As an aspiring medical student, I always dreamed of the incredible good I could do for my future patients. I would gain extensive skills that I can use diagnose and treat all manners of diseases. Medicine seemed like such a miraculous field – I wanted to study and be part of it. As my first year of medical school came to an end, I reflected heavily. It became clear that to me that while, for many people, medicine can truly be miraculous and help return them to health and happiness, for others, the case is very different. For many people, medical problems relate to social determinants of health, and the services to address these issues are not offered in clinics, hospitals or pharmacies.
Social determinants of health are at the root of many of the health problems that our generation of healthcare professionals will have to address when working with our patients. Social determinants of health include various factors—from race and gender to grocery store access, education, living conditions, and age. These factors have a very real and powerful impact on health, and as of now, the healthcare field is ill-equipped to address many of them. More than prescriptions and surgeries, people whose health problems stem from the social determinants of health need things like education, access to healthy food and effective exercise spaces.
Dr. LaPrincess Brewer (Mayo Clinic Cardiovascular Diseases Fellow) has sought to fill some of those gaps. While working toward her Master’s degree in Public Health, Dr. Brewer and her colleagues initiated The FAITH! (Fostering African American Improvement in Total Health) program. The program takes health and health education out of the ivory towers and into the public’s backyard. Through this initiative, she collaborated with churches in her area to address many of the social determinants of health and improve the heart health of African American congregation members. This community-based program (which began in Baltimore, MD and is now in place in Rochester, MN) included significant input from the communities it wished to serve. The program includes interactive, informative sessions in many aspects of cardiovascular health including cooking and healthy eating (including a cooking demonstration), exercise classes and education on risk factors for cardiovascular disease. The Baltimore program also helped establish a FAITH! pantry where participants could purchase fresh fruits and vegetables and other healthy snacks each Sunday after the church services.
A few of my classmates and I had the fantastic opportunity to volunteer for the FAITH! program as it concluded at the congregations in Rochester in April. At the start of the day, the participants were encouraged to share some of what they learned and any experiences or challenges they had in integrating a healthy lifestyle as a result of the program. Many shared what they learned regarding shopping for and cooking healthy foods. One participant shared her favorite strategy in shopping for healthy foods—never go to the grocery store when you’re hungry—a trick I use to avoid the snack food aisle’s many temptations. Another woman saved up to purchase an elliptical machine to increase her exercise. Others spoke about how they control their diabetes to prevent heart disease and other negative consequences. One grandmother even enlisted her grandson as her motivator; he reminds her to put down the potato chips and goes for walks with her! It was apparent that the group was empowered by the program and had learned a plethora of useful, easily applicable tips and tricks. Our role for the program was to measure height, weight, blood pressure and approximate body fat to help the participants track their progress throughout the program. In assisting the participants, I talked with many who were extremely grateful for the program. They expressed genuine motivation to continue to work toward their health goals. I was overjoyed to be part of this specifically catered, extremely impactful aspect of their health journey.
While the healthcare system still needs work, it was incredibly inspiring for me to witness a physician using her skills to deliver health in a non-traditional way. The benefits were obvious to me, and the participants were incredibly grateful. I know now that I will never be able to cure everyone I encounter with pills and surgery. Challenges relating to the social determinants of health require much more time, and community-based attention than the clinic can offer. However, there is hope and with more passionate efforts like Dr. Brewer's, we can spread health from clinic to the community.
Kari is a second year medical student from central Minnesota. As a kid, her mom (cardiac RN) introduced her to the most fascinating organ in the body (the heart of course!), and she has been an aspiring cardiologist ever since. She enjoys camping, hiking and other outdoor activities in her spare time.
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