How asking people about things other than their health can lead to better health

May 10, 2023

Student volunteers in a UConn Health program are identifying barriers that prevent some people from getting diagnosed and treated.

Medical students and undergraduates interested in a career in medicine ask patients at waiting rooms a set of socio-economic questions to find out which unmet needs might prevent them from accessing health care.

The needs include not having a job, housing instability, lack of transportation, and food insecurity, which collectively pose a 101% higher risk of hospitalization, the UConn researchers found. Data also shows Black people have a 43% increased risk of having unmet needs, while Hispanics have a 278% increased risk.

"That tells us that, if you have one of these issues, you were more likely to be a sicker person," said Dr. Henry Siccardi, who launched the program when he was a student.

"We trained 303 students over the three-year period," he said. "We screened 8,994 people, identified 5,945 patients with unmet social factors and addressed 2,115 unmet social needs."

The program spans several UConn Health outpatient care waiting rooms in five towns, and is expanding statewide.

Albanian immigrant Pellumb Medolli speaks little English. On a sunny morning, he's out on his daughter's deck in Manchester, chatting about this and that in his native language.

"Feeling good," he said with a huge smile, hands on his chest. "Everything is good."

That's quite something for a 71-year-old who had cancer removed from his lung last month. After 55 years of smoking, the retired mechanic said he's lucky to be alive.

It's not all luck. Medolli's surgery would not have happened but for UConn student Sarah Bellizzi, who volunteers in the lung cancer screening program. A primary care physician at UConn Health had ordered a lung scan, but Medolli never went to the appointment.

Then he got a call from Bellizzi, asking why. She even had an Albanian translator standing by, but Medolli's English-speaking daughter picked up the phone.

"They had some financial concerns regarding insurance. So I gave them the UConn's financial services numbers and then was able to schedule the lung cancer screening appointment," Bellizzi said. "I was able to follow up with them just to make sure that they were planning on going to it."

Thankfully, the scan showed that Medolli's cancer was in stage 1.

Dr. Christopher Steele, assistant professor of medicine at UConn, said many patients never get screening tests done because of insurance and other concerns. "We hope to expand this program to other clinical sites nationally and develop partnerships of like-minded individuals looking to improve the delivery of health care," he said.

The goal is to address the unmet needs by partnering with local community organizations. "A big part of this will be obtaining funding for community health workers to be on the ground to work with our neighborhood organizations and patients to get the care they need," Steele said.

The five most common barriers to health care experienced by patients in the program included smoking cessation, being unemployed, homeless or at risk of losing housing, transportation barriers to and from doctor visits, and having less than a high school education.