When Barbara Zeller talks about the success of “A Healthier You,” the program she runs at the Free Clinic of Meridian, Mississippi, a particular patient comes to mind.
A middle-aged man with anxiety and depression, his mother often brings him to appointments at the clinic. Before beginning the program, he was significantly overweight, and reluctant to make eye contact or speak to strangers.
A Healthier You is designed to help patients with multiple co-morbidities – serious, concurrent medical issues, such as obesity, hypertension, diabetes, and smoking – to have better health outcomes. The goal is to provide hands-on steps to help people become more active, learn how to make nutritious food choices, and achieve greater health literacy – and, in the process, to help them lose weight, lower cholesterol, and regain control of their blood sugar.
“I have had bad habits all my adult life that lead to high blood pressure, diabetes, and obesity,” Zeller’s patient said. “I tried to change many times, but did not succeed.”
After participating in the program for several months, he’d lost 40 pounds and had success controlling his blood sugar and blood pressure. He’s more willing to speak and make eye contact. “Since I have been participating in AHY, I have had the support of the staff and the other participants,” he explained.
Increasing Knowledge, Improving Health
He’s not the only one. A Healthier You has approximately 120 people – all of them patients at the free clinic – who participate in the group’s activities to varying degrees. Those include exercise classes and walking sessions, lessons in how to shop for groceries at the local megastore and farmer’s market, and classes on stress management, sleep hygiene, oral and eye health, and other essential subjects, taught by medical students at a nearby university.
With support from Teva Pharmaceuticals through the Enhancing Access2Care program and Volunteers in Medicine, Direct Relief is providing $75,000 to the Free Clinic of Meridian to fund the A Healthier You program. In total, eight grantees have received $450,000 through the Access2Care program since 2017.
Among participants, there’s a wide range of enthusiasm and knowledge, according to Zeller. “Some people in our program know what to do – they just need encouragement – and some people have no idea,” she said.
Zeller shows people how to read nutrition labels. During monthly shopping trips, she guides participants – who receive a food stipend from the clinic – in choosing healthy, cost-efficient foods.
For clinic patients, getting healthy comes with a host of challenges. Most of them are low-income but don’t qualify for government-sponsored insurance; one patient said that she “makes too much money to be on government assistance but doesn’t earn enough to pay for health insurance.”
Literacy – in addition to health literacy – is limited for some of the program’s participants. Others lack access to a car or public transportation – one person may drive fellow community members to multiple appointments a day. To counter this, Zeller uses a combination of gasoline vouchers, rideshare apps, and taxis to get patients to their appointments, so that they’ll more successfully manage their chronic conditions.
And Covid-19 has put a damper on some of A Healthier You’s activities. “I feel like an outsider looking in would say, ‘Why aren’t you doing Zoom events?’” Zeller said. But many of the program’s participants don’t have internet access or a smartphone, or aren’t familiar with the necessary technology.
Instead, group members have opted for masks and hand sanitizer so that they can continue walks and shopping trips.
Zeller takes a series of additional steps to help program participants live a healthy life. The clinic has negotiated for reduced costs at a local gym, and some of the program participants “love it and they’ve never had a gym membership. They are really, really trying to go very consistently,” Zeller said.
Participants can take home exercise equipment such as bands, balls, yoga mats, and workout DVDs – a popular option for people who might be self-conscious about exercising in public.
And at classes, Zeller makes an effort to offer a range of healthy new options for people to try – hummus, sparkling water, kale. “Soda and sweet tea are probably a problem everywhere, but they’re a huge problem here,” she said.
She explained that because so few of A Healthier You’s participants have income to spare, she’s concerned they wouldn’t try these things for themselves. This way, “there’s not a risk of spending money on something they won’t like.”
People seem to appreciate the program – and Zeller, who “has been real good at keeping me on track with eating healthy foods and snacks,” one patient said. “I have really learned how to take better care of myself.”