Underserved Workers Gain Access to UCSF OEM Specialists

Street Level Health Project, a grassroots non-profit organization in the heart of Oakland’s Fruitvale neighborhood, offers free medical screening to urban immigrants without health insurance. Known as the “International Clinic” with patients from over 26 countries, its staff connects underserved community members with local support services for healthcare, food, housing, and more.

Now, in an innovative partnership with UCSF, Street Level Health Project is offering occupational medicine consultations to injured workers who depend on the free clinic for care. Immigrant day laborers with chronic low-back pain and house cleaners with work-related respiratory problems are receiving treatment from Manijeh Berenji, MD, a Clinical Fellow from the Division of Occupational and Environmental Medicine (OEM) in the UCSF School of Medicine.

“This is a population that has fallen through the cracks,” says Berenji. “They don’t have access to the traditional channels after an occupational injury. Unfortunately, these workers can go without medical care for a long period of time.”

The services offered by Berenji and two additional occupational medicine residents, Scott Petersen, MD, and Lan Nguyen, MD, and UCSF faculty are made possible through a training grant from the Health Resources and Services Administration, or HRSA.

The goal of the grant, now in its third year, is to increase clinical experience with underserved populations within UCSF’s OEM program.

“I think it’s a great training opportunity for our residents and nursing students,” says Dr. Robert Harrison, the associate residency director of OEM and principal investigator of the HRSA grant.

“At a Tertiary Care institution like UCSF we’re very good at the challenging diagnoses and at providing high-level consultation and multi-specialty evaluation, but gaining access to vulnerable low-wage populations through a partnership with Street Level Health Project is good for our trainees and also good for the workers by providing access to UCSF faculty and advanced level residents,” adds Harrison.

Bay Area immigrants are frequently employed in construction, food preparation, cleaning, and transportation. Their exposure to work-related health hazards is higher than average, yet they are less likely to have health insurance.

“These are migrant workers and often their employer doesn’t have established healthcare,” explains Berenji. “If something happens to them on the worksite, they have nowhere to go.”

In Alameda County, where Street Level Health Project is located, 18 percent of adults are without insurance for all or part of the year, according to the 2011 California Health Interview Survey.

“When a low wage worker is out of job for a day or more, it has a ripple effect on their families,” notes Noellyn Robleto, Street Level’s Wellness and Prevention Coordinator. “Our main goal is to ensure we are providing the right services so they can stay healthy.”

On a recent clinic visit, Berenji got to know more about her patients by stepping in to serve lunch to the community. “It’s amazing what they’ve been through,” she says. “They are making it day by day. With Street Level Health Project, they have somewhere to go and people they can talk with in their native language. It’s a valuable community resource.”

Harrison says the collaboration is a pilot to assess the need for continued clinics. Currently, Street Level Health Project is building a worker-driven leadership network to spread the word about the occupational medicine services now available.

Through the HRSA grant, Fellows and faculty from UCSF provide assistance to a community that is acutely underserved. “This is why I went into medicine,” says Berenji. “I believe, especially with this population, we are making a difference.”

For information about Occupational and Environmental Medicine at UCSF: http://oem.ucsf.edu

For information about Street Level Health Project: http://streetlevelhealth.org

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