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Public health comes to life in London

Students see stark differences between U.S. and U.K. health care systems

Students tour Dean Street Express in London’s Soho district

Many facets of life are better understood when experienced firsthand. For a group of public health, kinesiology and biocultural anthropology students, studying abroad in London this past summer did just that.

“Our trip to London altered my perspective, specifically regarding the global need for an efficient public health structure,” says Chase Fettig, a public health senior and one of nine students who made the trip.

The group was led by CPHHS Instructor Aimee Snyder, along with Michelle Klotz, faculty-led program consultant with the OSU Office of Global Opportunities (OSU GO). The students earned nine public health credits during the three-week experience, but more importantly were exposed to new systems and components of public health.

Through expert eyes

The group toured four National Health Service (NHS) facilities, participated in meetings and attended talks given by doctors and professionals. One of the presentations was made by junior doctors – the equivalent of residents in the U.S. – and a public health consultant about the structure of the NHS in England.

“The administrative process is much different in the U.K.,” Aimee says. “When you walk into a medical facility, there are no desks to pay. This affects accessibility, and people go in to see the doctor more often so diseases are not as serious.”

Students showing their Oregon State pride in London

“The processes the NHS executes are one of the clearest advantages of their socialized medical structure,” Chase says. “Both efficient and effective, the method in which individuals receive care is straightforward, which limits complicated transfers of personal health records and confusing health insurance paperwork.”

The major difference between health care in London and the United States is that the U.K. facilitates universal health care. The NHS is funded through taxes and free of charge to United Kingdom citizens at the point of service. “The system looks at areas and populations to determine what screenings and services they may need,” Aimee says.

“In the U.S., it seems like the system suggests health as a privilege, whereas the U.K. views health as a natural human right,” says Christy Cheng, a biocultural anthropology student who made the trip.

A new approach to sexual health services

The group visited three HIV and NHS-funded sexual health service clinics that are revolutionizing public health among Soho’s LGBTQ community. 56 Dean Street and Dean Street Express, operated by the Chelsea and Westminster Hospital NHS Trust, are located in an area with one of London’s highest HIV transmission rates. These award-winning clinics are leading the world with STI and HIV rapid testing and treatment services. According to a brief published by the NHS Foundation Trust, there was a 42 percent drop in HIV diagnoses in 2016 in the Soho area.

The clinics are open late to accommodate patients. They are chic and classy in appearance, resembling a trendy nightclub and not a medical facility. Within the walls of Dean Street Express’ dark upholstered and dimly light center, anyone can walk in and enter a phone number and answer questions related to their sexual history. They then receive a test kit, enter a room and are instructed through a digital screen on how to swab themselves for the test. The test is sent to the on-site lab through an automated tube and the individual can wait or receive a text with the results. If the test is positive, a treatment plan is initiated.

“If basic resources are offered to citizens, the population can save time and energy by acknowledging potential issues ahead of time,” Chase says.

Christy says seeing the convenience of resources in high-need and less privileged areas – such as Dean Street and other mental and physical health programs for disadvantaged youth – left a lasting impact. Christy’s family immigrated from Hong Kong when she was young. Her family lacked financial resources, and she didn’t have access to adequate health care services. She would like to attend medical school and is interested in advocating sexual health and education in diverse demographics. 

Lasting impact

Other public health components in London’s history were exposed during the trip. The group read “The Ghost Map” by Steven Johnson, which details the city’s cholera outbreak of 1854 and brought to life the places they were reading about.

On the glass floor in the Tower Bridge over the River Thames

John Snow – one of the founders of modern epidemiology – used death counts by home address, door-to-door interviews and mapping to trace the cholera outbreak to a contaminated water source. The students hypothesized that this history may be why there is limited tap water available and consumed in London and why dehydration is a valid concern. They also realized that often you have to “pay to potty,” which has to do with the historical sewage problems in the city.

The group also had time to get in some sightseeing and educational tours, including the London School of Hygiene and Tropical Medicine,  the Tower Bridge, Tower of London, Leeds Castle, the London Eye, two river cruises, London Loo Tour, The Old Operating Theatre Museum, public health tours with the Royal College of Physicians, Wellcome Collection – an eclectic display of medical artifacts – and the British Museum where they saw a unique exhibit showing the medication taken during an average male and female’s lifespan. They also tested their teamwork skills on a high ropes course, visited Brighton on July 4 and enjoyed many traditional English cuisines.

Christy says the trip is a must for students interested in public health or a career in medicine because it will open expose them to cultural perspectives. “These experiences give students the opportunity to participate in diverse cultures and societies and see different perspectives of learning and living,” she says. “You’ll inevitability work with other people and they will come from different backgrounds, countries and beliefs.”

Applications for the next London Summer Abroad are due March 15. The priority deadline is February 15.