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Communication is a critical aspect of the human experience, and, for Dr. Jason Rosenfeld, it is the key to making any societal shift.
From working with small communities in Africa to helping rural towns in the Rio Grande Valley, he has devoted his career to crafting the right phrase or infographic that can effect change. This work in healthcare communications has led to numerous victories over countless threats.
With the spread of the current novel coronavirus, COVID-19, Rosenfeld, his colleagues, and a team of medical students at UT Health San Antonio are addressing this new danger by creating health messaging to help people understand what this illness is, how it spreads, how to stay safe, and other critical pandemic information.
Rosenfeld, DrPH, MPH—an Assistant Professor of Medicine and the Assistant Director for Global Health of the Center for Medical Humanities & Ethics at UT Health San Antonio—and the group hope their effort can improve health knowledge and behaviors in San Antonio and beyond.
“It’s been a bit of a whirlwind journey,” he said. “But I feel blessed that I’ve had an opportunity to pursue my dreams and to do what I think is really important — bring lessons from around the world to bear in mind when we’re designing health interventions locally.”
Learning to Talk the Talk
Healthcare is a family business for Rosenfeld.
Originally from Dallas, his closest relatives are all associated with the medical community in one way or another. Initially, Rosenfeld aimed to pursue a different path — one that bent toward public service.
“I come from a family of educators and physicians, predominantly,” Rosenfeld said. “My father is a now-retired professor of neonatology at UT Southwestern. My mother is a retired pediatric, emergency room nurse. So, I grew up surrounded by health care and research. Still, from the beginning, I’ve always been service-oriented — it’s just in something that has been inherent to me.”
Nevertheless, his journey led to a career in medicine.
“My career in public health began pretty shortly after I graduated from Duke University with a degree in political science,” Rosenfeld said. “I wasn’t entirely sure what I wanted to do with my life and career at that time. I knew that I was interested in traveling, I was interested in service, but beyond that, I didn’t have a huge amount of direction. And so a friend of mine recommended that I look into the United States Peace Corps, which I did.”
He accepted a U.S. Peace Corps position as a community water sanitation health advisor in Ghana, West Africa.
Here, Rosenfeld worked with a rural community of roughly 9,000 to implement communication campaigns centered around better-health practices.
“I spent the majority of my time designing health education campaigns to contribute to the national Guinea worm eradication campaign,” he said. “I would spend a lot of time educating, both in my community that I lived in worked with but also in surrounding communities.”
These experiences with the peace corps and seeing how these two pursuits—spreading knowledge and healthcare—could align, Rosenfeld’s trajectory shifted.
“What’s actually really funny is I went to university to study political science, after initially wanting to be a medical doctor — organic chemistry and I did not get along very well. My parents laughed at me because I graduated with this degree in political science, and then I went off to serve in the United States Peace Corps for the health adviser.
“Their joke was, ‘As far as I wanted to run away from healthcare, there’s no way that I could get away from it.'”
Healthcare Communications Abroad
The first thing Rosenfeld says people must realize about healthcare is that understanding concepts and practicing them do not always have a straightforward relationship.
“I always shocked at how many people knew exactly how to prevent guinea worm,” he said. “About 80% of the audiences that I would speak with could answer prevention questions correctly. Then I would ask, ‘Well, how many of you got guinea worm the previous year?’ Half of that population would raise their hands.
“There’s a disconnect between knowledge and health behaviors.”
That divide prompted Rosenfeld to pursue a master’s degree in public health at Emory University. He also continued his efforts across the globe, working with other communities in Africa.
In various towns throughout the continent, Rosenfeld’s group would bring community members together to create a team of dedicated individuals. These participants would become informed of the healthcare issues impacting their communities, then spread that knowledge among their family, friends, and neighbors.
Rosenfeld said this approach succeeded in more ways than one.
Not only were previously overlooked groups given the resources needed to make changes, an actual social shift was made because those individuals played a part in the process.
“After many years of doing this work, I’ve come to realize that knowledge is this is the starting point,” he said. “We can’t make changes in our lives without first having an understanding of the world in which we live. The part of my work that I love so much is that the knowledge that these communities have — they’re co-creating it. That’s the goal of our intervention programs.”
He would go on to continue his work in Africa, focusing efforts across the entirety of Zimbabwe. Rosenfeld said this national focus would impact his understanding of another crisis that would affect the entire world.
Bringing Healthcare Clubs Home
Despite Rosenfeld’s success, politics in Zimbabwe changed the course of his entire life.
In 2010, the government expelled all foreign workers before the start of the national election. While this practice can be common, according to Rosenfeld, it still came as a shock.
“It was a unique opportunity for me to cut my teeth in the field, which is exactly what I wanted to do after completing my course work,” he said. “Realizing that I wanted to be overseas, I wanted to be designing and evaluating community-based health interventions — but the rug was pulled out from under me.
“So, we ended up coming back to San Antonio quite abruptly.”
Even though this forced return home took Rosenfeld by surprise, it did not impact his passion for helping others. Shortly after coming back to the U.S., he began working with the Center for Medical Humanities and Ethics at UT Health San Antonio’s Long School of Medicine.
Since 2011, Rosenfeld has been using his learned experience from Africa to implement similar programs in underserved Texas communities — specifically in the Rio Grande Valley.
“We’re beginning to adapt and utilize what that I’ve learned from our international programs to help improve health outcomes and address health disparities in our South Texas communities,” he said.
Here, Rosenfeld found familiar roadblocks in the Valley to those in African communities, such as a community-wide distrust of outside help, little to no practical aid, and an overall lack of access for holistic wellness.
“If you think about under-resourced communities around the world—whether it’s a rural village Ghana, an informal settlement in South Africa, or even colonias in South Texas—one a common denominator across those communities is that, oftentimes, access to education has been limited,” Rosenfeld said. “We know that without education, all outcomes are lower, whether it’s economic outcomes, health outcomes, or even social achievement.”
So, he and his collogues went to work on changing not only how much information was spread but how they tailored that dissemination to specific groups and areas.
One strategy included targeting the matriarchs of these communities. This is because when health information is given to women, they often spread and encourage those practices amongst their spouse, children, and other loved ones.
“You’re improving that entire family’s knowledge and their children’s health into the future,” Rosenfeld said. “That, to me, is the beauty and the value of knowledge.”
A New Issue Emerges: COVID-19
In the middle of this Rio Grande Valley initiative, another curveball changed Rosenfeld’s professional pursuits — the coronavirus pandemic of 2020.
Like many people’s experience, the outbreak put a halt to his on-the-ground outreach work in the Rio Grande Valley. Nevertheless, Rosenfeld began using his experience abroad and at home to start another health-centric communications campaign: generating informational content on COVID-19.
This project began when Rosenfeld partnered with Dr. Barbara Taylor, an associate professor of infectious diseases and assistant dean for the MD/MPH Program at UT Health San Antonio. She surveyed students’ interest in aiding in COVID-19 information dissemination.
“The response was overwhelming,” Rosenfeld said. “A portion of those students went and supported Metro Health — manning the hotlines, talking to physicians who had questions about COVID, and other projects. But a larger portion of that student body was redirected toward helping to develop two different information campaigns that we’ve now been running for a few months.”
The first of these initiatives focuses on spreading factual information about the disease. These students are creating simple-to-understand infographics that could be spread virtually.
More importantly, they also converted digital information into hard copies to reach underserved communities with no Internet access, according to Rosenfeld.
In about 2 to 3 weeks, that team developed five, including:
- Why physical distancing is critical
- What a mask is and why it is needed
- The steps to follow if somebody thinks they might have a COVID-19 infection
- Essential resources that help with access to housing or transportation
The second arm of the initiative was developing a storytelling model that shares the experiences of healthcare heroes who are working in the COVID-19 outbreak.
“Our slogan has been ‘Heroes Beyond the Mask’ because our students didn’t want to just focus on really the vital role that our healthcare providers are providing, but the role that our community members are engaging in,” Rosenfeld said. “Making masks for each other, and supporting each other by providing child care, going to grocery store shopping. It’s really a catchall for all heroes across San Antonio and Bexar County.”
So far, the group has profiled at least six individuals. They have many more coming soon.
Moreover, there has been a positive response to these inatiatives, which the group shares via Facebook.
Still, when it comes to systematic change, Rosenfeld said spreading knowledge is not nearly enough to affect hearts and minds. When it comes to the COVID-19 outbreak, he relates to the public’s understanding of the disease to his experience with the people of Ghana.
“Knowledge in and of itself is insufficient,” Rosenfeld said. “There has to be a social process by which people grapple with that knowledge. It has to be important, socially, that they do something with that knowledge—practice action on the knowledge that you gain—that’s where change really occurs.”
Looking Toward the (Uncertain) Future
Still, even with these efforts, Rosenfeld believes it will take a community-to-state-to-country mindset change to make a difference in how the U.S. handles this virus — and its long-term impacts.
“Knowledge is constantly created,” Rosenfeld said. “It’s created by other people that are then shared with these with communities, but we also ignore the fact that communities and individuals generate knowledge every single day, even if it’s not you know shared on CNN or the national news. We can’t envision a different future—we can’t achieve change—until we first understand and give life to the world that we currently live in.”
Despite all the chaos COVID-19 has caused, Rosenfeld said he hopes that people recognize the need for change.
His call to everyday individuals? Use the gifts you’ve been given to make an impact.
“I recognize that I come from a place of privilege,” Rosenfeld said. “I try to use the privilege and the opportunities that I’ve been afforded to try to help other communities that have less — try to help them reach their greatest potential and live their best lives.”
Editor’s Note: Listen to last week’s episode of the Salud Talks podcast to learn more about Dr. Jason Rosenfeld and his work!
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This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.
The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.