While serving at our host sites, part of our experience is to understand the bigger picture as it relates to public health. All of us participate in direct service, so many would expect much of our understanding to result from direct experiences. For me this has been true – but not in the way one would think. My patient’s story has thus far been the capstone of my NHC experience. Each day serving at Health Center 5 is a little different than the last, and each patient’s story unique and wise in their own way. What they have in common are the lessons they teach me. I’ve learned much from my patients how often sources outside of their control contribute to negative health outcomes, and what these stories reveal about public health and wellness.
When discussing matters of health, we often contribute poor health with personal choices and lack of education. Outside of genetics, we contribute the onset of many health conditions such as diabetes, heart disease, and stroke to life choices throughout one’s life. I have seen this and heard from my patients about the management of their health conditions. Although misinformation is a factor, adequate education is only one facet in improving health. Take the story of one woman after retirement. She moved into a Senior Citizen’s apartment building. It was an older building and riddled with mold and old asthma-inducing carpeting. She knew the conditions in her apartment caused her to experience harsher symptoms and she would have difficulty managing them while there, yet she had no other options. Eventually both mold and carpet were removed, but not before the woman had to be admitted into the emergency room twice. She mentioned how it was a common issue she faced with her asthma -- being triggered by dust, perfume and other ailments in her environment. After this story, it made sense for my patient to be on a common inhaler. I noticed many of my other patients were on some kind of asthma or asthma-related inhaler - approximately 75% - and I knew they had similar stories. I figured it was significant, but I was unsure how or why.
A perk of being in NHC is the access to training on topics of interest. I still faced curiosity to the significance of the large proportion of patients using inhalers. You can imagine my interest when a training opened up on the clinical and community based approaches to preventing childhood asthma. Attending this grand rounds at the College of Physician’s Mutter Museum made me appreciate my service, especially for the “light bulb” moment. For one, representation matters and seeing all women of color as speakers and pioneers of public health was dear to my heart and a great motivator. Secondly, the speakers uttered words of how significant the environment and stress were to health. This allowed me to glean how those affect my patients. And finally, they provided empirical support for childhood asthma prevention, which is in turn prevention for adulthood onset of asthma. I was able to see that Philadelphia has a history of having homes in need of repair, with environmental risks like lead, and how those environmental facets act as stressors. Now I had proof for why so many patients faced similar conditions, and showed the importance of community engagement- sometimes you get the story without the origins but you can find it through some digging.
This blog post was written by NHC Philadelphia member Kendra Hester.
Kendra serves as a Patient Advocate at Philadelphia Department of Public Health-Ambulatory Health Services, Health Center 5.