A popular Vanderbilt course mobilizes students to make a difference among Nashville's diverse populations

by Kara Furlong
photography by John Russell

Clockwise, from left: Nicole Gunasekera, Alex Arnold, Emily Zern, Kate Foster and Ravi Patel are members of the Nashville Mobile Market executive board.

In recent weeks, things have changed for the better in the Edgehill community, a neighborhood located a few blocks from the Vanderbilt campus. Healthy food is now more readily available to Edgehill’s low-income residents, thanks to an innovative “mobile grocery store” developed by second-year medical student Ravi Patel and initially inspired by his experience in an undergraduate Human and Organizational Development class.

The summer following his sophomore year, Patel spent a month in Uganda working with HIV and AIDS patients through the Kampala Project, an initiative of Vanderbilt’s Office of Active Citizenship and Service. His time in the East African nation was a definitive experience for the then pre-medicine major with a keen interest in global health. But it wasn’t until he was back in Nashville that Patel was exposed to a wholly different epidemic.

That fall he enrolled in HOD 2510, a class known as Health Service Delivery to Diverse Populations, and learned about “food deserts,” a distinctly urban health concern linked to a host of preventable diseases. Food deserts are city neighborhoods without full-fledged grocery stores, limiting residents’ access to fresh, healthy foods.

“In Uganda I saw people who were dying from HIV and AIDS, so it was a totally different perspective to see people who were struggling with obesity and life-threatening diseases like diabetes, hypertension and high cholesterol,” Patel said.

HOD 2510 – taught by Human and Organizational Development professors Sharon Shields and Leigh Gilchrist in conjunction with Liz Aleman, manager of the Healthy Children outreach program at Monroe Carell Jr. Children’s Hospital at Vanderbilt – gives students going into the public health, direct medical care, social work or counseling fields foundational information about health care policy and health service agencies and delivery systems. The class demonstrates how various influences affect health risk and disease reduction among diverse populations.

“There are four core concepts that we want students to focus on – diversity, advocacy, social justice and compassion – and to use these as a lens through which to view the delivery of health service in this country,” Shields said. The class does this so effectively by putting a human face on the issue: Advocates from the community come to the classroom to share their stories and lead discussion, and students participate in site visits to see community needs first-hand.

“The students’ experiences in the class and through service learning make them part of a larger network,” Aleman said. “They gain critical connections in the community.”

One of the site visits is a community tour taken by bus to familiarize students with the social and economic disparities of Nashville’s neighborhoods. The tour starts in Edgehill, where the primary food retailers are convenience stores, and eventually travels to upscale Belle Meade, where three or four full-scale grocery stores can be found within blocks of one another. The tour tends to leave a big impression on students – as it did Patel.

“We followed the route that someone from Edgehill using public transportation would take to get to the grocery store,” he explained. “We calculated how long it would take, including switching buses, and how much it would cost someone on a limited income – and it really adds up.

“Another thing is, how do you carry a week’s worth of groceries from store to bus stop to home?” Patel said. “It opened my eyes to the fact that being able to get food conveniently or even in a reasonable manner is a factor in people not having access to healthy foods.” As an assignment for the class, Patel wrote a memorandum describing a plan to combat food deserts in Nashville.

Writing the memorandum was a valuable exercise – though completely theoretical – until Patel, now a Vanderbilt medical student, began volunteering at Shade Tree Clinic in East Nashville. There he routinely sees patients facing chronic diseases due to poor diets who say that healthy food is simply out of their reach.

“Hearing that for the first time was a slap in the face,” Patel said. Not only did it reinforce what he learned about food deserts as an undergrad, but “it really hit home that I can do all of the education in the world and try to get these people the medications they need, but if they don’t eat what they’re supposed to, at the end of the day medicine can’t help them.”

Robert Miller, Shade Tree’s medical director and associate professor of clinical medicine at Vanderbilt, encouraged Patel to explore the feasibility of opening a fresh foods grocery store near the clinic as part of Patel’s medical school emphasis project, a research requirement of all first- and second-year students. He dove in, even taking professor Jim Schorr’s Social Enterprise and Entrepreneurship course at the Owen Graduate School of Management to learn how to create a business plan.

Patel sought help from fellow student leaders, including seniors Alex Arnold, Emily Zern, Nicole Gunasekera and Alex Ernst. With their assistance, he formed a student executive board that could begin to search for funding, create an operations base and start community outreach educational efforts.

Funded by a $65,000 grant from the Frist Foundation, the mobile market is a 28-foot trailer that transports fresh produce, dairy and other refrigerated items to five stops in the Edgehill neighborhood each Friday, Saturday and Sunday. Customers walk through the trailer as they would a grocery store aisle. Food is priced competitively with that at Kroger supermarkets in town, and the mobile market accepts Electronic Benefit Transfer cards (i.e. Food Stamp assistance) along with other forms of payment. The market is run by volunteers from across the Vanderbilt campus, as well as two full-time employees.

“Ravi did a phenomenal job of really thinking through every aspect of the project and bringing all of the key players to the table, from the General Counsel’s office to Risk Management to the medical center to the Provost’s office,” said Gilchrist, who serves as the mobile market’s faculty adviser. Not only did this lend legitimacy to the project, it raised awareness of food deserts as a long-time need in the community, she said.

For more information on the Nashville Mobile Market or to see a schedule of stops, visit www.nashvillemobilemarket.org.