After three years of planning (and many delays due to the COVID-19 pandemic), I am happy to announce that 14 University of Alabama at Birmingham (UAB) graduate and undergraduate students are setting off to explore population health in the United Kingdom. This blog will document our travels, activities, the people we will meet, and the things we will learn along the way.
As part of this experience, students will be traveling to both London, England and Aberystwyth, Wales. While in country, we are planning to meet with university, government, and community partners and organizations to learn more about the structure and delivery of public health and healthcare services in England and Wales. We will walk the streets of SOHO in London with public health experts and imagine what it must have been like to live in the city during Victorian times, before the implementation of sanitation and environmental health services. Finally, we will learn, firsthand, about priority public health issues affecting communities in the UK, how these issues are being addressed, and strategies being implemented to advance health equity. The sum of this experience will illustrate the interdisciplinary nature of public health practice and the need to add attention to the social determinants of health – the conditions in the social, physical, cultural, and economic environment in which people are born, live, work, and age.
Leading this trip is Lisa McCormick, DrPH, and Meena Nabavi, MPH. Dr. McCormick is the associate dean for public health practice and professor in the Department of Environmental Health Sciences and Mrs. Meena Nabavi is a program manager in the Office of Public Health Practice in the UAB School of Public Health.
Before the students departed for the UK, they had an opportunity to meet with several public health practitioners and representatives from community-based organizations in Birmingham (AL) to learn about local public health issues and the programs and initiatives that are working to address them. These pre-travel presentations will allow students to compare issues and programs in the United States to those we will be learning about in the United Kingdom.
Monday, May 9th
First, the students met with Dr. Meredith Gartin, associate professor in the department of Health Policy and Organization at the UAB SOPH. First, Dr. Gartin talked to students about culture and how culture can influence health behaviors and outcomes. She started by defining culture and discussed different dimensions of culture. When examining culture in a population, Jane Vines, an MPH Population Health student said “there is so much under the surface that you do not understand until you immerse yourself in the culture… that’s why immersive experiences like this course are so important.” Grace Albright, a Ph.D. student shared “What stuck out to me was how social norms are so ingrained into our culture that we don’t always think about them or even recognize them. Because culture is “learned” and “shared”, many of our “typical” health behaviors and customs are largely defined by those around us.”
Dr. Gartin then discussed her work with the Alabama Interfaith Refugee Partnership (ALIRP). We learned about common refugee populations and about those who come to Alabama seeking asylum. Dr. Gartin highlighted the difficulties, challenges, and barriers that asylum seekers and refugees have securing legal status and basic human services, including preventative healthcare.
Tuesday, May 10th
Carrie Leland, MPA, executive director of Pathways, met with the students and introduced systematic barriers for people experiencing homelessness in Alabama. She provided several definitions of the term “homelessness” and discussed chronic homelessness and the services available in the community based on the Housing and Urban Development (HUD) definition. She also described Pathway’s programs, including their new emergency Childcare Center, which opened to mothers and children who are experiencing homelessness. After her discussion, Melissa Beck, an MPH Population Health student shared, “I was so impressed that Pathways had created childcare services for children, filling an important gap in the Birmingham community.”
Ritika Samant, a Fast Track MPH student in Health Behavior noted after both Dr. Gartin and Ms. Leland’s presentations that “there is a trend in where public health interventions take place, especially in regards to the most vulnerable populations, which makes me wonder if there are more upstream approaches which can be implemented to address the social determinants of health.”
Dr. Amy Chatham, assistant dean for undergraduate education and assistant professor in the department of Environmental Health Sciences, discussed her rural health work in the Black Belt of Alabama, which focuses on sanitation, environmental activism, and health disparities. She described the lack of sewage treatment infrastructure in Lowndes, Wilcox, Perry, and Dallas counties (AL). People in these counties are still experiencing economic repercussions of the Black Belt’s history, and as such, there is not a tax base to support establishing basic environmental services that are important to keeping a community healthy. Dr. Chatham shared that people who live in rural Alabama have deep roots and ties to the region. Jonathan Baker, a public health undergraduate student said, “the people who live in these communities don’t want to leave their home, they have generational wealth in these properties.”
There needs to be more activism and action in these communities so that these problems will be addressed. Jane Vines summed it up best, “These are their homes, their history, and their heritage.. people in these communities shouldn’t have to leave to live.”
Later in the afternoon, students visited the new location of UAB’s 1917 Clinic at Dewberry and met with Kachina Kudroff, the prevention programs manager. Ms. Kudroff provided an overview of HIV in the United States, focusing specifically on the Southeast. Ms. Kudroff Kachina shared basic information on HIV transmission and prevention, discussed current treatment options and the importance of viral suppression, and challenges and barriers to accessing treatment for those living with HIV. Several students shared that they were impressed with the multidisciplinary approach to patient-centered care at the 1917 Clinic and how multiple services are co-located in the same building. Maya Van Houten, an undergraduate public health student observed, “The 1917 Clinic is a one-stop-shop, where people can access needed services in one visit at one location in one day.”
Next, we visited with Karen Musgrove, Ph.D., CEO, and Josh Bruce, MPH, Director of Research of Birmingham AIDS Outreach or BAO. The mission of BAO is to enhance the quality of life for people living with HIV / AIDS, at-risk, affected individuals, and the LGBTQ community through outreach, age-appropriate prevention education, and supportive services. BAO is able to accomplish this mission through several programs including the Magic City Wellness Center (which provides wellness and medical for the LGBTQ community), the Magic City Acceptance Academy (which facilitates a community in which all learners are empowered to embrace education in an LGBTQ-affirming learning environment), the Magic City Research Institute (improving the health of and service delivery to people with HIV, the LGBTQ community, and other underserved populations through collaboration, research, and evaluation), the Magic City Acceptance Center (provides a safe, supportive, and affirming space for LGBTQ young adults and their allies providing weekly supportive and social services to the LGBTQ community), and the Magic City Legal Center (provides legal advocacy for LGBTQ communities and community members impacted by HIV).
The students will leave Birmingham on May 12th and return on May 24th and will be blogging most every day! Make sure you bookmark the blog and follow our adventures!
– Lisa McCormick and Meena Nabavi