Writer: Lisa Rossi
Photos: Duane Tinkey
As a health coach at Broadlawns Primary Care Clinic, Corey Lewis says he walks a fine line between health coaching and therapy.
There are a lot of negative behaviors around diet and nutrition — behaviors most people learn in childhood — that health coaches try to break.
“If you grew up where food was not readily available for you and you couldn’t leave the table until you finished your food, or they gave you these huge-sized plates and you couldn’t leave, those behaviors follow you,” he said. “So we’re trying to break those behaviors they learned when they were 10, 11, 12 as 40- or 50-year-olds. And that takes time.”
Sometimes, it also takes the courage to look back at past trauma.
Lewis, along with Katie Hassler, another health coach with Broadlawns and health co-chair in the Family Health Center, work with a diverse population with diverse needs, including clients who live in food deserts or whose supplies are insecure for various other reasons. Lewis and Hassler see patients for up to 40 minutes at a time on a weekly, biweekly or monthly basis. They often have to be creative to keep up with the complex needs of who they serve.
Broadlawns is located in the poorest ZIP code of Polk County, so Medicare and Medicaid patients make up the majority of their clients, Lewis said.
“Those are the challenges, the real problems we’re dealing with when we’re trying to help someone who has high blood pressure but all they can afford is very high sodium ramen noodles,” he said. “So working through that has been an exciting challenge.”
Hassler said she shows every patient a demonstration plate with ideal serving sizes. Half of the plate should be vegetables, about a fourth of it should be protein, and a little sliver should be the grain, she said. “It’s simple things that we can help them with that I think can make a big difference,” she said.
Hassler and Lewis said one program that helped patients was the recent Produce Prescription Program, funded by the Broadlawns Foundation with additional funding from the Iowa Healthiest State Initiative. It started three years ago and just concluded. It worked by subsidizing grocery costs for every family member of the patient — $30 per family member per month. If there was one person in the household, that person would receive $30, two people got $60, and so on.
Patients loved the program, the health coaches said. “When someone gets even $30 extra a month, and they’re able to get fresh fruits and vegetables, it’s a great impact, not only on their A1C but their mental health,” Lewis said, referring to a patient’s blood-sugar average recorded over three months. “It’s one thing they don’t have to worry about. So for me, it just brings up more questions about what we can do like that for our community as a whole.”
Health coaches help patients work on more than food and nutrition. “There are other gaps in their lives we need to work on, too,” Lewis said, recalling one patient who was worried about paying rent on time after her husband had just lost his job. Lewis helped her find rent assistance, which helped her focus on getting the healthy foods she needed.
The two biggest issues for people who are food insecure are access and price. Lewis said that a lot of the people he serves live closer to a convenience store than a grocery store, even in the city. “So how do we minimize the damage from that?” he said. For starters, he might encourage someone to buy a snack size of chips instead of a whole big bag.
SNAP also helps patients make better choices, Lewis said. “If someone isn’t accessing those benefits, but they are not financially secure and they are eligible for SNAP, they need to get that access,” he said. “It plays a huge role in how someone can purchase fresh fruits and vegetables, and just food in general.”
