Our community outreach project is an ambitious project which goes out to community centers like highschools in underserved areas and provides both screening and follow up for the most common morbidity causing chronic diseases for that community. Some examples of conditions we screen and treat are asthma, obesity, hypertension, post traumatic stress disorder, and depression. We have found a suprising level of these conditions but have also found that our success in treatment is enhanced by addressing all of the patients' major issues. The best example of this is asthma and depression. Optimal asthma care requires that the patient comes regularly for follow up and takes their medicines. They often have difficulty doing these things if we do not also address their depression. Another issue we have identified is that though many of these people have significant health care issues and also health care providers they often do not seek care. So the issue of access to care is more subtle. They have "access to care" they just don't always take advantage of it. There are many reasons for this ranging from social and financial barriers to denial and lack of awareness of either the extent of services available to them and/or the severity and seriousness of their condition.