As an advocate at Woodhull Medical Center for a nonprofit organization that strives to address social determinants of health, I find my work both riveting and frustrating. Each week, I call a number of my clients, most of whom do not speak English, and the others hardly answer the phone to begin with.
How does a public health professional become a catalyst for change and empower those they work with?
I feel like I fail week after week when I do get in touch with my clients and they tell me things like “Oh I did not have time to go an apply for health insurance” or “I do not see the value in going back to school and taking GED classes when I need to work.” How do you convince someone that these social needs are actually essential? It is nearly impossible to create a sense of agency for someone who finds a need like adult education undesirable or inaccessible…but that is why the field of public health captivates me. Each day I try to find unique ways to market to my clients value-value in their own health. It is one thing to exhaustively explain to someone that educational status is in fact a lead indicator for poor health, and it is not always clear to everyone the impact of their routine on their overall quality of life. When clients of mine fear even setting foot into a hospital, you know there needs to be a change.
New York City has an abundance of resources. If there is one city in the United States that can address some facet of health, this would be the place, and though I am going to make a rather broad generalization, I do not believe every organization makes the most of their potential to maximize resources. I should not have to explain to someone living in one borough that they are better off traveling into another borough to receive quality service, or that help with their need does not exist in their specific borough. This goes back to the notion of accessibility and acceptability.  Is it feasible to ask someone to travel for a class or to fill out an application? (I hope you agree with me that the previous question is rhetorical). If the resource landscape in New York City as a whole is so robust that every other major city in the US looks to us to inform their own public health agenda, then why shouldn’t that be the case in each borough? Would overall health increase by providing permanent solutions to address borough-specific social determinants? It is by no means a panacea, and I know I am not the first person to question the system, but it is just some food for thought. My mind continuously wonders about my role in the public health of our community, and so, why not think about your own?
Written by Pilar Mendez



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