In Waterloo, what is the third most commonly used language after English and Spanish? You might be surprised to learn that it’s Bosnian. In Davenport, the third most common language after English and Spanish is Vietnamese. These linguistic facts illustrate how Iowa’s demographics and cultural identities are changing. With these changes, there are new challenges and opportunities in interacting with medically underserved populations.

A breakout group on community and health disparity discussed this topic at the April 8 UI Conference on Obesity. The small-group participants included representatives from the following four colleges: education, medicine, nursing and public health; from Food and Nutrition Services at UI Hospitals and Clinics; and from the Iowa Department of Public Health. (List of specific attendees is provided at the end of this summary.)

The group discussed current research and intervention efforts in schools and communities and noted the need to learn more about what problems different groups are having accessing health services or adopting healthy lifestyles. The group also discussed that even when there is access to health services, outcomes can vary, not just because of language but also cultural, socio-economic and personal differences.

“What people take home from a clinical setting interaction or other setting depends significantly on their home environment,” said Lisa Skemp, assistant professor of nursing, who co-facilitated the breakout group. “Understanding what influences people to make changes is essential to helping them make changes.”

Group participant Helena Laroche, a UI associate in internal medicine, said an overall goal in addressing issues of obesity is to “make the healthy path, the easy path.”

The group also discussed how community research and interventions require building trust and should include measures for sustainability of health efforts once a research project is over, so as not to “abandon” communities.

This group identified two possible avenues of research:

•Providing interventions, such as a “healthy living/health eating” referral service, to underserved community members who are seen in emergency treatment centers; and
•Studying and identifying environmental changes in schools that could also promote healthy habits. This type of research could be conducted in partnership with the UI Prevention Research Center and with “Iowans Fit for Life,” an existing program at the Iowa Department of Public Health.

Faryle Nothwehr, group co-facilitator and director of the UI Prevention Research Center, said the center is ready to partner with CTSA projects. The Prevention Research Center, one of 33 such centers nationwide funded by the CDC, focuses on rural health.

In addition, group participant Joe Coulter, associate dean of public health, co-directs a CTSA community engagement key function that can help bring together efforts to address community and health disparities

Attendees
Greg Bell, clinical assistant professor of emergency medicine, UI Carver College of Medicine
Joe Coulter, associate dean and professor of behavioral and community health, UI College of Public Health
Dennis Haney, community health consultant, Iowans Fit for Life (CDC-funded), Iowa Department of Public Health
Donna Hemingway, dietitian II, Food and Nutrition Services, UI Hospitals and Clinics
Helena Laroche, associate in internal medicine, UI Carver College of Medicine
Faryle Nothwehr, associate professor UI College of Public Health and director, UI Prevention Research Center
Lisa Skemp, assistant professor, UI College of Nursing
Ida Spruill, graduate fellow, UI College of Nursing
Don Yarbrough, director, Center for Evaluation and Assessment, UI College of Education