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Spring is in full swing!
 
Some welcome the season with open arms - Hooray for longer days, butterflies, and cute baby ducks - while others greet the change with less enthusiasm (think allergy sufferers).
 
No matter your perspective, we can all agree that this time of year embodies 3 things: growth, renewal, and rebirth. When we think about it in this way, we can’t help but embrace the optimism and hope this brings.
 
With the transition to warmer weather, we soon find ourselves shifting our focus away from marveling at nature’s beauty towards the reality summer is just weeks away and our swimsuit body is still in sleep mode. The aesthetics of achieving our ideal weight and fitness is not all bad - who doesn’t want to be ‘summertime fine.’ But it is fair to challenge our thinking to get to the core of the matter: healthful living.
 
The art of living healthfully is centered around establishing the deliberate habit of practicing wellness. According to SAMHSA (Substance Abuse and Mental Health Services Administration) wellness is “not the absence of illness or stress”, but it is “being in good physical and mental health”[1].
 
A key factor as we strive to achieve optimal wellness is our access to health care. This concept is also an integral part of the framework that guides the mission and goals of Healthy people 2020, the United States strategy to achieve optimal health for all Americans. According to Healthy People, “access to comprehensive, quality health care services is important for promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, and achieving health equity for all[2].”  

Access to health care “impacts one's overall physical, social, and mental health status and quality of life and can be broken down into three main components: health insurance coverage, timeliness that care is received, and consistent and reliable delivery of health services[2].
 
In an ideal world everyone would get the high-quality care they need in a timely manner regardless of insurance coverage status, but the reality we face is a far from perfect health system. 

Many people face difficulties in navigating health care access. The reasons for this varies but impact is felt the same across socioeconomic groups. Regardless of race, education level, or sexual orientation we all may at some point face difficulty in getting needed health care. Barriers to accessing healthcare, (literal and perceived), are real and can be very frustrating if you don’t have a plan of action. So, what do you do when you encounter a health care barrier?  Great question! 
Today we are going to provide you with a few useful healthcare hacks so you can overcome barriers to health care. We will address options to access primary care, women’s health services, mental health, dental, vision, and prescription services.
Before we go any further, allow me to introduce myself. I am Danita King and hold my Master of Public Health and have worked within health benefits for one of the nation’s largest workplace benefits administrators for the past four years. I also act as program coordinator for an HIV Awareness program which serves my entire county. I have roughly 10 years of professional experience in the health benefits field and on a personal level, have navigated health choices for my own family for the past 16 years.

Believe me when I tell you, I have seen it all from people who are insured and face sudden layoff, to divorcees and survivors of deceased family members that lose benefits eligibility and those who are insured but the cost is so significant they must choose between paying for health coverage or groceries. The one thing they all have in common is the need to understand how to get access to basic care needs.

Fact is most insured individuals have access to health benefits due to private employer sponsored group coverage while those who lack insurance historically have worse access to care than those with private coverage[3]. Kaiser Family Foundation reports, “One in five uninsured adults in 2016 went without needed medical care due to cost[3]."
  
In recent years due to the passage of the Affordable Care Act not only have we witnessed the creation of avenues where people who at one point were considered ineligible for health insurance now have options to choose from, but it has set minimum health insurance requirements. I’ll spare you all the details but in short, this means the insurance carriers must now cover 10 essential services by at least 60% and some at 100% (think annual physical)[4].

What that means my good people is if you are offered health coverage through your employer even if you get the least expensive plan, it is worth considering enrollment as it must abide by these minimum coverage rules as well. Can we say winning? What are the 10 essential services all health insurance must cover[5]?
  • Preventive & wellness services and chronic disease management
  • Prescription drugs
  • Pregnancy, maternity, and newborn care
  • Emergency services
  • Ambulatory patient services
  • Laboratory services
  • Pediatric services, including oral and vision care
  • Hospitalization
  • Rehabilitative and habilitative services and devices
  • Mental health and substance use disorder services

Now let’s get down to the nitty gritty with these long-awaited healthcare hacks!

Hack #1: Find a Primary Care Physician (PCP) You Trust  
Why is this important? It’s about way more than just the ease to get a prescription filled when you run out, a PCP is familiar with your health needs—they know what questions to ask and can better help you manage a chronic disease as compared to having a new person each time you go.

As a rule of thumb, “seek primary care for non-emergent needs, including check ups, screenings, care for common illnesses and immunizations. Primary care should always be your first stop if possible — but not in an emergency.6” Remember preventive care office visits in most cases are covered 100% by insurance, which means no out of pocket cost to you if you have this visit with your regular primary care doctor, so you save money and get better personalized care at the same time.

Healthcare Hack #2: Most women’s health services have zero out of pocket cost.
Another benefit of the ACA is a great number of health screenings and services important for women’s health are required to be covered as part of preventive care. Key to having these services charged at no cost is to be sure to follow the rules of your health plan by making sure your provider is in-network and paying attention to your final bill.

When your visit is for a service considered preventive, if you have an out of pocket cost always question why and challenge the validity of the charges. Examples of preventive services for women include the following[7]:
  • Breast cancer screening (mammography)
  • Cervical cancer screening (Pap test)
  • Contraception
  • HIV and STD screening and counseling
  • Osteoporosis screening (bone density)
  • Well-woman visits

For those who may be uninsured, depending on your individual financial situation and the state you live, your family may qualify for programs such as Medicaid or the Child Health Insurance Program (CHIP) which “provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities8. Even if you don’t qualify for these programs there are low cost community health centers nationwide that operate on a sliding fee scale to provide these same services at a reduced cost based on your income[9].

Hack #3: Short-term Mental Health Counseling is Often FREE
Most employees underuse the phenomenal benefit known as the Employee Assistance Program (EAP). This is a mental health counseling benefit to help you and eligible family members receive anywhere from three to eight visits per person, per issue to cope with short-term counseling needs (such as stress, anxiety, depression, marital, death, etc.)

Hack #4: Dental Schools Need Real-Live Subjects for Students to Practice On
Most dental schools have clinics which provide dental care at a reduced cost. These clinics allow students to gain experience treating patients, while being closely supervised by licensed dentists. If you’re not feeling adventurous enough to try out one of these clinics, many community health centers also offer low cost dental options.

Hack #5: Seek out Vision and Prescription Discount Programs
Preventive care for children usually includes an eye exam but requires a stand alone plan for eyewear. Many organizations offer discounts or fully cover the cost for both children and adults if you can't afford routine eye exams and prescription eyeglasses[10]. Pharmacies and primary care providers may also have discount cards, free samples, and coupons available if we ask. Another cost saving tip, if there are no health reasons not to, consider taking the generic version of a drug[11].

Let’s take these tips and continue the mission to live our best lives without fear.


Resources:
  1. Eight Dimensions of Wellness (2017 October 24). Retrieved from https://www.samhsa.gov/wellness-initiative/eight-dimensions-wellness
  2. Access to Health Services (2018 May 30). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
  3. Key Facts About the Uninsured Population (2017 November 29). Retrieved from https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/
  4. Minimum Essential Coverage & 10 Essential Benefits (2018 February 26). Retrieved from https://resources.ehealthinsurance.com/affordable-care-act/minimum-essential-coverage-10-essential-benefits
  5. What Marketplace health insurance plans cover Retrieved from https://www.healthcare.gov/coverage/what-marketplace-plans-cover/
  6. The Importance of a Primary Care Provider (2015 April 07). Retrieved from https://mayoclinichealthsystem.org/hometown-health/speaking-of-health/the-importance-of-a-primary-care-provider
  7. Centers for Disease Control and Prevention. Meeting Women’s Needs Through the Health Insurance Marketplace: What You Need to Know (2017 September 8). Retrieved from https://www.cdc.gov/women/healthcare/index.htm
  8. Medicaid and CHIP Coverage. Retrieved from https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/
  9. How to Find Low-Cost Healthcare in Your Community. Retrieved from https://www.healthcare.gov/community-health-centers/
  10. Heiting, Gary. (2018 March) Free Exams and Eyeglasses. Retrieved from https://www.allaboutvision.com/eye-exam/free-exam.htm
  11. Scutti, Susan. (2016 August 25). How to Pay Less for Your Prescription Drugs, Legally. Retrieved from https://www.cnn.com/2016/08/25/health/where-to-get-cheap-drugs/index.html
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Funny Girl Farm located at 504 Erwin Road in Durham, North Carolina. Photo by Katelyn Belch.
​What does CSA mean?

A CSA program is a Community Supported Agriculture Program and perhaps one of the best things you can do for your health, your finances and the environment.

No big deal.

If you’ve been sleeping on CSA programs, stop and don’t be so hard on yourself. These programs started coming into the norm in the 1990s, but 30 years later they’re still not getting the attention they deserve. Seriously.

The most popular CSA program content on the interwebs in the last year only received 207 social media shares. That number ought to have been like 300 million. Perhaps I’m being a bit excessive there, but these programs are awesome and genuinely one of the best things you can do for yourself.

Stick with me and delve into why Community Supported Agriculture Programs deserve more attention, namely yours.
How does community supported agriculture work?

For starters, as much as I’ve built it up, they are really simple. A farm sells a certain number of shares, which are portions of their projected produce, early in the year before their produce is ready. These shares are generally called baskets or boxes. Each week throughout the growing season you get to collect your delicious share or basket.

You enjoy delicious, FRESH produce at typically a significantly lower cost than the boxed grocery stores. By purchasing a CSA share you are becoming part of a community that supports their local farm. You’re also more likely to eat the fresh produce your purchased and thus become a well-nourished member of your new-found community.

Some CSA programs have you come to the farm to pick up your share, which helps you connect with the farm as well as other members of the CSA program. Some even offer tours. This is a great way to share with children where their food comes from, which gets them engaged and excited about the produce you bring home.

Children are more likely to eat food when they are familiar with the farm it comes from, AKA ‘their’ farm. This actually works on us grownups too. Even the pickiest of child or grownup doesn’t want food ‘their’ farmer grew going to waste.

Some CSAs deliver right to your doorstep. This is perfect for someone who is constantly on the go and trying to figure out how to work delicious, nutritious food into their life. Coming home to a box of local produce on your doorstep makes for a great way to end the day.

Because of the immense benefits of CSA programs, more and more workplaces are collaborating with local farms to create a CSA for their employees. Typically, that means your employer sets everything up and all you do is pay and pickup at your office, where you were already hanging out. This is a great way to boost employee morale and help improve the health of your staff.

I will totally write a letter to your boss stating just that if you’re trying to convince them. Ha! But no, seriously, email me and I’ll make a bullet pointed list of all the measurable reasons it’s a good idea.

Another style of CSA program is mix-and-match or market style. This type of CSA program has you pay your set amount for the season and you get to pick and choose each week what produce items you’d like. That way you’re not dealing with 12 weeks of unrelenting mangos… not that I’m traumatized 7 years later from that happening to me.

Most CSA programs will allow you to take an ‘off’ week here and there. In fact, most work it into their program given that the growing season is also prime summer vacation season. Generally, the number of weekly shares covered in your CSA program is slightly less than the total number of weeks in the season, this allows you to get your money’s worth and not worry about rotten tomatoes. Nothing ruins a beach vacation like worrying about tomatoes.
 
This is not always the case, but it’s probable there will always be someone willing to take your basket for you. Delicious food has a way of bringing out the altruism in people.

Finally, here’s an exciting take on CSA programs that will have you squealing with delight. There are FLOWER CSA programs. Yes. Flipping seriously. You can get local flowers once a week. This is excellent for anyone who loves flowers and a total ace card for any forgetful men… I mean lovers of any gender who would like to come home to a few less cold shoulders.

How to get started with a Community Supported Agriculture Program?

You’ve made it this far and you like what you’ve read. You’re totally convinced that a CSA program is the best idea ever (it is) and you’re ready to jump on in. Yay! I knew you’d love this.

As in most cases Google is your best bet. Simply search for community supported agriculture and the name of your city. You can also use LocalHarvest.org.

Using LocalHarvest.org here are the CSA programs that I found that there are 37 CSA programs in my area, including a flower one with a florist down the street from me. Hey Pine State Flowers! We're about to become real close friends. 

The one I love the most and am choosing to go with for this growing season is Funny Girl Farm. This is a perfect example of how and why a community supported agriculture program works. I literally, not figuratively, know the farmers and have been to the farm – I feel a sense of community with them.

Also, I am a big fan of doing whatever I want, when I want, so I love that their program allows me to spend my share mix and match style at their farm stand instead of being bound to what’s in the box. They have the most adorable chickens with the happiest of lives. This puts an end to my grocery store meltdowns about the ‘ethical’ eggs being packaged in a horrific amount of plastic.

I get delicious, local produce while oogling cute chickens at a farm stand that is a 10-minute drive from my home. Again, this is magic.

I also appreciate that I can join the CSA program even though it’s already began rolling. Funny Girl Farm prorates their program based on the number of weeks remaining. I’m originally from the cold, so the idea of a CSA starting before May or June is mind-blowing.

I also appreciate that I can set it all up online. Seriously. You fill out this form and POOF. Done deal. They also let me know what to expect in addition to cute chickens. This spring I’ll be enjoying strawberries, mushrooms, kale, collards, rainbow chard, cauliflower, broccoli, fennel, beets, lettuce, carrots, spinach, salad mix, baby kale, adorable baby bok choy, turnips, radishes and herbs like cilantro, dill and parsley.

I won’t be enjoying the arugula because I have never enjoyed arugula. The mix-and-match option of the market style CSA program is where it’s at!

Their summer produce includes basil, tomatoes, peppers, okra, zucchini, yellow squash, cucumbers, watermelon and more. Again, I’ll be opting out of cantaloupe, because my CSA program gives me options. Know who you are and what you value in all cases. Ha!

Are Community Supported Agriculture Programs worth it?

In short, yes!

Your local farm of choice gets to enjoy a steady stream of income and customers. You get to enjoy improving your health with delicious, locally grown produce while saving a lot of money and trips to the store. Together you create a community, something we humans need. 
Love this installment of local logistics, the series of making life work for you?

​Make sure to SUBSCRIBE to keep in the loop while also enjoying free healthy recipes PLUS nutrition, health and wellness information you can use in real life. ​
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Photo by Linda Nguyen of girleatsworld.curious-notions.net
How are zen, poke bowls and logistics related?

Ever notice that you find what you look for?

There’s two reasons for that: Science and the Unknown.

Like how I capitalized Unknown to make it seem super important? When I say unknown I’m referencing what some call God, Allah, Buddha, the Flying Spaghetti Monster, the Universe, Britney Spears or simply the Higher Power. NutritionSheila.com is a safe place free of judgement and open to all who seek health, so I went with the Unknown to encompasses all the aforementioned names.
Scientifically speaking you find what you seek because your neurons are all geared up for it. Like when you are hankering to buy a new car and everywhere you turn there’s some jerk driving your brand new red Prius with witty personalized plates. Just as an example of course.

When it comes to the Unknown reasoning, let’s go with quoting Persian poet Rumi and side stepping any potential emotional triggers. M’kay?

Rumi is often quoted as saying, “What you seek is seeking you.” I dig this and for many years went around living by the quote. Turns out, it’s a mistranslation. Thank the Unknown for cousins. My cousin across the ocean blue in all his infinite Persian wisdom told me that the actual translation is, “You are what you seek.” Small variation, but this brings the woo-woo back to science.
If you’re seeking to be healthy, you’ll find:
  • Great, positive, health-focused websites like NutritionSheila.com
  • Time in your schedule to workout
  • Great sales on yoga pants
  • The benefit of taking the stairs versus the elevator
  • A newfound fear of sitting for longer than 15 minutes
  • Healthy swaps that make your life better
  • Opportunities and resources to become healthy

If you’re not seeking to be healthy, you’ll find:
  • The nearest drive through donut shop
  • People to enable your behavior
  • Every possible fad diet scam

Rumi Meets Logistics

I am forever looking for healthy options in my area, not only to enjoy for myself, but share with others. That’s because our health comes down to the logistics of our lives.

Whatever your health status is, it’s largely due to the logistics of your life. Taking a moment to assess that and start making small changes can have huge, if not completely life-altering effects on your life.

For example, when you look at your drive time to and from work, is there anything that you can do to improve it? Before you getting into a swear-spree about the pure hell that is your commute, step back and really think about it.

Is it possible to adjust your work schedule to go in an hour earlier or later to circumvent the most congested traffic? Is there a gym, yoga-studio or quiet café near your work that you could go to an hour before work starts, dodge being stuck in traffic and instead workout, practice yoga or read a self-improvement book?

And remember all those books you’ve been wanting to read and how study after study after study proves that the more you read the more money you make and better the quality of your life? Yeah. You could totally listen to those while you drive.

I live in Durham, North Carolina, which is part of an area known as the Triangle. Many spend 1 to 2 hours a day commuting to and from work. Our traffic problems are real y’all.

Using the average drive time and most common length of an audio book, a person could listen to 36 books a year on the way to and from work. The positive improvements in mental health, income and quality of life that could come with that are endless. Oh hey, here’s the 2018 Wellness Reading List to get you started. :)

See how opportunities to live a happy, healthy, well-nourished life start popping up if you look for them? And this is why I constantly look for healthy options in my area. You tend to find exactly what you are looking for.
Photo by Linda Nguyen of girleatsworld.curious-notions.net
Local Health Find – ZenFish Poké Bar

​Recently I stumbled across an incredible gem here in Durham, ZenFish Poké Bar located at 810 9th street and it lit up every health loving neuron in my brain.  

ZenFish serves up poké bowls, which are akin to the Buddha bowl version of sushi. These bowls are a Hawaiian staple that have moved inland in a big way. BTW it’s pronounce POH-kay, like if your friend was helping you on an online classic English literature test.

You: Who was that one dude that wrote the story about the heart beating in the floor?
Your Awesome Friend: Poe!
You: K!

ZenFish poké bowls are brimming with fresh, local produce – seriously local, like some farms are literally located just down the street. Owner Janet Lee mentioned one of her favorite farms she gets her ingredients from is another local gem Funny Girl Farm, which is a short 7.8 miles away from the restaurant.

You can get an entire day’s worth of fruits and vegetables in own poke bowl! If you’re into fish, you’re in luck. ZenFish features fish caught right off the coast of North Carolina. Ingredients that are locally sourced are few and far between and always to make the dish the best it can be.

The Secret Sauce

You’ll also get something that’s not on the menu, but rather all over the walls and infused into the business plan itself – gratitude, compassion, love and happiness. Janet is a Duke graduate that once-upon-a-time was working her way up the corporate ladder in a high-paced, high-stressed job the promise of ever bigger paychecks that would seemingly make working yourself into the ground worth it.

​She quickly burnt out and had a divine reality check – A.K.A. the health scare we Americans (author included) seem to need before we realize that quality of life is far more important than the status quo.

As Janet put it, “I did corporate for many years. I realized that wasn’t my passion. It was actually with yoga. I was feeling stressed a lot and not myself at work. My yoga teacher told me, along the lines of “Do what you love. This is your body. Take care of it. You only have one life.” That night, I put in my 30 day notice.

“That’s why my goals are grateful, kindness, compassion, courageous, all the words that really spoke to me over yoga. I wanted to create a place where I could incorporate Durham and incorporate my love for local farming and health. I want to showcase the story behind the farmers here.”

Janet has always loved, loved, loved food. She paired that with her personal mission to live a simple, happy life to create ZenFish. The first thing you’ll notice when you walk in is a chalk wall with the word gratitude painted on it and chalk for you to write out something you’re grateful for.

Take one look at the menu and you’ll see Janet’s heart beaming through. Under signature bowls you’ll see the Grateful Bowl, Kindness Bowl, Courageous Bowl and Compassion Bowl. I love all the names, but being the vegetarian that I am I skip right now down to the Veggie Bowl and dig in.

Think that Janet couldn’t be any kinder? Think there is no way that the joint could get healthier for your body and soul? Guess again.

Cold and flu season hit Durham hard this year with crazed fluctuations in temps adding gasoline to the fire. Janet got into the kitchen and then onto Instagram offering up immunity shots of fresh squeezed tangelos, turmeric, ginger and local honey. The turmeric came from Funny Girl Farm.

If you live in the Durham area, ZenFish is an absolute MUST. Stop by and enjoy the wide variety on the menu and practice some gratitude while you’re there. More over take a minute to see how this health gem can fit into your life as part of reworking the logistics of your life for your health, happiness and wellbeing.

Could you get a poke bowl to go for lunch tomorrow at work? They’re open until 9:00pm, so could swap out your Wednesday wine with your crew for this healthy alternative once or twice a month? Is it walking distance from your office serving as a perfect excuse to stop working through your lunch?

For those who don’t live or work in Durham, first and foremost sorry. I kid. I love my city, but I realize that people live other places too. Do a search to see if there is a poke restaurant in your area. You can also try making poke bowls at home. Ogle some of Janet’s food porn on her ZenFish Instagram account for inspiration and see what local produce options you have available to make your own at home. And no matter where you live, take a moment each day to practice gratitude.
I’m grateful to live only a mile away from the treasure that is ZenFish.
Actionable Takeaways
  • Start looking for healthy options.
  • Practice gratitude.
  • Use Google to search for 4 to 5 healthy restaurants near your home and work.
  • Think of 5 unhealthy behaviors you’d like to change and what you could swap each one out for.
  • Pick one and start making that swap.
  • Look at your schedule. What could you change that would improve your health?
  • Look up local farms, farmers markets and CSAs in your area. Try one out.
  • If you’re in the Durham area, try out ZenFish Poké Bowls.
Follow along Local Logistics series to learn how you can find positive, healthy and delicious options right were you live and work. Click HERE to get the next feature delivered to you inbox.​
Happy Coffee Mug
$15.00
Happiness is an inside job.  Ain't that the truth!
​11 ounce white coffee mug with adorable, honest pic. 
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