Campus News

Med students see firsthand how social factors impact health care

Image of Promiseland Missionary Baptist Church on High Street.

The Promiseland Missionary Baptist Church on High Street was the setting for one session of the medical school's first Humanities Day, an effort to show students firsthand the social and cultural factors that influence health. Photos: Douglas Levere

By ELLEN GOLDBAUM

Published December 5, 2016 This content is archived.

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“We hope that better understanding of cultural assumptions will aid our ability to form empathic relationships. ”
Linda Pessar, professor emerita of psychiatry and director
Center for Medical Humanities

Pastor Kinzer Pointer stood before the group of first-year students from the Jacobs School of Medicine and Biomedical Sciences who had traveled to the Promiseland Missionary Baptist Church on High Street on a windy, rainy morning to meet him and tour his neighborhood.

“What we want from you is to become excellent medical doctors,” Pointer said. “Consider this an invitation: I invite you to stay with us and grow with us, right here in this neighborhood. There is an absolute necessity for you to do that because in this neighborhood you see people suffering from the social determinants of health in ways that other people don’t.”

The neighborhood is the Fruit Belt, just a few blocks from where the new home of the medical school is being built on the Buffalo Niagara Medical Campus.

The conversation with Pointer was just one of more than a dozen sessions held throughout the city last Thursday and attended by more than 150 first-year students, who put aside lab coats and textbooks and headed into the heart of the city for the medical school’s first Humanities Day.

The goal was to expose students to the social and cultural issues they will encounter with patients throughout Western New York when they start clinical rotations in their third year.

“In order to forge a trusting relationship with patients, students need to have some understanding of the social, economic, psychological and cultural issues that shape them,” said Linda F. Pessar, director of the Center for Medical Humanities and professor emerita of psychiatry.

Linda Pessar listening to Pastor Pointer.

Linda Pessar, director of UB's Center for Medical Humanities, listens attentively to Pastor Kinzer Pointer's detailed history of the Fruit Belt's past, present and future.

“Getting our first-year students off campus and into the city so that they are exposed to some of the challenges our patients face allows us to introduce them early in their professional development to the important goal of better understanding how our patients live,” Pessar explained. “This is a new opportunity, in addition to the others we provide, for our students to actively engage with the city.”

Students began the day by taking part in programs presented by agencies that provide services throughout Buffalo, among them Family Court; the Family Justice Center, which provides free services for domestic violence victims; the Child Advocacy Center; Jericho Road Community Health Center; Lakeshore Behavioral Health; the Arab-American Community Center for Economic and Social Services; Aspire of WNY, which serves individuals with disabilities; and the Western New York Center for Survivors of Torture.

As students who met with Pastor Pointer learned, the needs of community members are great. Students attending a Buffalo Public Schools’ English as a second language program at the Immigration and Refugee Assistance Program Education Center spoke with refugees about their experiences with health care in their home countries and in the U.S.

Others who toured the neighborhood near Martin Luther King Jr. Park on Buffalo’s East Side with Henry Louis Taylor, UB professor of urban and regional planning, and Pastor Dennis Lee of Hopewell Baptist Church experienced firsthand what it’s like to shop in a food desert, an urban area where access to nutritional food is very limited. Their market: a neighborhood convenience store.

Students later reconvened at the medical school for afternoon sessions during which they talked about their experiences from the morning sessions with UB faculty members and community leaders.

During one session, refugee leaders discussed folk beliefs from their cultures, factors that sometimes conflict with American medical practice. Other sessions focused on social factors that impact health care and health disparities, as well as a discussion of implicit bias, during which works of art were used to challenge inherent assumptions and stereotypes.

“We hope that better understanding of cultural assumptions will aid our ability to form empathic relationships,” Pessar says.

The program, which was mandatory for all first-year medical students, stems from last year’s pilot program during which 13 first-year students took part in community immersion activities.

“That experience was so beneficial and profound for students,” Pessar recalls. “They felt it really changed their understanding of medical practice and even, in some cases, made them rethink career plans about which specialties of medicine to pursue.”

She notes the experience led students to realize that some of what they had been taught might not be applicable to certain patients. For example, students are generally taught that if an obese patient visits a primary care physician, the main issue to discuss is a treatment plan for obesity.

“But the students learned that if the patient is a single mother and she is working two jobs and has two small children and the nearest supermarket is two bus rides away, then to start telling her about the risks of obesity and why she should eat better is unempathic and shaming,” Pessar says. “Somehow, there has to be a different kind of engagement.”