Olivia Shadid, a member of the inaugural cohort of Tulsa fellows and a student at the School of Community Medicine out of the University of Oklahoma and University of Tulsa, is taking a unique and highly personal approach to encouraging low-income families to be more active participants in their health.
Through her program Companions: Medical Students Breaking Bread & Breaking Down Barriers to Care, Shadid visits the homes of clients of the Educare Family Health Project to prepare and share a meal with them. She uses these visits to develop a personal relationship with the families in order to help them overcome barriers to accessing resources―such as health care coverage, gym memberships, fresh food, and cooking/nutrition classes―that are offered to them through Educare.
Educare Tulsa consists of three schools belonging to a nationwide network that provides full-day, year-round early childhood education and family support services for low-income families. The Educare Family Health Project improves the health of Educare households by ensuring that household members are connected to a medical home, are enrolled in affordable healthcare coverage, and have access to health education, healthy foods, and exercise opportunities.
Shadid credits Dr. Sarah-Anne Schumann, the medical director at Community Health Connection in Tulsa, for introducing her to the concept of leveraging interpersonal connections with patients as a way to help people living in poverty make better decisions about their health. Not only is she exploring the barriers that keep her client families from accessing the Educare services available to them during one-one-sessions, she is also digesting the research on the effects of poverty on one’s decision-making ability. A 2013 Princeton study, for example, demonstrated that the strain of poverty can result in a drop in IQ of 13 points.
Her experiences with families have convinced Shadid that when people in difficult circumstances, such as poverty, are “conferred dignity by others and given opportunities to be generous” it can empower them to “operate from a place of abundance, mindfulness, and choice.”
While Shadid’s project aims to cultivate long-lasting shifts in families’ understanding of health, she has seen changes in the short-term that indicate progress toward that goal. For example, she recently spent an evening preparing enchiladas at the home of a couple who reminisced about the fabulous Mexican food they said could be found only in carts on the streets of the villages where they grew up or on their mothers’ dinner tables. The wife suggested that, as a health goal, perhaps they could aim as a family to cut back on dining out for most weekday meals and instead eat at home.
In an effort to encourage that practice, Shadid reached out to her own mother for recipes that were healthy, quick, economical, kid-friendly, and featured traditional Mexican ingredients to share with them. She was delighted to find a recipe for albondingas, a meatball soup that the husband had pined for during their dinner together, in one of her mother’s 80s-era weight-loss cookbooks. Shadid texted him with the good news. “He suggested the family and I make it together ‘next time,’” she said, adding that she hoped that the experience of sharing personal stories about food combined with the pleasure of cooking together would “instill new ‘family traditions’ of health.”
Shadid also hopes that her project is synergistic―that as families gain confidence in being effective advocates of their own wellness through one-on-one intervention, the medical students working with them will see firsthand that practicing good medicine also means practicing medicine in context of the particular needs of individuals, families, subcultures, and communities. She is particularly hopeful that the program will enable the children of her client families to “grow and develop in a home environment that knows the joys of good health, is savvy about navigating healthcare, and understands the most important guardian of a person’s wellbeing is herself.”
“This project has been distinctly compelling to me for its potential to positively reverberate in the future, when the young children have their own families and when the medical students have their own patients,” says Shadid.
Shadid would also like to see her program find a home in a network of medical schools committed to training physicians who provide care in-context―especially for disadvantaged populations―and who can nimbly navigate healthcare systems for the benefit of their patients.
The young families with whom Shadid is working are mostly low-income immigrants. Nonetheless, because they have access to free or reduced cost health coverage, gym memberships fresh food and nutrition education, she has been able to remove certain variables and compare her clients’ perceptions of, and struggles with, health to those of more affluent, societally-established patients. She’s been surprised by the similarities between the two groups.
“After removing the most basic barriers to access, there is a pronounced similarity between what keeps both groups well,” said Shadid. “Less surprisingly, this is because lifestyle factors are typically the cause of any disability a young family would experience. What my surprise tells us is that fostering behavior change in disadvantaged populations, as so many Schweitzer Fellows and others endeavor to do, has direct implications not only for the vulnerable, but for society as a whole.”
Being a part of the Schweitzer Fellowship network simultaneously brings Shadid both contentment and agitation. “As a Fellow, I feel I’ve been woven into a collective that similarly holds dear the principle of Reverence for Life and who is working to create conditions where this ethic may be enhanced,” she says. “Feeling this way gives me a calming assurance as to the essential goodness and intentionality that motivate so many who are working to reduce health disparities.” But it also percolates in her “a queer divine dissatisfaction, a blessed unrest that keeps us marching,” said Shadid, quoting choreographer Martha Graham. “I see there is work to do, fellow Fellows are doing it, and I want to be a part of it!”