[but] the real impact is on this relational level,” said Pickard. “The relationships are the best chance at getting that change.
It’s not about billing or ‘you’ve got to see X number of people.’ If you want to see change, people have got to believe that you care about them at this deep-heart level. It’s a little bit of a drop in the bucket in a sense, but we have 4,400 patients. That’s a lot people that have come through, been loved on by the staff … so I know that means something.”

“It’s coming,” said Barnett. “Prayerfully, it’s coming. And that’ll be the change.”

The Crossover team believes the conversation around north Tulsa is changing, and that barriers built over decades are finally coming down. But talking about the problems isn’t enough.

“I think that’s the problem: There’s too much conversation. It’s all talk and no action. Stop talking. I don’t want to hear you. If you’re not out here doing something, get on it.”

Health discrepancies still exist. Fresh produce is still hard to find, and much of the community is still isolated from the rest of their city. The challenges are great, but nobody at Crossover is waiting to be rescued.

“[We’re] changing from a culture of poverty, to a community. We love on each other. We help each other out,” said Whitley. “Just having a clinic here isn’t going to make big changes, but if we can love on people, be an example, show their value and their worth, there’s hope in that.”

Slowly, but surely, change is coming to north Tulsa. For those who don’t live here, that change begins within. It means not being afraid to travel north of Admiral, and not seeing the community as separate from the rest of our shared city.

“We’re kind of in the gap of what the status quo leaves you with,” said Pickard. “People who want to see what’s being done here, we love to show people and would support people doing similar things in other neighborhoods. We’re actively trying to do that.”

“I feel more loved here [in north Tulsa] than anywhere...People are missing out,” said Whitley. “You don’t even realize it. It’s such an awesome place.”

Barnett agrees and states simply: “If everybody does a little, it turns into a lot.”