HealthlinkNY's Hudson Valley 'Poverty Simulation' Exercise Shows How Daunting Daily Life Can Be for Those Who Live Without

To really know a person, you need to walk in their shoes. What better way for 50 men and women who support economically disadvantaged populations in Westchester and the lower Hudson Valley to appreciate the daily trials and tribulations faced by those they serve?

In a Blueprint for Health Equity poverty simulation, organized by HealthlinkNY’s Health Action Priorities Network in the Hudson Valley (HAPN), members of healthcare and community organizations found out what it’s like to live for a month as a low-income family trying to make ends meet. During the exercise, participants had to visit the doctor, go grocery shopping, and put meals together with very limited funds. They had to travel from place to place without a car, visit human services organizations, attend school, and more.

“They saw firsthand what it’s like to live in poverty and how the difficulties of day-to-day life can impact someone’s healthcare access and choices,” said Phillip A. Ginter, Director for Community Initiatives at HealthlinkNY. HealthlinkNY is a nonprofit that connects healthcare providers to New York State’s health information network, and it also is driving innovation in managing population health in the Hudson Valley as well as in the Catskills and Southern Tier of New York.

‘How Do People Do It?’ Asked One Participant

A poverty simulation is a guided experience that exposes participants to the realities of poverty, including the challenges of navigating the complex world of government services and other essential service providers. During the simulation, participants assume the roles of different families facing poverty. The task for each family is to provide basic necessities and shelter over a four-week period, while balancing the requirements of various service providers with the realities of daily life. The exercise is designed to open the eyes of doctors, nurses, social workers, and community-based organizations to what many of their patients and clients deal with every day—and how their circumstances affect their interactions with safety net providers.

“The poverty simulation was a great experience for me because in my work, I encounter families who go through what I encountered today. The exercise was really stressful; my chest literally hurt,” said Vanessa Sukra, MD, a pediatrician with Caring Pediatrics of White Plains, NY. “As a physician, I stood here saying ‘How do people do it?’ People’s basic human needs should be met.”

Patrice Wallace-Moore, CEO Arms Acres, Inc, a recovery center in Carmel, NY, said, “It’s an amazing experience for me, especially as a leader of an organization, to better understand the social determinants of the people we serve. I’m looking forward to putting an action plan together to better serve the LGBTQ community.”

Keynote Erika Bernabei, of Equity and Results, LLC, urged participants to be careful in how they interpret data measuring social services program success. “Unless data are disaggregated by race, ethnicity, poverty, and gender, your efforts are wasted,” she said. “We look at [health] data but we forget to look at the root cause of the social determinants. We have to look at both to be successful.”

At the conclusion of the simulation exercise the participants committed to take action:

Each organization agreed to form a Health Equity Taskforce within their organizations, and within six months, implement at least one meaningful organizational change to better serve patients and clients living in poverty.

The eleven participating organizations were:

• •Arms Acres
• •Boston Children’s Health Physicians
• •Cornell Cooperative Extension of Orange County
• •Food Bank of the Hudson Valley
• •Lower Hudson Valley Perinatal Network
• •Planned Parenthood Hudson Peconic
• •Westchester Children’s Association
• •Westchester Jewish Community Services
• •Westchester Medical Health PPS
• •WMCHealth – Health Alliance Hospitals
• •Yonkers Community Action Program

What is HealthlinkNY and why is it doing this? HealthlinkNY is a New York State-funded nonprofit that runs the health information exchange (HIE) in the Hudson Valley, the Catskills, and the Southern Tier in New York. As a neutral organization (no hospital or provider bias), it also is charged to facilitate the New York State Department of Health Population Health Improvement Program (PHIP) in the Hudson Valley and the Southern Tier of New York. HealthlinkNY calls it the Health Action Priorities Network (HAPN). Its goal is to improve population health and reduce healthcare disparities in seven Hudson Valley counties — Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, and Westchester. The network includes county departments of health, hospitals, community-based organizations, and provider organizations.