Now Viewing: Public and Community Health

New Leaders Use Telehealth—and Teamwork—to Tackle Opioid Use

Sep 26, 2017, 9:30 AM, Posted by Kaytura Felix

A pioneering team of clinicians is tearing down barriers that prevented opioid dependent patients in a rural community from receiving treatment. Their efforts—and those of leaders like them—are helping communities across the nation have an equal opportunity to lead healthier lives.

In Hagerstown, rural Maryland, tucked amongst a series of charming brick buildings is Wells House, a long-standing charity. It provides recovery services to community members battling drug and alcohol dependencies. But for some time, what Wells House didn’t have was a regular clinician to provide specific, evidence-based opioid treatment.

Wells House eventually turned to “telemedicine”—using technology to tap into a network of physicians who could provide treatment remotely. The initial idea came from Eric Weintraub, MD, director of substance abuse services at University of Maryland School of Medicine (UMSOM). The charity had sought out his help in prescribing and managing buprenorphine treatment for clients with opioid disorders. But frequent travel out to Wells House from Baltimore posed a problem for Weintraub and his colleagues. So he turned to technology.

“It was a no-brainer,” Weintraub said. “Medication-assisted treatment is the gold standard for opioid addiction, and we have learned that telemedicine is as effective in most places as face-to-face care, so why not put the two together?”

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Can a Trash Can Reveal a Community’s Values?

Sep 21, 2017, 12:00 PM, Posted by Karabi Acharya

What can the U.S. learn from Copenhagen about designing public spaces to foster healthier, more inclusive communities?

One of the most striking cultural symbols upon arriving in Copenhagen is the sheer number of cyclists navigating city streets—in fact bicycles outnumber cars!

But during my recent visit, it was the trash cans that actually caught my eye.

Just as in many U.S. cities, Copenhagen’s citizens can return used bottles and cans for cash. But, unlike other cities, Copenhagen’s trash cans are equipped with small “deposit” shelves on the outside to place recyclables. This provides an easier, safer, and more sanitary way of collecting discarded cans. Instead of digging through trash cans overflowing with smelly garbage and sharp glass, collectors can easily retrieve bottles and cans from these exterior shelves.

A small feature like this speaks volumes about how our public spaces can support social values like dignity and compassion.

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How Lessons From Abroad Are Uplifting Youth In the United States

Aug 23, 2017, 12:00 PM, Posted by Jennifer Ng'andu

Creative programs in Latin America are inspiring U.S. communities to pursue similar approaches that connect young adults to education and employment.

Like many high school graduates in Brazil, Caroline was eager to find a job. She desperately needed money to continue her studies and pursue her dream of becoming an engineer. But two years after graduating, she was still unemployed. Caroline eventually managed to improve her job prospects in an unlikely way—through drawing, dance and breath work.

Intent on breaking free from a family history of women who weren’t able to get good jobs or finish high school, Caroline discovered a job training program run by Rede Cidadã (The Citizen Network). The non-profit organization connects youth to jobs and apprenticeships throughout Brazil, where the youth unemployment rate is nearly 25 percent.

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Honoring Tradition to Support Tribal Health

Aug 3, 2017, 10:00 AM, Posted by Jamie Judkins

Twenty-five years ago, the future of the Shoalwater Bay Indian Tribe was in jeopardy. Today, they are looking at seven generations: back three generations, the present, and forward three generations. Here is how they are ‘pulling together’ for health.

My tribe sees life within the frame of seven generations: The current generation is shaped by the experience of people three generations before and tasked with setting the course for three generations to come.

That’s why I summoned the stamina needed to paddle a canoe for eight days last summer in a tradition that binds our generations. I joined thousands of men, women, teens and children from my tribe—Shoalwater Bay Indian Tribe—as well as our neighbors from the Chinook Indian Nation, to paddle together in a dugout canoe for 200 miles. It was an annual journey with deep roots in our culture and history. I learned what it really means to pull together. You get into a rhythm with your team, and you move forward.

That’s what we’re trying to do for our community’s health, too.

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How Multi-Sector Health Partnerships Evolve

Jul 10, 2017, 2:00 PM, Posted by Emmy Ganos

Strong partnerships spanning an array of sectors—including public health, housing, education, transportation and others—are the bedrocks of healthy communities. How do they evolve and what makes them successful?

When Mercer Medical Center in Trenton, New Jersey, planned to close its doors more than 10 years ago, many in the community were alarmed by the likely impact on health services available to the city’s large, low-income population. Encouraged by Mayor Douglas Palmer and the State Department of Health, two hospitals, a federally-qualified health center, and the city health department came together to consider how best to meet the needs of Trenton residents.

At the time, many of these providers knew one another more as competitors than as collaborators. But they recognized a shared commitment to Trenton’s most vulnerable residents and set aside potential rivalries to form the Trenton Health Team. Today, that team links more than 60 behavioral, social service, educational, and faith-based organizations to pursue better community health outcomes.

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How Prepared is Your Community for an Emergency?

May 24, 2017, 3:00 PM, Posted by Alonzo L. Plough, Michelle Larkin

America’s preparedness for managing health emergencies is improving, yet progress is slow and regional inequities persist. Miami-Dade County shows us that actively engaging communities is key to improving local health security.

Hurricanes and tornados, Zika and Ebola, wildfires and flash floods, terrorist attacks and tainted water systems. Threats to American health security are on the rise and could hit U.S. communities at any time. The responsibility for preparing for potential threats and keeping people safe doesn’t fall on any one official or institution but on diverse and diffuse government agencies, health care organizations, public health, non-profit organizations, business leaders and community members.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has been measuring how ready our nation is to face emergencies that threaten health and well-being through the National Health Security Preparedness Index (Preparedness Index).

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Rich Besser’s Journey of Service

May 11, 2017, 11:00 AM, Posted by Najaf Ahmad

From his Princeton roots to his experiences as a pediatrician, public health practitioner and journalist, Rich Besser shares stories and lessons from a career dedicated to service in this Q&A.

Rich Besser was a fourth-year medical student when he found himself performing his first (and last!) solo emergency Cesarean section at a hospital tucked within a rural Himalayan village in Manali, India.

He had come to Lady Willingdon Hospital eager to learn about health problems facing people within the developing world, and worked under a gifted local surgeon, Dr. George “Laji” Varghese. Providing care for the underserved population there was no small feat. For instance, the power would often go out during surgeries, requiring someone to hold a flashlight over the operating table.

Dr. Laji one day left Rich in charge as he departed for a week-long meeting. Before leaving, as a precaution, he walked Rich through how to perform an emergency Cesarean section since they were high up in the mountains and hours away from the next health care facility.

Sure enough, a few days later a woman who’d struggled through labor for over a day arrived. A senior nurse noted that the baby’s heart didn’t sound good.

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New Effort Will Give Researchers Access to Valuable Health Datasets

Apr 24, 2017, 9:00 AM, Posted by Katherine Hempstead

A new program is providing research teams with $750,000 in funding and access to rich health data. In doing so, we're hoping to create opportunities for researchers to use this data to inform policy and improve systems.

Many of us track health data without even thinking about it. With our step counters, fitness tracker apps, and “smart” watches, we collect thousands of points of data about ourselves—data we hope to use to make us healthier and more fit (or motivate ourselves to work harder). Now think about all the data health care providers and insurance companies track. That data, if put together and de-identified to protect privacy, could help researchers spot health trends in certain geographic areas. That data could help researchers see if there are linkages between people with chronic conditions and what type of health plans they choose.

Now, imagine you know about a library of health data, but it’s locked in a room that is in a building that costs money to enter, requires legal negotiation, and is not organized for researchers to use.

For many researchers, this analogy is more real than you think. Many valuable health datasets are actually this elusive. Proprietary datasets may be hard to obtain due to cost, or have technical/systems requirements that make it difficult for researchers to access and actually use.  

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System and Services Research for Better Health

Apr 18, 2017, 8:30 AM, Posted by Oktawia Wojcik

How can we identify the system-level strategies needed to improve the delivery of medical, public health, and social services? With $2 million in funding, we’re calling on research teams to find out.

What does it look like when systems work better together?

At Arizona State University, a research team is exploring this very question. By integrating data sources from Arizona’s medical, mental health, and criminal justice systems, they’re looking for ways to effectively coordinate health and support services for those confronting mental health or substance abuse challenges. The study uses systems modeling and network analysis methods to see how individuals and dollars move between and within these systems. These insights will help us better understand how changes in financing and service delivery can improve health outcomes.

Over at Drexel University, a team is studying how aligning Medicaid coverage for behavioral services with the Temporary Assistance for Needy Families program (TANF) can reduce children’s developmental risks, improve future employment and income, and reduce the return of beneficiaries to the TANF program.

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Working Together to Take on the Opioid Crisis

Mar 29, 2017, 8:00 AM, Posted by Tim Soucy

Drug overdose deaths are fueling a dramatic increase in premature deaths nationally. This community is taking action—here’s how.

I’ve lived in Manchester, New Hampshire, my entire life and led the health department here for more than a decade. So for me, the opioid crisis that has hit the city and surrounding region hard feels like a very personal kick to the gut. Between 2003 and 2015, overdose deaths in Manchester increased 12-fold, and until recently, our emergency responders were seeing 60 to 70 suspected overdoses each month in this city of 110,000 people.

We’ve seen more and more in the news that the drug overdose epidemic has become a national crisis, and the 2017 County Health Rankings released today reveal the extent of its terrible impact. Drug overdose deaths are now the leading cause of death in the United States among 25- to 44-year-olds, cutting short the lives of too many people and underlying a national rise in premature death rates.

Fueled largely by overdose deaths from opioid prescription drugs, heroin, and illegally manufactured fentanyl, the epidemic killed more than half a million people from 2000 to 2015.

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