Rebecca Wehrly ’06 has majored in Sociology and has completed the pre-medical curriculum at Dartmouth College. She is currently working on a senior thesis, researching lead poisoning, a problem that disproportionately affects children from low-income families in Manchester, New Hampshire. For this project, Rebecca interviewed various stakeholders in medicine, public health, housing, government, and non-profit organizations in order to understand their views of the causes of and solutions to the problem.
In addition to her academic work, Rebecca hopes to draw on her experience with the Dartmouth Policy Research Shop and at RESULTS, an advocacy organization committed to fighting hunger and poverty, in her Olga-Gruss Lewin Fellowship project. At the Dartmouth Policy research Shop, Rebecca researched Medicaid in New Hampshire and Vermont; while at RESULTS she researched federal assistance programs, lobbied Congressional staff members and worked to mobilize volunteers. Rebecca’s prior commitments also include chairing the mentoring program at Sharon Elementary School (in Sharon, VT), chairing the Students Fighting Hunger campaign, and serving as the Navigators Christian Fellowship Service Coordinator. Finally, this past summer, Rebecca volunteered at a prenatal clinic for low-income women and at a community health clinic in pediatrics where she saw the effects of disparities in income, education, and housing on health. These experiences have reinforced her desire to address health issues in low-income communities and have given her a framework she can use to understand health disparities.
For her Olga-Gruss Lewin Fellowship project, Rebecca will partner with Integrated Health Outreach System, an agency in South Texas whose primary mission is
“to create a proactive public health model that will help isolated residents of colonias along the Texas border to enhance their understanding of how to remain healthy or reduce physical and mental health problems, improve their access to appropriate primary care services, and participate in building the capacity of their community to more effectively improve the health of its members.”
Integrated Health Outreach System uses a community health development approach that relies heavily on the work of promatoras, community health workers, who provide both health education and assistance accessing food, clothing, and social services. The primary setting for Rebecca’s internship activities will be the colonias, unincorporated communities along the Texas-Mexico border characterized by high levels of persistent poverty. Residents of colonias often lack plumbing, electricity, access to safe water, and access to affordable, nutritious food. Residents’ lack of resources and lack of knowledge of how to utilize existing services lead to inadequate access to medical care and other health and human services. The lack of access to nutritious food, appropriate space for physical activity, and a regular source of health care creates a situation in which obesity and type 2 diabetes are particularly prevalent.
In this project, Rebecca will first perform an assessment of residents’ needs and the services that they currently receive. To accomplish this community assessment, Rebecca will conduct personal interviews to determine individuals’ beliefs about the causes and consequences of diabetes and their views on appropriate strategies for its management. She will also attend town meetings to learn the communities’ priorities. Only when she understands the unique context of individual colonias and the priorities of residents will Rebecca be able to develop effective interventions. On a daily basis, Rebecca will visit families in the community with promatoras as they provide culturally relevant information to individuals either diagnosed with or at risk for diabetes. With the promatoras, Rebecca will educate families about the causes of diabetes and its management. She will serve as an advocate to link families to existing social services, increasing the ease with which families can access health care. Ultimately, Rebecca hopes to empower families to improve the health of their families and of the community.
After gaining an understanding of the context of the colonias from the community assessment and from working with promatoras and families, Rebecca will examine innovative options to provide care for diabetes in communities of high and persistent poverty. She will recommend new strategies as she identifies interventions that could improve the health of residents of the colonias. Rebecca will collaborate with and train promatoras to implement these interventions. In order to make these strategies to prevent and manage diabetes sustainable, she will embed these interventions into existing community structures.
The Olga-Gruss Lewin Fellowship allows Rebecca to participate in activities that combine her interests in social and biological sciences, with the goal of addressing disparities in health. After completing the project, Rebecca would like to enroll in a joint medical and public health (MD/MPH) program. Her ultimate research and practice goals are to address the influence of environmental factors on health within families. Rebecca hopes to eventually work in a community health clinic in Texas practicing pediatrics and designing and implementing community outreach programs.
