by: JT Parker

Twice a year we award a student the iVein Health and Wellness Scholarship. Students must write an essay that promotes a practical approach to a healthy lifestyle in college and how these habits can be sustained over a lifetime.

This year’s fall scholarship was awarded to a student from Yale. Here is the winning essay:

APIA, Samoa—In the early heat of the morning rush-hour, a line wraps around the corner
for 10 sene panikeke, small buttered doughnuts donning the check-out lines of markets. A
woman hands her children plastic bags filled with panikeke as they each pop one into their
mouths, wiping streaks of frying oil on their lava lavas. She hands them each a bag of Bongos,
the Pacific’s most popular brand of cheese puffs, for a lunchtime snack and sends them on the
public bus as vendors try the perimeter with bags of chips and soft drinks.

I looked on in confusion. A papaya tree stood tall directly behind me, ripe with its
orange-red fruit. Avocadoes, limes, pineapple, and oranges…I envied this tropical oasis placed
directly before those who preferred canned Vienna sausages or corned beef. Yet, as much as I
tried to search for answers, I began to find an innate similarity between the choices made by the
Samoan people and those made by college students.

Why do these food preferences exist? What has caused this epidemiologic transition from
fresh produce to high-fat diets?

These questions formed the crux of my research questions this summer as I traveled to
Samoa as a Wilbur Downs International Research Fellow to investigate the chronic disease
burden in Pacific Islanders. The Pacific faces the highest rates of obesity and diabetes globally,
in which up to 93% of adults are overweight or obese and nearly 47% have diabetes. Lifestyle
changes, nutrient-poor diets, and a lack of physical activity have contributed to significant noncommunicable disease morbidity and mortality. On top of these existing challenges, geographic isolation from the nearest specialty care centers in Hawaii and New Zealand, which are more
than 2000 miles away, has created a system where many cannot access proper care. Medical
supplies are limited and the cost of diabetic care is unsustainable.

In 2011, the Pacific Islands Forum even issued the statement, “The Pacific is in an NCD
crisis.” How did the Pacific get here? What will the chronic disease burden look like 10 years
from now?

Traveling to remote villages, I was hoping for an answer that would address the unique
challenges of Pacific Islanders. I collected anthropometric measurements, blood pressure,
hemoglobin A1C values, and even screened for eye complications. Yet, as much as I expected
that these would deliver me the answer I was looking for, it was through conversation with the
Samoan people that I gained remarkable insight into the difficulty to achieve healthy living.

“It’s affordable and pre-packaged,” some of the villagers noted. Others commented,
“Those with larger stature are viewed as more beautiful, wealthier, …more Western.” And others
would note, “We don’t have time to sit down for a long lunch. There is no such thing as ‘lunchtime’
here. You grab what you can and continue to work.”

As I listened to their recounts, I realized that despite traveling across the world, I had
uncovered some of the very same tenets that I—and other college students—encounter at home.
Affordability, time, and social perception—these three factors weigh heavily in food choice and
the ability to live a healthy lifestyle. As a Master of Public Health student, I was familiar with the
role that external factors, including cultural norms and social variables, play in the rise of the
obesity epidemic in the United States, but did not anticipate the similarity among these variables
that exists on a global scale.

I boarded the plane from Samoa to Boston, considering what I had witnessed and what I
had discussed with those from some of the most remote villages. I questioned my lifestyle
choices as a college-aged female student, acknowledging that affordability, time, and social
perception often dictated my food choices while living at college. Pursuing a rigorous curriculum
and course-load, I found that many of my peers and myself often allowed healthy food choices to
suffer at the expense of attending class, staying in the laboratory until 11:00 pm to finish an
experiment, or skipping lunch to attend an organizational meeting.

As a first-generation college student, I experienced the challenge that cost and social
perception plays these decisions—between choosing less expensive snacks versus more
expensive fruit or vegetable options. Just as Samoans expressed that many of these factors began
to control their decisions, I found that I had also fallen victim to these variables.

I was frustrated. I felt that these choices had to be black or white…for myself, for Pacific
Islanders, for first-generation or low-income students, and for all college students.

Seeking to address just a few of these healthy lifestyle barriers—affordability, time, and
social perception—I approached healthy living with a community I could support and would
support each other in turn. As President of A Leg Even, the First-Generation and Low-Income
Student Network at Yale, I have worked closely with first-year students encountering the
challenges of college-life and how to balance an academic lifestyle with personal health. I have
worked with students to obtain PDF versions of textbooks to avoid the cost, to create a
community that shares professional clothing for interviews and meetings, and to openly discuss
questions related to choices during their first year.

Recognizing the inherent need for earlier guidance and intervention with regards to
healthy living, I implemented the first Yale First-Generation Speaker Series, inviting
professionals to speak about how they managed their finances as a first-generation or low income
college student, and how these relate to healthy living. I witnessed the powerful
underlying causes that tied my work with first-year students at Yale and the community of
Samoans who generously invited me into their homes and villages, making healthy living far
from a narrow but rather a global endeavor.

I have learned to approach public health and community work with the provision that you
cannot judge the condition of another without providing equity in resources and the
empowerment to sustain them.

Medical Assistant

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