​Peggy Toy is project director of the Center's Healthy Aging Partnerships in Preventative Initiative (HAPPI) which awarded $140,000 in grants to eight community groups to increase use of preventive services -- such as flu shots and cancer screenings -- among underserved adults age 50 and over in South Los Angeles. In this brief interview, Toy discusses the urgent need behind the awarding of these grants, the community groups and their focus, and the fears and mistrust that will need to be overcome.

Q: Why is this project important?

​The population of adults ages 50-64 years doubled in the last 10 years in South Los Angeles (LA). Elder care, especially in low-income, underserved areas, is becoming an urgent challenge. In South LA, older African-Americans and Latinos are at higher risk for having heart-related disease, certain cancers and chronic respiratory illnesses than the overall county population. The flu shot immunization rate is 10 points lower than the state average ― less than 50 percent of residents age 50 and over get a flu shot each year in our project area. And the death rate in this area related to flu and pneumonia is 10 points higher than Los Angeles County generally.

Q: Who received the grants and who will benefit from them?

A majority of the grantees are partnering with clinics in South LA to specifically encourage African-Americans and Latinos over 50 to get mammograms, colon cancer screenings and cholesterol and other tests to check for early signs of disease and help them take steps to reduce premature disability and death. Our goal is to connect at least 300 older residents to preventive services and to spread awareness about the importance of preventive services to many more.

The grant winners' projects were guided by the Center study, Bringing It to the Community: Successful Programs That Increase the Use of Clinical Preventive Services by Vulnerable Older Populations, which reviewed different preventive care programs across the nation in various communities using local, community-based approaches found to be effective in increasing the use of clinical preventive services.

Our aim is to do the same thing here in South LA ― identify what works best for these communities by the community itself. Community-driven approaches foster solutions that can be embraced and sustained over time.

Q: How will the organizations facilitate access for those who need clinical preventive care services? For instance, a recent study using California Health Interview Survey data reports African-Americans have a skeptical attitude toward flu shot effectiveness

​Attitudes ― or misconceptions ― about preventive services can be a significant barrier to preventive care, along with lack of access. Among some African-Americans, there is a suspicion that the care they do receive is inferior to the care provided to other communities. Among Latinos, especially the undocumented, there may be a reluctance to seek care due to fears of deportation.

Unfortunately, one does not have to look very far into this country's history such as the Tuskegee experiment and the treatment of undocumented persons to understand some of the reluctance. There are also issues about insufficient information, barriers to follow up, and concerns about what to do with the results.

Our grantees are local organizations with a history of service to African-Americans and Latinos, and a level of trust to effectively address those concerns. They will use workshops lead by community representatives who themselves have benefited from preventive care. They will also engage local clinics, members of the Southside Coalition of Community Health Centers, to provide preventive services where people live. Some of the grantees will conduct education events to encourage participants to go to their own provider to get the service.

And some of the projects will be able to deliver the services in non-clinical settings, like churches and housing complexes, which will be important and reassuring for those who are reluctant to seek help from hospitals and clinics.