The 6,400 people living in Cleveland in 1837 faced hard times. Poverty and disease were rampant. Many could not afford the standard medical treatment of the time: a personal doctor's visit. City leaders determined that a hospital was needed, and on May 6, 1837, drafted an ordinance that "it shall be the duty of the Board of Health to provide suitable support for the poor of the city." City Hospital was born.

To deal with an outbreak of smallpox and the growing demand for medical care, the City ordered all physicians to go to homes and vaccinate against it. It was recorded that 200 people were vaccinated who claimed to be unable to pay. The expense of caring for the health of the city's indigent that year, including hospital expenses and "outdoor relief," was recorded as $2,800.

The mission to provide health care to vulnerable populations has not changed since the hospital was founded. Today, MetroHealth dedicates great resources to continue this goal, including providing outreach programs in disadvantaged neighborhoods to identify those most at risk for health problems and enroll them in early intervention, prevention, and wellness programs.

Through a $10 million, 10-year grant from the Saint Luke's Foundation of Cleveland, Ohio, MetroHealth has been able to further extend its community outreach to those in need. Since the grant money was issued in 2006, there have been marked improvements in the management of chronic conditions like pediatric asthma, diabetes, and obesity in the targeted neighborhood around MetroHealth's Buckeye Health Center - where the program was implemented. For example, prior to enrollment in a new pediatric asthma program, children experienced 38 hospitalizations and 49 emergency room visits. After learning the proper use of inhalers and other symptom management techniques, the group reported only one hospitalization and one emergency room visit.

The Buckeye Health Center is also the annual site for the popular Take A Loved One to the Doctor Day, often performing more than 1,200 free health screenings in a single day.

MetroHealth's breast cancer outreach program to minority women reported a similarly positive impact on community health. Funded partly by the Northeast Ohio Affiliate of the Susan G. Komen Breast Cancer Foundation, the BREAST program (BRinging Education, Advocacy, and Support Together) delivers patient education and screening services to uninsured and underinsured women. The program has received the American Cancer Society's Award for Community Outreach and was chosen for the Cancer Care Hall of Fame by the ACS Ohio Chapter.

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