Edible Alphabet: Bringing together a community through food

The Edible Alphabet program provides refugees who have recently arrived in Philadelphia with an opportunity to learn English through cooking classes at the main branch of the Free Library of Philadelphia. The teaching staff includes librarians, an ESL instructor, and a professional chef. Together they implement a curriculum centered on the preparation of a low-cost, healthful meal each week. The curriculum includes games and activities to help students learn American foodways and the language of cooking--food groups, types of foods, cooking techniques and utensils, measurements (e.g. cups, teaspoons, etc), and the fractional quantities of measurements. Each week is capped off with a shared meal, prepared by students from from many countries of origin, including Syria, Iraq, Iran, Pakistan, Congo, and Malaysia.

My early impressions of the class have thus far been positive. In the first class, I was impressed by how well many students already spoke proficient English. I was even more impressed, however, by the desire of students who spoke good English to help those students who were just learning the language. I witnessed this willingness to help most strongly in a pair of young sisters from Southeast Asia. They were not only proactive in learning themselves, but also in taking leadership roles in the class. They were among the first to volunteer in the games at the start of the class and they were always highly engaged with and friendly to the other students. They were excited to inform us that they recently secured jobs at a local department store, despite their limited time in the U.S.

In subsequent classes, despite our role as observers, we were drawn into the warm dynamic of the class and found it challenging to completely separate ourselves from the students. In fact, we interacted quite frequently with the students, often while they waited for instruction from the teachers or ate the food they had just cooked. We learned about the passion a man from Pakistan had for cooking. Roxanne conversed in French with a pastor from the Congo. I got distracted from taking notes by a six-year old Syrian boy who tried to teach me Arabic. And we always had students insisting that we try the dish they had just prepared. Overall, we were humbled by the generosity and kindness of the students.

Post by Alex Reisley
Photograph by Nema Etebar

Public Libraries & Health: Leveraging libraries’ potential to address population health

Americans visit a public library over one and a half billion times each year, more than four million visits each day. In contrast, Americans visit a physician's office just over 928 million times annually. What if library visits could be leveraged as opportunities to promote health? In Health Affairs, as part of the Culture of Health issue, colleagues and I from the Healthy Library Initiative analyze the ways in which the Free Library of Philadelphia, the city’s public library system, already promotes better health, and suggest what more it could do.

In Philadelphia, a city of one and a half million people, the Free Library has five and a half million visits annually. That provides untapped opportunities to reach Philadelphians, especially vulnerable individuals for whom libraries often serve as a haven. Our team conducted an analysis of current library programming and a needs assessment of community members and library staff. We found that libraries are already working to promote health, but there are opportunities to do more to harness their power and potential.

At their core, libraries are sites of literacy promotion and lifelong learning, and literacy is linked to better health outcomes from childhood, through adulthood, and into old age. A recent study also showed that reading more books was linked to better health.

People use public libraries as sources for health-related information that they may not be able to get from the health care system, perhaps due to lack of access, time, language barriers, or feeling intimidated while speaking to a health care provider. According to a recent survey, over 40 percent of the information that patrons search for online at the library is related to health. 

Public libraries are also addressing the social determinants of health (i.e., nutrition, employment, education), which is crucial to reducing health disparities. In Philadelphia, the Free Library offers programming that includes nutrition classes at the Culinary Literacy Center and workshops at its job and career information center. These services are utilized by half a million people.

Our analysis showed public librarians to be committed to public service, deeply trusted, and responsive to the needs of their patrons. Librarians report addressing almost any question asked of them - from assistance finding cookbooks about nutrition and interpreting official documents, to help setting up email accounts and writing resumes. However, library staff are often stressed by the tremendous needs of their patrons and lament that they feel ill-equipped to deal with the challenges of working as front-line staff in vulnerable communities.  

What else is needed? A first step in harnessing the power of public libraries to address population health is increasing library capacity. While the library often serves as a haven for vulnerable individuals, the formal training of librarians is often inadequate. Our team worked to address this gap by developing a training curriculum for librarians to “recognize, engage and refer” vulnerable individuals to appropriate resources. The topics selected for the training - mental health and substance use, homelessness, immigration, and childhood and family trauma - were identified by library staff and community members as the most pressing health concerns in their communities.  

We delivered the training in South Philadelphia, and preliminary analysis shows that the case-based training modules significantly improved library staff knowledge, confidence and comfort in addressing the needs of these patrons. We plan to repeat the training in West Philadelphia in the next few months.

We must also work to build partnerships between public libraries, health systems, and public health agencies to encourage an interdisciplinary approach to patient care and well-being. An innovative model exists here in Philadelphia at the new Community Health and Literacy Center, which co-locates a health-focused library, adult and pediatric public and private medical clinics, and a city-sponsored recreation center.   

Finally, we should leverage the trusted role of librarians in their communities. Libraries and their staff are free and open to the public, rooted in the local neighborhood, and deeply trusted, making them a key partner in building a healthy community. While doctors may understand little about their patients’ lives outside the consultation room, librarians are embedded in their communities, and know their patrons’ daily routines and challenges. Library staff are in an ideal position to serve as “sentinels” in their communities. If we work with librarians to identify ever-changing health and community needs, we may be able to more rapidly address health concerns.  

Post by Anna Morgan. Originally published on Health Policy$ense.

Photograph by Nema Etebar.

Libraries are a lifeline for vulnerable populations.

We learned this straightforward, valuable lesson by listening carefully to our research participant, Brandon Stokes. Brandon told us about the many challenges he faced while growing up homeless. He also taught us how he coped. For him, the Free Library of Philadelphia was a refuge, offering a safe place to spend the day while the youth shelter was closed. Brandon often spent hours in the library, devouring biographies of great leaders. He searched those books for the male role models who were missing from his life. In their stories of adversity and triumph, Brandon found lessons for life.

Today, Brandon is on a promising path. He is a student and an activist, and he is building a network of social entrepreneurs in Philadelphia and beyond. In this work, the Free Library of Philadelphia is still playing a critical role, offering a meetup space for like-minded go-getters who share the combined ambitions of business and social impact.

We are inspired by Brandon, and we are grateful to him—and to many other research participants over the years—for telling us their own stories of adversity, resilience, and health in the city. Brandon’s example offered us a call to action, showing us how public libraries are places of hope and possibility.

Today, we are committed to making libraries even stronger as “health hubs.” We are working closely with the Free Library of Philadelphia to optimize staff trainings, services, and programs that meet the health and social needs of diverse Philadelphia residents. We see this as one step in a national conversation about how we can strengthen public libraries and connect them to health institutions, in order to improve population health. We welcome your stories and your input. Let us know how your public library is working to meet the needs of vulnerable populations. Contact us at healthylibrary@gmail.com.

To read more about Brandon and about our team’s research on youth homelessness, see Cannuscio et. al, The Life Stories of Homeless Youths. AJPH, November 2015 (105): 2216-2219.

Post by Carolyn Cannusio.
Photograph by Nema Etebar.