By Ansley Franco
In 2005, John Dorsey, MD, MBA moved from California, where he had been on the faculty at Loma Linda University Medical Center, to Greensboro, Alabama to provide psychiatric care at Hale County Hospital. Two years later, seeing a need in the area, Dorsey established Project Horseshoe Farm, a non-profit dedicated to helping improve the lives of vulnerable community members, and developing future service leaders.
Over the next few years, Dorsey and the small Horseshoe Farms staff were busy. Working with Greensboro Elementary School, they launched an after-school tutoring program for 4th and 5th graders. They created a one-year educational grant-supported Community Health Fellowship for recent college graduates. Fellows live together in housing provided by Horseshoe Farm, and in 2009 they welcomed their inaugural class of Fellows. That same year, they opened Horseshoe Farm's first Enhanced Independent Living home for women. A few years later, they opened a community center for hosting social, health, and wellness programs and activities for seniors and adults living with mental illness.
Loneliness has a deleterious effect on physical and emotional health. So much so that the U.S. Surgeon General estimated that loneliness and social isolation have roughly the same negative health impact as smoking 15 cigarettes per day. Dorsey wanted to help alleviate this problem for the large number of seniors and others in rural Alabama who are shut-in and isolated. With that in mind, Horseshoe Farm launched the Health Partners Program in 2013. The program pairs each of their Fellows with seven to 10 seniors, adults living with chronic illnesses (including mental illness), or other vulnerable individuals. The two sites – Greensboro and Marion, both in Alabama, host 13 first-year Fellows and three Senior Fellows.
“Rural communities are overlooked when it comes to access to healthcare and transportation, and I think it’s very easy to put the blame on the people. It’s pretty amazing what we can all do together. You talk to people, and there becomes this shared uplifting spirit,” said Chris Cho, Senior Fellow. “When you focus on what makes our communities strong, it comes down to the relationship aspect. This program is allowing people to come together. We’re like an avenue for people to reach out to each other.”
Senior Fellow, Mackenzie Christensen, says that the people they work with are actively striving to improve their quality of life, but generally do not have a support system to do so.
The people who come into the program are labeled as health partners because they are not patients or clients – both partner and Fellow have a mutual bond that comes from the shared experiences during their visits.
Fellows foster caring relationships with their health partners by meeting with them for one hour once a week. The type of visit depends on the needs of the individual and can range from going to a doctor’s visit, taking a walk in the park or cooking tacos for a family dinner.
“There is a wide range of people who enter the program,” said senior fellow, Mary Sophia Reich. “We do have some youth that we partner with. That relationship is more focused on school and education. And it’s also about building healthy habits like nutrition, making the right choices and behavioral things. Towards the other end of the spectrum, one of my partners was 98 years old. She was more of the social visits.”
According to the 2020 Census Study Report conducted by the National Academies of Sciences, Engineering, and Medicine, “Over four decades of research has produced robust evidence that lacking social connection – and in particular, scoring high on measures of social isolation – is associated with a significantly increased risk for early death from all causes.”
“Each relationship takes on its own purpose and helps support them in any way they need it,” Christensen said. “It’s really important because many of these partners don’t have consistent people to show up in their lives, and we get to come in and provide that social support. They know that someone is going to show up every week and that reduces a lot of loneliness.”
To further combat social isolation, people who are not in the program can visit the community center for the twice-weekly get-together. “A lot of these people are suffering from isolation, and now they’re able to get out and meet new people,” Cho said. The community center is also used for health partner visits to go to a new environment and play games or use workout equipment.
When not with their health partners, fellows will spend a few hours once a week working with several community engagement sites. In Greensboro, Christensen is working with the Hale County Hospital to refer patients to the Health Partner Program as a transitory partnership. This would provide extra support for those who may need help getting their prescriptions, setting up future appointments and giving them social resources that they may be lacking.
Other fellows work with neighboring organizations such as the emergency management agency, local high schools and gardens. “We get to know a side of the community that I don’t often come in contact with,” Christensen said.
Community engagement sites in Marion include work at the local library, city hall and Sewing Seeds of Hope – a local non-profit. Fellows also can work at Spencer’s Farm, a nearby farm where extra produce is taken to the community.
“You can see how important it is for the community,” Christensen said. “I learned that if you just show up, people see that you're there to help, and then often they will let you in. And I feel like that's a lesson I'll take with me for the rest of my life.”