The South is known for its tasty, rich foods like fried chicken, macaroni and cheese, and peach cobbler. Unfortunately, one Southern state, Mississippi, is also known for having some of the nation’s highest rates of obesity and chronic diseases such as cancer, cardiovascular disease and diabetes—health threats that disproportionately affect African Americans.
For more than 20 years, Mississippi nurse Ella Garner Jackson, RN, CHN, has been working to change these grim statistics by providing health promotion and disease prevention programs to African American church congregations on a volunteer basis. In 2005 she turned her passion into a non-profit organization, the Abundant Living Community Organization (ALCO), which provides health and wellness education, screenings, referrals and other resources through a network of more than two dozen congregational health nurses (CHNs) throughout the state. Jackson is ALCO’s executive director.
Congregational health nursing, also known as parish nursing or faith community nursing, is a specialized practice of professional nursing which focuses on optimal health and wellness within the context of the values, beliefs and practices of the faith community. CHNs serve as health advocates for congregations and the community by providing information on topics like healthy eating, disease prevention, early detection and disease management. CHNs serve the whole person—physically and spiritually. “The first time I thought about the church really being a place of wellness was in 1989,” Jackson says. “A local physician, another nurse and I did a large health fair [at the church I was a member of at that time]. We did it as an outreach to the community.”
In 1997 Jackson took over as leader of the health and wellness ministry within her current church, New Horizon Church in Jackson, Mississippi. “Then in 2001 I learned through some [nursing co-workers at Mississippi Baptist Medical Center] that there was going to be training for CHNs in Alabama and one of the nurses who had been tagged to go couldn’t make it. So I took her spot. The purpose of going to that training was so that we could come back to Mississippi and start training other nurses [in our state] to lead health and wellness ministries in their churches,” Jackson explains.
In 2004 she began coordinating CHN training sessions in Mississippi in collaboration with Baptist Hospital, the Southern Baptist Convention Board, the Samaritan Counseling Center and Mississippi College School of Nursing. The training, which is offered once a year, covers topics such as functions and roles of a CHN, functioning within a ministerial team and assessing the congregation’s health and wellness needs. To date, Jackson and her colleagues have trained nearly 100 CHNs, 25 of whom work directly with ALCO to support the health and wellness ministries in each nurse’s local church.
“I am only one member of the training team,” says Jackson. “Deborah Bolian [MSN, RN] from Mississippi College is the lead instructor. My most significant [contribution] is that through ALCO I have been able to find funding for some nurses who work in underserved African American communities [to receive the training].”
This year, thanks to a grant from the Mississippi State Department of Health (MSDH) Office of Health Promotion and Preventive Health, under the direction of Dr. Victor Sutton, ALCO was able to provide five nurses from the rural Mississippi Delta region with scholarships to the CHN training, plus seed money for starting health ministries. The Mississippi Delta is an area characterized by extreme poverty and some of the most severe African American health disparities in the entire nation. “The people who live there,” says Jackson, “really are the poorest of the poor.”
The primary reason why ALCO has chosen to work with faith-based organizations is because many nurses see the church as extended family and they are striving to keep their families healthy, Jackson says. “It’s just a natural growth of who you are as a person,” she adds. “You want to use the gifts the Lord has given you to help people.”
It’s definitely a higher calling. Many of the ALCO nurses spend most of their free time planning health programs and screenings for their own churches or traveling to other churches in the ALCO network to help with their events, giving up many weekends to serve the cause.
“I’ve always had a heart for people,” says Cindy Johns, BSN, RN, CHN, leader of the health and wellness ministry at Pine Grove Missionary Baptist Church, where she is a member. “I believe health ministry is a calling in our lives. We [CHNs] all have fulltime jobs, but what we do through Abundant Living is what we do for the Lord.”
Johns works full time as a Medicaid program nurse for the Mississippi Division of Medicaid in Jackson and has served as her church’s congregational health nurse since completing her CHN training in 2005.
Not only are the ALCO nurses generously volunteering their time, they have also invested their own money into the work—at least initially. Jackson, who works full time as an oncology case manager at Mississippi Baptist Medical Center, says she incorporated ALCO as a non-profit organization so that the group could begin seeking grants to help fund its activities.
“We knew that there was money out there and that other [local, state and national] organizations wanted us to continue to do the work that we’re doing,” she explains.
ALCO works closely with organizations like the American Heart Association (AHA), the American Diabetes Association (ADA), the Mississippi State Department of Health and other groups that share the CHNs’ commitment to promoting health in communities of color and eliminating health disparities. These organizations have been invaluable to ALCO’s work, says Jackson. The AHA and ADA provide the nurses with a variety of resources for their health ministries, from supplies for blood glucose and cholesterol screening to culturally sensitive patient education materials, such as those available through ADA’s “Live Empowered” initiative.
Even though she is the executive director of ALCO, Jackson does not receive any salary for her work. All of the grant money the organization receives is used to fund specific health education programs, such as workshops on diabetes, heart disease, stroke and sudden infant death syndrome (SIDS) prevention. For example, ALCO has received funding from the Central Mississippi Steel Magnolias Affiliate of Susan G. Komen for the Cure and the MSDH Office of Health Promotion and Preventive Health to provide programs on cancer and diabetes awareness.
“A lot of my friends say that I work at Baptist so that I can do my ‘real job,’ which is my [ALCO] community work,” Jackson says. “[Financially,] we are working toward getting [the nonprofit organization] to the point where we can [expand our] programs and also get more funds to pay someone to help really run the organization instead of [us] doing it all as volunteers.”
Throughout the year, ALCO offers a full calendar of health-based events through its network of church ministries. CHNs at each ministry regularly provide congregation members with screenings for blood pressure, body mass index, total and HDL cholesterol and blood glucose.
In January 2008 ALCO sponsored its first large-scale community cancer awareness event in rural Pocahontas, Mississippi. The program, organized and promoted by New Horizon Church and a group of several other local churches, was called B’Cause (Breast Cancer Awareness Understanding Screening and Education). Despite the rain on that cold winter morning, 200 women from 50 area churches were in attendance. Jackson says it was a marvelous day of cancer education and fun.
“We started the morning with devotions and then we ate a wonderful meal,” she explains. “We listened to [invited guest speaker Sandra Millon-Underwood, PhD, RN, FAAN, oncology nursing professor at University of Wisconsin-Milwaukee College of Nursing], who gave an excellent cancer overview—not just about breast cancer but cancer in general and how it affects African Americans. She talked about prevention, exercising, eating right— the whole gamut. We also had a health fair that featured vendors. One vendor did a healthy cooking demonstration; another featured an African dancer, showing how you could incorporate exercise [into your life] in a fun way. We also had door prizes.”
Based on the success of that event, in January 2009 ALCO presented its second general cancer awareness/ prevention seminar, FACT II (Fighting Against Cancer Together). Held this time at New Horizon Church, the program was co-sponsored by ALCO, Baptist Health Systems and the MSDH. Five medical oncologists specializing in breast, gynecological, colorectal, prostate and lung cancer were brought in as guest speakers, and the health fair vendors included the American Cancer Society, AHA, ADA, Cure Sickle Cell, Our Family Home Hospice and others.
It takes teamwork to successfully plan and implement important programs like these. While ALCO’s congregational health nurses are spearheading these efforts at their churches, the health and wellness ministries they lead are group efforts, not one-person shows. At New Horizon Church, for example, Jackson’s health care ministry team includes two physicians, four pharmacists, a chiropractor, RNs, LPNs, patient care administrators, health educators and more.
Similarly, Johns’ health and wellness ministry at Pine Grove Missionary Baptist Church includes a health educator, a physical activity coach and several nurses. Her team also includes at least one representative from each of the church’s other ministries, to help determine the needs of each population within the church.
“We’ve accomplished many things at Pine Grove,” says Johns. “We’ve set up a physical activity program that’s offered twice a month. We teach people why it’s important to get physical activity even when they are not exercising [at the church] with us. We have a Healthy Heart Day event that focuses on raising awareness that [heart disease] is the number one killer of women.”
Another ALCO nurse, Ruby Denson, MSN, NP, CHN, leads a health and wellness ministry at Jackson Revival Center Church, where she is a member. Her team of 15 to 20 health care professionals provides the congregation with a variety of health education and wellness promotion services, including quarterly blood pressure and blood glucose screenings, vision and hearing exams, healthy eating and nutrition workshops, dental exams and a weight management program.
“We write health tips for the church newsletter and we’re even doing inhouse commercials featuring health tips,” says Denson, who completed her CHN training and started her ministry in 2004.
At Pine Grove Missionary Baptist Church, the good health habits taught by Johns and her health ministry team are rubbing off on other ministries within the church. For example, the hospitality ministry has started serving healthier foods, such as more salads, water and baked rather than fried foods. “I’m seeing that people [in the congregation] are taking control of their health issues,” Johns says. “We are equipping them [with the information they need] and then it’s their choice.”
The ALCO nurses say their goal for the future is to continue to build on these achievements and eventually grow their volunteer involvement with the organization into full-time jobs. As Johns puts it: “My dream is for Abundant Living to be known nationwide. I want us to [be able to] do more [disease prevention programs to] decrease obesity, high blood pressure and diabetes. I would also like to see more nurses [from other parts of the country get involved in this work].”
For more information about the Abundant Living Community Organization, visit www.alcoinc.org.