Changes: Microfiance & Motion

Changes: Microfiance & Motion

A Sustainable Way to Feed the World

Marcia Metcalfe, MPH ’79, thought she’d retired from the health profession in 2003. But then Art Goshin, MPH ’75, got in touch.

Goshin serves on the board of Freedom from Hunger, an international development organization that’s been working to feed the chronically hungry poor since 1946. A decade ago, the organization embraced microfinance and education as the most effective means of helping the very poor lift themselves from poverty. Since then, Freedom from Hunger has partnered with organizations around the world to provide small loans and financial services (including health loan and health savings programs), as well as educational programs, to millions of people in need. Many are women like Patience Ameyaw of Ghana, above left, whose income from sewing was barely enough to help her family. Three years and six loans later, Patience has three electric sewing machines and a generator and employs three apprentices.

Once Metcalfe learned about Freedom from Hunger, she knew she had to get involved. Today she is global manager for the organization’s Microfinance and Health Protection Initiative.

“Once I started understanding it and saw the potential for putting together health and microfinance, I just became very excited,” she says. “There is such potential here to reach millions of people around the world with a global platform.” The initiative has already touched the lives of more than one million women and brought health-protection services to an estimated 150,000.

“I’m really lucky,” Metcalfe says. “All of the wonderful training I got at Michigan has come back to me in ways I never could have anticipated.”

Marianne Udow-Phillips, MHSA ’78, also serves on the organization’s board of directors.

A Model for Change:

Bobby PestronkLast October, Bobby Pestronk, MPH ’79, stepped down from his job as director of the Genesee County (Michigan) Health Department to become executive director of the National Association of County and City Health Officials. The association represents the nation’s 3,000 local health departments across the nation, and as its leader Pestronk says his job will be “to help other people be successful.”

The move from Flint to Washington, D.C., means he’ll also get to share the lessons he’s learned during his 22 years with the health department, chief among them that “it’s possible to change policy and practice to affect health outcomes.” A case in point is one of Pestronk’s proudest achievements—the creation and implementation of a health care plan that covers nearly 28,000 Genesee County residents who would otherwise lack access to a coordinated, primary care–based system of health care.

Pestronk and his colleagues launched the Genesee Health Plan in 2001 with local funding (from the county board of commissioners and community nonprofit agencies) and expanded it with state money and grants from three area foundations. They then asked the citizens of Genesee County to vote to sustain the program via a tax raise. “By modern standards, it passed overwhelmingly,” he says. Fear of job loss was a key factor. “Everyone knew that either they, a friend, or a family member was no more than one paycheck away from losing their employer-based coverage,” Pestronk says. But he believes voters also saw that the program worked, and moreover “didn’t break the bank,” and therefore voted to sustain it.

Thanks to the plan, emergency-room use in Genesee County is now down; compliance with physician advice is up— as is careful management of prescription drug use; chronic conditions like back pain and diabetes are better controlled; and medical homes have been established for families on the plan. Another documented outcome is a drop in sick days at both schools and workplaces.

Pestronk hopes the program will serve as a model for other communities working to solve the nation’s health insurance prob-lems. “Success will result from making effective use of assets both at the ground and at the treetops,” he says. “I think we’ve proven that.”

He’s also proud of the progress his department made with local partners, including the Prevention Research Center of Michigan, to reduce African-American infant mortality in Genesee County and to establish a culture of quality improvement within the health department itself.

Hate to Exercise?

Michelle Segar feels your pain. The SPH alumna (MPH ’97), motivational psychologist, and mother has spent a decade trying to figure out why so few women exercise. Founder and director of EssentialSteps®, an evidence-based, exercise-motivation coaching program for women, Segar offers these tips:

  1. Don’t think of exercise as exercise. Think of it as an opportunity to move. Seek out excuses to move throughout your day. Park far away from buildings; walk rather than drive. You’ll feel better and have greater motivation for structured physical activity—and research shows your health will benefit.
  2. Exercise doesn’t have to be vigorous to be good for you. The greatest exercise benefit comes when you go from doing nothing to doing something. Anything.
  3. Think of physical activity as one of your essential steps to well-being. Movement is empowering. It boosts your quality of life and energizes your day.
  4. Stop blaming yourself. Thanks to fitness companies whose goal is to sell products and services, we’ve been taught a harmful approach to exercise. Toss out what you’ve learned that hasn’t worked for you. Find new ways of being active that fit into your life and give you pleasure.
  5. Don’t set yourself up for failure. If you want to lose weight, don’t launch concurrent dietary and exercise changes. Instead, choose one change, pursue it for nine months until you’ve mastered it, and then add the other. You’ll see results that will be more sustainable over time.
  6. Don’t think of exercise as a way to lose weight. While exercise is essential to maintaining weight, diet trumps exercise when it comes to losing weight. Focus on learning how to integrate exercise as a founda-tional and positive behavior in your life, and then find a diet that works for you.
  7. Tell yourself you’re worth it. Women, in particular, have trouble investing time and energy in themselves. Instead of buying more anti-aging cream and clothes, invest in your basic self-care and inner well-being. You’re worth it.
  8. Move your body throughout the day. Physical activity yields benefits, whether you do it all at once or break it up into pieces over the course of the day.
  9. Stop using exercise as a vehicle for warring with your body. Instead, use physical activity to feel better and take care of yourself. Don’t huff and puff and get your pace up—just walk and enjoy the knowledge that you’re investing in your health.
  10. Learn how to be consistent, then work on quantity. To fit a complex new behavior into your life, start small. Do five minutes of exercise a day, every day, for a month and feel good about that—then see if you can increase the time. On the days when you can’t do five minutes, don’t fret. Just go back the next day. It’s all about attitude.