July 12, 2012 — The 13-year-old girl was overweight and in danger of becoming diabetic if she didn’t develop healthier eating habits. When Tobias Barker suggested she replace one bag of chips with one banana each day, the girl responded that she’d only had her very first banana two weeks earlier.
Barker was shocked. But the incident underscored the importance of the diabetes screening that he and two Harvard School of Public Health (HSPH) classmates were conducting at the Chicago middle school the girl attended. The girl’s admission also made Barker even more grateful for the flurry of media attention about the event generated by a famous visitor—Chicago Bears quarterback Jay Cutler, who has type 1 diabetes. Cutler visited the first day of the screening to speak with students about the dangers of diabetes and the importance of a healthy diet and exercise.
The screening, held in May, was the result of a marketing project put together by Barker, vice president of medical operations for MinuteClinic, the medical clinic inside CVS pharmacies; Priti Lakhani, a podiatrist from Topeka, Kansas; and University of Illinois at Chicago transplant surgeon Jose Oberholzer. The three MDs, all slated to earn HSPH master’s degrees in health care management in 2013, developed the diabetes-screening plan as a class assignment, then decided to transform it into a full-fledged initiative.
Cutler’s visit to the school helped attract widespread media attention, ranging from news articles to local and national television coverage, including ESPN. More importantly, the screening found about 100 children at risk for diabetes who will now have access to preventive care.
“The whole thing was inspiring,” said Lakhani. “It’s amazing how you can effect change with very little.”
Lakhani, Barker, and Oberholzer met last fall in a marketing course taught by Linda MacCracken, adjunct lecturer on health policy and management. In the course, which spanned five weekends during the 2011-2012 school year, students were expected to develop a marketing plan for a health care service or product, submit the plan to MacCracken, and present it in class.
But Barker, Lakhani, and Oberholzer decided to make their plan a reality. “We couldn’t imagine doing all of this work and then not actually following through,” said Lakhani.
The trio focused on diabetes because each has a stake in offsetting the alarming increase in the disease’s prevalence. Oberholzer has seen far too many young people who needed a kidney transplant or became blind because of complications from diabetes. A large percentage of Lakhani’s patients have diabetes-related foot problems, including amputations. And Barker is involved with diabetes prevention efforts through MinuteClinic.
Perspectives Charter School Calumet Campus, the school on Chicago’s South Side where the five-day screening was held, was chosen because CVS had already established a relationship with the school and an adjacent health clinic and was regularly offering informational sessions on health topics. Cutler, who runs a foundation that benefits children with diabetes, decided to participate after Oberholzer sent him what Lakhani called “a random email” asking for his help. Both Cutler’s foundation and CVS donated $5,000 apiece to the project, which was key to bringing it to fruition.
Volunteers from the University of Illinois Health Hospital and Health Sciences System provided body mass index (BMI) screenings, and if a child had a high BMI then nurses from MinuteClinic did a finger stick test to measure blood glucose. Among the children screened, about half were above the 85thpercentile for BMI for their age, meaning they are at greater risk for diabetes than other children. One child had elevated blood sugar; a few more had high blood pressure.
“Some kids had [a systolic] blood pressure in the 140s—and a kid shouldn’t have a blood pressure of that magnitude,” said Oberholzer. “And some of the kids had a BMI of over 40. [A healthy BMI, or body mass index, for children ranges from about 14 to 19 for 10-year-olds to about 16 to 23 for 15-year-olds.] But in the neighborhood we were in, these kids didn’t even stand out—they’re just one of many kids who are overweight.”
After the screenings, Lakhani, Barker, and Oberholzer spoke with students about ways to be healthier. That’s when Barker learned about the 13-year-old girl who’d just had her first banana. Another girl told Oberholzer that she can’t exercise outside in her neighborhood because sometimes people get shot by stray bullets; instead, she hangs out in her basement.
“Many of these kids don’t get fruits and vegetables and they don’t get exercise,” said Lakhani. “And many of them don’t get taken to the doctor regularly. It makes you understand the realities that exist in some of these neighborhoods.”
As sobering as the event was, Barker, Lakhani, and Oberholzer were pleased with the project and hope to expand it to other schools in the future. “If we can help even one kid who was going to develop diabetes—to stave off blindness or kidney disease— it’s all worth it,” said Barker.
MacCracken was also delighted with the HSPH students’ work and results. “These three doctors got community leaders and volunteers from the University of Illinois to organize and deliver BMI testing, got the University of Illinois, MinuteClinic and a celebrity to put in resources, and now any of the kids who need more follow-up can get it,” she marveled. “All starting from a marketing class’s student project.”
photo: Kathryn Marchetti/University of Illinois at Chicago