Some students stole to pay bills. Others begged. Still, others deliberated whether to buy their child’s medication or pay the mortgage. These acts—part of a simulated poverty experience for students at McGovern Medical School at UTHealth—illuminate the circumstances some of their future patients may face.
“Can they afford the medication you’re prescribing? Are they sick because they don’t have a place to live or access to food?” asks Rebecca Lunstroth, JD, who directs the simulation.
Lunstroth brought the first Community Action Poverty Simulation to the school in June 2018 to help medical students understand the challenges of living in poverty—challenges that may prevent some patients from following treatment regimens.
The simulation assigns students to “families” with unique life circumstances. During four 15-minute “weeks,” students must acquire necessities like
food and shelter, accessing community services while juggling responsibilities like child care, work, and illness.
“Health care only accounts for about 10%–20% of our overall health,” Lunstroth says. “The rest comes from factors like where we live, how much we earn, and how much education we have. It’s this 80 to 90 percent that the poverty simulation really gets at.”
Following the simulation, students debrief to process and discuss their experiences. Overall, students who participated in the simulation reported greater empathy toward people in poverty, while also expressing increased confidence in their ability to assess a patient’s socioeconomic status and point the patient toward helpful resources.
McGovern Medical School incorporated the poverty simulation into its curriculum as an annual event, holding the second simulation in January 2019. Lunstroth hopes the experience will continue to help future doctors see impoverished patients— including those who struggle to adhere to treatment plans—with compassionate eyes.
“It’s not that they want to be sick,” she says. “They just have more pressing needs.”