Health and Wellness isn’t just about exercise and diets, it’s also about accessing medical health care and knowing how to protect your body. But not everyone knows how to obtain preventative care, and youth don’t necessarily graduate from high school with the information they need to understand sex or the proper ways to safeguard themselves. Staff Writer Taylor O’Connor writes about an OB-GYN clinic that’s on the horizon at Marian Regional Medical Center; and New Times Staff Writer Bulbul Rajagopal speaks with a Cal Poly professor about what college students are lacking when it comes to awareness about sexual health.
A new federal grant will help Marian Regional Medical Center build a new obstetrics and gynecology clinic
BY TAYLOR O’CONNOR
After moving to Santa Maria from Los Angeles to pursue her dream of becoming a doctor, Stephanie Zamora quickly fell in love with the community.
“It’s very much a vulnerable population, and it’s very unique because we do have a Mixteco community here, and we are their first encounter with a hospital system,” Zamora said. “The people in the area, the support staff in the hospital, are all really great, and all of that made me fall in love with this area to the point where I continue being in attendance.”
She’s now the chief resident physician at Marian Regional Medical Center and completing her final year in residency to become a certified obstetrician-gynecologist (OB-GYN), a program Marian hopes to expand after receiving a $1 million federal grant, with the help of U.S. Rep. Salud Carbajal (D-Santa Barbara), to create a new on-site clinic.
“I think it’s going to be great for the community. It will hopefully increase the access to services and continue to build that bond [between] providers and the population that needs access to care,” Zamora said. “This new money we are able to use will only improve their care and improve us as providers, and open doors for more opportunities to help better serve them.”
The funding will cover a portion of the costs associated with medical equipment needs and construction fees for the 8,700-square-foot clinic. The total cost of building the new clinic is estimated at $3 million, said Anne Kennard, associate program director of the OB-GYN residency program.
“OB-GYNs are not doctors for pregnancy. We are doctors for women that take care of women through adolescence and old age. We are often the primary physician for much of a woman’s life in a holistic sense—body, mind, and spirit,” Kennard said. “Women are like all humans who have complaints or concerns about mental health, chronic stress, low libido, low nutrition. These are all elements in our wheelhouse to discuss treatments and recommendations.”
In 2018, Marian began its OB-GYN residency program, in which doctors learn after graduating from medical school by working a variety of rotations to take in all of the procedural knowledge associated with the practice, Kennard explained.
“We didn’t have a dedicated space for our OB-GYN residents to learn and see patients and undergo their education lectures,” she said. “So patients suffered a long wait because of a lack of access, and the residents were trying to fit in wherever they could in terms of their learning environment.”
The added space will also allow the clinic to focus on patients of low health equity, meaning the patient does not have optimal access to or understanding of health care, Kennard said. Many patients who come to Marian often have low educational attainment, low health literacy, and low health equity. More than half of the patients speak a primary language other than English, and about 60 to 70 percent are on state insurance, Kennard explained.
“For many of our patients, a pregnancy may be the first time someone accesses a health organization; it may be the first time seeing a physician. Patients have not had access and don’t know how to access or get care within the system,” she said. “Everything’s new, you don’t know how to get a lab draw or an X-ray. They’re navigating the system with very little resources to do so.”
Long waiting periods before a patient can see a doctor—like the two- to three-month wait at Marian—can often deter people from getting preventative care and can cause problems in the long run, Kennard said.
“The emergency room ends up impacted, too, because then they are seeing patients in the emergency department that could have been helped in an outpatient setting, but they didn’t and they end up receiving care in the emergency department,” she said. “We have a seven-hour wait in our emergency room, it’s just not good for anybody.”
The new clinic space will help increase access by adding 12 more residents—a 50 percent increase to the workforce—full-time interpreters for Spanish and Mixteco-speaking patients, and a specialist who can help people navigate insurance options and access insurance services, Kennard said.
Ground-breaking and construction should begin this spring, and the goal is to have the facility running by 2024. In the meantime, Marian is applying for more grants and asking local organizations for donations to cover the rest of the costs, she said.
“This is amazing for me both as an OB-GYN who cares deeply about our community as well as improving health access and equity for women, and as a director responsible for training the next generation of OB-GYN physicians. It ripples outward,” Kennard said. “You have women getting care in a compassionate and comprehensive manner, and that improves disparities.”
Reach Staff Writer Taylor O’Connor at [email protected].
A Cal Poly professor from Mississippi reveals that young people’s sexual health awareness isn’t so different in California
BY BULBUL RAJAGOPAL
Dr. Joni Roberts moved to California from Mississippi believing that sexual wellness awareness among young people on the West Coast would be higher.
“If you’re familiar with sexual health in Mississippi, or in the South, in general, it is night and day, from Southern U.S. to the Western U.S.,” she said. “In Mississippi, it is state law that any sexual education courses that are taught in K-12 cannot be comprehensive; it has to be abstinence, or abstinence-plus. In fact, teachers could get arrested if they even attempted to talk about safe sex with condoms, and so forth.”
An assistant professor in Cal Poly’s Department of Kinesiology and Public Health, Roberts runs a sexual and reproductive health lab. After moving to San Luis Obispo County in 2019, she spearheaded a 2020 assessment that studied knowledge and beliefs around sexual health held by Cal Poly students.
Unlike Mississippi, California school districts must teach comprehensive sex education courses at least one time each in middle school and high school. These schools are bound by the state’s Healthy Youth Act of 2016, which promotes unbiased and accurate sexual health and HIV prevention education. Roberts had high expectations for the results of such a progressive program.
“It was surprising to me, because I sort of had this bias going in,” she said. “What we found is that there’s still a lot of misconceptions as far as what students knew. Then there was practice that was different.”
Roberts said that while Cal Poly students participating in the study knew theoretically what safe sex entailed, that knowledge didn’t necessarily translate to practice. The assessment revealed that students didn’t use protection methods—such as dental dams during oral sex—and there was a lack of safe sex conversations between partners. In fact, 43 percent of participating students said that they wouldn’t refuse to have sex if their partner refused to use a condom.
Roberts added that the two main themes that cropped up during the study were “cleanliness”—a term participants used to describe STI (sexually-transmitted infection) status—and gender-based differences.
The results of the study prompted Roberts to introduce sex education modules in her lab. On Feb. 9, she’ll be joined by kinesiology and public health major Gabriella Snow and biology major Alexa Asson to host a campus sex education seminar as part of the seventh annual Social Justice Teach In workshops.
Roberts described sexual health as everything regarding an individual’s body and what they choose to do with it. She’s interested in learning more about young people’s mindset about it.
“So, whether that is engaging in sexual intercourse—whether that’s oral, anal, or vaginal-penile,” she said. “What are the thought processes that they sort of go through before they get to a decision? How do they go from being in their home at 2 o’clock on an afternoon, to having sex at 10 p.m. on the same day?”
Other surprising discoveries came as a result of Roberts moving from a racially diverse student population in Mississippi to Cal Poly—statistically the whitest campus in the California State University (CSU) system.
“Something I thought that was unique here within the white population—and I haven’t been able to test this in other predominantly white spaces—is there is a complete level of trust that students seem to have,” she said.
Roberts—a Jamaican raised in the Caribbean—found herself using the phrase “blind trust” often, especially after her lab followed up with the white students who participated in the quantitative section of the survey.
“It didn’t matter how long they were in a relationship with their partner, whether it was a few months or several years,” Roberts said. “But there was this assumption that they could not get an STI from their partner because their partner was faithful to them. They believed that wholeheartedly. That’s something that I did not experience before, especially among communities of color.”
White students, too, seem more confident in their sex lives, Roberts said. Confidence didn’t necessarily begin at home either. Roberts said that outside support systems like clubs and organizations, which students could access based on their economic privilege, played a big role in sexual wellness. While she acknowledged that the present generation of young people is more vocal about sex than their predecessors, race and economic issues still exist.
“Especially here at Cal Poly, where we are known as the whitest CSU, it is not uncommon then to have more students of color have more negative experiences,” Roberts said. “That’s something that was reported: Students felt fetishized by their white counterparts, or they weren’t taken as seriously in relationships. Those are their reported experiences compared to their white counterparts.”
In Roberts’ experience, many students’ misconceptions about sexual health centered on the definition of virginity, queer relationships, and lax attitudes toward STIs. Her lab team is also focusing on including the voices of queer and cisgender male students. One of those team members is Anoushka Samuel, a second-year Cal Poly student.
“I think there are so many gaps in our sexual health education right now,” said the born-and-raised Californian. “The only time I remember learning about it was a mandatory video we had to watch in the fifth grade, and then again in one of my biology classes in high school but barely touching on STIs.”
Samuel specializes in research around menstrual products and their use. She said it’s an integral part of understanding sexual wellness, and she advocates for Cal Poly to stock menstrual products in all campus restrooms.
“The use of menstrual products is a good way to gauge cultural differences,” she said. “Like the whole thing about whether using tampons means losing your virginity or not.”
Roberts attributed the lower-than-expected sexual wellness awareness in California to some loopholes in the Healthy Youth Act. Every school district can choose a different curriculum for sex education. When the time rolls around for a middle or high school to provide that one-time discourse, parents can write in and deny permission for their kid to participate. Then, there’s the matter of when the student received sex education.
“Say, maybe I received it in seventh grade, and then I didn’t receive it again until 12th grade. Well, by the time it comes back around in 12th, grade, I likely forgot what I learned in seventh grade,” Roberts said.
The length of time between each sex education course might also be long enough that students learn from other sources of information.
“I likely may have been experimenting between that time. By the time I get the official education from the school system, I would have already been learning from my peers,” she hypothesized. “There’ll be people around me who would be engaging in things or telling me things; they would be my primary source of education—not to mention social media, which is very common in this age range.”
Reach New Times Staff Writer Bulbul Rajagopal at [email protected].