U of L Partnership Helps Backside Workers Stay Healthy as a Horse
By Kevin Hyde
For the past 16 years, Randy Martin has been on the move.
Here's how it usually plays out. From December to April, he's at Gulfstream Race Track in Florida. Then for the most of the spring, you can find him at Keeneland in Lexington.
During summer he heads north to Arlington Park Race Track in Chicago. And then it's back to Keeneland for a couple of months before heading down south again to Florida.
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And repeat. Every year.
"We do travel," says Martin, an assistant horse trainer for Paul McGee, the Louisville-based trainer of notable thoroughbreds like former Breeders' Cup contender Suave, Honor and War and longtime Churchill Down's favorite Bet On Sunshine.
The affable horseman is talking on a phone from Florida in mid-March, just two weeks before returning to his home in Lexington.
"It gets a little strenuous on the road," he admits. "We always look forward to getting back."
While Martin's migratory lifestyle might not represent all of horseracing industry's backside workers, there are nevertheless many who can relate.
Backside workers are the assistant trainers, hot-walkers, grooms, exercise riders, stable workers, forman, blacksmiths--the men and women who work with the horses behind the scenes, feeding them, conditioning them, preparing them for the starting gate.
It can be a rugged, dusty life filled with hard and sometimes even dangerous work. The backside worker is a hardy soul, but certainly not immune to illness and other health ailments.
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That's why the new Kentucky Racing Health Services Center has been a godsend for Martin and some of his fellow racetrack workers since it opened last spring. The center is a joint initiative between the University of Louisville and the Kentucky Racing Health and Welfare Fund Inc., (KRHWF), a nonprofit foundation created by uncashed parimutuel tickets from thoroughbred racetracks in Kentucky.
The pilot program, created by a $62,520 gift from the foundation, has become a vital source of free medical services for many racetrack workers and their families.
The health center is located in 3,000 square feet of the Old School at Fifth Street and Heywood Avenue near Churchill Downs. The beautifully restored 103-year-old building, formerly the John H. Heywood School, also houses headquarters of the KRHWF and 40 apartments for low income, retired backside workers.
'Opportunity to do service learning'
U of L junior and senior nursing and nurse practitioner students along with second-year medical students staff the center through a university grant. The program's director, nurse practitioner Whitney Nash, is also a student in the nursing school's new Ph.D. program.
"This is a great opportunity for U of L nursing students to do service learning," says Nash. "The health center received 837 walk-in patient visits during its first nine months in operation." As more backside workers learn about the service, the numbers have been increasing.
"In many cases, we have been the first real contact with a health-care professional that these folks have seen--ever," Nash says. "We've had patients over the age of 40 who were seeing a medical professional for the first time in their lives."
In its three exam rooms and spacious laboratory, the Kentucky Racing Health Services Center offers an array of basic medical services including routine physicals, PAP smears, breast exams, prostate exams, and blood and cholesterol tests. The center also treats headaches, itchy eyes, sore throats, minor aches and pains, digestive complaints, diabetes, asthma-related problems and much more.
The medical students work with the nursing students one night a week. It's a rare opportunity for them to learn how to provide care as a team, says Dr. Mary Coleman, senior vice chair for clinical affairs in U of L's Department of Family and Geriatric Medicine.
"I just thought this would be ideal because we could make it interprofessional," says Coleman, who is also associate dean of curriculum for the medical school.
It's really important for medical students, nursing students and other students to learn how to deliver care together.
As you can understand, that can be hard. Their schedules are different. Nursing has a completely different curriculum than the medical students. The students are pretty independent. So yeah, it's pretty unusual (to have an opportunity like the center).
'What else can we do?'
Providing a place where the workers feel comfortable was a crucial factor when the center was established, says Richard Riedel, the KRHWF's executive director. Riedel himself contributes to that comfort factor. Lanky and easy-going, he has worked in the horse industry since he was in high school.
 The Kentucky Racing Health Services Center is helping meet the needs of eligible backside workers. Richard Riedel (above), executive director of KRHWF, U of L's partner in the initiative, says the center's patients include some who are otherwise reluctant to seek medical help. |
Sitting behind his desk at the Old School, a glass-incased U of L basketball signed by Rick Pitino off his left shoulder, a Cardinal basketball season schedule off his right, he tells a visitor how the health center began.
The Kentucky Racing Health Service Center was the brainchild of Donald Ball, the KRHWF's longtime chair. He wanted health care to be more accessible for backside workers in the state. "When it comes to the racetrack workers," Riedel says, "Mr. Ball's attitude is always: "What else can we do?""
U of L has taken on the same attitude since getting involved with the center, he adds. Along with providing health-care expertise, U of L students facilitate communication, too.
Many of the workers who use the center's resources are from Mexico or South America, Riedel says. "They don't speak much English. And, frankly, they're very apprehensive and many time suspicious of doctors. They can be reluctant to seek medical help when they need it."
So the U of L Latin American Studies program pitched in to provide student interpreters. Jamie Wilson was one of them. A biology major, she completed an LAS internship last fall at the racing health center where she translated for Spanish-speaking patients and medical staff, helping take down medical histories and describing symptoms.
"Without translators, it can be very difficult to communicate certain aliments," Wilson says. "My services helped the patients feel more comfortable with the care they received and allowed the medical staff to feel more confident in the care they provided.
"This internship also gave me the opportunity to improve my own Spanish-speaking skills. I thoroughly enjoyed the experience and found it very rewarding."
'The three main concerns'
Last summer, as part of their clinical experience, a group of eight U of L nursing students embarked on a health-care fact-finding mission. They spent their summer with Nash at the health center, observing the work and developing new programs for the workers.
The students also attended the annual Churchill Downs worker picnic in June where they gathered workers' medical histories and listened to their concerns. Their goal was to find out what the workers' biggest health-care worries were.
"The three main concerns they learned about," Nash says, "were heart issues, diabetes and medications. There also seemed to be a concern about where to go for help with different issues." Based on the information gathered by the students, the KRHWF established a 'backstretch employee orientation," Riedel says.
"Sessions are at each track to let stable employees, assistant trainers, trainers and others know about the many agencies and benefits that are available to workers," he says.
Randy Martin took advantage of the KRHWSC this past fall, and he's extremely glad he did. Suffering from dangerously high blood pressure and chronic headaches, he made the trip from Lexington to see Nash.
"She helped me with my blood pressure," Martin says. "She also sent me to an eye doctor because I'd been having bad headaches. They found out that I was borderline glaucoma. I'm on treatment for that now too. "So it was good that I went in there when I did."
With his vision protected and his blood pressure under control, Martin says he plans to return to the Kentucky Racing Health Services Center this spring for a checkup. He might not have to keep making the drive to Louisville for long. U of L and the KRHWF are raising funds to extend the health services program to other racetracks around the state.
Not that Martin minds traveling a little.
