12 Apr Dr. Caroline Tucker
The Social Determinants of Health Are Real
Tell us how you got into psychology?
For two reasons. One my father was alcoholic and I wanted to understand what caused that and also looking at the impact on our family and on him. The other reason was I was taking a class on abnormal psychology in undergrad (North Carolina A&T University) there was this white professor that came in his name was Dr. Heiny. I will never forget it he had this beautiful Mercedes and was impeccably dressed. I said to myself I don’t know what he is doing but I want to do what he is doing. He was a clinical psychologist and I grew up very poor economically. Give that I knew I had to help make my mom and dad’s life better.
I also just really got into in I found my passion and I wanted to be a psychology professor.
Has your psychology background given you a different perspective on health?
I focus on health generally and obesity because it is linked to hypertension, diabetes and other disparity diseases that impacts people of color disproportionately. The other part is a lot of our work focus on cancer prevention. Obesity is linked to thirteen different types of cancer, and most people do not know this.
What inspired your passion in minority & culturally sensitive nutrition?
So we’re often in the communities, specifically black and latino. Where the way love is shown is often through food and the family get togethers are around food. Food even though it is delicious and still is! All those things are linked to health issues even now part of Health Smart we work with different communities with these trainings. The other part is as people are trying to be more healthy, and eating collard greens and cabbage and by the time you put all the ham hawks and sodium back in these aren’t very healthy. People aren’t aware.
It is part of our culture, and what food means, symbolizes, and the unity that comes with it. The cultural factors are major as well as income and access to food.
Explain to us the need and the barriers to access care that racial/ethnic minorities experience.
There are barriers to healthy eating and there are barriers to healthcare. The are commonalities between the two. A barrier to healthy eating is income. People just don’t have the money to get to buy fruits and vegetables. Another healthy eating barrier is knowledge, I didn’t know that there are 10 tsp. of sugar in a 12oz can of soda. I had one women when I started health smart she said, “Dr. Tucker there is something wrong, I eat a salad for breakfast, a salad for lunch, and I eat my dinner with a salad and I still haven’t lost any weight.”
So I said “What did you put on the salad?”
“I love that ranch dressing…” she said “I have bottles of it and I put about a third a bottle on my salad.”
I told her that there are about 31 calories in 1 tsp. of ranch dressing. It was really just not knowing and a lot of that has nothing to do with income they just don’t know the information.
Stress can also be barrier in lower income communities. People engage in unhealthy behaviors like drinking and smoking as ways of coping. We just experienced this in Jacksonville a lot of Black women were focusing on programs addressing obesity and they were giving reasons why they couldn’t participate. They included that they afford child care, there are real world challenges for these folks.
When we look at healthcare you have the same issues not having access. We found out that in Jacksonville weren’t even aware that some of the programs the Jacksonville Transit Authority had started. People also feel uncomfortable, that they are culturally insensitive. When you feel like you are being spoken to in an insensitive way you are not going to come back.
A barrier for both is not having the support, either rom a family member, friend, or partner. People are more likely to be healthy if they have that support.
Tell us about the Health Smarts program and what your motivation was for creating it?
All of those reasons! I felt we needed to have a program that’s anchored in health self-empowerment theory. We know we need to empower people to take charge of their health. A big part of Health Smart is motivation. We start with: what are your motivators, what are your barriers? We customize set goals and we use their motivators to to increase the likely hood of doing whatever they said as their target behaviors. Everything starts with small steps.
I created the name Health Smart because at the begging of my career at an education center. One of the students in the program was interviewed, and we were talking about healthy eating and she said, “Oh no I’m not going up to the cafeteria and asking for a salad. You know black folks don’t eat salad they are just trying to act white.”
So eating healthy is acting white and I thought oh no…thats not acting black or white that is just being smart. It was time to associate health with being smart not with being white.
I am very excited that it is now virtual, this year we can focus on how do we get the Health Smart program out throughout Jacksonville and Florida.
How has the program impacted the people it was designed to serve? Share some successes.
We have our first policy getting ready to be passed and worked really closely with JTA.
We’ve had large health promotion sessions with about 300 to 400 people. Where they’ve come together with a panels on different health issues and was a great format for people to ask questions. Another important piece is training our Health Disparity and Health Promotion Research Interns. One year we had people between 25 to 30 interns from 21 different countries, they also talked about cultural sharing. So we talk about the health problems in different cultures. They work and observe with Health Smart, especially working with our seniors online which has been absolutely amazing. They want to bring Health Smart back to their communities, so this year will be doing a lot of training with them.
Also a part of Health Smart Holistic Health program is training pastors in the churches we are working with to be mental health support coaches. We train them in stress, anger, grief, and depression management strategies. They are committed and practice this with members of their congregation while we observe them. I also don’t want to forget our community gardens Humana Foundations is moving forward with this. We have in our budget for one women to become a full time farmer. The idea is for her to be able to sell her vegetables with churches that are involved. The idea is to help communities be more sustainable and not always depending on anybody else. People can raise their own gardens on an individual and community level.
Mrs. Walker has been a major leadership role in all aspects of Health Smart.
What do you want people to know about the people Health-Smart is designed to serve?
We have been targeting seniors 55 and older. They are regular people who are concerned about their health. I am excited to say the with the data we have 441 participants (23% men) significant decreases in stress, depression, blood pressure, and weight! There have been decreases in social isolation and loneliness which were to areas prevalent amount seniors.
We showed significant increases in healthy gain in quality of life. These are very important health outcomes, mental health directly effects physical health. That is why it is a holistic program.
You are also an accomplished mentor. How does it feel to have had such a diverse group of students under your mentorship?
I’ve had thousands of students! I think being a mentor is a blessing it gives you the opportunity to give back and impact somebody’s life. My mentees make me better.
The other part is though I may inspire them, they inspire me as well to work harder. When I see their excitement and how they connect with the seniors teaching them how to use their smart phones and Zoom. It is just overwhelming, the seniors love them and it doesn’t matter what race or ethnicity the students are. People just need to feel like you love and care about them.
A mentor is also holistic, it isn’t just about advising about your career. It’s about checking in, it’s about having conversations. My mentees when they are dating or wanting to propose to someone they bring them by me! I have a lot of fun with them. I’ve been to the hospital everyday for months when one my mentees had stomach cancer. I took one of my Nigerian students to the dentist they have never been before. It is doing a lot of stuff and you have to love and care a lot to be a good mentor.
What are some ways people can get involved to support your mission and work to create more health equity?
The goal is to sustain Health Smart. To continue for people to get trained, I want to have a health disparity/equity center where Health Smart can live and get funding. How we can sustain the program and how it can get funded at the state level so all these communities can benefit. The other part is to support our policies with regard to transportation with JTA. We are also ding a commercial for the app that seniors can use. This year for the first time we are having people doing Health Smart have a family member in their house hold commit to achieving their goals in writing.
Whatever those goals are, often family members will sabotage you. We are also doing a version where a family member goes through Health Smart with you, we are hoping that the family approach will be more effective than the individual approach. Getting more males involved is a big thing we want to work towards with our target population.