On a hot, sunny June day, George Washington University (GW) School of Medicine and Health Sciences (SMHS) third-year MD students stood in a garden in northeast Washington, D.C., listening to the president, Ronnie Webb, and deputy director, Jerome Nesbitt, of nonprofit The Green Scheme talk about how the organization brings people from Ward 5 together to achieve one goal: access to healthier foods.
Just an hour later in southeast D.C. at the Washington Nationals Youth Baseball Academy, another group of students heard from residents of Ward 7 about the challenges to healthy lifestyles that the community’s residents face.
The visits occurred throughout the District on June 20 as part of the Clinical Public Health Summit on Obesity for the MD Class of 2019. During the three-day summit, students learned about the population health dimensions of obesity, a growing health issue throughout the United States. In interacting with leaders of the communities that surround GW, students saw first-hand the issues impacting their patients — as well as what can be done to address those issues.
“You need to learn how to be an active participant in developing both community and population-level interventions, programs, and policies that promote healthy weight in the populations and communities you serve,” Lawrence “Bopper” Deyton, MD ’85, MSPH, Murdock Head Professor of Medicine and Health Policy, senior associate dean for clinical public health, and professor of medicine at SMHS, explained to the students at the start of the summit.
The students were split into six groups, each one assigned to understand the factors that promote increased risk of obesity in a specific DC Ward and specific a specific age group – and how to improve them. The groups included preschool-aged children living in Ward 1, children 5 to 11 years old in Ward 4, 12 to 17 year olds in Ward 7, 18 to 34 year olds in Ward 2, 35 to 64 year olds in Ward 5, and reproductive women ages 18 to 50 in Ward 8.
In addition to the site visits, students heard from experts in the field, including Ruth Perot, co-founder and executive director/CEO of the Summit Health Institute for Research and Education (SHIRE); Aaron Doughty, SHIRE Wellness Circle participant; Marcus Andrews, presidential administrative fellow at the GW Rodham Institute; and Pam Hess, executive director of the Arcadia Center for Sustainable Food and Agriculture.
Kofi Essel, MD ’11, MPH ’17, general academic pediatrics fellow at Children’s National Health System (Children’s National), who helped direct and organize the summit, told the students to “think beyond the individual, into the community and population.”
“We want you to become the 21st century clinician and go beyond the office, into the health system and the communities, and we want you to go beyond clinical care to advocacy, leadership, and [health] system change,” he said.
Essel added that SMHS is embarking upon an innovative method of training using immersion to teach students about the social cultural influencers of obesity through the summit.
Using information gleaned from their first two years of medical school and from the site visits, the students developed and presented innovative proposals on how to increase healthy foods, decrease unhealthy foods, and increase physical activity by working alongside the communities for their age groups.
MD student Michael Froehlich, who worked with the Ward 7 group, said the site visits “helped to make the issues more real on a personal level and … helped drive us to create not only an innovative proposal, but also a realistic one.”
“We were able to put together a proposal that has a high likelihood of being implemented, and one that will address some of the day-to-day issues that those in the community want addressed but don't get the attention that they deserve or require,” he added.
The proposal included creating cooking classes for teens and their parents or caregivers in the kitchen of the Washington Nationals Youth Baseball Academy, an educational program in Ward 7 high schools that teaches teens about the negative effects of unhealthy eating, and increased advertising and marketing for the organization’s baseball and softball programs as a way to increase physical activity among high school-aged residents.
Students from the Ward 5 group also took to heart the advice from The Green Scheme Deputy Director Jerome Nesbitt on the importance of community in promoting healthy lifestyles. “The garden breaks down barriers, and there are many different generations involved, including people who have lived in the neighborhood for decades and those who have only been there a few years,” he said, standing between plots of plants and flowers at the community garden site on 20th Street NE.
Reflecting that, the students’ proposal focused on bringing community members together through educational sessions on mindful eating and the development of a mobile app and text service to help community members get information about local farmers’ markets.
Review committee members listened intently to the students’ presentations and offered both praise and recommendations on the proposed plans. Committee members included Andrews; Bill Dietz, director of the Sumner M. Redstone Global Center for Prevention and Wellness at the Milken Institute School of Public Health at GW; Erin Kennedy Hysom, MPH, RD, public health dietitian and program analyst at the Maryland Department of Education; Yolandra Hancock, MD, MPH, community pediatrician and pediatric obesity expert; Patty Nece, JD, Obesity Action Coalition national board member; Ambrose Lane Jr., chair of the Ward 7 Health Alliance Network; and Yolanda Lewis-Ragland, MD, pediatric obesity expert and assistant professor of pediatrics at Children’s National.
The public health summits — which also include programs on creating an AIDS-free generation and on eliminating childhood asthma in D.C. — are student Kami Veltri’s favorite part of the MD curriculum. “They allow us the opportunity to engage with our local communities beyond the boundaries of our academic institutions, offering a firsthand view of what’s happening upstream from where we stand in our hospitals and clinics,” she said. “With this wider angle, we can focus on preventive medical interventions — interventions inspired and implemented by the community members themselves.”