Health Equity Challenge finalist Bethlehem Michael

Grandma Lul and Grandpa Ghebreab first came to live with my family when I was three years old. They were my mother’s parents and traveled the same long path that brought my mother and father to the U.S. from a small country in the Horn of Africa, called Eritrea. I didn’t know it then, but over the years, my grandparents and I would form an unbreakable bond.

I can recall the days when my grandmother would sit with me for hours, placing my previously untamable curls into elaborate braids, or her multiple attempts at teaching me to speak, read, and write in Tigrinya (a native East African language). She would teach me her secret recipes, requesting my assistance when she’d be cooking or baking in the kitchen.

I remember walking with my grandfather to take my older brother to school, his funny sense of humor, and his many jokes and captivating stories of his youth in Eritrea. I felt so fortunate to have been raised, in part, by them. In their enduring legacy, I find profound gratitude for the love, wisdom, and nurturing presence of my grandparents whose impact has shaped my childhood memories and aspirations into adulthood.

As I grew into my teen years and adulthood, my grandparents grew older, too. My grandparents’ frequent visits to the doctor’s office required that a family member take time off work, arrange transportation, and translate between Tigrinya and English during their appointments.

A lot of my interest, in medicine and public health, was due to the experiences of caring for my grandparents and how our family would interface with the healthcare system to ensure they received the care they needed. When coming home from college on the weekends, I’d notice their slower gaits, their graying hair, and how they required so much more help than they needed before. In my absence, time would jump and they would seem so different to me. The changes in my grandfather became even more apparent to me when I worked as an in-home support provider for him after college. A man who could walk for miles well into his late 80s, who used to swim far into the waters of the Red Sea in Eritrea, needed a lot of help with his activities of daily living. These experiences highlighted the profound impact of aging on both my grandparents and our family dynamics, prompting me to recognize the complexities of elder care and the importance of support systems for older adults.

During my second year of medical school, in the midst of the COVID-19 pandemic, my family ended up contracting COVID-19. This was the time when COVID-19 vaccines had yet to be accessible to the general public, testing was difficult to come by, and treatment for COVID-19 was not available. At the time, I was anxious for my grandparents, as much of the literature had demonstrated severe complications and poor outcomes for older adults with COVID-19, my grandfather was 94 years old. While my grandmother, in her early 80s, was able to make a decent recovery and she still has lingering health issues to this day, my grandfather couldn’t recover after he became ill. About two months after becoming ill, two to three hospitalizations, and being transferred to receive hospice care at our home, my grandfather passed away three months short of his 95th birthday. The passing of my grandfather highlighted the vulnerability of older adults and emphasized the significance of championing their health and welfare, resonating with the insights acquired from caring for my grandparents.

“My journey in health care has been profoundly shaped by the experiences I shared with my grandparents. Their influence has not only guided my career path but also heightened my awareness of the unique health challenges faced by older adults.”

My journey in health care has been profoundly shaped by the experiences I shared with my grandparents. Their influence has not only guided my career path but also heightened my awareness of the unique health challenges faced by older adults. As a third-year medical student, I found myself drawn to patients who mirrored my grandparents’ journey, ultimately leading me to choose internal medicine as my specialty due, in part, to enjoying working with older adult patients. This also leads me to reflect on the shifting demographics in the U.S. and the health and well-being of older adults. As it stands, the older adult population, ages 65 and older, is projected to experience a 47% increase from 58 million in 2022 to 82 million in 2050. We must reflect on the complex and unique health needs of this growing population.

Conditions such as deafness, cataracts, osteoarthritis, chronic obstructive pulmonary disease, diabetes mellitus, obesity, and dementia are all age-related diseases that cause a decline in the physical and mental functions of older adults. Addressing these conditions is crucial for maintaining their overall well-being, emphasizing the importance of prevention, accurate treatment, and interventions to sustain their quality of life. Rooted in the principles of preventive medicine, one such way to prevent and improve the burden of chronic diseases for older adults is through improving access to good quality nutritious food.

Ensuring older adults have access to nutritious food, including fruits and vegetables, is crucial for their overall health and well-being. However, due to limited incomes, many older adults can struggle to afford an adequate supply of food, which can contribute to various health problems and chronic diseases. This lack of access may also result in insufficient nutrient intake, increasing their vulnerability to malnutrition. It is, therefore, imperative to support older adults in finding affordable and nutritious food options to maintain their health, independence, and quality of life. Research indicates that consuming a diverse range of fruits and vegetables can protect against numerous age-related diseases, such as heart problems, diabetes, memory loss, and osteoporosis. One potential way to promote access to nutritious vegetables and fruits is through the use of community and individual gardens.

Through the Preventive Medicine Scholars, I had the opportunity to participate in the East Rancho Dominguez (ERD) Community Center’s Senior Garden. The senior garden was established as a collaborative effort between community members and participants of UCLA Healthy Tomorrows program. The UCLA program has spent several years community building and making efforts to connect with local community members through initiatives at local parks in Los Angeles. At ERD, community members would spend time beautifying the space, connecting, and meditating, all while actively gardening together. Through my participation in this Senior Garden, community gardening presented itself as a means to alleviate food insecurity, enhance dietary and physical activity habits, and foster stronger ties within the community.

In applying for the Health Equity Challenge, I wanted to propose a project to address some of the urgent concerns surrounding the health and well-being of older adults. The project I am proposing seeks to address the mounting challenges faced by seniors, including issues like obesity and chronic diseases, food insecurity, and limited access to nutritious foods, particularly in marginalized communities. Drawing from SNAP-Ed curricula, the project aims to introduce a comprehensive gardening and nutrition program to empower older adults to enhance their nutrition, physical activity, and gardening skills while strengthening their social connections in shared community settings and green spaces.

Through collaboration with the LA Neighborhood Land Trust (LANLT), a nonprofit organization committed to sustainability, equity, and making green spaces accessible to all, we hope to bring this food gardening curriculum to life at their West Athens Community Garden, ideally located across the street from a senior living community. In conclusion, my project for the Health Equity Challenge aims to address critical issues facing older adults, inspired by my personal experiences caring for my grandparents. By implementing a comprehensive gardening and nutrition program in collaboration with the LA Neighborhood Land Trust, we aspire to empower older adults, enhance their well-being, and foster a sense of community in marginalized areas, ultimately striving for a healthier and more inclusive future for all older adults.

Bethlehem Michael

Bethlehem Michael
2024 Health Equity Challenge Finalist
Bethlehem Michael is a medical student at the David Geffen School of Medicine at UCLA in the dual-degree Program in Medical Education-Leadership and Advocacy (PRIME-LA). She is currently pursuing her MPH in Health Policy and Management at the UCLA Fielding School of Public Health.

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