Article 7 of 11-Part Series

Eula Butler, 71, and friends soul line dancing for good health at Southeast Health Center in Bayview-Hunters Point. Watch the audio slideshow »

SAN FRANCISCO — As the last patients of the day shuffled out the double glass doors of the Southeast Health Center, brightly clad ladies in dance shoes filtered in. Ella Kendrick, “60 something,” with a rowdy laugh and a boom box tucked under her arm took the front spot. She pushed play and as R&B filled the room, the women split into parallel lines and swayed to its beat.

“Cha, cha, cha and bust that turn,” said Kendrick. And they did, song after song.

“I like to get my groove on. Dancing takes my mind off things,” said Eula Butler, a 71-year-old, born in East Texas, raised in Bayview, and on this day, dressed entirely in red.

Butler and the dozen or so women here every Wednesday dance for fun and exercise, but most also come because they have diabetes— one of the chronic health issues in a neighborhood in which bad health is often the norm. Residents here are hospitalized at higher rates than anywhere else in the city for a long list of diseases including asthma, diabetes, congestive heart failure and urinary tract infections according to a recent San Francisco Department of Public Health report.

“Here it’s hard to get good food,” said Dr. Mark Ghaly, the health center’s director. “It’s hard to get around because transportation stinks. There are few healthcare options. When you start talking about health disparities, you have to talk about social disparities.”

Addressing chronic issues with complex, varied causes— such as diabetes— is tricky. They require major changes in a patient’s basic behavior— what they eat, what they drink and how much they move their bodies. The landscape of Bayview-Hunters Point works against them. The ubiquity of liquor stores and near absence of grocery stores makes eating fresh fruits and vegetables difficult. In the neighborhood with the fewest parks and the most toxic waste facilities, it’s hard to find a place to exercise or play.

Enter retired nurse Tress Stewart, who moves to the music with a certain uncalculated grace. Stewart launched the dancing sessions as part of an education clinic for diabetics at Southeast Health Center.

“It started as a walking program,” she said. “But I’d be out there walking alone. Walking never really caught on like dancing did.”

At first, Stewart gave each dancer a pedometer as incentive; a diabetic needs at least 10,000 steps per day. But few of the women twirling and snapping their fingers bring them anymore as music proved incentive enough.

Now residents hope the September health report will do the same to spur Mayor Gavin Newsom’s commitment to put more programs in the neighborhood.

Dr. Mark Ghaly and Jacob Moody, executive director of the Bayview-Hunters Point Foundation, have been asked by the department of public health to serve on a commission to help implement and prioritize the report’s recommendations—running the gamut from accelerated clean up of the Shipyard to extended mental health services and special training on medical issues confronted by the African American community.

At this early stage, Moody, a 33-year resident of the neighborhood, has more questions than answers. “What’s it going to take to get a community to re-imagine itself away from being plagued with health issues?” he asked. “How do we measure making a difference? What do we mean by ‘optimal health’ in the Bayview? What do we need to do to assist people in achieving that?”

Moody and the others have until September 2007 to report their findings.

Meanwhile, back in the health center’s waiting room facing a litter strewn park, the women rested between songs, drinking bottled water. Eula Butler recently received a plaque reading “Most Improved” from a local dance group and the recognition makes her smile.

“When you’re soul line dancing you feel good even without a partner,” said Butler, looking around at her dance mates. “I’ve been a widow for two years. Most of us here are widows, unmarried, divorced or we’ve got husbands that don’t dance and still we come and have fun.”

Those here are the lucky ones, health officials said. Most in Bayview-Hunters Point simply don’t have the time or are too sick to begin.

“Here, life can be so chaotic that people aren’t really sick until it’s debilitating,” said Ghaly. “Some of the patients here don’t have diabetes until they cannot feel their foot or their blood sugar is so high they need to be hospitalized. A mentor of mine from medical school always said, ‘Illness is the biological manifestation of social inequalities,’ and this place, in a city as wealthy as San Francisco, really demonstrates that.”