Conversation on Community Health Q&A: Robert Simmons
Recently, The Atlantic and GlaxoSmithKline hosted “A Conversation on Community Health”—a series of events in three U.S. cities to explore what it takes to create a healthy community. The series brought together leaders from across different sectors to forge a dialogue across different perspectives.
NewPublicHealth recently spoke with Robert Simmons, DrPH, MPH, head of the Master’s Program in Public Health at Thomas Jefferson University who was part of a recent panel. Other speakers on that panel included entertainer and activist Dr. Bill Cosby; Dr. Alvin Poussaint, professor of psychiatry at Harvard Medical School; Dr. Irwin Redlener, Clinical Professor of Population and Family Health at the Columbia University School of Public Health; Diane Cornman-Levy, executive director of the Federation of Neighborhood Centers and Sarah Martinez-Helfman, executive director of the Eagles Youth Partnership.
NewPublicHealth: Tell us a bit about your background.
Dr. Simmons: I’ve worked in public health for 40 years including at the County Health Department in San Diego, the State Health Department in California, and the American Lung Association, where I was program director on issues of asthma and tobacco and cardiopulmonary disease. In the last five and a half years, I’ve been directing the public health program at Thomas Jefferson University in Philadelphia.
NPH: What do you think have been key improvements in addressing population health?
Dr. Simmons: I think the key is forging together through partnerships and coalitions. That’s played out in many different ways. I think one of the biggest things in the field of public health have been the grants that became available through various government and private foundation sources that required a broad collaboration. If you go back 40 to 50 years, universities would get three to five year grants and go into a particular community and do assessments, but it might not be what the community saw as a priority. When they finished the grant, they moved on and the community was left to deal, or not deal, with the findings. Then the community would often rightly ask: what have we gained from this on a sustained level?
All that has really changed. Now, we’re looking at sustainability and community ownership, working with the population and the various service organizations in the community, and many of these organizations are not necessarily health organizations. They might be working with a particular population, maybe they’re dealing with employment, or they’re dealing with housing—all sorts of aspects of the broad framework of what makes up the community. And those are the types of groups that we work with because when it comes down to it, the ownership has to come from community itself in order to have needed changes sustained over time.
NPH: How are lay leaders becoming critical in serving as effective communicators about health prevention?
Dr. Simmons: Many of these programs in the community train volunteers that community members will be able to identify with—your neighbor, someone from the same culture, the same background, and who speaks the same language. Increasingly research on the use of community health workers shows it to be a very effective method for improving patient communication, and by extension population health.
NPH: What are some areas where lay leaders can help facilitate better communication in health care?
Dr. Simmons: I think informed consent is one area that shows how important effective communication is. Too often people have something put in front of them and really don’t know what they’re signing. Health literacy is a huge area and part of that is really engaging the population. We have a state grant with the Philadelphia Department of Health on health literacy and it’s a two-pronged approach. We’re working with 13 hospitals in Eastern Pennsylvania on their health literacy initiatives, patient communication, and printed education materials and communications infrastructure.
The complementary part is working with senior centers and other community groups to train seniors who then become peer activators of consumer education to help patients and families learn how to get the most out of a visit in the health care system, how to make sure you’re asking the right questions ahead of time, to ensure that if your question was not answered that you ask again until you fully understand what is going on about your own health.
NPH: How can schools of public health connect with local and state health departments to help improve health and promote wellbeing?
Dr. Simmons: Programs in schools of public health continue to work with state and local health departments, not just on research, but also as part of advisory groups working hand in hand with the state and local governments. Pretty much every department works with their local university in collaboration.
Here in Philadelphia, for example, Health Commissioner Dr. Donald Schwartz and Dr. Mallya Giridhar, director of policy and planning for the department of health have advisory groups, particularly in two areas – one in tobacco control and the other in obesity prevention. We get together on a regular basis by conference call and in person to address data and key issues. We had a meeting recently in Philadelphia about the high hypertension rates.
It’s very gratifying to see a significant change in how various organizations—health care, government, academic and community to name a few—are working in partnerships and I think that’s really made a difference over time. Is it hard work? Absolutely. Because we all have different missions and objectives and goals and it takes some time to build those coalitions over time. But once they get started, frankly, they end up getting additional external resources often on different types of areas of need and interest in a community where hopefully the coalition can be sustained and expanded over time.