Category Archives: Partnerships
Study: Common Asthma Treatment Suppresses Growth in Children
A common treatment for asthma may suppress growth in children, according to a new review of two studies that was published in The Cochrane Library journal. The studies included 45 trials on corticosteroid drugs, which are delivered via inhalers to both children and adults with asthma and generally used as first-line treatments for persistent asthma. "The evidence... suggests that children treated daily with inhaled corticosteroids may grow approximately half a centimeter less during the first year of treatment," said Linjie Zhang at the Federal University of Rio Grande in Brazil, according to Reuters. "But this effect is less pronounced in subsequent years, is not cumulative, and seems minor compared to the known benefits of the drugs for controlling asthma." The World Health Organization estimates that there are approximately 235 million people living with asthma. Read more on pediatrics.
Study: Busiest ERs Often Provide the Best Care
People with life-threatening emergencies have better odds of survival when treated at busier emergency departments, according to a new study in the Annals of Emergency Medicine. The study found that patients admitted to a hospital after an emergency had a 10 percent lower chance of dying in the hospital if they initially went to one of the nation's busiest emergency departments; that people with sepsis had a 26 percent lower death rate at the busiest emergency centers; and that lung failure patients had a 22 percent lower death rate. The researchers behind the study estimate that if all emergency patients received the level of care provided by the busiest emergency departments then approximately 24,000 fewer people would die each year. "It's too early to say that based on these results, patients and first responders should change their decision about which hospital to choose in an emergency," said Keith Kocher, MD, MPH, the lead author of the new study and a University of Michigan Health System emergency physician, in a release. "But the bottom line is that emergency departments and hospitals perform differently, there really are differences in care and they matter." Read more on health disparities.
HHS: $11M Toward Integrating HIV Services into Primary Care
As part of the ongoing National HIV/AIDS Strategy, the U.S. Department of Health and Human Services is making $11 million available for the integration of HIV services into primary care services in Florida, Massachusetts, Maryland and New York. The funds will go toward innovative partnerships between health centers and those states’ health departments. They are part of Partnerships for Care: Health Departments and Health Centers Collaborating to Improve HIV Health Outcomes, a multi-agency project that includes the U.S. Centers for Disease Control and Prevention and the Health Resources and Services Administration. Read more on HIV/AIDS.
Health Beyond Health Care: RWJF-Sponsored Washington Post Live Event Sparks Conversation on Creating a Culture of Health
“Health Beyond Health Care” was the focus of a Robert Wood Johnson Foundation (RWJF)-sponsored Washington Post Live Forum today that looked at how creative minds in traditionally non-health fields—such as bankers, architects, designers and educators—are working together to build a Culture of Health in the United States.
“No matter where you live and how much money you have, you should have the opportunity to live a Culture of Health,” said RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA.
>>View the full archived live stream of the forum.
Lavizzo-Mourey said RWJF began its work on the concept of a U.S. Culture of Health in 2009, when the foundation’s Commission to Build a Healthier America released a report recommending the concept. Last year, the Commission came together to see what progress had been made. Among the sites embracing the concept is Marvin Gaye Park in Washington, D.C. Once known as “Needle Park,” the community has transformed itself through lighting and landscaping. This was possible “because the community embraced the principles of a Culture of Health and demonstrated how, from the ground up, people partnering can change the nature of their community and make it healthier,” she said.
Pointing to the most recent Commission report, Lavizzo-Mourey said that looking at communities undergoing changes pushed the Commission to conclude that in order to improve health as a nation, we have to change communities—especially low-income communities—so that people can make healthy choices every day. That also means that health care has to connect with non-health care.
“Each of you,” she told the audience of thought leaders and policy makers, “is uniquely positioned to make changes that can get us to a nationwide Culture of Health.”
The day’s speakers spoke about innovations in their fields that are helping to create local changes in health, and which are often scalable for communities across the country.
“The most successful projects are those that start with bringing communities together to first assess the need, and then prioritize them and move forward with a particular project,” said Sister Susan Vickers, RSM, Vice President of Community Health, Dignity Health, who added that just about all the loans that Dignity Health has made to nonprofits in the community have been repaid.
Why a focus on health? “Health summarized all [of the other factors],” said David J. Erickson, PhD, Director, Center for Community Development Investments, Federal Reserve Bank of San Francisco. “The best predictor for future health for a third grader is whether they are reading on a grade level. Community development is big, but not big enough, and the medical system is not big enough either. We need to start aligning all of these sectors so we’re all working in the same direction to turn these neighborhoods around.” [Editor’s Note: Read a previous NewPublicHealth Q&A with Erickson.]
“We have to treat health as a national treasure—a natural resource—and put it up on the level of the seriousness of the economy,” said Rear Adm. Boris D. Lushniak, Acting U.S. Surgeon General. “The economy doesn’t do anything without a healthy people.”
The Prince George's County, Maryland Place Matters team is addressing food inequity by establishing a Food Policy Council and working with the county's recreation department to design and implement after-school healthy eating and active-living programs.
The project is beginning with the waterfront towns of Bladensburg, Colmar Manor, Cottage City and Edmonston, which have drafted a Community Action Plan with strategies on how to reduce chronic disease in Prince George's County. Partners on the Community Action Plan included Kaiser Permanente, the Consumer Health Foundation, United Way of the National Capital Area and the Meyer Foundation. Place Matters plans to replicate the initiative in other county municipalities.
Prince George's County is the most diverse in Maryland; 80 percent of the population is made up of minority groups. According to the 2010 Census, 8 percent of households live below the poverty line, but some of the towns have higher rates of poverty. Cottage City has a 21 percent poverty level, Bladensburg has a poverty level of 12 percent and Edmonston has a poverty rate of 9 percent.
Key Team Objectives:
- Improve healthy food access and wellness for all through food policy and action.
- Create reliable public transit, bike and pedestrian access to schools and recreational facilities.
- Enhance community capacity to lead and support the Community Action Plan.
“What we decided to do was instead of trying to address the full county is to build a model which the county could replicate,” said team co-leader David Harrington. Harrington said the project, which started seven years ago, has “had some good success in helping to address some policy issues and system change issues.”
Place Matters is building a team around stakeholders called the Community Implementation Team and a countywide team called the Policy Development Team, which consists of the county agencies that influence policy and can provide support for help in doing the community work. They were engaged early in the conversation “so that they would consider administrative and other policies that will help them buttress the community work, and then the community work would help then influence their work, so this becomes a supportive concentric circle of activity that helps systems change, as well as change at the community level,” said Harrington.
NIH Spearheads Private/Public Collaboration to Improve Care for Several Serious Health Conditions, Including Alzheimer’s
The U.S. Department of Health and Human Services (HHS) today released the 2014 update for the National Plan to Address Alzheimer’s Disease, which includes a determination to accelerate efforts to identify the earliest stages of Alzheimer’s disease and to develop and test targets for intervention. That acceleration has new momentum this year with the announcement several weeks ago by the National Institutes of Health (NIH) that it has formed a first-if-its-kind partnership—the Accelerated Medicines Partnership (AMP) with ten pharmaceutical companies and several nonprofit organizations—to help identify and validate new diagnostics and drugs for several diseases that impact tens of millions of Americans and their families. The three other conditions are Type II diabetes, lupus and rheumatoid arthritis.
“Despite the fact that there have been huge revolutions in science from discovery of the double-helical structure of DNA, to recombinant DNA, to all sorts of interesting technological advances...it still takes too long and costs too much and we fail too often in the development of new drugs,” said Kathy Hudson, PHD, deputy director for Science, Outreach and Policy at the NIH, in a conversation with NewPublicHealth.
Hudson said a key development that drove the creation of the AMP is a new center at NIH, the National Center for Advancing Translational Sciences, which she says will work on how to “create new methods and new approaches that will decrease the failure rate and decrease the timeline for delivering new, important medicines to patients’ medicine cabinets.” Hudson said it currently takes about 15 years and more than $1 billion to develop a new drug and the failure rates are quite high at every step because of safety and because of efficacy.
“The new partnership effort is really targeted towards trying to boost the success of the pipeline by improving efficacy. What we’re exploring in this partnership is using a whole bunch of different new approaches and new technologies to try to identify higher quality targets that can enter the drug development pipeline,” said Hudson.
The private sector drug firms will match NIH dollars one-for–one. The other key contribution, according to Hudson, is that “industry scientists and NIH scientists and academic scientists all come at these problems with slightly different perspectives and experience and expertise, and by combining those together we’re really getting a research plan that is distinctive from what any one of us would have generated by ourselves.”
Hudson said another critical issue that is helping the collaboration is the fact that “the ground rules have been so clearly laid out about us working in a precompetitive space, about all of the data being broadly shared not just with the participants but with the entire scientific community.” Even with the collaboration, identifying and testing new compounds will take years. How to commercialize successful products will be part of the ongoing discussions.
>>Bonus Link: Read more about the Accelerated Medicines Partnership
A Hospital Helps Revitalize the Community Outside Its Walls: Q&A with George Kleb and Christine Madigan
Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of more than 40 organizations, including 36 non-profit health systems that share innovative practices aimed at improving health and economic viability of communities.
>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.
One Stakeholder Health member is the Bon Secours Baltimore Health System in Maryland, whose Community Works initiative helps improve the lives of the people in one of the poorest neighborhoods in the city. Bon Secours Baltimore is part of a national health system founded by the Sisters of the Order of Bon Secours.
Bon Secours engaged the community before embarking on projects and have created programs aimed at improving the community’s health through services that include the hospital, community clinics and visiting nurse programs, as well as housing, GED and financial literacy programs and revitalization programs.
The ambitious housing program will ultimately provide more than 1,000 units of affordable housing in the streets just around the hospital.
Bon Secours’ partner in its housing program is Enterprise Community Partners Inc., which builds affordable housing throughout the United States. NewPublicHealth recently visited the Bon Secours housing and services sites in Baltimore and spoke with George Kleb, executive director Bon Secours Health System, and Christine Madigan, senior vice president of development at Enterprise Homes.
NewPublicHealth: When did the housing program begin?
George Kleb: Bon Secours here in Baltimore has been developing and operating housing since 1988. We started by developing a couple of senior buildings through a U.S. Department of Housing and Urban Development (HUD) program. Both buildings had been schools that were part of the surplus capacity in Baltimore. The HUD program serves people who are elderly, disabled, or very low income. There was a clear need and so we pursued that, and that was the start of our reach into housing. Then in the ‘90s we began work on housing really in line with a neighborhood revitalization strategy attached to our presence in the neighborhood of Southwest Baltimore. There was an area of West Baltimore Street, which is the street the hospital is on, that had become largely vacant. Two-thirds of the units in the three blocks leading up to the hospital were empty and we acquired 31 of those buildings and started a project we now call Bon Secours Apartments. We renovated three-story Victorian row homes into affordable apartments, and that’s when we started working with Enterprise. That’s a relationship that goes back to the mid-1990s.
NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to firstname.lastname@example.org.
Recent dental surveys find that less than half of children in America brush their teeth twice a day and research shows that dental decay is the most common chronic childhood disease in the United States.
To encourage kids to brush their teeth, the Ad Council recently launched a neat mobile app aimed at bringing public service announcements (PSAs) right to where they can be most useful—in this case, the bathroom sink. The new PSA is called “Toothsavers” and it's designed to encourage kids to brush their teeth for two minutes, twice a day.
The back story of Toothsavers is that an evil sorceress has cast a wicked spell, leaving everyone’s mouths to rot and be overrun by cavities. Now it's up to little toothbrushers to help Toothy and the Toothsavers save everyone's teeth!
Kids use the app to swipe and tab in order to brush and scrub away the spell for each of the kingdom’s denizens, including the Dragon, Little Red Riding Hood and the Pirate. And for every few days a child brushes their own teeth for two minutes, twice a day, they unlock a new character on the Toothsaver game. Brush for 30 days and kids get the chance to defeat the evil sorceress herself.
Features of the app include:
- 10 different two-minute animations to add some fun to daily tooth brushing
- 10 cartoon teeth that move on the screen when activated by a voice
- An interactive map to chart daily tooth brushing
- Parents can connect on Facebook and post whenever their child reaches a brushing milestone
Toothsavers is a program of the Partnership for Healthy Mouths, Healthy Lives, a coalition of 36 oral health organizations including the American Dental Association. The campaign’s goal is to motivate parents to take action to reduce their children’s risk of oral disease by making sure their kids are brushing their teeth for two minutes, twice a day. Toothsavers is the first mobile app to be entirely created by the Ad Council. “The game represents a huge milestone for us in our efforts to use gaming and mobile technology to effect social change,” said Ellyn Fisher, Vice President, Public Relations and Social Media.
NIH, Industry and Non-profits Form Partnership to Speed Drug Development
The National Institutes of Health (NIH), 10 biopharmaceutical companies and several non-profit organizations have launched the Accelerating Medicines Partnership (AMP) to identify and validate the most promising biological for several diseases. The first set of disease targets will be Alzheimer’s disease, type 2 diabetes, rheumatoid arthritis and lupus. Through the foundation for the NIH, AMP partners will invest more than $230 million over five years in the first drug projects. Read more on partnerships.
CDC: Child passenger Deaths Decrease 43 Percent from 2002-2011
While car crash deaths among children age 12 and younger dropped by 43 percent from 2002 to 2011, more than 9,000 children died in crashes during that time period, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention. The report found that 45 percent of black children and 46 percent of Hispanic children who died in crashes were not buckled up, compared to 26 percent of white children. Read more on injury prevention.
New Survey Finds Skepticism about Health Law Continues for Many Adults
Analysis of a new Health Reform Monitoring Survey, funded in part by the Robert Wood Johnson Foundation, finds that more and better outreach is needed to educate uninsured people about free or low-cost health insurance through expanded Medicaid programs or subsidies to help them purchase health insurance in the new marketplaces. Among the survey findings:
- On seven measures of health care quality, access, and cost, the majority of adults expect to be neither better-off nor worse-off in 2014 than in 2013, but of those expecting a change in 2014; more expect to be worse-off than better-off.
- Adults are more pessimistic about health-related costs in 2014 than about health care quality and access.
- Compared with insured adults, a higher share of the uninsured—expects to be better-off in 2014.
- Younger adults tend to be more optimistic than older adults about overall health care quality, access, and cost.
In an effort to help more people seek out health insurance coverage, Enroll America in partnership with the Ad Council, just launched “Take Care, People,” a national multimedia public service advertising (PSA) campaign to raise awareness, educate and motivate uninsured Americans to get health insurance for themselves and their families under the Affordable Care Act (ACA).
The campaign uses pets to tell people it’s time to take care of themselves, with a particular focus on women ages 18 to 34. Research by Enroll America finds that that women are more likely than men to do investigate health insurance options, enroll and encourage others to seek out information. Enroll America research also shows that 81 percent of people who are uninsured are unaware of the March 31 deadline to enroll in coverage for 2014 and 69 percent don’t know that financial assistance is available to help pay for their coverage. The PSAs were produced in both English and Spanish. Read more on the Affordable Care Act.
This week the National Association of Counties (NACo) will hold the fourth Healthy Communities Initiative Forum, in San Diego, bringing together county health directors and staff to share best practices to improve community health. The NACo Healthy Counties Initiative supports innovative public-private partnerships to enhance community health.
Ahead of the conference, NewPublicHealth spoke with Linda Langston, president of NACo and Supervisor of Linn County, Iowa, who will be attending and presenting at the conference.
NewPublicHealth: Tell us about the Healthy Counties Initiative.
Linda Langston: I was the first chair of the initiative when it came into being four years ago. We modeled it after what we had done with our Green Government initiative—we had local government elected officials and staff connected to various areas of health, and then we also populated the committee with some of our corporate sponsors that were ultimately working toward very similar kinds of goals and trying to figure out how we could work affectively together.
We're also helping people understand upcoming issues and ideas they may know about.
NPH: What are the key health issues that counties face in 2014 and how is NACo generally helping counties with those issues?
Langston: Many counties are responsible for safety-net services and virtually every county in the nation has a jail. We’ve learned that many people, including many federal legislators, don’t understand the difference between jails and prisons. Jails are unique to local government, at the county level, and are often where people who have been arrested but can’t afford bail wait until their trial dates. Our challenges include providing health care in the jails, as well as connecting those released to health services in the community, with a goal of continuity for such services as mental health care and treatment for substance abuse.
We are also employers and very often, particularly in small-to-medium-sized counties, we are the largest employer in the area. So we have a lot of employees who need our best efforts, such as looking at how to incentivize people to make good decisions about their own health. And, of course, we also have the community public health responsibility. So we're pretty effectively placed to deal with all things related to health.
A conference in St. Paul, Minn., earlier this month examined ideas and emerging examples for building a healthier Minnesota by promoting the integration of health-related programs and community development to address health where we live, learn, work and play. The conference was convened by the Federal Reserve Bank of Minnesota and Wilder Research, the research arm of the Amherst H. Wilder Foundation. The gathering, which was a follow-up to an initial conference on the intersection of health and community development held in Minnesota a year ago, highlighted current successful cross-sector efforts throughout the state.
Elaine Arkin, manager of the Robert Wood Johnson Foundation Commission to Build a Healthier America, was a keynote speaker at the conference. Her remarks included the announcement that the Commission’s recommendations on early childhood and supporting healthy communities will be released in early 2013.
The highlighted projects included a task force on increasing access to healthier foods, often an obstacle in poorer communities; locating needed services alongside senior housing; a stable housing concept for people at risk of homelessness following a hospital stay; and a project underway to give kids living in trailer parks a safe place to play.
“The strategy that we used this year in engaging people with actual examples...was very effective in really acknowledging that this work is messy, that it does take time and that in order to keep people enthusiastic about it sometimes it does require giving people a pat on the back even just for the small progress that they’ve made,” said Ela Rausch, community development project manager of the Federal Reserve of Minnesota.
Following the conference, NewPublicHealth spoke with Ela Rausch and Paul Mattessich, PhD, Executive Director of Wilder Research.
NewPublicHealth: What were the key goals of this year’s meeting?
Paul Mattessich: The overarching goal is at the national level to bring together public health with community development finance in order to better address health issues, social determinants of health and improved community health. But what we did the first time a year ago was to try to get the two sectors to understand what each other does, what their vocabulary was, how best to work together and to start some networking.
This year the goal was to take the next step and highlight some examples where this cross-sector collaboration occurred, and to use that to try to further that even more and to underscore the fact that the two sectors really do address the same end goal, even though they do it in different ways. And if they team up they can do it more effectively.
It’s no secret that public health department budgets have been shrinking in the past few years. In the face of the recession, public health professionals must seek new and diverse partnerships in order to achieve greater impact despite the lack of funding. The topic of one session at the American Public Health Association (APHA) Annual Meeting held in Boston was just that—how to increase impact through strategic partnerships with unlikely partners.
“The need for austerity and efficiency opens up the conversation for collective impact,” said Joseph Schuchter of the University of California-Berkeley School of Public Health. Partnerships can include a wide array of non-public health entities, including non-profit organizations, businesses and schools. The APHA panel discussed different approaches to successful partnerships that advance public health programs.
The Center for Health Leadership and Practice provides group leadership training for cross-sector teams that are working together to advance public health. “We may all be talking about the same thing, we’re just using different vocabulary and styles,” says VP of External Relations and Director Carmen Rita Nevarez. The Center provides existing partnerships with the tools and training needed to move forward in the same direction, while understanding that individual efforts may differ. More than 90 percent of program participants agree that the approach is effective in supporting intersectoral leadership development and most teams report regularly engaging other sectors as a result.
Networked and Entrepreneurial Approaches
Networked and entrepreneurial approaches to partnerships offer public health professionals with resources and allow them to reduce the negative externalities of the economy. The impact investment market constitutes an $8 billion industry that is eager to fund novel solutions to social problems. In order to succeed in these partnerships, the field of public health must work with social entrepreneurs and investors to highlight the potential return on investment for prevention programs and produce irrefutable outcomes.
The Community Health Improvement Partners (CHIP) serves as a backbone organization for a larger, cross-sector childhood obesity initiative. Cheryl Moder of CHIP shared her insights into the role of such an organization and how to successfully grow a diverse partnership. A backbone organization must serve as mission leaders by recruiting and retaining partners and support aligned activities so that they connect to one another. In addition, backbone organizations must navigate the challenges of larger partnerships—such as developing and retaining trust, encouraging equal partner recognition and shared measurement and evaluation—in a way that suits the needs of partners from different sectors.
>>NewPublicHealth was on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Find the complete coverage here.