The following article is a part of conference coverage from the American Academy of PAs 2021 Conference (AAPA 2021), held virtually from May 23 to May 26, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading PAs. Check back for more from AAPA 2021
When PAs partner in the communities they serve, it can build trust and enable a 2-way transfer of knowledge to improve health outcomes. “As a primary care [provider], I can do more than just see someone in the clinic. I can be in the community that I serve and have more validity because of that. That kind of relationship is possible,” said Maj Adhana McCarthy, US Army, MPAS, PA-C, who is a doctoral student at the San Diego State University/UC San Diego School of Medicine Joint Doctoral Program in Public Health.
McCarthy collaborated with community leaders to address food justice in an underserved neighborhood in San Diego and presented findings in a poster session at the American Academy of PAs 2021 Conference (AAPA 2021).
Effects of Food Deserts on Health
People who live in food deserts, areas with little access to fresh healthy foods, tend to have poorer health-related outcomes. By the time they are seen by a health care provider, they likely already have underlying diseases, noted McCarthy. PAs can only do so much to affect the social determinants for people living in under-resourced communities, but they can take a more active role in addressing the social determinants of health in the communities they serve, according to McCarthy’s research.
McCarthy incorporated key components of the Community Based Participatory Research (CBPR) to build and sustain a community garden in City Heights, a neighborhood in San Diego that faces multiple health disparities. City Heights is an example of a classic food desert with 30% of adults classified as obese and 26% of the population living under the poverty level. Together, the residents and McCarthy built the Umoja (Swahili for Unity) community garden. The garden was constructed in an abandoned lot on land stewarded by DeVaughn Walker and Lucken Gibore.
From March 2020 to December 2020, 85 community members participated in gardening classes where they learned how to source soil, create compost, plant, transplant, and rotate crops. Key components of CBPRwere deployed to build and sustain the garden, including building trust, power sharing, fostering colearning and capacity building among partners, and finding a balance between research and action for the mutual benefit of all partners.
Weekly hands-on workshops were co-led by community members, McCarthy, and other master gardeners at no charge. The group built upon the strengths and cultural norms of the existing community to include prayer, acknowledgment of cultural lineage and ancestral connections to foodways, as well as bringing everyone’s voice into an opening and closing circle, McCarthy reported.
Over the course of 10 months, participants built 12 raised beds, erected greenhouses, and learned to start plants from seed and transplants. Community members who had never grown food before became leaders in teaching gardening principles to their peers, the study found. In the first year, the garden yielded 4 harvests that included tomatoes, eggplants, peppers, snap peas, beets, cauliflower, spinach, strawberries, kale, chamomile, and squash, McCarthy said. The food was distributed to neighbors, local food fridge, and unhoused people in the area.
“There is a need within communities that are disenfranchised to have information, insight, and learning and there are also great organizers within the community that can be tapped into but are often ignored,” McCarthy said. “Sometimes academics are so focused on organizations they already know that they overlook grassroots organizers.”
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McCarthy A, Hill C, Martin M Jr, Walker D. One must teach one: PA community collaboration to address food injustice. Poster presented at: American Academy of PAs 2021 Conference; May 23-26, 2021. Poster 184.