Public health interventions will save lives and the future of the health care industry.
In today’s health care industry, physicians are playing defense. When someone comes into the Emergency Department, this person has already had a stroke or a heart attack and it is the physicians’ jobs to make sure the patient doesn’t die. What if I told you that there was a way to prevent physicians from having to play defense? The offense performs so well that the defense never has to take the field. Well, the offense is public health. Public health is an underappreciated and underutilized health care tool. The Center for Disease Control and Prevention (CDC) says that public health promotes health and the quality of life by preventing and controlling disease, injury, and disability. The top influencer on health is behavior and public health strives to change behavior. Behavior isn’t easy to change. More than likely a person has maintained the same behaviors over the span of their life. These negative behaviors and people not willing to change for the better is a major cause in the nation’s shift from acute diseases to chronic but preventable diseases. Public health comes in many different forms. Images of public health may include hand washing, clean water and safe food, anti-smoking campaigns, rural medicine, recycling, or wearing a seat belt. If I could describe public health in one word it would be “prevention.” Public health initiatives strive to change behaviors that lead to poor health before the damage has been done. Public health interventions will save lives and the future of the health care industry.
Through friends I learned of an organization called Carolina Health Outreach. I decided to attend an interest meeting and learn more about what the organization does. Ultimately I was hooked when I learned that members from the organization work with local churches and implement stroke prevention screenings. I signed up for the club and was able to attend my first “Holy Stroke” event. Holy Strokes is a program that Dr. Anil Yallapragada kickstarted. Dr. Yallapragada is the medical director of Prisma Health Stroke Center in Columbia, South Carolina. South Carolina falls in a region of the country known to most as the “bible belt”, but it also falls in the “stroke belt.” Entire communities are facing extremely high rates of cardiovascular disease and strokes. Teams from the Holy Stroke program attend predominantly African American churches in rural South Carolina and provide stroke screenings free of charge. Participants of the churches will have their weight and blood pressure measured, diabetes testing, and talk with health care workers about their risk for having a stroke.
My first Holy Strokes event came as a little bit of a shock. We were welcomed with open arms to attend their service and perform the screenings afterwards. As we were there to do health screenings, we were offered plates of fried chicken, collard greens, mashed potatoes, and decadent desserts. Not exactly the meal you want to see people eating as you’re trying to stress the importance of stroke prevention. Nonetheless, we completed screenings for everyone that was willing to have one and we packed up and drove back to Columbia. While I know we probably helped some, I still wonder if that was effective. If we told someone they are at a high risk for stroke and then left at the end of the day, I wonder if they changed their lifestyle and got healthy or if shortly after had a stroke. My artifact for this beyond-the-classroom experience is collection of photographs from a Holy Stroke event. I am seen sitting at the table talking with a patient about their blood pressure readings, body mass index, and other factors that could lead to strokes. You can see a picture of the information table and also health screenings being performed as a long line waits their turn. As a second artifact, I have a screenshot of a note on my phone of the dates and times I did Holy Stroke events and a description of what was done. I keep a running list of all clinical exposure so that I can submit it for physician assistant school applications.
The congregation in line for their Holy Stroke screenings. I am pictured at the table speaking with a patient.
Public health is a wonderful tool but only if it is enforced properly. Holy Stroke is a wonderful program that does great work in communities throughout the state. However, there are a few gaps in the program, specifically with the sustainability of the program after health care workers leave. In HPEB 300: Introduction to Health Education, Health Promotion and Behavior, we develop knowledge on health promotion programs and how to plan and enforce them properly. Without proper planning, programs will fail. It is crucial to know your target population and what they need. It is hard to change behavior but when program planners take the time to learn what is important to communities, they can build the right environment to support change. We have also learned that in order to have change, the change has to be reasonable and achievable. A major part of HPEB 300 is creating our own health promotion program. As a group, we decided to build a program that aims to prevent cervical cancer. Cervical cancer is one of the most preventable cancers, yet people still are not taking the necessary steps to prevent the disease. For this project, which you can see linked below as my artifact, I researched all aspects of cervical cancer. I did the majority of the writing portions of the project, with help from my group members on organization, in text citations, and research. I began with informing myself and my group members on what it is, how someone gets it, and how to prevent it. We then moved on to how to realistically create a program that promotes change. Cervical cancer can be prevented through Gardasil vaccines as a young girl and then annual Pap smears as an adult. Our program targets moms and their daughters, primarily around age 11. We start the program by educating the women on what cervical cancer is and how to prevent it. We then offer Gardasil vaccines for girls and Pap smears for the women, all free of charge. Appointments were set up for the girls to receive the rest of the Gardasil vaccines over the next year and OB/GYN referrals for mothers to receive life-saving yearly examinations. The most important part of wrapping up a program is to make sure that the people you help one day can receive help the next, which is something I felt was lacking in my beyond-the-classroom experience. Health promotion programs are only effective if the change lasts after you leave and in order to do that you have to provide support within the local community.
Information table with pamphlets for all church members to take home with them
My personal note of my experiences from Holy Stroke and the dates of the events.
In the United States most diseases are preventable with simple behavior modification. But, it’s hard to change and those working in the field of public health know this. However, once people are willing to change and believe that change is achievable, lives can be turned around in the right direction. Through seeing a public health program in action and developing one of my own, I’ve seen that public health is necessary in order to create change. In my future career as a Physician Assistant, I want to be the link between people and change. Public health has taught me that people can save their own lives if they are given the support and environment to change. The future of health care is public health, beginning with impactful programs and finishing with people changing themselves for the better.
Click here to see my within the classroom artifact: HPEB 300 program planning project