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If Dr. William Pepper, the physician who founded the Free Library of Philadelphia in 1891, could wander through its neighborhood libraries today, I’m certain he’d be smiling. Not at how the library had grown or how many books it had, but at its efforts to improve the health of Philadelphia-area residents.

I recently popped into our Parkway Central Library’s Culinary Literacy Center. This 35-seat state-of-the-art kitchen and teaching classroom hosts a wide variety of nutrition and cooking programs. In it, a class of third-graders was busy chopping cabbage as it learned about the difference between good and bad bacteria by making and jarring sauerkraut. (They were also learning reading, math, and science skills, but that’s a different story.) On the next day’s schedule, a group of veterans would arrive to “Chow Down on Wellness,” a cooking and mental health class. Later in the week, an expert chef would teach her wildly popular “Taste of African Heritage” course.

In the library’s lobby I watched as our on-site nurse checked a customer’s blood pressure. Noting that it was high, she explained the risks and gave him suggestions for lowering it. In addition to checking blood pressures, the nurse talks with library users about their health and acts as a point person for the best resources. She recently partnered with local medical experts to offer breast cancer awareness workshops, CPR training, and testing for HIV and hepatitis B, all of which are acute concerns in Philadelphia.

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Ever since the Affordable Care Act Health Insurance Marketplace was launched in 2013, consumers have come to our neighborhood libraries to get help signing up for insurance. We partner with federally funded navigators and helpers who understand the ins and outs of enrollment. They walk through the complicated process with anyone who makes an appointment. We estimate that several thousand consumers have taken advantage of this library service to sign up for health insurance over the past four years.

Another exciting experiment is the Community Health and Literacy Center. This first-of-its-kind national prototype houses a Children’s Hospital of Philadelphia care clinic, a city of Philadelphia health center, a recreation center, and the South Philadelphia neighborhood library in a single campus. It is designed to be a place where families can learn, exercise, heal, and grow — all in one place.

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The center’s library provides the usual quotidian services — books and DVDs, free public computers and Wi-Fi, after school programs for kids, and the like — while also focusing on providing the best health information and programs to the public. Our consumer health librarian is certified through the Medical Library Association’s Consumer Health Information Specialization, a yearly accreditation that keeps our staff in the know by providing access to the most up-to-date resources and programs. As the center matures, it will show us how to provide ideal, holistic health services to the public.

At the Free Library, we’re constantly asking ourselves, What do Philadelphians need? What could help our community blossom? What types of literacies besides reading are integral to growing a population that can fully participate in the social, economic, and cultural life of the region?

Some answers came from a 2012 study that the Pew Philadelphia Research Initiative did on the Free Library. It found that one-third of the customers visiting our 54 locations were seeking health information. While the library had traditionally offered scattershot health programs, that finding prompted us to build a strategy to meet this need. It reflects the ever-expanding mission of libraries and librarians and the shift from behind-the-desk reference to into-the-community outreach.

An ongoing partnership with the University of Pennsylvania Center for Public Health Initiatives taught us about the social determinants of health and gave us the opportunity to deeply understand community needs in South Philadelphia, one of the city’s most diverse and quickly changing areas. The Penn researchers conducted unique on-the-street interviews with community members, strolled neighborhoods with a photographer, and talked with neighborhood residents about what they saw and how it made them feel.

With the results of this needs assessment in hand, the researchers designed a training module to equip the Free Library staff with the information and hyper-local resources we needed to help the public around four key issues and populations: mental health and substance abuse, homelessness, new Americans and refugees, and children and families. This effort now serves as a model for assessment and training in other Philadelphia neighborhoods. The Healthy Library Initiative, designed to sustain this work, grew out of this research effort. The Penn team and I recently described this work in the journal Health Affairs.

The Free Library is certainly not alone among public libraries that have taken the plunge into offering health services. Pima County Public Library in Arizona acted as our model for the nurse-in-the-library program. The San Francisco Public Library, Denver Public Library, and others have robust on-site social work efforts.

Other libraries should consider exploring their customers’ need for health programs. As we wrote in Health Affairs, “public libraries are trusted institutions that have broad population reach and untapped potential to improve population health.” One way to get started is by talking to local health experts. Partnerships are key — librarians don’t have to be the experts about health, they just have to provide the best resources, something they have traditionally done.

Libraries have come a long way since the days when their sole function was to provide the public with books and research materials. Building a health literacy initiative is part of this evolution. The Free Library is on its way but still has much to learn. We hope to forge ever-deeper connections with the citizens and communities we serve. Understanding the public’s basic health needs is a great way for us to make the library an integral part of everyone’s daily lives and to improve the health of our city.

Autumn McClintock is a strategy coordinator for strategic initiatives department at the Free Library of Philadelphia.
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