Health, wellness, and the future of Charlotte

The tumultuous events in Charlotte after the death of Keith Scott almost a month ago have sparked an explosion of ideas on what we should do next.


Elected officials are proposing multiple plans, some with detailed interventions related to particular needs like affordable housing, others emphasizing universal pre-K to address underlying disparities, still others focused on providing enhanced training to police officers to deescalate tense situations.


The Opportunity Task Force is in the final stages of an 18 month discovery process, and the Task Force is now poised to bring insights and recommendations on a variety of ways we might improve economic opportunity and social mobility for all in Charlotte.


Some of our leading thinkers, including James Ford with the Public School Forum of North Carolina, counsel it is way too early to rush in with solutions. Ford argues we must first address and accept root causes of inequality that create a system that favors the well-off, before rushing into solution mode.


I think Mr. Ford and others like him are on the right track.


“If you want to lower my blood pressure, help me pay my electricity bill”


As an executive at a health and wellness agency serving individuals with very limited resources, I have my own set of suggestions to address disparities in health care access and health care outcomes. There are multiple health care policy and practice interventions that could help – from adding new federally qualified health centers in underserved neighborhoods to improving access to affordable nutritious food options to expanding proven poverty fighting programs, like our own Nurse-Family Partnership.


But as I reflect on the causes of unrest in our city and the challenges that those with the least face in living in Charlotte, I am struck by the fact that any solution we bring must come at this problem holistically.


We should not splinter into favoring one tactical intervention at the expense of other promising tactics.


Simply addressing one very clear symptom of the unrest, like lack of access to affordable, quality health care, without also recognizing that folks who lack health care access also are disadvantaged in securing adequate housing, paying for child care, accessing affordable transportation and much more would be a mistake.


Dr. James Purnell, in his recent piece “Financial Health is Public Health,” for the San Francisco Federal Reserve, leads with a quote from an individual that captures the challenge. An individual shares that “If you want to lower my blood pressure, help me pay my electricity bill.” 


Our patients have difficulty keeping the lights on at home, they typically have poor or nearly nonexistent transportation options, they often cannot access or afford healthy foods.


Stressed to keep their heads above water just to keep their electricity bill paid, a cascade of negative, “toxic health” conditions arise. As Purnell writes, “…those who experience high levels of stress related to their finances are more likely to cope by smoking, eating, drinking alcohol, and watching television in excess, all of which increase their risk for chronic conditions like diabetes and heart disease.”


We know one’s physical health is closely related to one’s financial health. And there are even larger systems impacting the health of those with the least in our city, including inequities in our educational system for those born into poverty, neighborhood housing patterns highly segregated by race and ethnicity, and much more.


No one agency or individual has the single, fool-proof magic bullet intervention that will “solve” once and for all inequalities in our city or our country.


So as our community wrestles with next steps to improve conditions for those who have felt neglected for decades, I suggest we each need to put aside advocating exclusively for solutions that narrowly address our own sliver of the issue, regardless of how powerful or proven any one program may be.


What we need to do is to be better advocates for each other.

Our Hope for Community Health luncheon, scheduled for today, was cancelled due to the events in the city last night. These were my remarks I was preparing to deliver to our guests. 


  “The best way to find yourself is to lose yourself in the service of others”


So yesterday afternoon, after one of the most difficult days in Charlotte’s history, when one of our fellow citizens lay mortally wounded, 16 of Charlotte’s finest were injured, families across this community were in unbearable grief, and the bonds of social trust and connectedness in this city were badly frayed for all the world to see, I was at a loss.


With our biggest day of the year almost upon us – our annual Hope for Community Health Luncheon would be on Thursday --  when we would be meeting with hundreds of our neighbors on this day of great celebration and happiness and joy for all things Care Ring…here comes the reality of violence and misunderstanding and unrest that sadly afflicts our country and has now very visibly visited our city. 


One of our Care Ring nurses lives next to where the violence first erupted on Tuesday night.


One of the families we serve lives right there.


So I needed to walk.


As my colleagues at Care Ring know, I’m a walker. I think and walk. If I don’t have a meeting or a budget sheet to revise or a donor to thank, I walk.


I walk and try my best to put down my devices and look around this city and think about who we are. Think about who we serve. Think about how we can serve them better.


So I walked across the street by Police Headquarters, which happen to be next to our Care Ring uptown headquarters. I walked past a CNN reporter and countless local press that had assembled to report on developments this week, one of Charlotte’s most violent weeks. 


And I stumbled upon an “old friend,” someone I hadn’t planned on visiting, but who serendipitously appeared as I walked.




Yes, Gandhi. How many folks here know there is a fantastic statue of Gandhi right uptown? Erected by a volunteer committee of citizens a few years ago, it is tucked in behind the old county courthouse and often obscured from the street by the beautiful trees near its location.


The statue includes a number of memorable quotes and reflections from Gandhi, and one in particular stood out for me during these times of unrest and uncertainty:


  “The best way to find yourself is to lose yourself in the service of others”


This little nugget, which came to me on an impromptu, unplanned walk, is helping me in many ways this week.


I think about the desperate need for excellent, affordable, accessible health care in this community. There are tens of thousands – tens of thousands – of our neighbors here in Charlotte, in neighborhoods just like the one where violence broke out this week, where folks do not have adequate, affordable, and in some cases any health care options. 


What can we do? How can our broader Charlotte community find our way?


How can we, and by this I mean Care Ring, find our way?


We can “lose ourselves in service to others.”


What do folks in our community who are struggling need?


How can we more effectively serve them?


Can we do a better job of listening to them and truly understanding the challenges of their day-to-day lives?


When I think about what we can do to help our community not only heal from this epic week, but what we can do to make a difference and improve conditions going forward, I find comfort in thinking about how all of the work we do is designed to serve others in need.


That’s our mission. We’ve been at it for more than 60 years and will be doing it 60 years from now.


We work to empower individuals with limited resources to establish and maintain good health.


We have a vision of a community that promotes, protects, and improves the health and well-being of all people.


What we need to do – what we have to do and will do – is embrace and live out this mission in our work.


We will lose ourselves in service to others.




You guys are here today to listen to us extol our awesomeness.




You want us to tell you about how we change lives.


I assure you this amazing team of health care professionals at Care Ring does this every day.


Nearly 7,000 of our neighbors – every one of them an individual with limited resources and representing the broad diversity of our community – rely on us for their wellbeing.


They lean on us and depend on us to bring vitality to their lives.  


Our clinic in uptown Charlotte has a remarkable chronic disease management program. In a few short years this program has seen tremendous growth, taking care of more than 500 of our neighbors through healthy exercise and eating clubs, and by connecting folks to food pantries and much more.


More than half of the physicians in Charlotte volunteer with us to care for those unable to get public or private insurance – THANK YOU for giving back. Last year these docs – and increasingly more dentists, too – gave back nearly $13 million in services they did not charge for.


Every day our heroic nurses in Nurse-Family Partnership go into homes and neighborhoods most of us have never visited.


These community health heroes literally transform lives, leading to healthier babies, moms prepared for motherhood, and over time, a reduction in poverty.


We are finding ourselves through service to others in the community.


Our staff, our clients, our work is rooted in the VERY communities that feel so disenfranchised, and often are marginalized in our society.


I am so grateful and excited each of you has chosen to be here today to learn more about Care Ring and hear our vision for the future.


One of the things I truly LOVE about Care Ring is that our support goes out to every one of our clients.


I keep a sign on my door at Care Ring of the London Underground subway system visual “Mind the Gap.” This visible cue is designed to keep passengers wary of their steps and to be careful as they proceed on the subway.


I’ve shamelessly borrowed this visual for Care Ring. For us this message is a daily reminder of why we exist, why we care, and why we can never forget about the people we are privileged to serve each day.


There is a massive challenge and, sadly, a widening gap in Charlotte in the ability of those on the lowest rung of the economic ladder being able to climb up to success in Charlotte. In fact, as many of you know, Charlotte is the most difficult large city in the country for those trying to escape poverty.  


We are minding the gap in access to affordable, high quality health care in Charlotte.


We help people regardless of their station in life. Regardless of the zip code they were born into.


A person may be new to our country. We can help them.


He or she may be socially isolated. We are here to help.


Perhaps a neighbor has not seen a doctor in decades. Tell them to come see us. If we can’t help them, we’ll connect them to someone who can.


We are mindful of each individual’s current situation – and we are ready to step in to help.


ALL are welcome at Care Ring.


This is part of our core values, which the Care Ring board revised and adopted this year.


Our values are pretty simple, just four words:


Compassion – Compassion towards ALL of our neighbors. Compassion drives us to do our work. It is a central motivating factor for our staff and board.  

Integrity – Acting responsibly and ethically, we always strive to be inclusive and open about our work.

Collaboration – We embrace our poverty-fighting partners. We stand shoulder-to-shoulder with them. In fact, we couldn’t do any of our work without them.

Empowerment  - We strive to empower others to take responsibility for their health, giving them the tools and the education they need to excell.


These are our values, and this is our vision: We see a community that promotes, protects, and improves the health and wellbeing of everyone.


Not just some of us.


Not just those with good health insurance.




We work to empower individuals to get and stay healthy – giving them the tools and the education and the support they need to thrive.


I hope you will embrace our mission and JOIN us in this movement.


I invite you to be a part of Care Ring, as a donor, as a volunteer, as a supporter, as a connector. You can come along with me and this remarkable staff and board to “find yourself by losing yourself in the service of others.”


There is a palpable buzz around Charlotte about how we can harness and accelerate innovation in the social sector. For years Care Ring has been in the background in this field, quietly tinkering with new models of care and testing promising practices to improve the health and well-being of all people in Charlotte.


We are ready to break out of the shadows and share our story.  


Care Ring’s “Hope for Community Health” annual luncheon is fast approaching (September 22, 11:30am – 1:00 pm at the Westin – click here to learn more about the luncheon and find out how you can save a seat to join me and hundreds of your neighbors!). Each year we bring together more than 500 of our supporters, elected officials, and others interested in the pulse of health care in Charlotte to learn about our work over the last year, gain insights on current opportunities to improve health and wellness for all in our city, and hear our vision for the future.


This year’s luncheon focuses on innovation in health care, with a particular emphasis on how we can embrace and fully live our legacy of incubating innovative approaches and testing new models of care delivery to help those with limited resources establish and maintain good health.


Fortunately, the innovation laboratory in Charlotte is stocked with trailblazing people, programs, and possibilities that we can learn from and partner with to advance innovation in Charlotte.


For example, Queen City Forward has a variety of initiatives to boost innovation in Charlotte, including a social innovation program dedicated to launching and supporting high-impact start-ups with a social mission. The Knight Cities Challenge is back this fall, providing anyone interested the opportunity to suggest a breakthrough idea that can make Charlotte a more vibrant place to live and work. Folks from all walks of life are finding inspiration and tickling their imaginations through the Creative Mornings Charlotte series that seemingly overnight has become a must-go, monthly breakfast event.


Keynote speaker at our Hope Luncheon on September 22nd will be Dr. Jean Wright, Chief Innovation Officer with Carolinas HealthCare System.  Dr. Wright will share her insights on where innovation comes from and how nurturing and testing innovative ideas in health care is so critical.


Care Ring’s been in the innovation space for years (more than six decades actually!), though we haven’t always done the best at sharing our value as a place to bring innovation to bear on the challenge of having far too many people lacking access to affordable, excellent health care.  


Our Hope Luncheon will give us a chance to tell our innovation story. You’ll learn about our history of testing out new models of care designed to improve the human condition for those with limited resources in Charlotte. You’ll see how we have built a network of partner agencies to provide wrap-around care to some of the most fragile families in Charlotte. You’ll learn about how we are expanding our network of volunteer physicians to include dentists and other health care providers, establishing a model of care that cities and agencies across the country are emulating.   


So mark your calendars and sign up to join us September 22nd – we are eager to share Care Ring’s vision for a community that promotes, protects, and improves the health and well-being of all in Charlotte.

Health care might be the most competitive industry in the country. But what happens when hospital systems and health care providers work together for the greater good?


In another year of remarkable generosity, over the last 12 months Charlotte physicians and dentists donated nearly $13 million in care to those in need.  Over the last decade local medical professionals have given back far in excess of $100 million in medical services to help those needing care.


Nearly 1,600 physicians with OrthoCarolina, Novant Health, and Carolinas Healthcare System – along with independent physicians and dentists from across the region – band together to volunteer their services so that individuals lacking access to care receive consistent, dignified care.   


Managed by Care Ring, Physicians Reach Out provides a convenient and efficient way for medical professionals to give back. By simply opening up available slots in their clinic for those without access to care, local providers collectively create a health care safety net for 3,500 low-income, uninsured people in Mecklenburg County each year. Residents who are uninsured and have income below 200 percent of the federal poverty level can gain access to PRO and are assigned doctors and dentists practicing close to where they live.


For those lacking access to public or private insurance, PRO is truly a lifeline, an option other than simply ignoring their illness or arriving in poor health at a local emergency room.

This summer, I had the opportunity to intern at Care Ring – a wonderful nonprofit healthcare organization in downtown Charlotte. Each year, the Levine Scholars program at UNC Charlotte sends one student to Care Ring for approximately five weeks to get a solid glimpse into the nonprofit realm and what Care Ring does for the Charlotte community. I must say, after my about twenty-five days of working at the organization, Care Ring is a crucial puzzle piece in solving the healthcare dilemma that faces Charlotte (and the entire state of North Carolina).


            During my first week or so, I was hesitant about doing things – am I doing this right? Could I be doing it better?  What if they don’t like me? I have never worked a “9:00-5:00” job prior to this internship, so I was pretty overwhelmed by diving headfirst into it all. Nonetheless, I quickly acclimated to the environment and soon realized everyone was so welcoming, encouraging, and helpful.


            My first project consisted of identifying a food desert between I-77, Billy Graham Parkway, and Wilkinson Boulevard; essentially, in this triangle, fresh food was pretty scarce. Using Google Maps, I mapped out all of the clinic and Physicians Reach Out (PRO) patients that resided within or around this area. Knowing someone lives in a food desert alone can reveal so much information about that individual – why they are not eating well, why they are gaining weight, why fruits and vegetables and other fresh produce is not a part of their diet, and more.


            Next, I delved into the Physicians Reach Out realm of Care Ring. In PRO, specialty care is available at no cost (in addition to primary care, hospital admission, and lab testing), which extends to dentistry. Unfortunately, the dentistry side of PRO is currently facing challenges in rallying dentists and eliminating the waitlist for PRO patients. My next project involved creating a dental patient survey, a “Share Your Story” form for patients who have seen dentists, and a phone script to use when contacting patients about the survey. A vital part of Care Ring is utilizing patient stories, which are the most impactful tools in getting people, doctors, funders, and more to understand the importance of Care Ring’s work. However, there is a small hole in the dental part. As a result, I created these forms to specifically target dental patients that used PRO to aid in hearing how dentists have changed the lives of our patients – and, hopefully, these can be used in getting non-participating dentists to join PRO.


            Another instrumental part about Care Ring is the bilingual staff members. The amount of Spanish-speaking Charlotteans has quickly increased over the years (in addition to many other languages other than English). These members of our community need somewhere to go for their health – and Care Ring is that place for many. As a result, Care Ring’s need for translators or bilingual physicians has also risen. For another project of mine, I contacted all of the offices of the physicians that Care Ring uses to see if the physician themselves speak another language. Unfortunately, many of the physicians do not speak another language – although, if he/she does, it was likely Spanish or an Asian-originating language, as I discovered. Fortunately, however, many of the places can provide their own interpreter for patients and, if they cannot, then Care Ring can. Needless to say, Care Ring is not only a place for the underserved English speakers of Charlotte, but those of any race, ethnicity, or language.


            In addition to these projects, I did two more – one on durable medical equipment companies (in seeing if any companies in the area provides charity care for those who are uninsured) and one on hospital admissions (in analyzing data about the most common diagnoses on patients who go to the hospital and other similar data). I was also able to attend several meetings with many of the staff:  one on MedLink (an overarching organization that brings together all of the healthcare resources in the area), one on Nurse-Family Partnership and its potential in expansion, and several others. On my last day at Care Ring, I was given the opportunity to shadow Dr. Sailer in Care Ring’s Low-Cost Clinic, which gave me a fascinating view of how clinics operate, the clients they serve, and the many health issues that people face. One of my favorite parts of the internship included going to a community fair called National Night Out. I attended with the community liaison, who is also the Affordable Care Act Navigator for Care Ring. Essentially, we setup a table which information on the programs in Care Ring and the services they provide. About 300-400 people in the community came to the event to survey the tables and see what resources are available for them. I really enjoyed this event because I was able to directly interact with the client base, as well as inform people of the aid that is available.


            All in all, my experience at Care Ring was a great one. I care about Care Ring because they care about the healthcare for those who do not have adequate access to healthcare services. I care about Care Ring because they provide services via their clinic to those who fill “the gap” in healthcare. I care about Care Ring because they care about first-time mothers, babies, and families in ensuring children are raised the best they can be. But, most of all, I care about Care Ring simply because they care – and that can go a long way.


Tyler Rapp is a Levine Scholar at UNC Charlotte (Class of 2019). During the summer of 2016 Tyler interned with Care Ring.

Latest comments

27.09 | 16:50

Thanks Robin!
We will be in touch

25.09 | 07:56

What an incredible vision and mantra you have with this organization. I would love to contribute some volunteer time to you. My number is 704-906-4075

23.09 | 15:25

Thank you Paul!

23.09 | 14:46

Don, this is outstanding! Perhaps it could be published in the Observer under editorial comment or something. Thanks for serving our community!