Minting Yu

My name is Minting Yu, a first year medical student at the University of Pittsburgh School of Medicine. I began as one of the pilot Birmingham Health Links (BHL) fellows during summer of 2013, and continued with this program for 3 years. (Connections4Health was originally names Birmingham Health Links because of its initial, and now flagship, affiliation with the clinic.) 

The story begins in the spring semester of my sophomore year. I was captivated by an advertisement in my inbox: a new volunteer program in the Birmingham Free Clinic that aimed to work closely with an underserved population in Pittsburgh and to address the social determinants of health. To me, these phrases in the advertisement were extremely attractive. Not just because I was a pre-med student at that time. There was a more personal reason that I became interested in this program. Growing up in an underserved area in Southern China, my family and I had personally experienced the difficulties and stress of not having enough medical and social resources. I felt especially attracted to opportunities to work with any underserved population.

My three years in BHL has influenced me in many ways. As an undergraduate, it motivated me to choose various sociology and cultural classes to better understand the relationship between social determinants and my patients’ well-being, and to gain a more in-depth view of the culture of my Latino patients. Several patients with incarceration and criminal backgrounds also turned my attention to the criminal justice system in the US and prompted me to add a second major: Administration of Justice. Now, as a medical student and as a part of the Social Determinants Interest Group at the medical school, I am able use the knowledge and experiences I gained though BHL to reach out and assist a broader patient population.

My time volunteering cemented my interest in medicine. Being a fellow allowed me to closely observe how physicians volunteer their time from busy schedules to help underserved patients to ensure that their medical needs are met. I hope that one day I can be part of that physician team, incorporating my experience and knowledge I have gained through volunteering with the BHL to make a positive impact on my patients.

#c4hAlum #FeaturedFellow

Advertisements

Ms. Fee

anonymousfemaleThe degree to which a person has experienced hardship is often as subjective as it is obvious to the bystander. Meaning, most of us have no idea the intricacies, triumphs, and challenges in the lives of others. Sometimes hardship involves finances, sometimes it involves loss of family, sometimes it involves abuse. Sometimes it involves an amalgamation of many things. And far too often these experiences take place out of view, shielded from the outside world in order to protect a semblance of self-preservation, or even survival.

Whatever the reasons for such silences, it must first be acknowledged and respected that those reasons are valid. They are okay, more than okay. Empowerment begins when we feel in control of our own story, when it is shared, how it is shared, and who has access to it.

What follows is a summarized conversation with someone with whom we here at C4H have become quite fond of, and have had the privilege of being invited into their life story. They have chosen how, where, and when their story will be shared.

Ms. Fee feels like a new person since she has been meeting with the fellows of Connections4Health.  She has set goals and feels so much better about herself and her life as she sees herself progressing and getting closer to where she wants to be. This even helps her on a bad day like today when she lost her job.

Ms. Fee only started coming to the library because her son, who lives with severe autism and other health issues, insisted they come so he could play games on the computer. Now she feels like the library is part of her family and she comes by just to say hello and feel supported – she’s not alone.

The first time she came to the library some months ago, she came in crying and desperate. She didn’t want to go on because she had so many problems. She and her son didn’t have a place to stay, her son was not getting treatment and was very sick. On top of this, the Housing Authority informed her she had lost her housing after waiting so many months – because she arrived late to a housing appointment. That she lived far away and was unable to get a bus at the designated time was of little matter.  That this was not the first time she missed the appointment was the point of issue, a point made and held without fully considering the broader landscape that included barriers to accessible transportation that left her with no way to get there on time. No early morning bus route running from where you live to downtown, no way of getting there.

But Ms. Fee has experienced these sort of set-backs before. Unfortunately they are not new experiences, and through them (because of them?) she carries within her a wealth of resilience. She continues to work with C4H applying for another job, getting connected with a medical provider who accepts her insurance, and finding affordable, accessible and decent housing. Her son is also receiving treatment and is doing so much better.

Ms. Fee is so grateful to C4H for helping her change her life. The connection and support she’s found have made her feel so much stronger and better about her life and her son’s life. She is grateful, a point reiterated because she often reiterates it herself.

Mr. Smith

Untitled design (3)Mr. Smith is a 48-year- old gentleman who was referred to the Birmingham Clinic this fall by a social worker. He and his wife have three children and until recently, were both working and had health insurance. In the spring of 2017, Mr. Smith was let go from his job because he was told, “your chronic health conditions are no longer allowing you to perform your duties.” Because of this, he lost his health insurance and access to treatment for his complex health conditions including high blood pressure, diabetes and a severe autoimmune disease resulting in kidney injury. In the ensuing months, Mr. Smith’s situation became increasingly dire as he was not able to afford his medications (at a cost of more than $1700 per month without insurance), and he and his wife began struggling to feed their family and keep their utilities on. He could not obtain health insurance through his wife’s employer, did not qualify for State Medicaid because his wife’s income and his unemployment benefits exceeded the income guidelines. They could not afford the monthly premiums for insurance through the Affordable Care Act. In the setting of these struggles, Mr. Smith developed an overpowering depression.

Mr. Smith was finally referred to the Birmingham Clinic. Their volunteer physicians and pharmacists evaluated his medical conditions and provided him with necessary medications on site, free of charge. He met with the clinic’s psychiatry resident and received counseling and medication for his depression. He saw occupational therapists to get support with his activities of daily living. Through clinic partnerships with local agencies, he met with a certified health insurance navigator who is helping him apply for a specific type of Medicaid he may be eligible for, as it has a higher income limit. Additionally, providers at the clinic have called his utility company to help keep his electric on, and he has met with Connections4Health student volunteers for help with food and other social health needs.

Though he is currently awaiting determination regarding an insurance decision, hopefully Mr. Smith will soon have Medicaid so he is able to be referred back to his original care team in the health system.

While talking with Mr. Smith about sharing his story, he wanted to add that the Birmingham Clinic has been his only source of hope this past year. Unfortunate does not quite capture his situation over the past year, the desperation and at times despair he felt ran deeper than that. That he was able to find some hope and direction forward at Birmingham Clinic, where the intersection of critical physical, mental, and social health service come together – at no financial cost to him – has been able to provide a helpful oasis when needed most. 

C4H Co-founder: Mary Herbert

Welcome to the inaugural post of the Connections4Health (C4H) Social Health Project! This is a space that brings together the real, sometimes raw stories of underserved people in our community: unfiltered and unslanted. As a way to kick-off this blog, Birmingham Free Clinic Clinical Director and C4H Co-founder Mary Herbert shares some reflections on the meaningfulness of working within the underserved community as well as her excitement for the future.

herbert

“In 2018 all those who have been and continue to be a part of C4H are celebrating our 5th year serving patients at the Birmingham Free Clinic (and beyond)! Our founder, Jennifer Sloan, MPH, and I are so proud of the work that volunteer students have done over these first five years – hundreds of patients have been helped with their social service needs as we have tried to help mitigate the social determinants which greatly impact people’s capacity for positively impacting their overall health and well-being. Addressing these issues within the scope of a patient’s medical care visit is vital, both because it is most convenient for patients (reduces their burden of visiting other resource providers) and because research has been showing that our social needs are intimately intertwined with our health status. Additionally, C4H volunteer student Fellows are not only learning about this connection and how they as future providers or public health professionals can impact these issues, but they are making a REAL difference in people’s lives! We are so excited and humbled to soon celebrate our 5th anniversary, and to continue to serve even more patients across Pittsburgh!”