By Ben Feldheim
At Richard T. Crane Medical Preparatory High School on Chicago’s Near West Side, around 250 teens gathered in the school’s gymnasium for a Power Hour, a physical activity clinic created by students from Rush University College of Nursing and Crane.
While there was chatter at the beginning the students quickly settled, before trying out yoga poses and exercises while paying close attention to instructions.
Monique Reed, PhD, RN, a BMO Harris Bank Health Disparities Fellow at Rush, is researching ways to bring more health education to underserved populations. The goal is to reduce medical disparities between wealthier and less-affluent communities, in part by reducing preventable conditions.
Among several efforts, Reed oversees students in Rush’s nursing Generalist Entry Master’s Program as they create a curriculum, working with Crane students, faculty and staff during after-school hours, that encourages mindful eating and physical activity. Reed’s work is funded through a $5 million grant from BMO Harris Bank as part of the Building Healthy Urban Communities project — one of many community outreach efforts at Rush.
“Everyone participating gained from this Power Hour program,” Reed said. “The Rush students got hands-on experience leading hundreds of teens in a program. They also recruited their own colleagues for volunteer support, arranged for a Chicago Park District yoga instructor to demonstrate and enlisted Crane staff to assist. Crane itself was in need of diverse after-school programming, and a lot of the Crane students had never actively participated in yoga before.”
Engaging outside the medical center to prevent illness
Lowering health care costs requires preventing disease as much as effective treatment. In tandem, health care education has shifted from classroom lectures to hands-on learning — the types of student experiences for which Rush University is known best.
Today, Rush students and faculty exemplify both shifts, as they work to improve health education, enhance access to preventive care and address contributing factors like physical activity and nutrition.
Through a series of innovative faculty- and student-run programs, Rush University is strengthening the health of its neighbors, while preparing its students for the new realities of health care delivery.
“If we’re really going to achieve health equity, we can’t just address what goes on within the four walls of medical centers,” said David Ansell, MD, MPH, senior vice president of system integration at Rush.
“We’ve made a commitment for the last 25 years to partner with communities and listen to their needs,” Ansell said. “We’re measuring educational outcomes for students, and we’re measuring how we improve the health of our community. It’s a tall mountain to climb, but if we do this, even in a small way, there’s a model for this city and across the country.”
In this archival photo, Rush Medical College students assist homeless patients at Chicago’s Franciscan House of Mary and Joseph shelter in 1994. The shelter’s clinic, operated by Rush student and clinician volunteers once a week, currently see 90-100 patients per clinic night.
Photo credit: Jean Clough
Photo courtesy of the Rush University Medical Center Archives. Learn more on the archive website.
If we’re really going to achieve health equity, we can’t just address what goes on within the four walls of medical centers.
Taking care directly to those in need
In 1991, more than 20 years before the Affordable Care Act required medical centers to engage in community outreach, the Rush Community Service Initiatives Program, or RCSIP, was created to match students and faculty with various community health needs.
The nearby community needs are substantial — especially west and south of downtown Chicago. Less affluent areas of the city face significantly greater health issues and have fewer resources that are nearby to meet the needs.
“In Chicago’s Loop, life expectancy is 85, but five miles away in Garfield Park, the life expectancy is 72,” Ansell said. “You go a little further west, it’s 69 years. By building relationships and paying attention to what people need, we can go to Garfield Park and bend that life-expectancy curve.”
RCSIP programs are mostly broken down into three types: health care education, promotion and access, such as community-based clinics; pipeline training, where high school and college students are mentored and guided toward health-related careers, such as Crane Prep; and outreach programs, such as the Day of Service in honor of Martin Luther King Jr., on which all RCSIP participants serve breakfast at shelters, give health screenings and more in honor of the civil rights leader.
Certain RCSIP programs help people better care for themselves, while also educating their peers, such as 5+1=20. Through this program, Rush volunteers teach students at Chicago Public Schools how to screen for common conditions such as diabetes and high blood pressure. The CPS students are then encouraged to bring their family members to health fairs at their schools.
I tell students that they’re not just going to treat people who look like them.
“There are studies that show that peer education programs can get the health message across much better than we clinicians can,” said John Nixon, MD ’15, who as a Rush student helped create the 5+1=20 program.
Often scheduled to coincide with report card pickup or parent-teacher conferences, health fairs are held in support of programs such as 5+1=20, where Rush volunteers supervise screenings and set up referrals to nearby clinics. In the 2013–14 academic year, more than 840 people attended Rush’s community health fairs. Among the attendees, 274 were referred for diabetes screening, 362 were referred for high blood pressure and 196 were referred for mammograms.
“Every time we do one of these fairs, we find people who are in such dire need of care that we’ve sent them immediately by ambulance to Rush,” said Sharon Gates, senior director of community engagement at Rush. “The doctors have said that they were walking time bombs. They are alive because they attended the health fairs.”
Exposing students to the populations they will serve
For many Rush students, a community outreach experience may be the first time they have closely interacted with people whose ages, ethnicities and socio-economic backgrounds differ from their own.
These opportunities are often watershed moments in the students’ paths toward lifelong careers, built on invaluable interactions that cannot be replicated in any class setting.
“I tell students that they’re not just going to treat people who look like them,” said Gates. “So often I witness students walking into rooms, and they see they are no longer among the dominant culture. And because of these experiences, they are confident, comfortable and ready to help all people.”
While participating in Rush’s community outreach, students also see firsthand the myriad challenges people in need face, including homelessness, drug addiction and teens raising their own children.
“Bearing witness to suffering of others is an act of compassion that gives people hope when they have none,” Ansell said.
“Our students can do that every day, and they can do it everywhere they go after graduating.”
More community outreach, more effective caregivers
Rush faculty, staff and students agree that community outreach develops more committed and well-rounded health professionals. Interest in participating is so widespread that several programs often have waitlists.
Additionally, the programs continue to be passed down to new students and participants as years pass and Rush’s population changes, which has helped sustain and enrich this effort for the last 25 years.
“Compassion and empathy, putting yourself in someone else’s shoes, are critical skill sets to develop,” Ansell said. “They are just as essential as any other health care skill one would describe as technical. In fact, these are the technical skills of exceptional health care professionals.”
