South Texas goes ‘all-in’ for health care

The name “Texas” is based on the word “tejas.” It’s a Spanish adaptation of a word used by East Texas Caddo Indians meaning “allies” or “friends.” Texas is a friendly state, and although not everybody will speak the same language or share the same culture, the friendliness is something that every Texan—from Brownsville to Amarillo—can understand.

Friends care for each other, and allies help each other. And when it comes to battling major public health problems like chronic disease and poor health care networks, South Texas has a new ally. Healthy South Texas is a program dedicated to improving the lives of everyone in the South Texas region, in addition to setting a foundation for interdisciplinary success in education and applied research for future generations of health care professionals.

“The Rio Grande Valley has over 1.3 million citizens, many who are underserved or uninsured,” said Olga Gabriel, MPH, director of the Texas A&M University Health Science Center McAllen campus. “We wanted to have a role in the community that in addition to an academic setting, applies successful evidence-based programs in the community through research, outreach and community involvement.”

The need for greater health care presence in the lower Rio Grande Valley was clear. Many families in the area struggle with asthma, diabetes, obesity and infectious diseases, and many have often relied on traveling across the border to get their medication at a cheaper rate because they cannot afford to buy them in the United States.

With these health difficulties in the area, and the 1.3 million Americans in the four counties that make up the Rio Grande Valley (not including the thousands of Mexican citizens who spend time on this side of the river), improving health needs a group effort.

The Texas A&M Health Science Center McAllen campus was established in 2000, serving as the Texas A&M System’s most southern location. The campus currently houses the Bachelor of Science in Public Health and Master of Public Health Degree and has branches that spread wide through other disciplines of health.

“The Health Science Center understood the need for more nurses in the area—especially ones that understood the culture here—and expanded to include the College of Nursing which will make an impact,” Gabriel said. “Our location has also served as a workshop setting for College of Pharmacy students, and we have had joint events where all disciplines come together to offer free education and services to the community.”

The Diabetes Education Program

The campus has become more than an academic setting; it has become its own “mini” Health Science Center, with two of the five disciplines making up the entire Texas A&M University Health Science Center: nursing, and public health and occasionally pharmacy, housed at the campus, and even dental fellows working in partnering organizations.

The Diabetes Education Program (DEP) collaborates with El Milagro Clinic (Spanish for “The Miracle”) which is next to the campus and offers free classes to their patients and the community.

“The DEP program is based on the same American Diabetes Association (ADA) curriculum our sister organization, the Coastal Bend Health Education Center, has run for the past 18 plus years”, Gabriel said. “The clinic is also collaborating with the Texas A&M College of Dentistry out of Dallas, as a location for their students to do their practicum.”

The clinic’s registered nurse teams up with staff from the Health Science Center’s McAllen campus, including a registered dietician, program coordinator and outreach specialists, to provide the DEP classes.

To monitor the progress of the participants, baseline information is taken. Through a simple finger stick, their cholesterol and HbA1c is noted as well as weight and BMI. This is done at the start of the program and the progress is monitored every three months.

The program’s registered dietitian gives individual meal plans and the registered nurse will answer questions about medication or their illness and the class is often offered in Spanish for those whose are more comfortable communicating in their native language.

However, it’s not realistic to think that an 8-hour course can make sustainable long-term changes by itself, and for that they encourage another program, Texercise Select.

Texercise Select

“The Texercise Select program is an evidence-based program that reinforces what is taught during the diabetes program,” Gabriel said. “The program is held over a 10-week period, and led through a trained facilitator.”

This lifestyle class discusses healthy eating and participants engage in physical activity, and set goals for adopting healthier lifestyles. For those who cannot stand to do the physical activity component, a chair-based workout routine is taught.

“Since people have done the Texercise program in conjunction with the Diabetes Education Program, many participants have seen their HbA1c levels decrease and have lost weight,” Gabriel said.

The group setting helps alleviate social isolation and fosters a sense of camaraderie.

“Participants do not want to stop coming as the program comes to end of the 10^th week and often ask, ‘What’s next?’” Gabriel said. “Some have gone on to form their own exercise group, which is exactly what we hope for. We want them encouraging each other in a supportive setting is a successful way to be active, lose weight and share conversation.”

Medication Assistance Program

Poverty in the Rio Grande Valley is a major problem as well, as cities of Cameron County often top the list of America’s poorest cities. This can affect the health of a community if they have to make tough choices between paying for food, shelter or medication. Thankfully, the Medication Assistance Program can help people not have to make those difficult decisions.

The Medication Assistance Program (MAP) is designed to assist those who may be struggling to pay for medication for a chronic illness, such as heart disease, diabetes, respiratory illness or asthma.

“We have two outreach specialists who rotate through 9 locations around the Rio Grande Valley,” Gabriel said. “They have assisted people with various ailments get the medication they need, including cancer patients get very costly medication and patients with diabetes who cannot afford their insulin. It’s a great program that the pharmaceutical companies have and we are able to be the facilitator between them and the patient so they can receive much needed medications.”

Community Events and city involvement

In 2013, the Brownsville-Harlingen area had a poverty rate of 36 percent, and the McAllen-Edinburg-Mission area had an average poverty rate of 34 percent, which were the highest and second-highest poverty rates in the nation, respectively. Many of the residents were also living without health insurance, which means a community intervention was needed.

“We try to offer assistance in every way that we can, such as education and intervention programs that help reinforce a healthy lifestyle, and help deter costly chronic diseases,” Gabriel said. “We also have large events that the entire community is welcome to attend to foster community engagement and help families make healthy changes to prevent health problems later in life.”

Some of the community events can range from medication assessment days, to a large health expo like the City of McAllen employees, “Our Health is Wealth Expo” held in September, 2017. The event had educational programs, information pamphlets, flu shots and much more for employees and their families in attendance.

The College of Pharmacy had booths where participants could discuss their medications and get advice for any adverse reactions.

“We hold several medication review days where residents come in with all of their medication in a bag and the College of Pharmacy students with their instructor go over the medications and make sure the participant understands how to properly take them and can suggest ways to alleviate side effects,” Gabriel said. “The McAllen Expo was almost entirely interdisciplinary involvement talking about diabetes, obesity, asthma, Zika and a whole variety of health issues.  It’s about getting the education to the people and service for the community.”

During the expo, City employees signed up for the DEP class and to support employee wellness, they were allowed to take time off work in order to complete the 8-hour course.

“The city has been very good to us from the onset of Texas A&M coming to McAllen,” Gabriel said. “They understand the long-term benefits their employees can have if they invest in their health with these classes.”  They have set an example that other communities can follow to encourage lifestyle changes for improved health.

The programs reflect the different activities that can make McAllen a healthier community. Information about these programs can be found on the Healthy South Texas website or by visiting the McAllen campus at 2101 S. McColl Rd. or calling 956.668.6300 to set up presentations or receive printed information.