This intersection can lead to health equity

One can lose hope for a healthier future given the negative news about high rates of adult diabetes and obesity, accelerating rates of childhood obesity and surging cases of adolescent Type 2 diabetes. The mountain before us is too tall, the boulders too heavy, the solutions too controversial.

After training to become a surgeon, I envisioned joining my fellow physicians to tackle disease one patient at a time. However, the glory of life-saving emergency surgery was overshadowed by a more common reality: having to amputate a person’s leg due to severe infection and poor circulation, both the result of uncontrolled diabetes.

Then I saw a shocking headline — one that was obvious to legions of epidemiologists, demographers, anthropologists and countless other scientists: Nonmedical variables explain about 80% of any given health outcome. These include each person’s experiences, conditions and behaviors, which can include the impacts of housing, education, healthy foods, green space, legal support, literacy, racism, pollution, misogyny, job opportunities and income level.

Following that light bulb moment, I founded the SAVE Clinic (San Antonio Vascular and Endovascular) to address the nonmedical factors that lead to 80% of health outcomes. One lesson has become abundantly clear: The intersection of education and workforce development is a space to improve future health outcomes, not only for individuals but for entire communities.

I am a founding board member of CAST Med, a health careers high school on San Antonio’s South Side, and serve on the board of the CAST Schools nonprofit, with six public schools in four independent school districts.

Health care outcomes on the South Side and the near East Side and near West Side urban core of the city are among the most dire in the state. San Antonio exhibits a stark disparity in hospital distribution between its North and South sides, a disparity that persists even when we control for the city’s population as a whole.

Thankfully, San Antonio offers an unparalleled educational opportunity at CAST Med, Palo Alto College, Texas A&M University-san Antonio and the University of the Incarnate Word School of Osteopathic Medicine. Since 2020, SAVE has offered paid summer internships and programs for CAST Med juniors and seniors. Students acquire a baseline ability to develop health literacy, and many are inspired. For example, some students created diabetes awareness and support groups.

Together, we can explore the potential at the confluence of education and workforce development. Some of the students who don’t continue in medicine may be the next developers who create housing with green space, or the corner store managers who offer fruits and vegetables, or the data analysts who make tech tools that extend healthy options.

An education-workforce development model can lead to health equity. To improve health care access to health care, we must consider the nonmedical factors that lead to 80% of health outcomes as an opportunity to make community-changing improvements.