An AmeriCorps Service Year at RUSH
A final reflection by citlali blanco
“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better…because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause.”
—Theodore Roosevelt, “Citizenship in a Republic,” Speech at the Sorbonne, Paris, April 23, 1910
AmeriCorps Members bag groceries during a service day at Fresh Market, a client-choice food pantry run by East Garfield Park nonprofit Breakthrough.
A Worthy Cause
For me, these words by Theodore Roosevelt encapsulate the feeling of being an AmeriCorps member in the field of Social Work and Community Health (SWaCH) at RUSH. AmeriCorps is an agency of the US government that aims to foster civic engagement around pressing issues, such as disaster relief, educational attainment, economic opportunity, conservation efforts, food insecurity, and care for veterans. These programs are in 36,000 locations across the country. AmeriCorps members have a pledge to “get things done” for our country.
Though I didn’t know it at the time, my journey towards AmeriCorps began as an undergraduate student at Stanford University. I majored in human biology, and I began to realize the importance of community health engagement and research with a focus on the social determinants, or drivers, of health (SDOH). I was not familiar with SDOH prior to my university education, but each of my courses emphasized the importance of upstream factors of health, like employment, housing, education, social connections, and neighborhood resources. I increasingly realized that upstream factors, rather than the medical attention one gets at an advanced disease state, largely determine health outcomes. Despite all of the hours spent accumulating this knowledge, I still wondered how someone could practically begin to make a dent in the complexity of upstream factors of health.
Doer of Deeds
A couple months after graduating from college, I took a term of public service as an AmeriCorps member at RUSH, an academic health system on the near-west side of Chicago. I came to RUSH because of their collaborative health equity efforts, described in the 2016 health equity plan. Through my time serving at RUSH, I aimed to understand the needs of underserved communities. I grew up in such a community–specifically, the Belmont-Cragin neighborhood on the North-West side of Chicago. This is a community with an estimated 12,000 undocumented residents and “one of the largest clusters of uninsured people in the city.”
Motivated by my interdisciplinary education and the prospect of helping RUSH patients in communities like my own, I became the “doer of deeds” by working with my small team of four AmeriCorps members, all recently graduated from college. We engaged in hundreds of telephonic encounters with patients from all walks of life. Our main role was to screen patients for SDOH needs using a screener with a few standard questions, document those needs, and refer them to resources specific to their needs. We also provided ad hoc support to RUSH’s health promotions workshops held virtually for patients, staffed in-person community health events in different neighborhoods, and more. My most memorable experience was going out to police districts with physicians and other staff to interpret the medical needs of asylum seekers. It was an invaluable experience to use my Spanish-speaking ability to assist in a humanitarian crisis, which saw more than 8,100 arrivals to Chicago from the US southern border from August 2022 to April 2023.
RUSH staff visit a Chicago police department, where Citlali helped to interpret the medical needs of asylum seekers.
We had the support of our supervisors and a great collaborative network of social workers, community health workers, and community organizations. In collaboration, we wove a safety net that could catch some of our city’s most vulnerable individuals. This meant asking the types of questions that hardly anyone asks and doing our best to provide them with adequate social care resources (food, housing, employment, mental health resources, and more). Many patients thanked me profusely when I called because they were sometimes experiencing the darkest moments in their lives.
As Roosevelt describes, there is criticism tied to all worthy efforts. In my experience, my criticism came from feeling like some skills that I had gained through my university education, such as data analysis and interpretation, were not being used. However, I used this feeling as fuel to become more involved in different efforts within the SWaCH department, and my supervisors always supported my involvement.
Overcoming Error and Shortcoming
The first time I made a call to a patient, my heart was racing. I thought, “What if they pick up and I don’t know how to help?” The first couple of weeks, I called patients and assessed their needs verbatim–nothing taken, nothing added from the SDOH screener. And when they screened positive for a need, I sent them automatically generated resources–nothing taken, nothing added. I wished I could follow up with patients to see if they had accessed the resources or not.
The first time I reached a patient having a mental health crisis, I did not know how to respond, so I asked a social worker to join the call. Experiences like these taught me that there is always room for growth, and that the more I capacitate myself and practice what I learn, the better equipped I am to help people in need. After utilizing training opportunities in Mental Health First Aid and Suicide Risk Assessment provided by RUSH, I am much more comfortable taking on difficult conversations with vulnerable patients. I am comfortable asking follow-up questions to truly understand the patient and provide the most relevant social care resources, knowing I have the support of a clinical team in case of safety or risk concern. After my role as an AmeriCorps member at RUSH, I am more courageous because I know that no effort is without error, and I know that not everyone would dare to engage in these difficult conversations with strangers.
I like to think that the safety net for vulnerable patients got stronger with each patient we connected to community-based organizations, primary care, social work, mental health resources, and RUSH’s own health promotion programs.
Citlali facilitates Walk With Ease, a health promotion program offered by RUSH Generations to help adults and older adults improve mobility, balance, strength, and physical activity. This group met at the Garfield Park Conservatory.
Final Thoughts
I believe AmeriCorps members at RUSH are immersed in a worthy cause–a cause that is only catching traction, as social care integration becomes more widely adopted in healthcare systems. According to Enst & Young LLP’s recent survey of 500 organizations across several health-related sectors, “98% of surveyed organizations report having a health equity strategy in place” and “34% of these [health equity] strategies were initiated during the COVID-19 pandemic.” These data suggest that organizations are striving to make health equity more than an aspirational value following the COVID-19 pandemic. Furthermore, technological advances are serving to shift labor away from repetitive tasks to those with generally more creative demands. In my service term, I witnessed the roll-out of an automated platform that sent text messages to the same patients I would otherwise be calling to assess their needs. Data on this quick preliminary approach is still in its infancy state, but it could help optimize social care integration.
To conclude, I give well-deserved kudos to my colleagues at RUSH. These caring individuals welcomed me into their practice of social care and provided me with the professional network I needed to feel supported and motivated during my service term. Keeping in perspective the gravity and complexity of social care needs and health disparities, they have no small feat each day they show up to work and they are united by a worthy cause. As I move on to graduate school to pursue higher levels of patient interaction, I will take with me the lessons I learned from the many conversations I had with colleagues and patients around SDOH.
About Citlali:
Citlali graduated with a BS in Human Biology and notations in Science Communication and Public Service from Stanford University in 2022. As a daughter of immigrant parents, first-generation college student and current graduate student at Rush’s College of Health Sciences, she is committed to promoting diversity, inclusion, and health equity. She is most passionate about promoting health and well-being and helping people manage their chronic diseases through interdisciplinary, evidence-based programs and interventions. In her free time, she travels and dances with Evolucion Latina Dance Company, loves reading books from thought leaders in the personal and professional development field, and enjoys spending time with family and close friends. This piece is a reflection of her time as an AmeriCorps member at Rush University Medical Center from October 2022-September 2023, where she joined health equity efforts within the Department of Social Work and Community Health.