Honoring the legacy of my professor Dr. Paul Farmer through delivery of the CDC’s National Diabetes Prevention Program

“Public health is about identifying the challenges that dampen humanity’s potential — and then finding ways to solve them. This work can take many forms. Leading frontiers of public health right now include improving nutrition, tackling climate change, controlling infectious diseases, curbing violence, and even reimagining aging to enable the elderly to live more independent and fulfilling lives. At their heart, though, all these fields and many others are about refusing to accept the status quo.

It is the status quo that nearly 3 million people worldwide will die each year from diseases caused by excess weight. We could accept that as inevitable. Or we could systematically identifycost-effective, culturally sensitive, population-level strategies to improve nutrition, boost physical activity, and help people from all backgrounds maintain healthier weights.

It is the status quo that the poor do not receive equitable access to quality health care. We could accept that as inevitable. Or, as Paul Farmer did, we could fight each day to change the odds.”

Working as the CEO of a diabetes prevention program delivered via Telehealth often feels like I am working against the odds and to change the status quo. The US healthcare system puts more dollars into funding treatment of disease rather than the prevention of it.

I am not sure what the best way is for Dr. Farmer’s former students to honor him, but Dean Williams may have said it best that instead of accepting the inevitable we could fight each day to change the odds. The way I plan to honor Dr. Farmer is to keep working as hard as I can to help individuals with prediabetes enroll into the CDCs National Diabetes Prevention Program so they can avoid developing Type 2 diabetes.

When I was in college, I was originally planning to go to medical school, but ultimately I became more interested in pursuing a career in public health for a variety of college experiences. I was volunteering in an emergency room while simultaneously taking a nutrition epidemiology course. I saw a man pass away from his obesity and heart disease and I viewed this man’s passing as the status quo. I thought, why couldn’t this have been prevented if someone helped him live a healthier lifestyle? The nutrition epidemiology course I was taking was being taught by Karen Michaels, a Harvard School of Public Health professor. This was actually the first course I took through the Harvard Extension School. I realized that many of the chronic diseases such as diabetes were preventable through diet and lifestyle. I also learned about this by reading about the work that Dr. Dean Ornish did to reverse heart disease through diet and lifestyle modification.

Dr Farmer’s course also inspired me where he highlighted that the poor do not have equitable access to healthcare. This made me think about the importance of offering Fruit Street’s diabetes prevention program to a lower income Medicaid population. Most of our competitors focus more on selling the diabetes prevention program to Fortune 500 companies rather than Medicaid. But the problem with that is that it is the Medicaid population that has the highest rates of obesity and diabetes.

I hope that when I pass away hopefully many years from now that I will be able to achieve at least a fraction of what Dr. Farmer accomplished with his life. I hope that one day I will be able to say that our team at Fruit Street enrolled millions of people into the CDCs national diabetes prevention program and that we prevented thousands of cases of diabetes, amputation, blindness, heart disease, and all of the other diabetes associated complications.

Dr. Farmer - just know that our team at Fruit Street will work every day to take what you taught us about public health and helping the poor have access to healthcare, to make the world a better place, improve human health, and reduce human suffering. You will always serve as an inspiration to every public health entrepreneur.

Your former student,

Laurence

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