February 3, 2016

Prescription for Change

by Emily Breuer '16

Emily is a senior concentrating in Public Health. She has been deeply involved in public service in Providence throughout her four years at Brown, and is presently a Campus Coordinator for Health Leads, a program that connects low-income families at Hasbro Hospital with basic resources in the community to improve their health from a structural level. 

Sitting in Room 16 of the Hasbro Pediatric Clinic was Maria, her 6-month-old baby Alexandra, Dr. Robinson, and myself, suited up in my blue Health Leads polo. Dr. Robinson had called me in from the Health Leads desk in the waiting area to speak to Maria after hearing about her and Alexandra’s unsafe housing conditions: a home with poor air ventilation, peeling paint, and roaches.

I began conducting an intake assessment; we discussed her situation and I recorded her demographics, trying to repress my surprise after realizing her birthdate was two years after mine. I shared with Maria various resources in the community that she could contact to ameliorate the conditions, and she shared with me some of the steps she’d taken to fix this problem so far.

By the time Maria and her daughter were ready to leave, in addition to walking out with a prescription for an inhaler for her baby, she left with a prescription for a healthy home.

At Health Leads, a national non-profit organization that believes basic needs such as food, heat, and clothing should be a standard component of quality care, college-student advocates work alongside low-income individuals as they navigate the resource landscape. What public health advocates like me envision is for basic needs and medical care to be truly integrated; in addition to treating a child for asthma, for example, pediatricians will work to eliminate the actual cause of the asthma: the mold in the child’s bedroom.

Just this year, we’ve made a huge leap to achieve this goal. After parting from the Health Leads umbrella organization and forming our own partnership between Swearer and Hasbro, our work in Providence is starting to look different.

Rather than an outside organization initiating change in the community, Hasbro itself is taking on the responsibility. Instead of just us, Brown University students, marketing Health Leads to potential clients, the doctors themselves are making these conversations a routine part of their patient visits. While college students are still the ones working directly with clients to address these basic needs, the doctors and Hasbro are putting a greater emphasis on addressing the problems in the first place.

At times this shift has been confusing and overwhelming, but overall it’s a really exciting move. After several conversations and reflections, I realized this is the new health care system we had dreamed about. What was always a seemingly distant vision is now becoming a reality, and we are at the forefront of this change.

So rather than fixating on the small hurdles we still need to resolve, I am trying to think big. What if all patients could be like Maria and receive access to resources to improve underlying problems rather than superficially treating medical problems as they arise? What if all doctors initiated these conversations with their patients?

We still have a long way to go. These issues are deeply entangled with poverty and racism, and so while Health Leads can provide individual support and empowerment, they are still relatively temporary fixes. But by starting the conversation about structural issues related to health, we play a small part of the transformation that is possible.

As Providence Health Leads advocates we are pioneers in this changing system. And I can’t wait to see where it leads.

* names have been changed

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