How Neighborhoods Make Us Sick by Veronica Squires

Author:Veronica Squires
Language: eng
Format: epub
Tags: social determinants of health;health equity;health disparities;community development;neighborhood;place-based initiatives;urban redevelopment;health care;healing;wellness;sickness;poverty;urban health;health in the city;ccda;Christian community development;racial injustice;food insecurity;community violence;asthma;childhood mortality;food;unemployment;disease;death;mortality rate;hospital;health clinic;urban clinic;community health;neighborhood
ISBN: 9780830873357
Publisher: InterVarsity Press
Published: 2018-03-15T00:00:00+00:00

THE FULL CIRCLE OF HEALTH IN ACTION

Gabriella and Mariana were fifteen and sixteen years old respectively when our pediatrician informed them of their positive pregnancy tests. The sisters had received care at Good Sam sporadically over the previous few years and had been brought in by their mother that afternoon. The girls had been young children when they fled Mexico with their mother. They left behind an abusive father to start over far away from his reach. The girls, particularly Mariana, struggled in school having learned English part way through elementary school and coping with the psychological trauma of abuse. As neither was a US citizen, they did not qualify for Medicaid health insurance. Once it was determined that the pregnancies were the results of consensual relationships, our pediatrician referred them to our prenatal program.

At their first visit, their mother asked questions while the girls bickered. We quickly realized how much they did not know about their own bodies and the process of pregnancy and childbirth. The sisters attended our prenatal education group visits, learning about pregnancy, delivery, infant care, and breastfeeding. Mariana started counseling, working through the trauma of her childhood abuse. Our staff encouraged them, brought in baby clothes, and spent hours answering questions. Both sisters delivered healthy babies within a month of each other. The babies received care through our pediatric program, allowing Gabriella and Mariana to continue their postpartum care at Good Sam. Both girls breastfed their babies, Mariana continuing even after her baby’s first birthday. Both graduated from high school. For Gabriella and Mariana, prenatal care alone was not enough to adequately address the barriers they faced in completing a healthy pregnancy and entering motherhood. Participation in health education and counseling helped prepare them to be the knowledgeable, caring mothers they have become.

Ms. Swan lives within walking distance of the clinic. She started seeing us for her blood pressure, and during the course of her treatment we discovered she had diabetes. We had a long discussion about her diet and how to quickly control her blood sugar. After that, she didn’t return for almost a year. The next time we saw her, she was following up after a hospitalization. She had been hospitalized with an extremely high sugar of over 500 and discharged with little idea of where to begin in terms of managing her diabetes. Usually a gregarious woman with an infectious smile, Ms. Swan looked defeated. She teared up as she told us she was overwhelmed with the idea of diabetes.

We started insulin that day, and she met with the nutritionist during the visit to set some obtainable goals. Ms. Swan also signed up for our diabetes education series and didn’t miss a class. Each month, she would see primary care, bringing in her sugar logs for adjustments in her insulin dosing. Her diabetes was improving, but more importantly her smile and commanding personality returned. When she completed the diabetes education series, she started our Eat Well Live Well program, where she attended cooking and nutrition classes.

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