LiveWorld Transcripts

MedCareers presents

Ann Connor, MSN, RN-C, FNP
Social Advocacy

August 16, 2000

Ann Connor answers your questions about medical care and social advocacy for those living in poverty and the homeless.

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MedCareers: Welcome everyone! MedCAREERS.com is committed to providing healthcare professionals with the information they need to lead rewarding careers. We welcome Ann Connor, MSN, RN-C, FNP, Assistant Professor at Emory University Nell Hodgson Woodruff School of Nursing. Tonight our discussion will focus on social advocacy and care delivery in vulnerable populations.

Ann Connor: Hello and I'm glad to be here tonight and hope I can help with some questions!

MissQ: Ann, how did you get interested in health care for the indigent?

Ann Connor: I was a part of the Faith community that was involved in opening a night shelter for people who were homeless. I think probably farther than that, my parents had taken in refugees who had lived with us for 5 years. So that, I'm sure, had a profound influence--that early experience with a population group like refugees. In 1980 I moved to Atlanta and became involved with a parish that helped with homeless people. In fact, my husband and I were the coordinators that opened a night shelter at the church. One thing sort of led to another and within a year we bought a house near the church and offered space to folks that needed some housing. I put a major note in here, I do not encourage people to go pick up people off the street and bring them home. There was this ability I had, because of the work, to be in contact with the homeless, and that's who came to our house - People who had been living in the shelter before that. We opened a restaurant named Cafe 458 in 1988 and that's another part of the work I've been involved in.

RedAdept: What would you think of a program that was like "Work-Fare" where maybe the homeless could do community service in exchange for their medical care?

Ann Connor: My particular experience has been with voluntary agencies as opposed to governmental agencies. I probably don't have quite as much experience in that arena. One thing that has worked in our work is small relationship centered care. I think that has been the key to the successes we've had. It's not to say that in larger programs that good things don't happen. In my experience the numbers were small. Often the folks we've worked with have had opportunities to contribute back. That has not been the guiding philosophy. I would certainly not be opposed to some sort of barter system like that. One has to be careful in professional life. My call is centered to this small relationship centered care.

Monti: Can you identify some important social variables that influence health outcomes in vulnerable populations?

Ann Connor: I think in our experience there were things like poverty, learned helplessness, and powerlessness, and cycles of family problems repeating themselves; things like alcohol and drug abuse and violence. In terms of a story, one of the fellows that was a participant in the Cafe and the recovery program he had been in jail by the time he was 14. Many people in his family had been in jail--almost a normal place to be. It had reinforced many of the behaviors that were fundamentally why he was there. I think these cycles impact where we wind up. James (a made up name) was sad, he never had the opportunity to express himself and the neighborhood where he grew up in was hostile and there were many social problems. He had many problems health-wise, overweight and a drug abuser. You can see many of the things in his life--qualities that helped produce that.lots off issues of loss. I often tell folks that if you look at someone homeless, they typically have gone through many losses, even the issue of losing housing. For most they have lost income, job loss or unexpected financial impact. Generally then they start getting rid of things to compensate for that loss and may live in a house for a long time with very little in it and then finally go live with someone else and then go live on the street. You can imagine what it's like for adults then add a child to that. It's very tragic for them to be in the midst of multiple losses like that. And knowing that we tend to repeat cycles in our family histories, I worry about the children whose numbers have increased over the years. What are they learning about housing about loss and relationships? All things that impact our health.

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