Helping Families Find Their Way to Health
Family Information and Navigation Desk (FIND) helps physicians address root causes of poor health, such as food and housing insecurity and mental illness.
The 4-year-old girl had been to the emergency room several times for asthma but still was wheezing and coughing when pediatrician Dayna Long, MD, saw her at UCSF Benioff Children’s Hospital Oakland.
“Traditional medicine would teach that ‘uncontrolled asthma’ [means] they’re non-compliant with their medicines,” she says. But Long’s deep interest in health equity leads her to dig deeper with such patients. In this case, the girl’s family lived in a shelter, where they were exposed to secondhand smoke and often went hungry. And the girl’s primary caregiver, though a “fantastic, loving” grandmother, had some mental health challenges.
So Long referred the family to FIND, the hospital’s Family Information and Navigation Desk Program. FIND, which Long created, helps families address non-medical issues like homelessness and food insecurity, which often have more impact on a child’s health than medical care does. The program’s 30 volunteer resource specialists are trained by social workers to navigate the maze of government agencies and nonprofits that can help in such situations. In this case, the grandmother was referred for counseling, and the family was enrolled in a food-stamp program, directed to a food bank, given housing advice, and registered in a local nature program.
Long, a specialist in asthma care and a UCSF resident alumna, learned early on that childhood asthma is especially susceptible to social determinants of health. “Simply refilling this girl’s asthma medicines wasn’t addressing the stress, the environmental triggers, that were leading to her emergency-room visits,” she says.
“I got to a real decision point,” Long explains, of what led her to create FIND. “I either decide to leave medicine, or I do something from inside to fix the system.” Established in 2012, FIND now runs on a robust technology platform that helps volunteers link families to the most appropriate resources and helps the program’s leaders assess its effectiveness on a population-wide level or stratified on the basis of language, age, and other demographic factors.
“When I started this work,” Long reflects, “well-meaning individuals told me, ‘Dayna, you’re not going to solve poverty.’ My answer is always, ‘Well, we certainly have to try.’”