It’s Friday night and you and your friends sit down for a good old fashioned board game. You know – the one where you pick your playing piece, roll the die, count the number of spaces to move. You land on a space instructing you to advance a space because a new program has been started to allow you to walk safely to school. Your friend’s not so lucky – her space instructs her to move back two spaces because the hours of her doctor’s office conflict with her work schedule and she doesn’t get personal time so she can’t make an appointment.
No – you haven’t entered the “Twilight Zone” – you are playing “Life Course,” a game designed to teach people and start conversations about the Social Determinants of Health. Ledge Light Health District and other organizations have used the game to introduce groups to the idea that health outcomes are not only about biology and behavior. Making healthy choices and having “good genes” are important to living a long and healthy life – but in the long run are not as influential as risk and protective factors experienced throughout your life.
I (Stephanye Clarke) played this game with a group of Connecticut College students who met to organize against racism on campus. Because the game is based on chance and not on personal life experiences, players can be shocked, and at time feel uncomfortable, when their advancement (in the game) is based on things like accessibility to health services and education, family income, and social support.
For instance, one student landed on a “red” card, she read it aloud and learned that her game piece had died. She was heartbroken. She was sad not because this was the first time she played a board game where she “died” based on chance; but because it was sobering to learn that real people every day die from preventable deaths due to their inability to navigate through complicated health systems.
The students marveled at the privilege cards that coincided with their respective game pieces. While playing the game, some students shared stories about feeling like life was moving forward, only to be yanked back due to unfair circumstances. The students began to identify varies factors that would impact a person’s health: stress from financial difficulties, minimal access to healthier foods and opportunities for regular physical activity.
The game initiated conversations on the connections between poverty and health – education and health. They correlated these factors with underage drinking, recreational drug use and unprotected sex, unplanned pregnancies; and had a deeper understanding of why certain groups have more health problems than others.
The Life Course game provided the students an opportunity to look at health in a different way. Some students shared stories of physicians they knew who made assumptions that they or their loved ones would (or wouldn’t) adhere to a medical treatment plan based on the color of their skin or ethnic background; while others shared the difficulties of accessing healthy foods or finding a safe space to play. Students also had opportunities to talk about possible solutions – and discussed ways in which they can work with policy makers, housing officials and residents to create conditions in low-income housing developments so that residents have a better opportunity to live longer, healthier lives.
Image credit: Stephanye Clarke
Jennifer Muggeo is a supervisor in administration and finance at Ledge Light Health District, who is pursuing a masters in public health.
Image credit iStock Photos / Edstock
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