Non-biological Constituents of Health

As a pre-medical student, it is often easy for me to forget the importance of a well-rounded education as I attempt to be successful in demanding science courses. After all, I never felt the urgency say, of learning how a bill is converted into a law and never understood how it affects my ability to be a good doctor in the future.  How will all of this additional information learned through additional required courses allow me to rid my future patients of cancer? I was surprised to learn that there are other factors contributing to the health of all people, with vast portions of illnesses caused by non-biological influences.

In a previous internship at a local hospital, I was heavily involved in the recruitment, interviewing, and training process of prospective “Health Scholars”, volunteers trained to help with the care of patients. Some of their tasks include ambulating, feeding, bathing, and repositioning patients alongside staff. In return, Health Scholars attain valuable educational opportunities by observing procedures such as angiograms, births, and much more in various hospital departments. Before every application cycle, we updated interview questions to better fit the needs of the hospital and the program. There was once a discussion before a new application cycle to test applicants regarding their knowledge of current health policies. One of the other directors suggested we ask applicants which policy they supported, the Affordable Care Act or Obama Care? I remember laughing alongside them because it is supposed to be common knowledge that both are the same policy, but on the inside I was thanking my lucky stars for watching Jimmy Kimmel, and finding out that both were the same. Had I been an applicant for that cycle, I might have made a complete fool of myself answering this question. Then I realized, what if medical schools also ask these types of questions during interviews? Suddenly, an education in political and social sciences seemed pertinent, but why was it important to keep up with the doings of our government?

I did not have an answer to that question, and due to my lack of knowledge, I decided it was important to set aside time for keeping up with the news, journals and I even started to listen to the news while getting ready for school and work. While doing so, I learned that an important non-biological constituent of health is health policy itself. Heated debates have been criticizing or praising the Affordable Care Act and then attempts to repeal and replace it. According to the Los Angeles Times, “The original version of Republican plan to replace the Affordable Care Act would remove health coverage for an estimated 24 million Americans by 2026, according to independent analysis by the Congressional Budget Office.” This 24 million added to the existing 28 million uninsured Americans brings us to a total of 52 million uninsured Americans who would steer clear of primary care, not utilizing health care services until their condition has worsened, essentially costing more to treat and having potential prolonged and adverse effects.

In my nutrition class, which I took purely based on my own interests, we discussed important dietary recommendations and daily value intakes, while also talking about food deserts. These are low-income communities that don’t have wholesome markets, forcing them to rely mostly on convenience stores and fast food chains to feed their families. Opportunistic fast food franchises open in areas where supermarkets are lacking, which correlates with malnutrition and obesity. During this class was the first time I thought about how where you live can be a social determinant for poor health. It became more apparent when I was training to be a Care Navigator, a recent effort by hospitals to reduce readmission rates through follow up calls and care after discharge. Our supervisor asked us each to write down our zip code. Then, she told us that by the zip code itself, she can determine what kind of health problems a person visiting a community hospital might have. If we compared the zip code of 97630 to 90262, we would see that hospitals in the 97630 zip code mostly dealt with retired geriatric patients in comparison to the 90262 zip code which was primarily comprised of young families living in food deserts. The families in the 90262 area therefore were more likely to have health problems impacted by poor nutrition. As a hopeful future doctor, it is my responsibility to learn how the environment impacts people in our communities and assist in preventable measures for better health based on the needs of the population.

So what does this all mean? Bacteria and viruses are not the only causes of sickness. The places to prepare for a medical career aren’t only biology and chemistry labs. There are lessons hidden behind every class and every life experience that can be applied towards our future occupation. I’ve learned not to dismiss any information and ignore everyday experiences, no matter how irrelevant I think something might be. The knowledge I attain now will amplify my ability to find the right resources for my future patients. After all, not everything can be cured with a prescription pad and a pen, and we need to make sure that the treatment our patients are getting is holistic.