Special Report Food Security
Can a clinic steady the turbulence?
Allies’ well-rounded approach to health care
In a medically underserved community just south of downtown Columbus, there’s an alliance dedicated to elevating the health of community members — people for whom the potential symbolized by the city’s skyline feels more like an impossible distance and less like
just 3 miles.
Angela He ’08 is among the allies. She is a dietitian at South High Primary Care Center, an Ohio State and Nationwide Children’s Hospital clinic where she works alongside physicians who specialize in pediatrics and internal medicine, nurses, a social worker and pharmacists.
“We see low-income patients. A lot of Caucasian, Hispanic, African American and some Somali patients,” she says. “Sometimes we see high school graduates, but a lot of times they haven’t gotten that far. We see pregnant teenagers. And we see a lot of kids who [are cared for] by a single parent or a temporary guardian.”
He, who spent several years working for the federal Women, Infants and Children (WIC) supplemental nutrition program, says she feels startled back into Middle America when she leaves the clinic each day.
“The population we’re dealing with, they need help. Food insecurity is just normal for them. A lot of times it’s generational. This is how it’s always been.”
The clinic’s lead physician and director, Dr. Megan Brundrett, is adding an Ohio State master’s degree in public health to her credentials. She provides an evidenced-based-care lecture for doctors weekly. The doctors, in turn, continually update their approaches to meet south-side residents’ needs.
South High Primary Care believes in the it-takes-a-village approach. Brundrett asks a patient, “Are you worried you’ll run out of food?” Then, “Have you already run out of food?” Next, she consults with He or social worker Anita Morgan ’93 MSW. (During a one-hour interview for this story, a doctor requested their collective help with food-insecure patients three times. It was a normal Thursday.)
Pharmacists follow up with patients to check on barriers to pharmacy access and to help ensure medication is taken correctly.
The small army of caregivers convenes regularly to analyze patients’ treatments, needs and progress. They advocate for those who aren’t as capable of advocating for themselves, for those who might not be heard — whether as a child by a parent or as a parent by a government agency.
He and Morgan recall a recent visit by a pair of siblings.
“We saw the two children come in,” He says. “Their hair and their clothes were dirty. You could tell they probably had a problem with nutrition because their other basic needs weren’t being met.”
Morgan picks up the story: “They were asking a lot of questions and getting into things. They couldn’t focus. We learned that an aunt was preparing food for them because their mother was challenged cognitively and couldn’t prepare the food safely.
“To address [a case] like this,” Morgan continues, “we would learn more about their home setting, their income, whether or not they were on SNAP or receiving cash assistance. We’d help them get the benefits they qualified for. The younger sibling still qualified for WIC, for example. And if they weren’t scheduled for a follow-up, we’d call them to make an appointment.”
The clinic also would assist with a cab or bus passes if transportation were a barrier. It might also provide supplements, such as nutritionally rich Boost Kid Essentials or PediaSure, which often are prohibitive out-of-pocket expenses.
“A lot of what I do is give patients ideas,” He says, “like making their cereal healthier. I’m not judging. I’m finding out if I can help them cut back on soda or fast food, for instance, so that they aren’t at risk for developing diabetes or heart disease.”
She also accompanies patients to a nearby Kroger, showing them how to shop efficiently on the perimeter of the store, where the fresher, more nutritious food is positioned.
“Buying potatoes in bulk,” she says, noting an example of the advice she offers. “You can get a 5-pound bag instead of two or three individual potatoes. You can stock up when frozen vegetables are 10 for $10. For $3, you can flavor water for a month with Crystal Light instead of drinking pop.” Following the tour, patients receive a $10 credit from Local Matters, a community-health partner co-founded by Noreen Warnock ’72 and Michael Jones.
In the case of the young siblings, He learned that they were open to trying new and healthful foods. “A bright spot,” she says.
Morgan recalls another patient, a young girl. Last year, her blood pressure had been normal; this year, it was high. Her father had been incarcerated six months earlier. Now, she wasn’t eating or growing well.
“For patients like her, I’d do a psychosocial assessment to find out what support she had,” Morgan says. “Is there any violence or depression or even suicidality? If so, I’d link her to resources for counseling so there’s an outlet to talk about what’s going on. I treat patients as the whole person, taking into consideration school, nutrition, home life, medicine — everything.
“This is what I went to school for,” adds Morgan, who holds a bachelor’s degree from the College of Social Work. “We were taught that the population looks different than you think it does.
“You see these hardships. You see these kids,” she says, pausing to steady her emotions. “We were taught that there are people who look just like us, but they have no resources.”
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