Students propose solutions to health disparities in Bexar County

(July 16, 2019) — Taking summer classes is a great way to apply learning outside the classroom and get involved in unique experiences. Students in the fields of social work, demography, student presentation criminal justice, and kinesiology who enrolled in Social Determinants of Health, a five-week graduate course elective, presented ideas on how to reduce health disparities in Bexar County by targeting social determinants of health. Social determinants of health are conditions in which people are born, live, work, play, worship, and age that affect health.

The students focused on three health disparities–life expectancy, obesity, and mental health hospitalizations–as identified in the Health Collaborative’s 2013 and 2016 Community Health Needs Reports. Jelena Todic, assistant professor in the UTSA Social Work Department, believes that integrating existing evidence, the diversity of disciplinary perspectives, and community knowledge can result in sustainable solutions.

“It’s crucial to understand that these disparities are avoidable, unnecessary, and unjust and that we can eliminate them,” Todic says.

The students worked in transdisciplinary teams to map out complex factors contributing to each of the three targeted health disparities, before presenting their ideas on how to intervene to a panel of community reviewers. The panel included Maria Alejandro (Program Director & Community Health Worker, The UTSA Center for Civic Engagement), Jessica Arriola (Community Health Worker-Healthy Neighborhoods, San Antonio Metropolitan Health District), Abigail Castillo (Community Coach, San Antonio Housing Authority), Lily Casura (Newly minted MSW & UTSA Alumna), Candace Christensen (Associate Professor, The UTSA College of Public Policy, Social Work Department), Denise Hernandez (City Council District 1 Constituent Service Specialist & Founder of Maestranza), Steven Alfonso Maldonado (Program Coordinator, The UTSA Center for Civic Engagement), and Beth Tootill (Community Organizer, San Antonio Housing Authority).

presentation“This project taught me that I can learn from people in other disciplines,” said Camela Epstein, Master of Social Work student.

“The process also taught me that I must not shy away from complicated issues. It takes a lot of effort to decipher all the factors that contribute to mental health hospitalizations,” she added.

“Trying to understand and explain how structural racism impacts mental health disparities is a lot of work. Creating solutions and then presenting them in a simple digestible way is even harder.  It takes stamina to create change.”

panel

During a session held on July 1 at the end of the term, students had to describe current local efforts aimed at eliminating the disparity and offer at least one new approach that targets social determinants of health.

Universal middle school afterschool programs, school district consolidation, increased minimum wage, urban agriculture, and scaled-up cooperatives were among the proposed solutions.

Students utilized the “Ignite” presentation format– promoted under the slogan “Enlighten us, but make it quick”– to present complex ideas in only five minutes to a panel of community reviewers.

students working on presentation

community panelThe session offered students the opportunity to engage in dialogue with community members on the relevance of their proposals.  Maria Alejandro, program director for the Center for Civic Engagement and one of the panelists, was instrumental in organizing the community panel.

“Creating the space to interweave academic and community knowledge for the greater good is, indeed, energizing and strengthens the relationships necessary for community engaged scholarship and experiential learning,” said Alejandro.

After presenting, students engaged in dialogue with the panel of community reviewers on the relevance of their proposals. The panel gave them feedback on their projects, identifying strengths of the proposed ideas, limitations, and blind spots.

“It was good hearing feedback from community members who definitely have different perspectives and different areas of specialized knowledge,” said Scott Craig, doctoral student of the College’s Applied Demography program.

“Hearing what areas they thought were particularly important or not so important, was useful.”

The last class was also an energizing experience for the reviewers.

“Each group had well researched and thoughtful plans to combat each of these larger issues,” said Denise Hernandez, one of the panelists who is a 5th generation San Antonian, an activist, founder of Maestranza, and City Council District 1 Constituent Service Specialist.

“Something I always center in my work is cultural competency and how the community is being collaborated with versus being taught to.  A few of them were very cognizant of this and recognized how their plans would need this community inclusion and buy-in to be successful.”

Hernandez added, “I expressed in my feedback to them that we need more people with these ideas in spaces of power.”

Critical praxis was foundational for the course.

“Critical praxis requires both reflection and action directed at the structures which require transformation in order to support good health for all of us,” Todic explained.

The final assignment consisted of writing a letter to the editor or an elected official to take action informed by what the students learned from the class and the community panel.

“Dr. Todic’s passion, expertise and enthusiasm were the foundation for the class,” Epstein added.

“She repeatedly told us that we must be able to envision a better future, if we were going to be successful. In short, the class filled me with hope for the future.”

by Jelena Todic and Michelle Skidmore

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