Equity in Healthcare: Journal of the Student National Medical Association (JSNMA), #22.1

By SNMA Publications

According to World Health Organizations equity can be defined as "the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically." The principles of health equity include insuring equal access, utilization and health outcomes for all populations seeking healthcare. It is important to have a global approach in solving these issues to create healthier communities. The theme of this issues focus on disparities faced by marginalized groups in the United States and abroad. Through creative works, innovative research, and thoughtful commentary, our authors explore challenges faced in achieving health equity and assert their opinions on the theme.

• Language: English
• Publisher: SNMA Publications
• Release date: Oct 18, 2016
• ISBN: 9781386078364

Book preview

EDITORIAL BOARD

EDITOR-IN-CHIEF: Comfort Elumogo

SENIOR EDITOR: Jonathan Batson

Letter from the Editor

We, the Publications Committee, are thrilled to present our Fall 2016-2017 issue of the JSNMA – Equity in Healthcare. According to World Health Organizations equity can be defined as the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. The principles of health equity include insuring equal access, utilization and health outcomes for all populations seeking healthcare. It is important to have a global approach in solving these issues to create healthier communities. The theme of this issues focus on disparities faced by marginalized groups in the United States and abroad. Through creative works, innovative research, and thoughtful commentary, our authors explore challenges faced in achieving health equity and assert their opinions on the theme.

We hope that you thoroughly enjoy the work of your talented colleagues in this fall issue of the JSNMA! May you be inspired to stop, reflect, and spread awareness to ensure equal access to high quality healthcare for all populations. If journalism peaks your interest, consider becoming a member of the 2016-2017 Publications committee and/or becoming a future JSNMA contributor! In addition to the grand opportunity to be published in the JSNMA, being a part of the Publications Committee offers many great opportunities for professional networking, writing development, creativity, and much more. To inquire further, please email [e-mail] or [e-mail].

Yours in SNMA,

COMFORT ELUMOGO

Case Western Reserve University School of Medicine

Doctorate of Medicine Candidate, 2017

SNMA Publications Committee Co-Chair, 2014-2017

Editor-in-Chief, Journal of the Student National Medical Association

[e-mail]

The Effects of a Nutrition Program in a Homeless Shelter to Promote Health Education in this Community

By Gayatri Malhotra-Gupta

MS4, Touro College of Osteopathic Medicine- Harlem, New York

Introduction

Health and homelessness are intimately interrelated in several ways. Illness is a leading factor of homelessness. Of the 1 million personal bankruptcies in 2007, 62% were caused by medical debt. With this medical debt as a precipitating factor and after a personal safety net is exhausted, the loss of housing, financial uncertainty, poor health, and deficiency of support can result in homelessness. In return, homelessness also exacerbates illness by increasing the risk for communicable disease, malnutrition, and violence related injuries. Maintaining a healthy diet that is tailored to one’s specific needs can be difficult in the setting of a soup kitchen where food is prepared to be filling on a limited budget. The high stress environment of a homeless shelter often leads to overlooked substance abuse and mental health issues. Homelessness additionally complicates the treatment course of many illnesses and thus, the average life expectancy for individuals living in homeless shelters is lower than the general population.

Data collected from the Social and Demographic Research Institute (SADRI) of the University of Massachusetts, Amherst, based on the reports from 16 of the Johnson-Pew Health Care for the Homeless (HCH) projects during their first year of full operation, shows a higher prevalence of chronic disease such as diabetes and hypertension in homeless populations compared to the general population. This data was gathered from homeless people who sought health care from available facilities and demonstrates less treatment compliance among homeless populations in the management of diabetes, which had to be treated inpatient more frequently than in their non-homeless counterparts. In a study done by Schanzer et al., however, they showed that resources of a homeless shelter, such as providing insurance, improved the health status of homeless people.

Global Physicians Network Foundation (GPNF) is a 501(C)(3) nonprofit organization comprised of healthcare professionals. The volunteers of GPNF serve as a health resource for residents of a homeless shelter in Queens, NY and provide health education programs to the people of this shelter to promote positive health outcomes in this underserved community. One such program is further discussed in this article.

Diet and Nutrition Educational Program in a Homeless Shelter

GPNF went into a women and children’s homeless shelter located in Queens, New York to provide the first health education program of a program series for the people of this shelter. A needs assessment was done prior to recognize specific reasons underlying healthcare disparity in this particular shelter. This program was then designed specifically for this shelter and was the first time this shelter was providing health education to its residents. Fifty women and children of all ages participated in the program conducted in May 2016, in which the topic was healthy diet and nutrition. The healthcare professional volunteers provided the participants with a brief presentation on healthy eating and the different food groups. The adult participants were then administered the CDC Prediabetes Screening Test to determine if they had risk factors for high blood sugar. Those with an increased risk were encouraged to ask their primary care physician about being screened for diabetes.

Figure A: An excerpt from the CDC Prediabetes Screening test filled out by an adult participant to assess risk factors for high blood glucose. Participants answered seven questions in order to calculate their risk score.

The participants were taught to calculate their body mass index (BMI) and were counseled on making healthy food choices. Notably, these shelter residents do not have kitchen or stove access, which was taken into account when advising them. The children participants were given worksheets on healthy food choices,