(tongue firmly in cheek)
I realize that it has been some time since I posted to the blog. Lots of reasons, lots of excuses (including my contributions at smhcop.wordpress.com), but a big reason has been my participation with Una Vida Sana! (UVS). This project enrolls medical, pharmacy and nursing students to provide outreach screening services to the Hispanic community in Richmond. The screening also involves medical interpreter students (to help interpret for the students and providers) and lay health workers (promotoras) from the CrossOver Ministry (who help with peer-to-peer health education for the community). The UVS outreach includes measuring height and weight to calculate a body mass index (BMI; helps assess overweight/obesity), waist circumference, smoking status, blood pressure, blood sugar and cholesterol measurements. This allows the team to assess patients' current health status and risk of future health concerns related to cardio-metabolic disease: high blood pressure, high cholesterol, diabetes, etc. The most recent screening event for UVS was as part of the City of Richmond's Imagine Festival, and took place last weekend (October 16, 2010).
In the last 10 years, Richmond's Hispanic community has nearly doubled, and my perception is that much of the increase is made up of young families that are establishing themselves in the community. In many cases, the adults are young (20s and 30s) and currently in good health, but run a significant risk of health problems in the future and may not realize the importance and value of screening for asymptomatic medical conditions. My fear is that these conditions could progress, and the incidence of asymptomatic disease could increase in the community until patients develop symptoms and start presenting to emergency departments and other safety net providers with symptoms or complications related to their illnesses.
Our early events last Fall and Spring suggested that we were working with a community at risk of future illness but without true illness at this point. The most recent UVS event supports this: a number had elevated blood pressures or elevated blood sugar, and a smaller number had a significant risk of heart disease in the near future. Past events showed similar results: a lot of "soft" outcomes (elevated blood pressures or sugars, but no official diagnosis) but not a lot of established cardio-metabolic disease yet.
We plan to hold more events during this academic year: December is planned as the next screening this semester, and we expect to hold three or four other events during the Spring semester in order to more clearly determine the community's current health status. My hope is that we might find that the community is at risk of serious illness but has not yet developed the illnesses themselves. If that is the case, there might be an opportunity to work with the community's members to emphasize and effect lifestyle changes.
At the same time, while providing these screening services to the community, our health professions students learn to provide team-based care while working across disciplines and with patients of different cultures. We think this experience will allow to learn from each other, and might encourage them to consider careers working with under-served and multicultural communities in the future.
I doubt I'll be saving the world on my watch, though that's no reason not to try. But maybe some of these students might...and our patients and our communities will benefit for their efforts.