What is your history? Such a wide and open-ended question offers an abundance of answers. Many histories begin with parents or immediate families. Traditions—formal and important—as well as culture and lineage also play roles. A history, in basic form, explains the host of previously passed events and people that make you, you.
Just as we are the product of years in the making, our health also carries a long record.
Health and history, and the link between, have been well studied. Perhaps not surprisingly, visits to hospitals and clinics (and the care within) contribute a paltry 20 percent to our health outcomes. The best medications and brightest doctors pale in comparison to the social and economic opportunities that a given person experiences.
This latter, broad health history could not be more important in 2017. As repeal efforts of the Affordable Care Act continue and approach triple digits (which would cause millions of Americans to lose health care); as policing practices continue to target black and brown bodies; as the average compensation for the American worker remains stagnant and corporate profits soar, it’s essential that our health structures (too often defined as edifices) recognize their limited role and instead connect practitioners and community members to address such inequities.
Enter social medicine education.
Earlier this month, 31 members of the greater Minneapolis and St. Paul community gathered for the second annual Global Health in a Local Context course. This dynamic course in social medicine brings together artists, nurses, doctors, students, and activists as participants dive deep into Minneapolis’s history to engage the current health issues faced by Twin Cities’ communities.
The course is led by SocMed—in collaboration with the University of Minnesota’s Center for Global Health and Social Responsibility—and takes students through a historical immersion of Minneapolis’s health. The course is “classroom-less” and weaves through the Twin Cities at sites including the Minnesota Department of Health, the Urban Research and Outreach-Engagement Center, and The Third Place, a studio owned by local artist and street photographer, Wing Young Huie. Such a broad landscape of health might seem displaced from medications and diseases, but the encompassing view of social medicine education seeks the roots of health and disease—a pedagogy that realizes health as the product of social forces and systems. Students learn that health and health inequities, to quote Dr. Paul Farmer, are "geographically broad and historically deep."
Last week, course participants ventured to Frogtown Farm, a greenspace pulse at the heart of St. Paul’s Frogtown neighborhood. Originally imagined by four Frogtown residents, the urban community farm was designed to foster social cohesion through food and collaboration. Seitu Jones, co-founder of Frogtown Farm, described earlier this summer that the farm’s intention was to “green line a space that has historically been red lined.”
With the course’s focus on story and history, students learned that the topsoil of Frogtown farm was donated by the Shakopee Mdewakanton Sioux community, a link to the literal roots of the land, where the Dakota people lived in the late 1700s and early 1800s before a national treaty ceded the land. At the surface, Frogtown Farm is a beautifully vegetated park in St. Paul. At a historical level, it’s the work of an organized community that built power and reclaimed land to serve the locale such that the health of Frogtown was prioritized.
In addition to history, the “Global-Local” course curriculum embraces praxis, an education model highlighted in Pedagogy of the Oppressed, a seminal work by Brazilian philosopher and educator, Paulo Freire. Praxis makes education active, where new knowledge nurtures action. Histories and their lessons were never meant to be static; learners were never meant to simply receive information. Instead, through praxis, students mold and shape information within the context of today’s pressing issues. Education, then, becomes a tool to connect history into pragmatic action that shapes the future. Action that is blueprinted toward positive social change.
Health education must reflect a structural and social context, just as an expansive and intentional history is needed to forward our social systems. Whether a family, a community, or 31 residents of the Twin Cities, there’s an abundance of forces that contribute to the health experienced by our communities. Armed with a deep history and social medicine education, we move toward a society where health is experienced by all.