Learning about social determinants of health at Brandeis informed the work I am doing at this internship. I am working a lot with poverty and food insecurity and its relation to poor health outcomes. Being able to understand this in the context of determinants of health allows me to understand how to best approach research problems.
For example, on one project I was asked to research policies in New York that affect food in any way. While I was first inclined to merely look at policies with the word ‘food’ in the title, I began to realize that so much more went into this task. I started looking for policies that addressed negative health outcomes associated with poor nutrition, such as diabetes and heart disease. I found that food was an upstream variable that was creating poor outcomes and consequently policies to remedy them.
The topics I learn in class I often thing I will not use again. Especially in my social science classes I am often skeptical or do not fully appreciate the value of the topics I am learning. I am very grateful that I had this knowledge for my internship. It enabled me to understand the policies I was working with.
Another aspect that I appreciated was seeing something I learned in school come to life. I knew that social determinants of health effected the health outcomes of individuals but this showed it to me. I saw briefs on policies about providing language assistance to individuals applying for the Supplemental Nutrition Assistance Program through the New York City Human Resources Administration. Often, these individuals would either go hungry or buy less nutritious food because they did not know how to get onto the Supplemental Nutrition Assistance Program. However, providing them with translations enabled them to provide for themselves in a way they could not before. This is important because if this one seemingly small factor had not been addressed these individuals and their families could become sick. This results in an undue burden on the American Health Care System. By stopping and mitigating this upstream effect, this Human Resources Administration of the the City of New York was able to save the health and lives of many while saving taxpayers’ dollars. I not only learned about this in school but this summer I was able to see it and to experience its use in public health and public policy.
Incorporating my classwork into my internship was not only interesting but it was necessary. It created a solution to a problem that I did not yet know occurred and enabled me to present my best work. Without the information I remembered from my HSSP class, I would not have thought to approach this task in this way. I understand the work that my organization does in a new light. Rather than treating negative health outcomes, we work to mitigate upstream factors by focusing on social determinants of health. This creates a solution that will have long-term impacts.
A sample policy: https://www1.nyc.gov/assets/omb/downloads/pdf/cbrboro4-17.pdf
The CUNY Urban Food Policy Institute focuses on bringing healthy and affordable food to all areas of New York. One way they do this is by mapping out food deserts in Upper Manhattan. This project consists of many different small steps which all lead to a larger goal. Though each step may feel small, taken together the project will produce a lot of change.
Food deserts are areas that do not have access to healthy or affordable healthy foods. This often means that the predominant form of food that these citizens eat is processed. This could mean packaged food but is also often fast foods and the like which are not nutritious. This ultimately leads to poor health outcomes down the line. To ensure that we do not have to
pay for costly medical procedures in the future, we should pay up front now in the form of ensuring that everyone can eat in a healthy way. Another problem with food deserts is that they are self-sustaining. This means that they create communities that prefer packaged and processed food instead of whole foods and fresh vegetables. Therefore, we must go into communities in an educational way that teaches people what to buy and how to use it. Engaging the community and centering programming on youth is an often used and successful tactic
To begin, a list of food stores in Upper Manhattan had to be created. These thousands of locations were then found on google maps and linked to a spreadsheet. Each location is linked to a 2007 snapshot and a 2017 snapshot. Then, it is coded to reflect the type of food retailer it is, any changes that have occurred and current status. While each step feels small and the coding takes a while, it is all very important. One intern may only be able to accomplish a few hundred entries but after a while this becomes a few thousand and then, as we progress, we are able to use GIS mapping to show our results.
It is sometimes hard to feel motivated when you don’t feel like you are making progress. However, the small steps are always important and it often takes time to see their true impact. At our site, we often are motivated by the ability to use GIS because it is a cool and novel technology to many of us. Knowing that in the end this will become a tool to bring healthier foods to disadvantaged communities also creates incentive to keep building the database. It is also disheartening to think that I may not be here when this project is complete. Since it is so large and the data quantities so vast, the project could take years to complete. However, I still know that the effort I am putting in makes a difference just as the effort of the person who completes the project will. Every step of the way is important and even though each step might feel arduous, the final product will make everything worth it.
This summer I am interning at the CUNY School of Public Health Urban Food Policy Institute. The Institute, located in upper Manhattan, works to ensure food equity throughout Manhattan’s and other borough’s most disadvantaged districts. Many of these districts we work with, for example Harlem and the Bronx, do not have access to healthy and fresh foods that can literally save their lives. Through the work done at the Institute, individuals all over New York City are gaining access to healthy and sustainable food instead of the fast and cheap food the predominates in this neighborhood.
One source of inequality comes from health. Certain demographics have access to healthy and whole foods while others rely on fast foods and processed foods to complete their diet. This stems from price, proximity to fresh food and time it takes to make healthy meals. The Urban Food Policy Institute aims to eradicate these food desserts and make healthy options not only preferable but easy. This ultimately leads to a decrease in the prevailing diseases plaguing these communities such as diabetes and heart disease. Creating equality in diet ultimately improves the health of everyone and saves lives and money.
My role as intern at this organization encompasses many projects. As the only undergraduate intern, I am among many public health graduate students. My first week, I used excel to analyze hundreds of surveys assessing the efficacy and results of urban farms in housing developments in upper Manhattan. After analyzing the data, I made graphs and charts to be used in a journal publication on this project. This data and the graphs I made are going to be used in an article for a public health journal. It is nice to see work of mine get sued in a meaningful way. In the weeks since then, I have assisted in research projects on the needs of food retailers in the Harlem area of Manhattan and how a training program by the Institute can best train teenagers to work in the health food industry. I am also working on a database outlining food policies throughout New York City in order to streamline the process of enacting change in the food industry.
The work I am doing this summer is helping to bring healthy and wholesome foods to areas that do not have access to the nutrition they need. Many communities only have unhealthy and packaged foods that harm their longevity. America spends more money on healthcare than other countries but it sees poorer results. This is because we do not feed our communities in a sustainable way. Additionally, by use processed foods, we harm the environment through shipping and processing energy expenditures. Often all that someone needs to begin eating a balanced diet is help knowing what that means. At the institute we engage citizens in a dialogue to ensure that their health does not decline as a result of their unhealthy habits. Ultimately, this relieves neighborhoods of epidemics of non-communicable diet-related diseases that cost money to treat and end lives too early.
The institute: http://www.cunyurbanfoodpolicy.org/