TMC PULSE

t m c » p u l s e | d e c e m b e r 2 0 1 6 20 It's a complicated process, putting patients in charge of their health, but for individuals living with Type 2 diabetes and other chronic but manageable medical conditions, it can mean the difference between life and death. "Instead of just handing participants a piece of paper and saying, 'Here, change your diet,' we're looking at: What does that mean? What can you afford? How do you cook that? What are some ideas for access?" explained Lisa Mitchell-Bennett, M.P.H., M.A., project manager for campus-based outreach and research. "In every way, we want to create a back-up system or a support system for implementing those recommendations." The entire city of Brownsville, it seems, is on board. Local churches have opened their doors to exercise classes rooted in Zumba® and Latin dance. Evening sessions feature tips on portion sizes and nutrition labels, as well as "diabetes bingo." The Brownsville Wellness Coalition, which has funding provided by CCTS, was created to manage the Brownsville Farmers' Market, five community gardens, a mobile farmer's market, and gardening and cooking classes. And the City of Brownsville is currently in plans to create a more bicycle- and walking-friendly city. The UTHealth team also broadcasts weekly health segments on local television, and Mitchell-Bennett writes a regu- lar column about health promotion practices for two newspapers in Cameron County. "It's systematically changing our commu- nity through policy change, environmental change, media, social media, community health workers—all of it," Reininger said. "Addressing health disparities is not a simple fix, so we're not trying to simplify. We're trying to build complementary strategies." A safe haven Located on the border where the Rio Grande and a high metal fence are visible from count- less vistas, the Valley is home to many low- income and uninsured residents, some of whom do not qualify for health care in the U.S. and who find it difficult to make a living wage. Recognizing this gap, UTHealth commis- sioned the Mobile Health Clinic for under- insured patients or patients with no health insurance at all. Regardless of legal status or ability to pay, the mobile clinic is a safe haven for those in need of acute care for minor ill- nesses and injuries, immunizations, blood tests, well women exams, physicals, help managing diabetes, and more. network station and spent years chasing stories up and down the Northern California coast. One day, he found himself working on a segment about migrant health workers, many of whom were sick with nowhere to go. Their sto- ries pulled at his long-buried dreams and, then and there, he decided to go back to school. The clinic parks at five different locations throughout the area for two months at a time. Initially, its purpose was to focus on screening and acute care, but it has grown to treat chronic illnesses, as well, and is now the only clinical care many have. Toscano and his medical assis- tant, Flor, take time to educate their patients. "We do a lot of social work here," Toscano said. "When patients come in, they get the diagnosis, the education, we do the physical exam—we do everything. Before they walk out, we always help them find their medications and then we can tell them where to go and give them coupons. The visit takes a lot of time, but we want to provide them with the whole spec- trum of care." Nelda Cantu-Cruz is a local kindergarten teacher and a patient at the mobile clinic. Due to a medical disability, her husband is unable to work, so she is the sole source of income for her household. Although the school provides her with insurance—for a fee of $525 a month—she cannot afford the additional $4,000 deductible. "This clinic has been sent from heaven for my husband and myself," she said. "The only thing I can afford is this little bus." Cantu-Cruz shares the clinic's number with anyone in need, especially at her school where the majority of her students are first-generation citizens, whose parents are often at a loss when it comes to seeking out medical care. "It's sent from heaven for them because they Left: The Mobile Health Clinic parks at five different locations in the Valley. Right: Paul Toscano, PA, helps patient Nelda Cantu-Cruz off the bus after a check-up. This clinic has been sent from heaven for my husband and myself. The only thing I can afford is this little bus. — NELDA CANTU-CRUZ Local kindergarten teacher and patient Painted burnt orange and outfitted with a small exam room and sitting area, the clinic is run by Paul Toscano, a physician assistant who grew up in Harlingen, about 30 miles north of Brownsville. As a young boy, Toscano had always dreamed of going to medical or dental school, but life took him in a different direc- tion. After college, he moved to San Francisco to work as a news videographer for an ABC

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