"When I began my nursing education, I hoped that I would eventually find the juncture of social justice work and nursing," Seamon says. "The Fellowship has begun to show me just how the two fields can mix, and it excites me to know that the experience will continue beyond this year as a Fellow for Life."

As a Schweitzer Fellow and a student at the MGH Institute of Health Professions School of Nursing, Katie Seamon is addressing the challenges of adolescent pregnancy and parenthood in Chelsea, Massachusetts by developing a class on infant health and well being for young mothers at Roca. (She is incorporating the class into Roca and Americorps’ Youth STAR program, which trains young people to become mentors, educators and outreach workers in the community.)

In today’s interview, Seamon shares the story of her Schweitzer project—which she hopes will serve the dual purpose of educating the young mothers of Youth STAR and also enhancing their role as community resources.

Why did you decide to develop your particular project?

Prior to studying nursing, I majored in political science and was interested in social justice. I studied social movements and worked to promote civic engagement in my college community. Through that experience, I came to focus on public health and the inequity of our health care system. I had a few tremendously influential personal experiences with nurses and decided to pursue a master’s degree in nursing. I have since remained dedicated to working in the community—only now I will do so as a practitioner, having a direct impact on peoples’ lives.

When I moved to Boston for nursing school, I endeavored to find opportunities to mix my clinical education with community service. I began my project when my clinical preceptor introduced me to the Youth STAR program at ROCA in Chelsea, Massachusetts. Youth STAR was looking for an instructor for a class on Infant Wellbeing, to be taught to a group of 10 adolescent mothers. The project intrigued me immediately because it offered me the opportunity to mix my clinical practice with community engagement. Working with young mothers to foster healthy relationships with their young children was an ideal fit for me. As I began the class, I applied for a Schweitzer Fellowship to help propel the class through the next year.

What do you hope will be the lasting impact of your project on the community it serves?

My program has a few very important strengths that position it to have a ripple effect on the community. Youth STAR is an Americorps program, and the young mothers I work are working to fulfill a substantial community service commitment. Upon completion of my class, they will go out in the community to teach other young people about infant health and wellbeing.

Already, some of the young women I worked with at the beginning of the project are leading a community education class. This is extremely exciting and rewarding for me because the mechanisms for sustainability are already in motion. One of the primary goals of the project is to foster the confidence of these young mothers. My larger hope is that some of the basic knowledge and skills that are covered in the Infant Wellbeing Class will eventually permeate the community and lead to improvement in overall health outcomes for the young people of Chelsea.

What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?

I believe the most pressing health-related issue of our time has to do with health inequity. This includes disparate abilities to access health care, health education, and healthy foods. Many of the disease epidemics we are experiencing in this country—diabetes, heart disease, obesity, etc.—are intricately related to access to care, access to health education and access to balanced nutrition.

As far as addressing access to health care, I am a firm believed in single-payer universal health care. All people should have access to primary care and preventive services. The challenge of reforming health care systems in the United States must be met on a community level. Changing the system from the top down is immensely challenging, as we have seen with Obama’s efforts at health care reform. We see that small steps can be made, but enormous gaps remain when legislation is removed from the local level. National and state legislative changes need grassroots, community-based problem solving to support their goals. It is the only way we can figure out how to rearrange the system so everyone benefits.

Although I am admittedly naïve and extremely optimistic, I believe that if health services are designed around the needs of a community—educational and nutritional needs,  especially—we will see an evening out of health disparities and an overall improvement in the health of the American people.

What has been the most surprising element of your experience as a Schweitzer Fellow?

Perhaps the most surprising element of my experience has been just how quickly I have been received into the community at ROCA. Despite cultural and language differences, I have felt extremely welcomed and appreciated by all the staff at ROCA and the members of Youth STAR. I am particularly self-conscious about entering into a community where I am not a member, especially as an educator. The possibility for miscommunication and accidental insensitivity are great. Yet the experience so far has been very smooth. I am very grateful that ROCA and the Youth STAR members have welcomed me into their community because it has allowed us to work together and make the most of the project thus far.

What does being a Schweitzer Fellow (and, ultimately, Fellow for Life) mean to you?

Being a Schweitzer Fellow feels like a direction-setter for my career as a Nurse Practitioner. When I began my nursing education, I hoped that I would eventually find the juncture of social justice work and nursing. The Fellowship has begun to show me just how the two fields can mix, and it excites me to know that the experience will continue beyond this year as a Fellow for Life.

Being a part of the Boston Schweitzer Fellows group has been an incredibly humbling and inspiring experience. Every Fellow has incredible motivation and dedication to similar causes that inspire me. I have been afforded the opportunity to meet community leaders during our monthly meetings, which has given me a blueprint for where I may be able to go. I think that the Fellowship will be a defining element of my educational experience and my career.

Katie Seamon is a Schweitzer Fellow in Boston, MA. Click here to read more about The Albert Schweitzer Fellowship (ASF)’s Boston Schweitzer Fellows Program and the Fellows like Seamon it supports in creating and carrying out yearlong direct service projects that improve the health and well-being of vulnerable people and communities. To make a gift to in honor of Seamon, click here.

Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.

"I’m excited to be a Schweitzer Fellowship board member because I really believe that our ability to address future challenges in health care will depend on the training and support of the next generation of leaders," says King, one of the newest members of ASF's Board of Directors.

Dr. Roderick K. King believes in transformational moments—and he believes that when it comes to achieving health equity and building healthy communities, we’re in the middle of one right now.

As the health disparities expert told the audience at The Albert Schweitzer Fellowship (ASF)’s annual conference last October, we’re in the midst of “an unprecedented confluence of drivers for change, including our country’s changing demographics and pressures to improve quality of care and reduce cost.”

As one of the newest members of The Albert Schweitzer Fellowship (ASF)’s Board of Directors, King is working to help Schweitzer Fellows, Fellows for Life (alumni), and other emerging and established professionals leverage this moment in ways that improve health and well-being in vulnerable communities.

King is Senior Faculty at the Massachusetts General Hospital (MGH) Disparities Solutions Center and an Instructor in the Department of Social Medicine at Harvard Medical School (HMS), as well as President of Next Generation Consulting Group. Among other roles, he has served as the Director for the Health Resources and Services Administration, Boston Regional Division and as a Commander in the US Public Health Service, US Department of Health and Human Services.

We spoke with King about his personal journey, his belief in results-based leadership models, and the steps emerging professionals can take to help achieve health equity without burning out along the way.

ASF: Can you tell us a little bit about what initially drew you to pediatric medicine as a career, and then about what drove you to work to effect change in health and health care at the systems and policy level?

RK: Initially, when I was in medical school, I was interested in orthopedic surgery. But after doing my pediatrics rotation, I realized that I really loved taking care of kids, and that I was interested in working more closely with families, specifically through the clinical encounter, to help them achieve better health in their communities.

I soon began to run into many families with the same set of pediatric issues—for example, children struggling with very difficult chronic diseases like asthma. It was out of that clinical experience that I began to see the differences in health outcomes between kids of color and kids not of color, and I soon made a deep connection with a theme from my childhood: what is the role of the provider in the community, and what are the broader issues that underlie the disease you’re treating?

My father was a general practitioner in Brooklyn, New York—a very underserved area in the early 1960s—and I grew up in that context. We were a mom-and-pop shop, so I saw my mom and dad deal with those underlying issues—for example, my mom worked to get parents aware of and connected to the importance of the SATs and the PSATs. Clearly, it wasn’t just the disease that was the issue at hand; my parents were really interested in the overall well-being of the family and the success of their children. My pediatric experiences brought me back to that original interest and exposure.

ASF: How can Schweitzer Fellows and other emerging professionals help to leverage the transformational moment you described at our annual conference in October?

RK: I think the first step is to get as clear as you can about what your passions and interests are. They may change—but what are they now? What really excites you? Are you most interested in issues around improving quality of care and health care access? Are you most interested in transformational change and, perhaps, health care reform administration? Each individual has a particular passion and interest; the way to be most impactful is to align that passion and interest with the opportunities that are available.

Once you get clear on your interest, the second step is to gather as much information and learn as much as you can around that particular topic. That process may involve reading the literature, searching the internet, going to conferences, and so on—in a sense, becoming a well-informed expert in that arena.

The third step is to pursue hands-on practical experience and exposure to that issue. Learn the hands-on piece of what you’re passionate about—because in order to be part of this transformation, you have to understand both the context (which is step 2) and have the experience of actually doing it.

Out of those three steps, what will start to emerge are windows of opportunity that align with your passion—windows of opportunity where you can make a difference.

ASF: Once you’ve identified that passion and found your niche, and followed these steps to become well-versed in it and figure out what your path will be, how to you stay motivated, find some semblance of balance, and avoid burnout—especially if you’re seeing a lot of things that make you feel like you’re downstream from the problem?

RK: By making sure that you take care of yourself, whether it’s physically, mentally, or spiritually. By doing things that will nourish you and continue to feed you, because addressing disparities is long-term work that requires you to maintain a certain capacity to continue that work.

The second thing is really developing a great support network—your friends, family, mentors, peers—and carving out very specific time to connect and engage authentically with them, whether it be time with your family, regular check-ins with your mentor(s), or regular convenings with your colleagues. Any of those things are important because they offer you balance—and informally, they will help you to put what you’re experiencing into context. Doing this kind of work can sometimes feel lonely. You can start to feel like you’re the only one. But connecting with this network will remind you that many are supporting you or are in the same battle with you.

The third way to sustain yourself is to continually evaluate the alignment between your interest and passion and what you’re doing—because as we mature and grow, we change. The things we learn might push us in different directions. You have to constantly reevaluate, ‘Is what I’m doing a good alignment between my values and passion, and the opportunities that exist?’

ASF: In your capacity with MGH Disparities Solutions Center and the Institute of Medicine, you have published numerous landmark papers and calls to action regarding health disparities. You also continue to mentor and lecture on leadership in minority health policy at Harvard. Are there any related trends or initiatives that you’re particularly excited about?

RK: Historically, we’ve had a very clear separation between health care and public health—health care meaning the management and treatment of disease, public health being the prevention of disease and improving population health. The trend I’m seeing now is that the two are finally, actually merging. People are starting to realize that in order to improve individual health, you have to engage strategies to improve population health.

I’m seeing this realization in the current literature, which shows that despite efforts to improve quality of care in the hospital setting, things that appear to work are  outside the hospital setting and require working as a community—community health workers, visiting home nurses, “health navigators” who actually go out and help people navigate the system. What works is going outside the health care system in addition to strategies within health care.

Additionally, there’s a clear signal being sent through health reform that, if we want to control costs in health care, it’s going to require institutions to be accountable for maintaining overall good health. In other words, hospitals no longer can just be financed and paid for the treatment of disease, but now are going to be compensated based on how healthy their patients are. The unsaid message is that in order to keep people healthy, you may have to go beyond the exam room and into people’s communities and homes.  Organizational incentives will now be based on achieving the result of keeping people healthy.

The other trend that I’m particularly excited about is the increasing realization that in order to improve population health, it’s going to take multi-stakeholder collaborations. [King’s recommended reading on this front: “Leading Toward Population Health” from the November/December 2011 issue of Health Care Executive and “Collective Impact” from the Winter 2011 issue of the Stanford Social Innovation Review.]

There is no one institution, there’s no one hospital system, there’s no one social service program that will singlehandedly improve the health of populations. It’s the collaborative efforts of multiple leaders across multiple sectors—health care, business, housing, education—that will have to come together to develop strategies to improve and maintain good population health. A lot of my current work is moving in that direction: how do you support and align leaders to take collective action for impact?

I’ve been trying out a number of different models over the past seven to ten years. The one that I have really been focusing on is called Results-Based Leadership (RBL). It was created by one of my colleagues in Washington, DC, Jolie Bain Pillsbury. It pulls together various  leadership skills, including skills around collective impact, accountability, and group decision making. I’m now trying to see how I can use this model in the Caribbean—pulling together leaders in Trinidad to see how to use the model to develop strategies to address chronic diseases, because they’re realizing that they have to manage and control the non-communicable chronic diseases (e.g. diabetes, hypertension, heart disease, etc.) that are now the number one killer in the Caribbean. But their health systems are not built to address these things. What I’ve proposed is that they look at the RBL model as a way to engage multi-sectoral leaders to come up with strategies to address chronic diseases.

This approach is something that I’m really passionate about, and I’m seeing more and more communities start to form these collaborations across the country, and more and more hospitals now being willing to be part of collaborative efforts in communities. So there’s this growing trend and interest around multi-stakeholder collaboratives, but the part that’s so revealing for me is that most people realize that this is what needs to happen, but don’t necessary have the leadership skills to do it. What I’ve been exploring is: what are those key skills that people need to have to do this effectively and move from talk to action?

ASF: What does being a Board Member of The Albert Schweitzer Fellowship mean to you? How do you hope to see the organization grow?

I’m excited to be a Schweitzer Fellowship board member because I really believe that our ability to address future challenges in health care will depend on the training and support of the next generation of leaders.

Being on the Schweitzer board gives me the ability to support those future leaders—to be able to identify ways we can best mentor them, guide them, coach them, and provide opportunities for them to be change agents. It gives me a very concrete way to support the next generation of leaders.

"With Galveston still recovering from the hurricane, I really wanted to bring both gardening and a health curriculum to the population that I serve at the St. Vincent’s free clinic," Darrow says.

Earlier this month, the American Medical News reported that “85% of primary care physicians and pediatricians say their patients have health concerns caused by unmet social needs” — but only 20% of physicians feel equipped to address those needs.

That gap is a big part of the reason that The Albert Schweitzer Fellowship (ASF) is so passionate about developing health professionals who have the skills and confidence to address not only clinical health issues, but also the social determinants of health (like poverty, the environment, and education).

And that gap is exactly what University of Texas Medical Branch student David Darrow faced as he helped to run St. Vincent’s Student Clinic in Galveston, Texas.

“Since Hurricane Ike in 2008, we’ve seen see an exorbitant number of diabetic patients,” Darrow says. “I found myself growing increasingly frustrated as I watched my patients suffer enormously—we’d struggle for months to normalize blood sugar, but most of the time the root of the issue remained hidden behind layers of social barriers.”

So Darrow took action to break down those social barriers—through community gardening. With the support of the Houston-Galveston Schweitzer Fellows Program and other friends and allies in the Galveston community, Darrow has established two gardens in Galveston’s low-income neighborhoods that will serve as the lynchpin of an interactive, culturally competent curriculum and training program on nutrition and health behaviors—and that will, he hopes, ultimately reverberate back to the examination rooms at St. Vincent’s Clinic.

Why did you decide to develop your particular project?

In 2008, three weeks into my first year of medical school, Hurricane Ike struck and our world was turned upside-down. We have been adapting and struggling to keep pace with the community’s rapidly changing needs ever since.

As a provider [at St. Vincent’s Clinic], you want to be encouraging about maintaining a healthy diet and reducing total caloric intake—but many Galveston families find themselves struggling as they deal with the wake of a natural disaster, large-scale layoffs, and a depressed job market. Trying to lose weight moves to the bottom of the priority list when a person is worrying about how to pay the bills in the coming months.

And even if providers can get their patients excited about improving their diets, the social barriers are often too unforgiving. In Galveston, a majority of low-income neighborhoods are food deserts. All of the local grocery stores are miles away, and local corner stores full of non-perishable foods dominate the marketplace for most of my patients. Since many of them have no transportation, obtaining fresh fruits or vegetables requires a taxi service or reliance on a limited public transportation system.

With Galveston still recovering from the hurricane, I really wanted to bring both gardening and a health curriculum to the population that I serve at the St. Vincent’s free clinic. I wanted to start chipping away at that history of nutritional oppression by helping to support local gardeners to erect teaching gardens, where neighbors could come discover the joys of raised bed gardening, while taking advantage of a culturally-sensitive curriculum created to inspire dialogue. Most importantly, I wanted to create a space where people could grow, learn, heal, eat, and commune with nature and each other.

Gardens can provide everything necessary for maintaining good health. Exercise is simply a requirement of community gardens, including everything from construction and maintenance to turning compost. Each morning when you head out to water, you either find yourself alone in the midst of the beautiful life cycle of different species of plants or taking advantage of a wonderful opportunity to communicate with neighbors that you never “had time” to get to know in the past. I have found that gardening crosses all political and social lines. The simple fact is that everyone looks the same covered in dirt. The inherent complexity of gardens fills all of the awkward pauses and unites everyone in awe.

In a garden, you are surrounded by food, but it is fresh, delicious, healthy food that offers many opportunities to address issues like proper fiber intake, caloric density, or even vitamin D absorption from being outdoors. From nutrition, it is just a short hop to health goals, a skip to tying in cultural roots, and a jump to community-building.

What do you hope will be the lasting impact of your project on the community it serves?

I have lofty goals for my project, but I am realistic enough to understand that there are roadblocks around every corner. I am fortunate to have a great set of mentors and the support of key people in the community. In the long run, I am hoping to have two community gardens set up in the most economically disadvantaged sections of Galveston.  At this point, both of them are approximately half-complete, one with 21 of 43 4×8 beds, and the other much smaller garden with about 8 of 11 beds finished.

Once both gardens are complete, planted, and being run by community members, I will begin a joint effort to bring together experts and community members to talk about health concerns and goals through a series of workshops. It is important to address the issues that the community is most worried about. There is a great deal of evidence demonstrating how health behaviors directly affect long and short term health outcomes, but if there is no passion coming from within the community, then generating interest must be the first step.

This project is a small piece of what should eventually be a large-scale, locally supported, national movement. Imagine what could be achieved if neighborhoods shared a common goal of eating healthy, locally grown foods, and the more fortunate members of the community provided the necessary but minimal capital required to create gardens and resources which the entire community could enjoy! For community members tormented by oppression and struggling in the present economy, a community garden can act as a life-preserver for health, pulling people away from the comfort and distraction of televisions with enough engagement and a proper foundation to address long-term goals.

What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?

Our diet and popular behaviors surrounding eating. Portion control and calorie counting are still the gold standard for bringing a conscious desire to lose weight into reality. But  unfortunately, weight loss has become a big business and everyone is looking for the ultimate panacea. It is easy to lose sight of the one essential thing that is missing.  In a world of abundance, a conscientious approach combined with a supportive social environment is paramount. Obesity and our social-cultural condition have become recursively intertwined, and when one looks at the trajectory of medicine, it appears that many people are looking to clinical research in addiction and psychiatry as hopeful end-game solutions. The facts have remained the same, however. I believe that obesity is the result of abundance, most of which we have subsidized into existence, and it is more important now than ever before to come together as communities to create activities that support a healthy lifestyle.

What has been the most surprising element of your experience as a Schweitzer Fellow?

As a Schweitzer Fellow, I have been most surprised by the cyclical nature of my experience. There can be periods of time where nothing seems to be going right, followed by long periods when multiple opportunities line up to make your project work. It is a great feeling when the planning finally pays off in the end, somehow leveraging each success to garner another. Finding community resources and juggling a budget while coordinating large groups of volunteers and trying to focus on the real people in the community can become overwhelming fast, but it is worth it when I get to see one of my major goals come to fruition.

What does being a Schweitzer Fellow (and, ultimately, Fellow for Life) mean to you?

Once I heard about the program, becoming a Schweitzer Fellow meant a life long journey of prioritizing serving others outside of the clinic. I firmly believe that if you want to serve others, then the optimal time to start is during school. While the thought of sometimes having to choose between school and one’s ultimate ambitions to serve can be daunting, it is much more difficult to make service a priority once your professional life unfolds.

I had to apply to the Fellowship twice in order to be accepted, and I was and am incredibly happy to have the privilege to participate while I am still in medical school.  Simply preparing my application took me down a rewarding path of meeting people who have become an essential part of my life. I have learned so much since I began that process, and I look forward to the day when I can serve as that crucial link for another ambitious student looking to change the world. I was so lucky to find mentors who were not cynical but emphatically optimistic. Empowering others is a skill that is a priceless quality, and I hope to both learn it and pass it on to future generations.

David Darrow is a Houston-Galveston Schweitzer Fellow. Click here to read more about The Albert Schweitzer Fellowship (ASF)’s Houston-Galveston Schweitzer Fellows Program and the Fellows like Darrow it supports in creating and carrying out yearlong direct service projects that improve the health and well-being of vulnerable people and communities. To make a gift to in honor of Darrow, click here.

Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.

Several weeks ago, the Associated Press reported that many of America’s 1.5 million gay senior citizens struggle with discrimination and isolation:

Experts say many gay, lesbian, bisexual and transgender seniors fear discrimination, disrespect or worse by health care workers and residents of elder housing facilities — ultimately leading many back into the closet after years of being open.

…

Gays are also less likely to have biological family to help out with informal caregiving, either through estrangement or being childless, making them more dependent on outside services. And that makes them more vulnerable, SAGE executive director Michael Adams said.

“They cannot at all assume that they will be treated well or given the welcome mat,” he said.

But established and emerging health and policy professionals throughout the country are working to bring these issues to the forefront — and on Wednesday, Jan. 25, the 2011-12 class of Chicago Area Schweitzer Fellows will continue the conversation. Their free, public symposium called “Aging With Pride” will focus on the health issues facing LGBT older adults.

Guest speakers will include:

Magda Houlberg, MD
Chief Medical Officer
Howard Brown Health Center

Cecilia Hardacker
LGBT competency trainer
Howard Brown Health Center

Light refreshments and snacks will be served. R.S.V.P. strongly encouraged. Please reply to rsvp@hmprg.org or 312-372-4292 ext. 24

Wednesday, January 25th, 2012
5:30 – 7:30pm
Rush University, Room 976
600 South Paulina St., Chicago, IL 60607

Support for this event is provided by the Rush University Interprofessional Learning Series on Improving Health Access, Equity and Outcomes for All People.

To view a flyer with full details, click the below link:
Schweitzer Symposium -Aging With Pride

This weekend, we’ll honor two extraordinary leaders whose commitment to service was equaled only by their compassion for all living beings. Tomorrow (January 14) is Albert Schweitzer’s birthday, and Monday (January 16) is Martin Luther King, Jr. Day.

It will be a reflective weekend, for sure—when it comes to achieving health and social equity for all, we have a long way to go. It’s easy to feel frustrated, to get burned out, to question whether your actions (and those of your peers) are having any lasting impact on individual lives, let alone entire families, entire communities, or entire health and social systems.

But at those low moments, a support network that shares your vision and your commitment can help to revive the glimmer of optimism that’s necessary to sustain a life of service. (That’s where the Schweitzer Fellows for Life network—and connections with other smart, passionate, and inspiring champions for change—come in.) And by focusing on a particular issue that you care deeply about and have the skill set to address—instead of trying to change everything, all at once—you’ll forge a path forward that is sustainable and personal and full of promise.

Albert Schweitzer called that “finding your own Lambarene”—that place or issue or calling where your skills and passions intersect in a way that makes a positive difference in the world around you. You’ll encounter boulders along the way. But when you do, you’ll build the strength to move past them. You’ll arrive at the answer to what Martin Luther King, Jr. called “life’s most persistent and urgent question: what are you doing for others?”, and you’ll move forward and far in accordance with the wisdom of these two great humanitarians:

“Everybody can be great, because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and verb agree to serve. You only need a heart full of grace. A soul generated by love.” – Martin Luther King, Jr.

“The only ones among you who will be truly happy are those who have sought and found how to serve.” – Albert Schweitzer

Visit http://mlkday.gov/ to learn about the Martin Luther King, Jr. Day of Service.

Visit www.schweitzerfellowship.org to learn about The Albert Schweitzer Fellowship.

"The responsibilities many of these kids had to bear at young ages was shocking to me, and their strength with dealing with major life issues was truly inspiring," McNerney says.

“‘Troubled teens’ are very much still developing—not in a permanent state of misbehavior, as they are sometimes treated,’” says Kevin McNerney, a Schweitzer Fellow at Dartmouth Medical School who partnered with Second Growth to implement an education and mentoring program for adolescents struggling with substance abuse issues (some of whom were in diversion programs).

Why did you decide to develop your particular project?

Substance abuse is a target for me because its negative effects on health are a mere fraction of its total devastation. While substance abuse can quickly and easily lay waste to body and mind, it is also the cause of immeasurable pain to those who are close to the casual users, the dependent, and the addicted.

Having seen or heard stories of kids raised by grandparents because both parents were deemed unfit to raise their children due to their habit, stories of wives left behind or abused by alcoholic husbands, stories of high school students driving fast into telephone poles while drunk, stories of young children going to juvenile detention centers for dealing drugs, I’ve recognized the extreme consequences of substance use.

Of equal importance, I’ve seen the slow decline that chronic substance use insidiously facilitates. There is a gradual loss of concentration, motivation, personality, and empathy.  These deficits lead to lower grades, loss of employment, divorce, and less satisfying relationships of any kind. The prevalence of substance abuse is staggering, and its consequences are often irreversible.

Irreversible consequences sounded like a smart thing to prevent—so my project is aimed at substance abuse prevention for youth.  According to the Valley News, Vermont leads the U.S. in underage alcohol use in the 12-20 age group, and New Hampshire leads in ages 18-25. There couldn’t be a better location to work on a project aimed at changing attitudes towards substance use and preventing initiation.              

What do you hope will be the lasting impact of your project on the community it serves?

The program I led with summer camps is called Peer Leadership Activities for Youth (PLAY). It is a program centered around recognizing personal assets, practicing refusal skills, evaluating sources of information, working as a helpful member of a team, and communicating effectively—lessons that can be applied immediately and continued throughout life. I also mentored five adolescents in diversion programs for a minimum of six weeks each, addressing topics including personal vulnerabilities, reasons for use, and the benefits of living substance free.

I hope that my project’s impact will be seen when the youth who participated in the camp programs I led, and those that I mentored, grow into productive and substance-free adults.  My hope is that they will continue to recognize and apply their talents and assets to better themselves and those around them.

A motivational poster created by the adolescents McNerney mentored.

In addition to the lessons that the PLAY program instilled in children from each of the summer camps, I also facilitated the making of 2 murals containing pro-health and anti-drug messages. The kids decided on the message they wanted to send to their peers, and then got to see the murals installed in their school and a local recreation center. On one mural, the messages had a theme of “Save the Place Around You” and included: “Cool Cats Recycle, Go Green!,” “Respect Your Body, Don’t Do Drugs!” and “We Stick Together, Stop Bullying!”  The process of creating the murals will help the messages to stay with these children, in addition to teaching them that they have a voice and can play a positive role in their community. Additionally, for other students at the school, seeing the murals every day is a great reminder of what healthy and inspired minds can create.

What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?

I think that the most pressing health-related issue of our time has less to do with the health care system than the economic situation of a large percentage of the population.  According to a Small Area Incomes and Poverty Estimate Report in 2009, the majority of the U.S. population lives in counties that have poverty rates between 10 and 20 percent.

How do I see this relating to health? Food insecurity, lack of access to medical care, not having health insurance, fear of exercising outdoors, familial instability, prevalent substance abuse, and stressful lives lay behind an incredible array of health issues. In the U.S., those living in poverty have higher rates of obesity (women only), chronic kidney disease, poor mental health, hypertension, and diabetes, just to name a few.

How to address this issue?  Having an opinion that is far from expert, I would suggest that lowering unemployment and poverty in the U.S. needs to begin with education reform. The inequality in education and lack of upward social mobility in those who receive poor education is appalling. Social reproduction is rampant, and those at the bottom are continually let down due to a lack of resources, opportunity, and guidance.  Programs like KIPP, a network of open-enrollment college preparatory schools, have had huge success with high school and college graduation rates for students in underserved communities. Community colleges make an incredible difference as well.

A major step towards narrowing the gap between the rich and the poor will be to make more quality educational opportunities available for underserved people. Quality school systems and more community colleges in low-income areas provide opportunities for development that can strengthen communities and our nation as a whole. Education is an important area to target because it is where people learn to set goals, gain discipline, interact with others, discover what motivates them, and, importantly, learn the material. Development in so many areas happens during school, and lack of development results in unemployment, poor health, and unsatisfying lives.

What has been the most surprising element of your experience as a Schweitzer Fellow?

The most surprising, and encouraging, aspects of my project so far have come from my interactions with kids sent to Second Growth through diversion programs. The surprising and encouraging part is related to the strength and resilience of these adolescents, many of who have come from very difficult situations. The responsibilities many of these kids had to bear at young ages was shocking to me, and their strength with dealing with major life issues was truly inspiring. Hearing about the lives of these children taught me much about the impermanence of behavior throughout life, and also the impact that an unstable family or school setting can have. “Troubled teens” are very much still developing—not in a permanent state of misbehavior as they are sometimes treated.

What does being a Schweitzer Fellow (and, ultimately, Fellow for Life) mean to you?

The greatest meaning that being a Schweitzer Fellow holds for me is belonging to a group of very motivated, intelligent, and selfless people. Hearing about all of the great things that Fellows are accomplishing or have accomplished is an endless source of inspiration. It is an honor to call myself a member of such a group.

Being a Fellow for Life means always making service a part of my life. The memory of the year that I devoted 200 hours to a service project will give me confidence to put myself out there and do it again in the future. As time progresses and areas that need improvement are encountered, I will look back on my experience and remember that life’s satisfaction comes from striving to meet societal needs, not simply recognizing them.

McNerney is a New Hampshire-Vermont Schweitzer Fellow. Click here to read more about the New Hampshire-Vermont Schweitzer Fellows Program and the Fellows like McNerney it supports in creating and carrying out yearlong direct service projects. To make a gift to The Albert Schweitzer Fellowship in honor of McNerney’s efforts to prevent substance use among at-risk adolescents, click here.

Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.

Nobel Peace Laureate and a pioneering physician-humanitarian Dr. Albert Schweitzer was one of the 20th century’s most admired global citizens.

The Albert Schweitzer Fellowship (ASF) today announced the launch of its Schweitzer Leadership Awards, which will recognize individuals local to ASF’s 13 U.S. Program sites whose life examples have significantly mitigated the social determinants of health in their communities, and whose commitments to service have influenced and inspired others. The award bears the name of Nobel Peace Laureate Dr. Albert Schweitzer, a pioneering physician-humanitarian who was one of the 20^th century’s most admired global citizens.

“Especially with the hundred-year anniversary of Dr. Albert Schweitzer’s iconic hospital in Africa approaching in 2013, we are thrilled about this opportunity to honor individuals who are following in his footsteps at a local level,” says ASF President Lachlan Forrow, MD, Director of Ethics and Palliative Care at Beth Israel Deaconess Medical Center. “We look forward to honoring leaders who have taken great strides towards achieving health equity in their communities, and who are inspiring our Schweitzer Fellows and many others as they work to do the same.”

Schweitzer Leadership Award nominations are open to the public. To submit an online nomination, please visit http://svy.mk/SchweitzerLeadershipAward (the nomination period closes on March 1, 2012).

Local ASF program directors and their advisory boards will make final selections. Only individuals who live and/or work in the regions where ASF has program sites (Baltimore, MD; San Francisco Bay Area, CA; Boston/Worcester, MA; Chicago, IL; Columbus/Athens, OH; Greater Philadelphia Area, PA/NJ; Indiana; Los Angeles, CA; New Hampshire/Vermont; New Orleans, LA; North Carolina; and Pittsburgh, PA) are eligible for nomination and selection.

Each year, approximately 250 multidisciplinary graduate student Schweitzer Fellows at 13 ASF program sites throughout the U.S. partner with community-based organizations to develop and implement yearlong, mentored service projects that sustainably address the social determinants of health (including poverty, the environment, and education). That service experience—coupled with ASF’s reflective leadership development programming—equips Fellows with the confidence and skill to address not just the clinical health needs of underserved people, but also the underlying social factors.

The Schweitzer Leadership Award will be presented at each program site’s Celebration of Service (the event marking the culmination of the Fellowship year). Exact details will vary by location, but in general, the Award package will include:

• The opportunity to deliver a brief keynote speech at the Celebration of Service;
• Special recognition at ASF’s annual national conference (to be held in Boston on Nov. 2-3, 2012).
• A physical Schweitzer Leadership Award plaque/trophy;
• A day of service at the recipient’s chosen nonprofit/charity organized by the local 2012-13 class of Schweitzer Fellows; and
• Coverage across ASF’s communications platforms.

Please contact info@schweitzerfellowship.org with any questions regarding the Schweitzer Leadership Awards.

"Being a Schweitzer Fellow is a way of life," Becerril says. "It is an affirmation and commitment that I have made to a life of service and solidarity with those whom I know and will come to know through my work."

Schweitzer Fellow and Rush University Medical College student Jordan Becerril grew up in a stable home with parents who supported him throughout his childhood and adolescence—but from an early age, he remembers feeling “different.”

“It was a struggle that my attractions didn’t match up with the lifestyle I had been raised to be a part of,” Becerril says. “So my time of getting away from my family when I went off to college was a huge part of my own self-discovery and self-acceptance. College and higher education allowed me to figure out how I saw myself fitting into society.”

As a Schweitzer Fellow in Chicago, Becerril has dedicated himself to supporting homeless and low-income LGBT (Lesbian, Gay, Bisexual, Transgender) youth in achieving what he hopes will be similarly powerful educational opportunities.

Partnering with the Center on Halsted, Becerril has established programming offering one-one-one coaching on finding GED prep programs, applying to college, creating resumes, completing job applications, and connecting with other resources.

­Why did you decide to develop your particular project?

In many ways, my project found me. When I started medical school, doing a 200-hour community service project wasn’t on my radar. But one of my mentors, Sharon Gates, knew of my interest in helping other Rush students learn more about LGBT (Lesbian, Gay, Bisexual, Transgender) health. She recommended that I consider the Schweitzer Fellowship.

In determining what my Schweitzer project would be, I did some soul-searching and found myself coming back again and again to working with homeless or low-income LGBT youth. Growing up, it was always a concern of mine that if my parents found out about the “real” me, I would be disowned and lose all my friends, and the life I knew would be, for all intents and purposes, over. It was that fear that kept me from accepting myself, that made me pray and hope that the feelings would just go away, that influenced me to move away for school, and that kept me from coming out to my parents until I had managed to gain some financial stability.

These are fears that no child should have to worry about—but they are all too real to some LGBT youth who are completely disowned by any family they have and are forced to start all over with nothing. It was this population—LGBT youth who are low-income or homeless—that I found myself called to work with.

I’ve learned from experience that when attempting to go into an unfamiliar community to help solve a “problem,” there’s a right way and a wrong way to go about doing it. During my time studying abroad in El Salvador, I remember a particular quote that was on the wall of one of the student houses. It read, “If you have come to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us walk together.”

This quote came from Lila Watson, an Australian Aboriginal woman, in response to mission workers. It has guided my project. Based on my own experience and development—in which an undergraduate education was pivotal—I initially thought that my project would focus on equipping homeless and low-income LGBT youth with the tools to succeed in applying and getting into college. There would be field trips to undergraduate institutions, sessions on financial aid, panel discussions involving undergrads from Chicago institutions who were involved in their respective LGBT groups who could talk about just how impactful going to college had been for them—all leading to youth who were inspired to go to college and live wonderful and fulfilling lives.

But this plan quickly changed as I realized all the hurdles these youth were up against and how many of them had not yet completed high school or attained their GED. The focus of the project became much more personalized as I sought to work one-on-one with these youth to address their particular goals and needs.

What do you hope will be the lasting impact of your project on the community it serves?

I hope that the lasting impact of the project is that those whom I’ve worked with, and whom my successor will work with, will be impacted and empowered.

I think one outcome of my project I hadn’t anticipated has been the effect that it has had on how the youth programs and vocation programs at the Center on Halsted interact. In meeting with my supervisor early on and distilling my Schweitzer proposal to meet the needs of the Center on Halsted, we found that by working on behalf of the vocational team within the youth space during Breakfast Club helped to bridge a gap that had existed between the two teams. Breakfast Club is a morning program at the Center on Halsted where “young adults between the ages of 18-24 are invited to be connected to resources designed specifically for LGBTQA young adults including legal support, health care and housing referrals. In addition, hot breakfast is served.”

This time had traditionally been fairly unstructured, and it was a great opportunity to interact with the youth and engage with them on issues of education and vocation. My time was spent interacting with youth in the mornings and setting up one-on-one appointments with them to work on resumes, find a GED prep program, apply to college, complete job applications, and connect them with resources to help them achieve their goals.

What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?

I think that access to water that is clean and free from contaminants is one of the true limiting factors plaguing developing nations. It has been a concern highlighted by the recent worldwide population milestone of seven billion people. While some developments in methods for cheap and reliable purification systems have been made recently, the issue of finding clean water continues to hinder the health of so many.

Addressing this concern will take continued innovation as well as the support of nations who have the luxury of readily accessible purified water. Innovation will be required to continue to search for effective and reliable methods of bringing clean water to those who need it, and to do so in such a way that is affordable and sustainable. Continued support from developed nations will be pivotal in accomplishing this innovation, as well as in financing and developing research and implementation. Access to clean, contaminant-free water is not an easy problem to address, as is evident in the prevalence of diseases like cholera, parasites, and other pathogens in countries as close to us as Mexico.

What has been the most surprising element of your experience as a Schweitzer Fellow so far?

One unexpected outcome of my project was how my work would impact my supervisor, Lynnea, who made my goal of sustainability incredibly easy. Anticipating my hours at the Center dwindling as medical school once again took over my life, she was already putting out a job posting mid-summer for a social work intern to sustain the project. Now, thanks to her efforts, Michaela—a MSW intern from Loyola—has been doing an amazing job. She continues to conduct outreach at the Center on Halsted’s Breakfast Club and plan field trips for the youth, and has even made plans for bigger and better things—such as a resource guide for youth interested in obtaining their GEDs.

What does being a Schweitzer Fellow (and ultimately, Fellow for Life) mean to you?

Being a Schweitzer Fellow is a way of life. It is an affirmation and commitment that I have made to a life of service and solidarity with those whom I know and will come to know through my work. It has strengthened my resolve to work with youth who deserve the best but haven’t been given it, at no fault of their own. Being a part of this community, for life, means that wherever I end up, I will be tapped into an inspiring network of individuals working towards a common cause, and will have the resources to continue the mission of the Fellowship.

Jordan Becerril is a Schweitzer Fellow in Chicago. Click here to read more about the Chicago Area Schweitzer Fellows Program and the Fellows like Becerril it supports in creating and carrying out yearlong direct service projects that impact the health of vulnerable communities. To make a gift to the Chicago Schweitzer Fellows Program in honor of Becerril’s efforts to empower homeless LGBT youth in Chicago, click here.

Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.                                                                                                                                                                                                                                                                                                                                                                                                                                                  

According to the Robert Wood Johnson Foundation and the American Medical Association (AMA), “85% of primary care physicians and pediatricians say their patients have health concerns caused by unmet social needs” — but only 20% of physicians feel equipped to address those needs:

“This should not be a big surprise. … Primary care physicians aren’t trained to address these issues,” said Jane Lowe, PhD, a senior program officer at the foundation.

Here at The Albert Schweitzer Fellowship (ASF), we’re working to change that. Fellow by Fellow, partnership by partnership, we’re developing a health professional workforce that is dedicated to (and skilled in) understanding and addressing the social determinants of health — not just clinical health issues.

We’re starting off 2012 with a new one-pager about our U.S. Schweitzer Fellows Program.  Click here to download it and learn about the ways we’re working toward a world where the social determinants of health are both understood and mitigated by health professionals.

"The more empowered a person feels when making their choices, the happier and more willing they are to continue moving in the right direction," Russell says.

Kenneth Russell enjoyed his time in corporate America working for Intel and NASA—but something was missing. So he made a mid-career U-turn, building on his desire to improve the health of underserved people and enrolling as a nursing student at Samuel Merritt University.

Now, as a Bay Area Schweitzer Fellow, Russell—who will complete his Master of Science in Nursing-Case Management this May—is partnering with the Intertribal Friendship House in Oakland to carry out comprehensive health education and screenings for Native American individuals.

“This is a perfect way to actually get some external experience; gain insight into some of the challenges of working with non-profit, local, and state government agencies; and understand how various systems create multi-faceted challenges for members of my project community,” Russell says.

Why did you decide to develop your particular Schweitzer project?

I decided to develop this project because the Native American population continues to be underserved both in Oakland, California and throughout the U.S. I saw an opportunity to empower this particular community through education sessions on healthier living choices, diabetes, hypertension, nutrition, exercise, depression, and stress management. Especially with California facing some of its worst economic times, my Schweitzer project focuses on information and choices that do not necessitate spending more money when personal budgets are already stretched to the limit.

My program also incorporates local businesses that focus on increasing activity levels. From aerobics to zumba, these businesses give brief demos of their programs. This way, the members can sample many different activity choices in which they may have an interest, and they can do it all from one location: their own community center.

What do you hope will be the lasting impact of your project on the community it serves?

A community that is empowered to not only recognize and integrate healthier living choices into their everyday regimen, but also be able to educate other community members using an “each one, teach one” methodology.  Not only does this strengthen the community as a whole, it also takes back ownership for one’s holistic health and well-being. The more empowered a person feels when making their choices, the happier and more willing they are to continue moving in the right direction.

What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?

I think that obesity—which is directly related to our ever-increasing sedentary lifestyle (longer hours at work, depression from loss of a job, etc.)—will continue to be at the top of the list. We have to find the time to take that first step into taking responsibility for our own health. We know that obesity leads to so many other health problems, and by losing just a few pounds, we can lower our susceptibility risk in several of these areas. We have to get America moving again!

What has been the most surprising element of your experience as a Schweitzer Fellow?

The most surprising element has been working with non-profit organizations and bridging the connection between them and the Native American people my project serves. Prior to my Fellowship experience, I heard many negative things about working with small non-profit organizations.  I am so glad that I had the opportunity to work with some before graduation, because I have found that there are many wonderful small non-profits out there. One example is the EyePACS program, whose CEO is Jorge Cuadros, OD, PhD of the University of California at Berkeley. EyePACS is a non-proprietary web-based application for exchanging eye-related clinical information, and it is especially useful in diabetic retinopathy screenings.

When an eye screening event I was planning was almost cancelled at the last minute due to external factors, I connected with Dr. Cuadros. I was able to explain what we were trying to accomplish with the event, and without hesitation, he stepped right in and provided the mobile equipment and two students to help manage the tool. This was such a huge win for a community that was already thinking that this would be another missed opportunity.

This was such a valuable experience for me because it really changed my thinking in regards to how I can approach other services and non-profit organizations and link them to the community I am serving.

What does being a Schweitzer Fellow (and, ultimately, Fellow for Life) mean to you?

This is such a wonderful honor that I almost cannot capture the emotion with words. Let’s see if I can give it a go.

The Fellowship is an opportunity to gain experience dealing with so many entities that are—or, in some cases, are not—working in synchronization. I see an opportunity to speak for those who may not have the means to have their voices heard. I see the opportunity to impart information to those who may not know where or how to find that information. I see the world getting smaller, but the challenges getting bigger. I see myself as one of those taking a few steps to help move those who may be somewhat less fortunate into an area where life hands them just a few less hardships.

Russell is a Schweitzer Fellow for Life in California. Click here to read more about the Bay Area Schweitzer Fellows Program and the Fellows like Russell it supports in creating and carrying out yearlong direct service projects that improve the health and well-being of vulnerable communities. To make a gift to The Albert Schweitzer Fellowship in honor of Russell’s efforts to empower Oakland’s Native American community, click here.

 

Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.