Education as Equity

Feb 9, 2022 | Community Health, Health Equity | 0 comments


Loma Linda University Health Opens Doors to Opportunity for San Bernardino’s Underserved


By Melanie Raskin

Along with delivering world-class health care, San Bernardino, California’s, Loma Linda University Health is also in the transformation business: one underserved, local, minority individual at a time. And it’s a transformation that benefits not only the person but also the city.

The Seventh-day Adventist hospital system has served the Inland Empire, as the San Bernardino metro area in Southern California near Los Angeles is known, for more than 100 years, averaging more than a million patient visits annually. The need is great — not just for health care, but also for positive change. It’s been a long, slow climb out of a deep economic depression: The community is rated the second poorest city of its size in the U.S., after Detroit.

In just about every way, San Bernardino is in trouble. It is one of the least educated areas of the state, with some of the lowest average wages in the nation, consistently higher than average unemployment, and poor air and water quality. But the city is also on the rise, a melting pot of good, smart people doing creative (sometimes inspired) work to renew the courage, persistence, resilience — and possibilities — of its citizens.

Pipeline to Prosperity

One of those efforts is Loma Linda Health’s community pipelines program. Discovery is a two-week, interactive summer experience on the hospital campus for under-represented, minority high schoolers to explore careers in health care. The free, experiential event (there’s a nominal application fee, and sponsorships are available) includes daily team-building exercises, interactions with hospital staff, hands-on activities (think: suturing an orange) and a day of community service. Some students are invited to come back for a third week to shadow health care pros in action. The university follows up with quarterly My Campus meetings and monthly alumni association meetings, as well as a biannual robotics program for students interested in medical engineering.

A recent addition is the 2020 Transitions to Success pilot program for a dozen high school and college students committed to health care careers. It provides a stipend and a mentor to ease the transition from high school into college, and from college into a health care higher learning program.

According to Juan Carlos Belliard, PhD, MPH, assistant vice president for the Institute of Community Partnerships, the pipeline is designed to fulfill the institute’s mission to be both relevant and responsive to the community. But he oversees the pipeline at a time when relevance and responsivity are tough. The percentage of disconnected youth (16- to 19-year-olds who are neither in school nor at work) in the county is the highest in the state. “We realized the most powerful public health intervention in a community is to ensure youth can access livable wages — jobs that pay the bills,” he said. “So, we’re meeting these kids where they are and opening their eyes to see themselves here, in the health care field.”

Not every student is going to become a doctor, nurse or dentist, but the allied health field has dozens of programs and career ladders leading to good job opportunities — many requiring just six months to a year of training. Belliard believes the Loma Linda pipeline is the right program at the right time. “There’s been a lack of diversity in the health profession. Latinx and Black health care providers are a fraction of the overall population, which should be a concern for us all.

Beyond the supply-and-demand challenge, this is an equity issue and a moral imperative. These professions are not affected by historical and financial stressors. Why not offer the community stable jobs that help address health disparities and pay the bills?” Connecting the dots from qualified candidates to job opportunities, hope to help, is San Manuel Gateway College, an extension of the university’s outreach mission.

Education at the Speed of Life

Established in 2016, San Manuel Gateway College’s mission is simple, to make people whole. Providing the Inland Empire with affordable education and training for entry-level medical jobs right in its own backyard is a good start. The college is the newest school within Loma Linda University and partnered with SAC Health System (SACHS), the largest specialty-based and teaching federally qualified health center in the nation, designed to meet the medical needs of the underserved. Seeded with $10 million in casino profits from the San Manuel Tribe of Mission Indians, the school funnels underserved, traditionally noncollege- bound high school students and others looking for a fresh start through five health care training programs, each lasting from six to 18 months: Certified Nursing Assistant, Medical Assistant, Community Health Worker, Pharmacy Technician and Surgical Technologist.

The beautiful facility, fully outfitted with all the latest equipment, including a SACHS clinic, is in the heart of the minority community it serves. It provides small, multi-generational class sizes; instruction and mentoring by Loma Linda faculty; hands-on clinical practicums; career guidance; and college course credits that can be applied to other institutions. Best of all, it delivers what it promises: The college has an approximately 85% job placement rate; the other 15% of its graduates pursue higher education degrees. Committed to ensuring its training programs lead directly to jobs in the Inland Empire, the college carefully monitors the marketplace for employment gluts. If a field is full, the school temporarily suspends that certification program until new jobs open. It is built for student success: to get a good education and a good job. With students ranging in age from 17 to 63, the college is closing in on 400 graduates since its launch. San Manuel Gateway College is just that: the wide, open door to opportunity at the intersection of hope, faith and works.

According to Executive Director Arwyn Wild, MA, education is the road out of poverty. As an educator in the San Bernardino City Unified School District for 22 years, he knows his community and its challenges well. To him, San Manuel is much more than just a college. For patients and the community, it’s a place for healing. For the students, it’s a sense of purpose and a gateway to a prospering future. “Most of our students come to us in survival mode. The stable ones plan only 30 days in advance,” he said. “They know that because we’re tied to Loma Linda University, they will receive a first-class education that will help them find a job. Our position is, we are here to help you help your family and your fellow man to heal, to have a fuller life in every way — in terms of health, economics, stress and fear. So, that shifts why and how we do things.” The college lives the philosophy of St. Francis of Assisi: Preach the gospel constantly; and if necessary, use words. “Faith is the cornerstone of everything we do,” Wild explained. “Faith in God, faith in the students, faith in the vision, faith in the program, faith in the healing and success of the Inland Empire community we serve.”

From Strategy to Steppingstone

Creating real change is the hardest thing in the world … and the most satisfying thing. Despite the unexpected change resulting from COVID-19, Loma Linda University Health and San Manuel Gateway College did what they do best: They got creative and rose to the occasion with virtual programs until it was safe to gather in person again. This included students rolling up their sleeves and supporting the community’s COVID-19 vaccine rollout. Vision and faith do that to people: They make them believe all things are possible. And it is. Belliard believes San Bernardino is ready for real change, for real good.

“Today, the biggest contribution to health care will be in addressing inequities,” he said. “Our students’ challenges are their superpower. If they are from a single parent home or a parent is imprisoned, they can connect and empathize with similar patients. There’s a real disconnect if health care workers are only from the middle class. Shared life experiences are huge and can effect real change in a community’s health and well-being.”

“We are transforming our community one student at a time,” Wild said. “If we give students hope and a pathway to fulfill their goals to contribute to their community and sustain themselves, that will change the entire community. It’s a journey from hopelessness to hopefulness.”

“This is one of the most impactful things I’ve done in my 27 years in the field,” Belliard concluded. “People think of public health as policies and regulations or telling people to eat better and exercise more. That doesn’t work for people who live in food deserts. Social determinants of health impact our population. In my view, the most important social determinant is education. If you have it, you’re not healthier because you’re smart enough to choose what to or not to eat. You are healthier because your education leads to a decent-paying job, which enables food shopping and gym memberships, and lowers stress and anxiety. To me, education equity is the solution. That’s what we’re striving for.”

“When you think of this population, they have often been on the asking and receiving side,” Wild concluded. “Now, they’re on the giving side. And that extends to the classroom, too, because while they’re learning, they’re also teaching their instructors about social determinants and how to connect with the underserved population. That is transformation and what true health care is all about. While it’s important to make a living, that’s not the ultimate reward. The reward is in making a difference in a life. Our students already know the shoes that underserved people are walking in, so it makes it that much easier and more profound to help their fellow man. That understanding and empathy turns a good health care worker into a great one.”

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