LEXINGTON, Ky. — Parish nurse Jackie Graves sees her job at Second Presbyterian Church in Lexington, Ky., as the perfect blend of faith and profession.
"It is a wonderful opportunity to encourage a healthier lifestyle in the context of our faith," said Graves, who recently retired as a professor of nursing at the University of Kentucky.
Second Presbyterian was an early adopter of the parish nurse model, creating the position in 1990.
In her part-time job, Graves visits about eight people a week and offers blood-pressure checks and referrals for other health concerns.
Graves sees it as an extension of the work the church community does during services, a way of putting biblical ideals into action to improve health and health care access.
The Kentucky Council of Churches is working to create the same kind of church engagement in health care across the state. The council is nearing the end of a five-year program to create a health advocacy network, share models that are working among churches and other religious groups, and share health information.
Funded the past five years by a $50,000 annual grant from the Foundation for a Healthy Kentucky, the council has been exploring ways individual churches are already providing health services to their members. The group is also advocating the view that access to health care is a social-justice issue that should be promoted by the religious community.
The nonprofit council's executive director, Marion McClure Taylor, says that at its simplest, churches are in a unique position to effectively help improve the health and health care access because they are where people come together.
"The one thing that we have that we can bring that hardly anybody else could is that we regularly communicate" with people, she said.
Graves calls it "having a wonderful, captive audience."
How that audience is reached by churches can vary. During a recent home visit, Graves chatted casually with Madge Smith, 90, in such a way that the woman could hardly feel checked-up-on.
Yet before Graves left she knew that Smith had taken nearly all the medicine she was prescribed for the bug that had kept her from church for a few weeks, that she didn't need help in getting to the grocery or any other doctor's appointments and that even though she wasn't feeling quite 100 percent, she was eating.
That kind of compassionate outreach is something at which churches have long excelled on the individual level, Taylor said.
The council has been working to help churches see how they use that same impulse to help the broader community. For example, she said, a church might branch out from helping one sight-impaired member to offering services to disabled people beyond the congregation.
Richard Heine became interested in the council's work in a number of ways. He is executive director of the Friedell Committee, a nonprofit group focused on improving Kentucky's health care system. He is also active in his church, Faith Lutheran Church, which has been exploring health support groups, with some success.
Heine said churches being involved in their communities is nothing new. But, he said, health care reform is shifting some of the focus to prevention. And some provisions mean hospitals will not get paid for some re-admissions for the same problem. That means, he said, hospitals have more of an incentive to work with churches on chronic illnesses.
He sees the potential from his own experience. He helped form a health support group at Faith Lutheran and attracted about 30 people. But real change for the state will involve tens of thousands getting involved, he said, and that is where a council's network can be critical.
"The only way we are going to address chronic disease," such as heart disease and diabetes, he said, "is by working together."
And that, he said, involves a fundamental shift in how some churches view their mission and an expansion of how some churches define their "community."
The Rev. Peggy Hickman, a Disciples of Christ interim pastor and a former public health professor at the University of Kentucky, applies all of that experience to her work as chair of the council's health committee.
She said getting church leaders from a broad range of denominations hasn't been without its challenges. Some embrace health care as part of the mission of a church, she said, but others have a theological bias against that involvement, believing that healing is in the hands of God and that church members shouldn't be active beyond offering prayer and support.
But, Hickman said, she is hopeful the work done by so many individual churches throughout Kentucky can serve as a model for others hoping to start their own health care missions.
Hickman thinks health care reform offers churches an opportunity to break out of historical limitations. As the public is discussing health care reform as a whole, she said, "I think it is time to relook at issues of social justice."
Dealing with issues such as access to Medicaid, she said, church leaders and the council must tread carefully in supporting the idea of helping people without targeting a particular piece of legislation.
"It is a difficult path," she said.
The council has spent years learning what is being done in churches across the state, Taylor said, creating networks of people who know how to access health care resources and coming to some consensus on what churches can do.
She understands the reluctance that some clergy, already stretched thin, might have in embracing a new mission.
And, she said, she hopes individual churches will see that the council and other churches can offer them the support to take the next steps.
As churches look beyond the folks within their own communities to whom they instinctively reach out, they will see "there is often a whole class of people" with similar challenges, she said.
The question church groups need to ask themselves, she said, is: "Will you and your church step up to the plate and resolve those bigger issues?"
"The big, scary word for that," she said, "is advocacy."