Black Lives Matter: TBSM Statement

We as Tampa Bay Street Medicine are committed to serving all people in need of healthcare regardless of race, ability to pay, or housing status.

We believe there is absolutely no place for hateful rhetoric or behavior towards any person.

We stand with the families of George Floyd, Breonna Taylor, Ahmaud Arbery, and the countless other victims of the unjust perpetuation of systemic and individual racism against the Black community.

We must stop alienating our neighbors and hiding behind walls that seek to divide us. We must openly admit that disparities exist, and work diligently, using our roles as healthcare providers, to change institutional culture in the United States and the Tampa Bay area.

For too long, the Black community has suffered from gross inequities in healthcare access, treatment, and outcomes. Examples include lower screening and higher mortality rates of various cancers; higher prevalence of hypertension, obesity, diabetes, and stroke; and nearly 3-times higher likelihood of mothers dying during childbirth[1]. Furthermore, Black Americans are almost twice as likely to be uninsured, or to lose insurance within one year[2].

Our student leadership board lacks diversity; we are committed seeking engagement from Black USF Health students across disciplines to ensure that all cultural priorities are represented in our clinical and community-based efforts.

We encourage students, faculty, and our community partners to reflect on their role in bringing about desperately needed change. Our nation is facing a public health crisis in health disparities caused by socioeconomic, educational, and justice inequalities[3],[4]. Urgency is necessary to education everyone on how systemic oppression, privilege, implicit bias[5], and structural racism[6] are deeply embedded in our healthcare system. We must confront injustices in day-to-day conversations remembering that true activism spans beyond awareness.

We would like to provide resources to help educate and enact change. Below are starter lists for reading and watching provided by USF SNMA. Click here for a robust, but by all means not wholly comprehensive, racial justice resource (includes educational, volunteering, donation, and mental health information).

[1] Petersen EE, Davis NL, Goodman D, et al. Racial/Ethnic Disparities in Pregnancy-Related Deaths - United States, 2007-2016. MMWR Morb Mortal Wkly Rep. 2019;68(35):762‐765. Published 2019 Sep 6. doi:10.15585/mmwr.mm6835a3

[2] Sohn H. Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage over the Life-Course. Popul Res Policy Rev. 2017;36(2):181‐201. doi:10.1007/s11113-016-9416-y

[3] Harris, A. P., & Pamukcu, A. The Civil Rights of Health: A New Approach to Challenging Structural Inequality. UCLA Law Review, Forthcoming. 2019.

[4] Fiscella K, Williams DR. Health disparities based on socioeconomic inequities: implications for urban health care. Academic Medicine. 2004 Dec 1;79(12):1139-47.

[5] Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision Making. Acad Emerg Med. 2017;24(8):895‐904. doi:10.1111/acem.13214

[6] Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. The Lancet. 2017 Apr 8;389(10077):1453-63.

Personal Protective Equipment Needed for Your Tampa Bay Neighbors

TBSM is currently in the process of creating a community-based mask and glove donations to support our patients during this pandemic. We need your generous help and support to ensure that are patients are properly following CDC and Hillsborough county recommendations.

First, if you have extra masks or the talent to make them, we are asking that you would consider donating them to our patients, many of whom are currently without.

We would also like to ask businesses for permission to establish a donation collection point at your storefront. TBSM would then arrange the collection and redistribution of the donations. Even if your business is not currently open, please consider donating to your fellow Tampa Bay neighbors. If you own a business, or know of one that would be receptive to helping us achieve our goal, please contact me by email: lclinkowski@usf.edu.

Current guidelines strongly recommend that all citizens wear masks in public and essential locations. Our aim is to collect and distribute these masks to the populations at highest risk, including patients/families of patients who have active cases of COVID-19 or suspected infection, but are still awaiting test results.

We feel hopeful that together we could make a serious and lasting impact for the people of Tampa Bay by reducing the transmission of COVID-19. If you would be interested in discussing your contribution or have questions, please contact us at your earliest convenience.

Stay healthy, stay safe, stay connected,

Your neighbors at Tampa Bay Street Medicine

Stepping Off the Sidelines

As we all sit at home becoming well acquainted with our webcams and walls, it can be difficult to accept our new lives. As persons invested in the healthcare system, albeit at an early stage, we might feel that internal pull towards clinical help. I know that the thought has crossed my mind to call physicians and inquire about a way to assist in person. But knowing my limited training, and risk of infecting my live-in grandparent, I have come to the conclusion that we have to allow more fully trained healthcare workers to directly encounter the disease. However, there are those that do not receive healthcare through the usual channels, that used to rely on healthcare students and volunteers for support. What of them?

The approximately 550,000 homeless persons in the United States are a particularly vulnerable population during the COVID-19 pandemic. With their needs often being met en masse, maintaining social distancing is nearly impossible, and shelters simply cannot provide the CDC-recommended 110 square feet of living space per person. In addition, this population suffers from disproportionately high rates of lung disease, heart disease, hypertension, and cancer—all comorbidities which greatly increase mortality from COVID.[i] Food bank and financial donations are decreasing, and are expected to continue to decline as government restrictions intensify.[ii] All this considered, the question remains—what can we do to help?

The American Medical Association offers a few options for medical professionals in training, including coordinated phone triage services. By engaging with potential patients before admission, volunteers can help to determine if persons should seek testing for COVID-19, an emergency that needs medical attention, or a combination of the two. Phone triaging reduces the burden on the already strained medical system, as well as, the number of unnecessary visits. Additionally, this virtual triage can detect possible cases and inform people where to find resources. While not yet popular in Florida, your reach is not limited by state—telemedical triage is open to volunteers from across the nation. For those of us who are not as advanced in our education, donating to telemedicine initiatives, like that for Volunteers in Medicine America, can still help connect patients with online care.

We can also help counter the incredible shortages food banks are encountering. Close to home, Feeding Tampa Bay’s Emergency Response Volunteer Team is accepting applications, where you can help sort food for shipment from their warehouse and in certain delivery services. Feeding Tampa Bay is also taking donations. However, rather than asking for people to travel and purchase extra groceries, they are simply asking for online monetary gifts. Even a one-time donation can greatly reduce the burden of food insecurity for a Tampa family.

With most volunteer clinics closing down or running at minimal capacity with licensed providers, many students are looking for a way to return to in-person volunteering. Shelters still require volunteers to maintain daily services, including keeping living and service areas clean. For now, Metropolitan Ministries Coronavirus Response Initiative is accepting volunteers at their Tampa campus with added precautions. Many opportunities include maintaining the shelter’s grounds and facilities, as well as food and essential goods distribution. With the drastic increase in unsheltered persons seeking admission, volunteering with them helps our most vulnerable citizens retain access to the essentials of life.

These unprecedented times have left many of us feeling powerless in the face of the virus. Taking the time to remember all the ways we can assist others can restore our sense of control and inspire hope. More importantly, the actions we take to volunteer and social distance keep our most at-risk persons alive. When this pandemic passes, I know that we will re-enter the world with a vigor to serve that has never before been seen. Until that day, we have more opportunities than we think to alleviate the suffering.

Robert Monsour is a first year medical student at USF Morsani College of Medicine and the Social Media Coordinator for TBSM.

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[i] CDC.gov. “Responding to Coronavirus Disease 2019 (COVID-19) among People Experiencing Unsheltered Homelessness.”

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/unsheltered-homelessness.html

[ii] Reiley, Laura. Washington Post. “Food banks are seeing volunteers disappear and supplies evaporate as coronavirus fears mount.” 16 March 2020.

https://www.washingtonpost.com/business/2020/03/16/food-banks-are-seeing-volunteers-disappear-food-supply-evaporate-coronavirus-fears-mount/