Cooperating for better care.

community health

Tag Archives

New ways to use data to boost community health


Stephen Goldsmith, in an article in Governing magazine, writes:

“Some policymakers have already had notable success with wellness-based approaches to public health. Oklahoma City famously went from the ‘fattest’ to the ‘fittest’ list in 2012 when its residents, led by the once-portly Mayor Mick Cornett, collectively shed a million pounds and recorded their progress on a Web site devoted to the project. In 2014, Austin, Texas, worked with Children’s Optimal Health, an Austin-based nonprofit, to map body mass index and cardiovascular fitness scores and convene educators, health experts and community members. Other interventions in communities around the country — such as soda taxes, calorie ‘nudges’ and bike-sharing programs — have shown tremendous promise for improving public health.

“Just as new diagnostic tools, fitness apps, digital monitoring devices and DNA breakthroughs are changing personal health with new data, public health is undergoing a revolution in the way it approaches epidemiology.”

To read Mr. Goldsmith’s article,  please hit this link.

‘From clinic to community’


A JAMA report, “Population Health Case Reports: From Clinic to Community,” describes collaborations between healthcare organizations and public-health departments and community organizations. In an era characterized by much stronger efforts to coordinate healthcare, it’s well worth reading.

The authors write:

“Like a winning lottery ticket, the productive alignment of medical services with public health has been long desired but infrequently experienced. Recently, however, the evolution of healthcare payment may be tilting the odds in favor of initiatives that cross from the clinic to the community. As Accountable Care Organizations, medical homes and hospitals under global budgets begin to accept financial risk for the health of large populations of patients, there is new momentum for the development of collaborations that aim to reduce preventable illness.”

To read the JAMA report, please hit this link.

Finding the returns for business in community health

Here’s a project aimed at making the business case for community health.

This involves a call for proposals (CFP), led by a partnership of the Robert Wood Johnson Foundation and AcademyHealth. The CFP, open through June 14,  seeks to answer questions related to making the business case for improving  the health of communities where companies  employ people or otherwise do business.

The aim is to fund research that builds not only the evidence base for how private-sector investment can help build a culture of community health, but also what returns businesses receive from this investment so that employers, out of enlightened self-interest, will participate more in improving such important factors in  regional  health as education, the environment and transportation.


New medical schools for a new healthcare world

This article by STAT (an offspring of The Boston Globe) looks at whether and how new medical schools can address some of American healthcare’s biggest challenges.

It starts: “New medical schools are launching across the country to address a projected physician shortage. They’re promising innovative curriculums that let aspiring doctors spend time doing research, working in community health settings, and following the same patients for months.

“But they face big obstacles, starting with the challenge of recruiting students and faculty when they’re not yet accredited — and won’t be, even in the best-case scenario, for several years.”

“What we’re doing is certainly a little bit risky,”  Clay Johnston,  M.D., the inaugural dean of the University of Texas at Austin Dell Medical School,  told STAT.

The university is building a nine-month research block into its four-year program, and working with the city of Austin to design a healthcare reimbursement system that rewards preventive care and long-term value. …”

“Academic medical centers are just reinforcing this broken health care system that pays too little attention to keeping people well,” Dr. Johnston  told STAT “We want to produce not just great physicians, but great physicians plus.”

Retiring Presence CEO says partnerships, community health are keys


Sandra Bruce, who is retiring at the end of the month as chief executive of  the Presence Health system, in Illinois, says brokering partnerships is increasingly the key to effective hospital leadership.

Hospitals & Health Networks calls it ” the Starbucks-ification of health care. Hospital leaders — looking to treat the health of populations, focus on wellness and pivot away from acute care — are building up convenient, less costly to operate locations around their communities. They’re partnering with consumer-savvy organizations like Walgreens to add greater, um, presence in neighborhoods, and build brand awareness.”

“Presence Health…with 11 hospitals, is no exception. Earlier this month, it announced plans to partner with urgent care provider Physicians Immediate Care to jointly manage 10 such clinics in the state, and build even more down the line. Those would be open seven days a week and into the evening, offering everything from X-rays to suturing. This is part of a larger strategy to expand the health system’s ambulatory footprint, with 55 sites coming in the first phase.”

Speaking about community health, Ms. Bruce said: “In some cases, it’s going to be safer streets. It could be housing it could be food. I’m not sure what we’re going to find in every community. While we’ve all done these broad community needs assessments, we haven’t really focused on what I call a ‘true population health assessment,’ and then determined what partnerships we need to begin to address those issues.”

“I don’t know if {healthcare is at} a crossroads, but we have an opportunity to step up in this country and reframe what it means to be an American from the perspective of health. And if we step up and lead the revolution to work on some of these social determinants of care, in a decade or two, the country will look very different; our communities will look very different, and obviously health care itself will be delivered in a very, very different way. ”



Brazil’s community-health approach




This article in The New England Journal of Medicine on Brazil’s family-health strategy may have lessons for U.S. community health efforts, be they of  hospitals, physician groups, Federally Qualified Health Centers or free clinics.

 Interdisciplinary healthcare teams are an important part of the system with each team having a physician, a nurse, a nurse assistant and four to six “full-time community health agents.”
“Each agent is assigned to approximately 150 households in a geographically delineated micro-area within the catchment area — usually the same micro-area where the agent lives. Agents visit each household within their micro-area at least once per month, irrespective of need or demand, and collect individual- and household-level data”

“{T}heworld can learn some lessons from the Brazilian experience. First, community-based primary care can work if done properly. It requires a solid blueprint, pilot testing and evidence generation, a long-term vision, and sustained financial and political commitments. ….Finally, building a robust primary care system is more than a bureaucratic exercise; in Brazil, it has required long-term social movements and professional commitments.”


Contact Info

(617) 230-4965

Wellesley, Mass