Category Archives: Maternal Health

Understanding Social Determinants of Health

Understanding the Social Determinants of Health: Breaking the Link between Poverty and Health

Brown graduates working with Project Health (program where college students work in local health clinics) based in Providence, Rhode Island. Samantha Murder (Program Manager) and Hanna Nichols (National Talent and Technology Coordinator)

Cycle of Poverty

  • MONEY is needed for healthy food, healthy housing, childcare (so you can go to work), education and school, clothing (job interviews), health care, utilities, medicine
  • in order to get money you need a JOB
  • in order to have a job, you need EDUCATION

Need education and a good job for money, but need money for education and chance for a job! Not a linear path and a difficult cycle to enter.

Project Health works to provide resources and knowledge.

Social Determinants of Health- “economic and social conditions under which people live which determine their health”

  • The Big Five: Food, housing, energy, education, and employment/insufficient income.
  • Shaped by the distribution of money, power, and resources (influenced by policy choices)
  • Social determinants are mostly responsible for health inequities

What do we mean by Poor?

Mentioned that the federal poverty line has been used a lot throughout the symposium as a measure of poverty. They stressed that people are struggling for money well above the federal poverty line. The federal poverty line for a family of 4 is $22,050, but, in suburban Illinois for instance, a family needs at least $58,000 for necessities (study done by NCCP -see budget calculator)

FOOD

Food insecurity greatly increases likelihood for poor health (ex. low birth weight for mothers)

Compared nationally, Vermont is doing well, subsidized lunches and breakfasts at school are critical (50% of kids in Essex county use this) Essex also has high levels of low birth weight.

What’s out there? Resources to combat food insecurity

ENERGY

Heat or eat?

Energy insecure households- 22% increased chance of being hospitalized since birth

What’s out there?

  • LIHEAP (covers a large amount of monthly winter heating bill, if you can’t meet cutoff your utilities will be shut off- difficult to pay back. Grants are getting smaller)
  • local neighborhood funds
  • Special protections for disabilities
  • Payment plans (utilites prefer some money)

HOUSING

Related to health. Household mold (makes you 2.2 times more likely to experience asthma!), cockroaches, cold, lead poisoning, unsafe housing conditions, stress from not being able to pay rent contribute to asthma and low nutrition, hospitalizations, poor health

Housing is considered not affordable when it costs more than 30% of income.

Housing in context- Vermont. Top 10 occupations in Vermont include retail salespeople, cashiers, janitors and cleaners- none of whom have a salary high enough to pay for housing. Not a livable salary! Poverty is “not just about getting a job”

What’s out there

  • public subsidized housing (projects)
  • private subsidized housing (contracted out)
  • housing choice voucher Program (Section 8)- pay up to 30% of income and government pays rest- HARD TO GET, 5 to 8 year wait for voucher in Rhode Island
  • shelters
  • transitional housing
  • rental assistance
  • legal action- something unsafe in house- legal pressure on landlord (less expensive than moving)

EDUCATION

They highly suggested the film “Waiting for Superman”! (check out the trailer)

What’s out there

  • GED classes
  • ESOL classes (English is 2nd language)
  • Adult basic education
  • Computer literacy
  • Child enrichment
  • Head start and early head start (includes literacy classes for parents, checkup for kids, losing seats right now)

INSUFFICIENT INCOME/ EMPLOYMENT

Related to obesity and other health issues. Not knowing what will happen raises stress and sickness- lack of locus of control.

People below the poverty line live an average of 9.6 health adjusted years less than Americans above the poverty line!

What’s out there

  • Child care subsidies
  • Food stamps

PROJECT HEALTH

Founder noticed underlying health problems involved with evictions

Doctors could do nothing for patients suffering from unemployment, poor housing.

Student in project health connect families to resources/volunteers. For example, they often connect families to food pantries or call utilities to arrange payment plans.

HOW THEY WORK

  • guided referrals
  • resource knowledge
  • identification of barriers
  • creative solutions
  • education
  • advocacy
  • connections

Conversations about food security and housing are important to both doctors and patients, but those conversations weren’t happening. Health services often don’t have the time or the knowledge to refer people, which is where Project Health steps in. Project Health also works to collect data that can be used in advocacy movements and campaigns.

Located in 6 cities, with 600 volunteers, and has helped over 5,000 families.

If you’re interested, check them out here!

Communicating Health Lisa Russell:”A Filmmaker’s Perspective: Utilizing Media and the Arts for Global Health Advocacy”

Before Lisa Russell became an Emmy-award winning filmmaker she was interested in medicine. She describes hearing Jonathan Mann, former head of the World Health Organization’s global AIDS program, speaking about AIDS as a social issue, from a gender, race, and economic perspective, as the day she changed her views. With a masters in Public Health, she set off on a career as a documentary filmmaker showcasing health issues in countries like the Congo, Niger, Ethiopia, Lebanon and many more.

During the talk she spoke about Not Yet Rain, a film she made in 2008 with Ipas about unsafe abortions in Ethiopia. Although Ethiopia decriminalized abortions in 2006, which the government believed would allow women access to safe abortions, many women still resort to unsafe abortions. The documentary follows two young women who are denied abortions because they are too far along in their terms. Russell describes her film as “putting a human face” to a human rights issue. She got a lot of feedback from people, even on Face Book, where a 19 year old girl from Dubai, sought help from Russell to get her to Ethiopia for an abortion. This shows the magnitude of power of media, that people from all over the world were made aware of this issue.

Another project Lisa Russell works with is Urban Word NYC. The program works with teenagers on areas such as creative writing, journalism, etc. It is based on the principle that “teenagers can and must speak for themselves.” This I thought was especially powerful because it gives young people an outlet to express themselves, and to raise awareness about certain issues.

This leads into her Emmy-award winning piece. Her close ties to NYC and the overall flexibility in her film topics are displayed in the next video she presents. She informs us of her close work with young students in the Bronx, New York on issues regarding race, gender and economics. She brings to life in her film, the inspiring poem of a young 13-year-old girl from New York, which she calls ”Biracial Hair”. The poem commences with light and humorous approach of a young girl fussing over her hair, but then both the poem beautifully creates a parallel between the pride holds for both her hair type and how she views herself in society.

Russell is heavily involved in promoting UN MDG Summit #5, one of the few goals the United Nations have prepared, in which the nations engaged plan to decrease and hopefully eliminate maternal mortality. She administers a site, www.MDGfive.com that provides a network and trafficking of situations, ideas, and news that will stimulate awareness and engagement on the said issue. Although the site is relatively new, we found it very well organized and took light into one very cool feature, which would be the clip remixer. In which there are tons of powerful quotes, photos and clips, which you can assemble together for your own custom slide show.

We decided to make one for Class and the Environment: (Please comment) (Fred picked the song)

http://mdgfive.realitydigital.net/Media.aspx?key=DDAC5AFF450B7832

Lisa Russell described her projects as more spontaneous than pre-decided, and we think this illustrates her unique and well-organized way in developing them more than anything. She is meticulous in almost every step of her project and makes sure that she is not offending the people that she films. She also analyzes every position of the issue; by making sure even the “bad guys” that are performing the abortions get their voice. At times she stated she feels in a paradox in terms of films being documented about Africa due to the overall negativity a the films, and she explained that she makes sure her films shed light to the positives, so that there is no inferiority.

Overall her presentation was insightful, informative, and an endearing pleasure to be a part of.

Fred and Sonam