CARBONDALE — Anna O’Malley and Dr. Bria Miller spent Week One in a homeless shelter.
Facing eviction after Week Two, they cashed their social security checks and pawned their possessions to rent a house and secure transportation, food and needed arthritis medication.
O’Malley, a student in the SIU School of Medicine’s Physician Assistant Program, and Miller, a resident in the med school’s Carbondale Family Medicine Program, were assigned to experience life as impoverished senior citizens, as part of a School of Medicine "poverty simulation," Wednesday afternoon in Carbondale.
They were joined by about 80 other Carbondale-based physician residents, physician assistant students and students from other public health majors at SIU, as they stepped into the shoes of low-income American families, struggling to navigate life on a limited budget.
“It’s eye-opening,” O’Malley said. “Growing up middle class, we didn’t have to worry about a lot of these issues. It’s scary to think that there are people living so hand-to-mouth that if one thing goes wrong, you could be down and out.”
In a Student Center ballroom, the students worked together to pay their bills and keep food on the table, while dealing with inconsistent transportation, school closures, medical emergencies and job shortages that could wipe out their savings instantly.
Their incomes and expenses were calculated to be similar to average low-income American households, and many “families” ended up applying for public benefits to help pay for food, utilities or childcare. Others ended up homeless or unemployed.
“As a student, you deal with fluctuations in your budget,” Miller said, “but I never dealt with anything this bad.”
The activity was the latest in a series of SIU School of Medicine simulations that prepare future doctors, nurses and other health professionals to work together to treat patients, and connect them to community services, explained Ruth Heitkamp, of the med school’s Center for Rural Health and Social Services.
It also helps students build empathy and understanding for patients in poverty.
“This is a group of very accomplished students. Still, we have students who have misperceptions about poverty or welfare, students who feel self-conscious asking about issues related to poverty, or who don’t think of poverty as a reason a patient might be acting in a certain way,” said Dr. Christine Todd, Chair of the Medical Humanities Department of the med school, who led the activity.
Data shows poverty has a big impact on health, often in unexpected ways.
Children facing hunger are “more likely to experience developmental impairments in areas like language and motor skills,” according to a School of Medicine fact sheet, and suffer from “more acute and chronic health conditions.”
For older Americans, poverty is considered “a risk factor for declines in mental health,” and there is a gap in life expectancy of 10 to 15 years between the richest 1 percent and the poorest 1 percent of Americans, the fact sheet said.
Paying attention to poverty is particularly important in our region, as the 16 southernmost Illinois counties have a poverty rate 43 percent higher than the rest of the state, and significantly higher unemployment, according to data from the University of Missouri.
As a physician at West Frankfort Family Medicine, located in one of the poorest counties in the state, the School of Medicine’s Dr. Sara Malone has spent more than 10 years working on what students experienced in the simulation.
“Now that I’ve been in practice over 10 years, I have seen the correlation between the poverty level and how children are developing, and where they’re at in school,” Malone said. “I have people in my office that have to make that decision: Are they going to buy food for their kids to eat, or are they going to buy their blood pressure medicine?”
As SIU’s future doctors, nurses, PAs and other care providers prepare to work with poor patients, it’s essential they learn about local resources, Malone said.
“As a physician, you often want to throw your own resources at everyone. And you just can’t do that,” Malone said. “That’s the toughest lesson I think you learn when you start to practice: You need to point people to the resources the community has.”
After the activity, students heard from a panel of local doctors and caregivers, and received information on public aid and resources available in Southern Illinois.
“Now, students know the facts about poverty and welfare. They have places to send people in this region, and they have made some contacts with people who are really doing the work in this region, just like they will be,” Dr. Todd said.
Physicians should be a link between the resources the community has to offer, and patients, Malone added. “Getting them connected will help them sustain themselves, and ultimately improve their outcomes.”