Combatting youth obesity: Interview with MIKE’s Founding Executive Director Cheryl Neal, M.D.

Cheryl Neal, M.D.Cheryl Neal, M.D., is the founding executive director of MIKE, Multicultural Integrated Kidney Education. For the past 15 years, MIKE has been working with schools to promote healthy lifestyles.

Jathan Janove: Tell us about MIKE, its founding, mission and services it provides.

Cheryl Neal M.D.: At the dawn of the 21st century, childhood obesity and the related adult obesity epidemic increasingly were recognized as drivers of chronic diseases, which account for the majority of medical need and healthcare spending. Mike Hartnett, M.D., my late husband, died in 2000 of an aggressive blood malignancy. His friends and colleagues approached me to help memorialize his life’s work.

As the first kidney doctor to obtain subspecialty training at Oregon Health & Science University in the medical approach to kidney failure, Mike’s life work revolved around the clinical care and emotional support of his most vulnerable “fellow man,” those affected by kidney failure with all the personal, social and societal impacts for self, family and community. MIKE’s values of Respect, Inclusion, Empowerment and Integrity reflect Mike, the man.

Mike was treating a disproportionate number of low-income people of color afflicted with chronic preventable diseases, the downstream effect of which was kidney failure. Illness was unnecessarily challenging their lives and their families’ lives—people Mike had become close to over the course of taking care of them. Mike believed that the roots of these diseases started early, in social and societal/environmental factors, and that education, education in anything, as well as healthy relationships to help young people reach the first rung on their ladder of success, would prevent these roots from taking hold. MIKE is not just all about kidneys. Our name incorporates words that an early volunteer found expressed our purpose and was also an acronym that honored the man who inspired our service.

MIKE (Multicultural Integrated Kidney Education)MIKE’s mission is to empower youth to be health leaders through education, mentorship and community outreach. MIKE recruits, screens, trains, places, monitors and supports near-age mentors, usually college-age students interested in, broadly-defined, health careers, to provide intensive preventive intervention to a small team of teens in need throughout a school year or semester. Through hands-on STEM (Science, Technology, Engineering and Math) activities young people gain the knowledge, skills and confidence to advocate for health for themselves and others in their communities. As a culminating project, all MIKE youth present a Health Leadership Project which serves others throughout their communities.

Mike was a visionary who saw holistic solutions to our interrelated complex social problems. MIKE’s vision is that all people meet their potential of vibrant, good health, contributing as members of a vibrant, strong society. We believe that education and mentoring increase healthy relationships to improve the social and societal contexts which drive health outcomes across generations.

MIKE’s goals are:

  • Empower youth to embrace and promote healthy behaviors
  • Introduce youth to health career options.
  • Develop cultural and service skills of early career health professionals
  • Advance health equity within communities at risk of poor health outcomes

Jathan: How big is the obesity problem?

Cheryl: Well—big. The majority of us in the U.S. are either overweight or obese. There are numbers which define these conditions. However, we all can do our own calculations by people-watching at checkout lines at a restaurant or supermarket, in a hospital lobby or at a transit station, especially in low-resource neighborhoods.

The potential positive to normalizing size differences is greater understanding and appreciation of diverse people. The downside, however, is that both primarily (obesity itself has a direct association) or secondarily (through disease conditions compounding obesity such as high blood pressure or diabetes) obesity leads to chronic diseases. There are other factors—alcohol, drugs, tobacco, multiple infectious diseases, all of which can lead to kidney failure—which are preventable causes of chronic diseases, but high blood pressure and diabetes top the list and they often are associated with obesity.

Obesity is influenced so much by social and societal conditions, and there is a biological (not genetic) component that can over time be passed down, and therefore, over time improved. Pre-conception, gestational and infant physical and emotional health establishes life-long health status, particularly adult expression of metabolic syndrome (abdominal obesity, type 2 diabetes, high cholesterol). Access to healthy food, manageable—not grinding, daily—stress, and the leisure and opportunity for daily, meaningful physical activity, and pre-natal, gestational and infant health all set the stage for sustained healthy life-styles from generation to generation.

I can’t tell you the number of mentors who tell me they didn’t get what they now know is vital information, and they want to make a difference to a younger person while they are still establishing healthy habits.

Jathan: How does the mentoring process work?

Cheryl Neal, M.D.Cheryl: MIKE mentoring brings the critical element of authentic relationship-building with a reliable, caring adult in a time and in a setting critical to youth development, that is, at a time when young people are answering those life-long questions: Who am I? Am I normal? Am I likeable and loveable? Am I competent? By building a real-time-and-place social network through the instrumental mentoring vehicle of health-science education, youth gain the skills and self-confidence to apply MIKE to their entire school experience and beyond.

As children mature, they increasingly are in control of their personal activities and are pivotal for influencing their families and peers to create a ripple of positive health outcomes in their communities. As they develop the knowledge and social-emotional skills that help them make educated decisions for healthy lives personally, they become better prepared to influence their peers and families. Our holistic, upstream approach accounts for the lived experiences, personal strengths and untapped dreams of tomorrow’s parents setting the stage for the next generation to gain, “Right from the Start!”—MIKE is the ultimate “early-childhood” intervention!

Jathan: What do you envision as MIKE’s future?

Cheryl: Right now, MIKE is serving ~150 teens and their near-age mentors annually in Portland, Oregon Metro. We envision MIKE in an ever-widening circle of service. MIKE is responsive to the needs of the people where we serve. MIKE can be adapted to any place, and we’re actively working to put those adaptive organizational mechanisms in place to meet current demand for MIKE.

In an urban setting, or in the urban-rural interface, we envision future partnerships with institutions of higher education interested in real-life, meaningful, guided and well-supported experiences for their undergraduate, graduate and professional health and education students. And we envision future partnerships with healthcare institutions focused on prevention for cost-saving and mission delivery.

We’re starting a new project this year which has special appeal, in that upperclassmen (high school seniors looking for experiences which will boost them through their transition to post-secondary education) will mentor middle school (eighth- and ninth-graders). As a self-contained school setting, this project model could more easily adapt to rural areas, as well as urban.

Jathan: For readers interested in volunteering or learning more about your organization, what should they do?

Cheryl: Our website, www.mikeprogram.org, has more information, and under the tab “Get Involved,” readers will find fillable volunteer interest forms. Or call (503) 296-7705.