Shawa was part of a team engaged in a six week course called Immersions EMT/Population Health. While all first year students are required to become certified by the end of the course as emergency medical technicians (EMTs) and then actually participate in EMT calls, they also must explore a neighborhood and learn how to conduct a community health assessment, a major tool used in Population Health to determine areas of need and possible realistic intervention targets for positive change.
Dr. Laura Culley, the UNLV School of Medicine Associate Dean for Community Engagement, notes the course exposes students to the “downstream” and “upstream” aspects of medical emergencies. Downstream refers to medical emergencies that doctors encounter, such as a sexual assault victim, and how to manage those situations. Upstream refers to the conditions that can contribute to those emergencies, such as homelessness.
Recently, during presentations in a Shadow Lane complex classroom, several teams of five students identified what they learned in each of their neighborhoods to other students, faculty and officials representing the areas the students chose to explore. Using slides they compiled during their study, the students dealt with neighborhood demographics, resources, crime, educational opportunities, safety conditions of roads and sidewalks, the presence of recreational opportunities, and the variety of food products available in stores
Shawa, along with Lauren Ostler, James Lovett, Tes Yadete, and Donnis Davis, came to understand why there were so many pedestrian accidents near Boulder Highway and E. Tropicana Ave. “Six lane crosswalks are just too wide for some people to negotiate in a hurry,” he said. “You have to keep that in mind as a physician when you tell people without a car to go to a particular store or pharmacy or whatever... And some sidewalks just end.”
Like Shawa, Ostler said the learning exercise taught her how helpful it would be for a physician to understand the background of a patient who lived in the area.
“By understanding these people and their lifestyles, I could tailor medical treatment to them,” she said. “Say we have a patient who is overweight but is afraid to go outside and exercise because of gang activity in the area... We learned there is a lot of gang activity from people in the neighborhood. I could set up exercises for him to do at home, have him walk stairs instead of taking an elevator.. And if he’s only been getting bad processed food at a 7-11, I could let him know about healthy foods at nearby food banks.”
Davis said a physician who understood that a patient came from an impoverished background would never prescribe medications that were out of his financial reach.
“What really hit home to me is how you have to understand what people are going through to be a good family physician,” he said. “The treatment plan you’re going to have to set up is something on the less expensive end. And you’re going to have to spend a lot of time educating because you can’t assume that all people know what you mean. Many of them haven’t had the opportunity for a good education.”
Lovett said it is critical for physicians to understand the resources in a neighborhood where people often are on foot. “You don’t want to tell somebody to exercise in an area controlled by gangs. The more you know about an area, the better.”
Ostler said the area around the Whitney Recreation Center needs new affordable housing and a crackdown on sex trafficking. Shawa, who learned from one resident that one man made money off 10 year old sex slaves, said one way that physicians may be able to help change lives for individuals is to work more closely with police and to get involved with planning agencies.
“Students are trying to get themselves integrated into different planning organizations,” he said. “We want to make a difference.”