Jamie Robinson has always been a healthy eater, but she never had to work as hard to make a healthy trip to the grocery store as she did in January. “I wanted to get a big bag of grapes for snacking, but they were $4, so no grape snacks,” Robinson says.
The unbought grapes were lesson one for the second-year medical student. Robinson and her 100-plus Vanderbilt School of Medicine classmates were asked to participate in the SNAP challenge as part of a class. SNAP stands for Supplemental Nutrition Assistance Program—the federal program formerly known as food stamps.
The challenge was to eat for five days on the amount of money the average person on SNAP receives—about $3 a day, or $1 per meal. To make things tougher, students were instructed to track their calories and nutrition on a government website (www.mypyramid.gov) to make sure they were still eating healthy.
That meant no midnight trips to stock up on all-you-can-eat tacos, and for healthy eaters like Robinson, it even meant eating foods she considered less healthy. At the end of her shopping trip, Robinson had white bread and bananas for lunchtime banana sandwiches, canned beans, frozen vegetables, eggs and no meat.
“The purpose of this experience is to help medical students better understand the patient’s perspective on the challenges he/she faces to maintain a healthy lifestyle given certain financial restraints,” says Lynn Webb, assistant vice chancellor for health affairs. “We want to put the students in the shoes of the patients so they can be better clinicians.”
Webb coordinated the SNAP challenge for the School of Medicine’s Patient, Profession and Society course. As part of a major curriculum revision in 2006, the course was added to integrate topics like ethics, economics, communication skills and prevention.
Many students commented about the lack of variety in their diet during the challenge. Second-year student David Marcovitz longed for a granola bar and blueberries on his cereal, but couldn’t afford them. Instead he located “day old” bread at Target so he could afford the whole-wheat variety for sandwiches at lunch, and ate a concoction of pasta mixed with egg and tomato sauce for dinner four nights straight.
“The lesson from this is that it’s not really about hunger in the U.S., because anyone can take this amount of money and go to the dollar menu and get enough calories for the day,” Marcovitz says. “But if you want to have good nutrition, it takes a lot of work, a lot of education, a lot of thought, and a lot of preparation.”
For the estimated 600 SNAP recipients who come to Vanderbilt clinics every day, following the advice of practitioners about the importance of diet may not be easy.
Webb says that is the point. “Overall, the goal is to help our students maintain an appreciation for the human dimension of care: that the disease being treated is just one aspect of what’s going on in a patient’s life.