Thinking outside the clinic: Delivering public health in surprising ways

From veterans’ shelters to neighborhood laundromats, Jack Tsai, PhD, is bringing preventive care and practical support into everyday spaces—meeting people where health disparities often begin. We spoke with Tsai about how philanthropy helps make these community-centered efforts possible.

Q: What inspired you to pursue these unconventional approaches to public health?

A: I like creative work where people ask, “Wait, you’re doing public health in laundromats?” or “How is financial literacy a public health issue?” The field of public health has been around a long time, so we need to keep finding innovative approaches. I am always interested in finding practical ways to reach  people who might otherwise be left out of the system.

Q: Let’s start with your work supporting veterans. What was the goal of the Recovery-Oriented Money Management program?

A: With support from the Bob Woodruff Foundation, we worked with about 100 veterans in San Antonio who were experiencing or at risk of  homelessness. The program focused on the basics that many of us take for granted—how to budget money, track expenses, and avoid scams. San Antonio is a military city, and unfortunately, there are people who target veterans, especially those facing homelessness, for predatory practices.

Q: What kind of impact did you see among participants?

A: Veterans improved their budgeting and money management skills, but there were some less traditional benefits, too. When people start looking at where their money goes, they begin to see how much they’re spending on alcohol, cigarettes, or other substances. People who smoke, for example, know it’s bad for their health. This gives them a new way to look at their situation. It’s not the main goal of the program, but we found it actually motivated positive change in this area, too.

We also heard that participants felt more confident and in control of their lives. Some even avoided scams they might have fallen for before. These are all lifelong skills. Once you know how to manage your money, you carry that knowledge with you.

Also, our public health students participated in the program through practicums and gained valuable hands-on training. The veterans loved interacting
with them, and the students benefited from the meaningful, real-world experience.

Q: Your more recent project—the Laundromat Health Interventions Project—takes an equally creative approach. How did that begin?

A: When people are at a laundromat, they’re sitting there waiting for their wash. It’s a good time to reach them. We conducted a needs assessment at eight laundromats across San Antonio and found that many customers had not seen a health care provider in more than a year and were not receiving regular care. So, for the past two years, our team has gone into laundromats and provided on-site health screenings for 200 low-income residents.

We offer blood pressure checks, diabetes testing, and mental health screenings. We share the results instantly and privately and then provide a list of local resources for care. Some people we tested were walking around with absolutely no idea they had very high blood pressure or that they’d had diabetes for a long time.

Q: How is new philanthropic support expanding this work?

A: Until now, the project has operated with very limited funding, a real shoestring budget. New support from the Baptist Health Foundation of San Antonio is allowing us to grow substantially. Over the next three years, we hope to reach 3,000 people, even stretching into some Houston sites. The
funding will also enable us to collaborate with San Antonio’s University Health hospital system and hire a case manager to coordinate follow-up care for those with diabetes or other chronic conditions.

Q: Why is philanthropy such an important part of what you do?

A: Philanthropy gives us the flexibility to do creative work. These are not typical projects you can get federal funding for. Both the veteran program and the laundromat project are a little out of the box, and that’s what makes them effective. Whether it’s talking about finances with veterans experiencing
homelessness or offering health screenings at a laundromat, we’re finding ways to connect with people when and where they’re ready to engage.