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 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.
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