Educating for a healthier life
The overall goal of public health is to prevent morbidity and mortality. In PUBH302: Introduction to Public Health, we studied how the social determinants of health can drastically affect the rates of morbidity and mortality within a population. These determinants can be grouped into five categories, all of which encompass additional broad aspects of health: economic stability, health care, neighborhood, community, and education. Economic stability encompasses an individual’s job status and income level, as well as their poverty level and capacity to improve their current socioeconomic (SES) level. Health care refers to both an individual’s access to health care and the quality of health care received, including insurance coverage and medication affordability. Neighborhood refers to the built environment in which an individual lives, including the crime rates, air quality, and walkability of their area. Community refers to the social and familial connections that individuals have that promote health behaviors and improve overall quality of life. Education refers to both access and quality, being that individuals may have different educational and career attainment depending on which school they attended. We learned that each of these five determinants are crucial in determining an individual’s overall quality of life. The impact of determinants on health outcomes can be seen in Artifact 1. We discussed how the U.S. Department of Health and Human Service’s Health People 2030 uses these five determinants to base their health goals and address the upstream factors that guide health outcomes in the United States.
Artifact 1. PUBH302 intervention assignment, showing the impact that determinants have on health outcomes.
The summer following my sophomore year, I began internship at South Carolina First Steps. Being that SC First Steps is both a state agency and a non-profit, I was presented with a valuable experience to interact with both public and private sector resources to expand educational attainment in South Carolina. I worked mostly with the Countdown to Kindergarten Program, an initiative aimed towards at-risk 3-5 year olds with the goal of fostering a smooth transition into kindergarten. My initial tasks associated with this position included sorting incoming contact information from each of the participating schools and teachers. I attended meetings related to other programs sponsored by SC First Steps and continued making various Excel sheets for my boss for the first several weeks of the summer. I knew that my work was helpful to my boss, however I didn’t feel like I was truly making a difference in the community. It wasn’t until my boss assigned me community outreach-related tasks that I realized the impact I could make.
At the instruction of my boss, I was able to attend Countdown to Kindergarten kickoff events throughout the Columbia and surrounding communities. I was able to speak with children and parents who were thinking about enrolling in the Countdown program, as well as students who were previously “Countdown kids.” I spoke with many students who explained that they were enrolled in the Countdown program before entering kindergarten, usually because of their low-income household or because their primary language was not English. One specific interaction with a young woman only a year younger than me is what stood out the most. She discussed how she participated in the program when she was going into kindergarten, and how her school experience was greatly benefitted by it. Growing up in a Spanish-speaking household, she was not taught English before entering kindergarten. As part of the Countdown program, her soon-to-be kindergarten teacher along with a translator came to her home to introduce her to topics to be covered in kindergarten and began teaching her necessary English. Because of this program, she was able to excel in kindergarten and the remainder of her schooling, and at the time was about to enter her freshman year at Duke on a full-ride academic scholarship. She noted that this program allowed her to get a head start on the barrier of learning a brand-new language at a new school, which then allowed her to academically flourish. After attending several of these events, I was able to report back to my boss about the conversations I had with this young woman, along others with similar stories. She then provided me with the statistics of students who had been enrolled in the program, and how they consistently perform better on state tests than their peers – both at-risk and not at-risk.
A photo of me at the Columbia location of South Carolina First Steps, where I completed my internship.
This conversation with my boss made me think about the social determinants of health, specifically education, which I had learned in PUBH302. When we learned about this specific determinant in class, I remember Dr. Galloway discussing how crucial education is to having an overall better quality of life. Access to good education, especially good primary education, is crucial to learning fundamental skills like reading and writing. We discussed how around one-fifth of all Americans are illiterate, which makes it difficult to do tasks such as reading medication labels or understanding instructions given by a physician. Individuals who graduate high school and college have a higher correlation with higher incomes and better health outcomes, as opposed to those who never graduate high school. If students are immediately discouraged from learning in their early years, whether it is due to a language or accessibility barrier, they are less likely to finish their education.
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Through my conversations with past participants of the Countdown program, I was able to see just how crucial early education is to the rest of an individual’s life. Though many people take going to kindergarten, high school, or college for granted, the impact education has on life outcomes is so great. In Artifact 2 , a one-pager I worked on during my internship, data from the CTK program shows just how valuable education is. From these experiences, the value in education I held significantly increased. I understood the impact that good education can make on individuals during their school years, as well as how it impacts downstream factors later- on. Though I’ve always known that education was valuable, my understanding for education’s impact on health outcomes grew tremendously.
For the remainder of my internship, I kept these conversations and statistics in mind. I realized that the work I was doing, no matter how remedial it seemed, was helping other students have better health outcomes. I also realized that I was lucky enough to be sitting at a desk at an internship during my college years all because I had great primary educators who taught me the foundational knowledge I needed to succeed in both school and life. This experience reminded me of a quote by poet Julia Carney, “Little drops of water make the mighty ocean.” For future endeavors I am able to carry with me the knowledge that small changes are able to make large impacts later on.
Artifact 2. Countdown to Kindergarten one-pager that I helped complete, showcasing the impact that the CTK program has on participant outcomes.