Family Medicine Vital Signs

By Sarah Riley-Burnett, DO

In late fall of 2014, after a long day of rounding on patients at the hospital and a half day of clinic, I changed into jeans and a sweatshirt and made my way over to a community garden nestled in the heart of Salt Lake City, Utah. I met a small group of fellow residents and faculty, also volunteering their time after a long day of work. Close to twilight, I grabbed a shovel and a pair of garden gloves and then bent my back to turning over the dark earth, removing the last of the tomato plants, zucchini vines and kale leaves. I felt my stress levels dive as the setting sun disappeared behind the high ring of mountains surrounding SLC. We were working with one of our community partners in health, Wasatch Community Gardens, preparing the soil to regenerate over the long winter months.  That evening I forgot about the difficulties of residency and about how tired I was. I was revitalized, working with the dirt, and my thoughts turned towards the different ways physicians could use a community garden to influence the health of our patients, of our community. Over the next year and a half, I’ve been exposed to several examples of how gardens bring people together in a common goal of health.

In late March 2016, the sky had been spitting rain down in intermittent bursts, and instead of being tucked away into a classroom for our weekly lectures, deep in the department of Family and Preventive Medicine, a larger group of residents and faculty met at a middle school in the western part of the city.  I arrived at the school driving down a four lane road lined by industrial warehouses, fast food joints and greasy spoon restaurants. The middle school and attached community health clinic are located in a neighborhood mostly populated by refugee families and immigrants. In a small lot, between the school and a dilapidated basketball court was a beginning of a garden, with raised plots holding the small delicate sprouts of lettuces and kale, colorful painted signs and a small garden shed. We spent the afternoon planting flowers to attract bees, butterflies and hummingbirds, sowing lettuce seeds and painting signs. The space is utilized by the school in teaching children about agriculture and “real food”, entomology, biology, health and physical activity. Children participate in the planting, weeding, and harvesting of the garden, tasting the fruits of their labor along the way. It is hoped that they will take these lessons home to share with their families, to offer a viable alternative to the food desert that they live in. Maybe the garden will help combat the obesity problem that now affects 1 in 6 children and adolescents in the United States, according to the CDC. It could help with food security, allowing children to feel better engaged in academics without the distraction of a hungry stomach.  The school and garden also attracts families, wary of the health care system and who may not seek care otherwise, to the attached health center. I see the combination of the school, garden and health clinic as a way to combat problems associated with childhood poverty such as lack of access to health care, inadequate nutrition, poor physical health, behavioral problems, poor academic achievement and school dropout.

In mid-September, our group again gathered at another garden project, this time in a part of downtown saturated by the homeless population. We drove past streets filled with wandering people packing what little they had in grocery carts and catching respite from the bright sun underneath shade trees. We arrived at a large 4 acre space that had been transformed in just a few short weeks from an abandoned gravel lot to a working garden, with rows of fertile soil growing seedlings of cold weather crops. This project is called the Green Team farm project. Their aim is to not only revitalize an underutilized and forgotten urban lot, but to also serve as a job training program for homeless women, who keep part of the crop for their own use and also to sell produce to the Head Start program, benefiting low income children. In the heat of the early autumn sun, we worked alongside two homeless women, building storage containers, laying new garden beds, shoveling mulch and sand, and creating a meditation circle with rocks found on the lot.

At these gardens, we are participating in a form of population health. As family physicians we recognize that health is not merely being free of disease, but that health is influenced by many different aspects of our community. These qualities of health include access to beautiful spaces, nutritious food sources, fresh air, physical activities, safety and hope. Physicians often are acutely aware that our medicines rarely solve the problems facing our patients, especially when their problems include the struggle to meet the very basic needs of food, shelter, and clothing. Health is influenced by not only how one lives, but where one lives and addressing access to basic needs is an important component of preventive health care. Community gardens can offer many mental and physical health benefits to our patients.  They bring together community members and strengthen social connections, provide educational spaces for children and families, increased food security, access to physical activity, skill building and environmental stewardship, and possibly decreased crime in the neighborhoods they serve.  It only seems natural that as health care providers we become involved in community gardens for our patients and for ourselves.  The tendency to put our heads down and work, push through the frustrating system of health care, balancing the disappointments with the triumphs in medicine can be daunting and exhausting. Perhaps one way we can help heal both our patients and ourselves is to solve problems of poor health, not only in the office and hospitals, but also out in a garden.

To find out more about our community partner visit their website:  https://wasatchgardens.org/

Sarah Riley-Burnett, DO is a third year Family Medicine Resident in the Department of Family & Preventive Medicine at the University of Utah School of Medicine.