National Health Policy Conference (Additional Perspectives)

These additional observations from the NHPC come from Dr. Loren Robinson.

What Will It Really Take to Improve the Nation’s Health? The RWJF Commission to Build a Healthier America

The commission’s Mark McCllelan, senior Fellow at the Brookings Institution, and Co-chair of the Commission, delivered a hearty presentation and took the conference attendees through the commission’s recommendations. The 2014 report identified three key priorities for improving health in the United States:

(1) Make investing in America’s youngest children a high priority

(2) Fundamentally change how we revitalize neighborhoods, fully integrating health into community development and

(3) Take a “more health-focused approach to health care financing and delivery.”

McCllelan expanded on this last point. He identified areas in which there was room for growth and movement toward a health focus in healthcare financing, delivery, and policy. Key next steps toward achieving this goal included increasing awareness of why integration (of health as a central focus of health policy) is important and putting programs in place that support collaboration across the private, public, academic, finance, and community sectors. McClellan highlighted the achievements of Health Leads, a national health care organization, funded by the RWJF, that seeks to build a health care system that addresses all patients’ basic resource needs as a standard part of quality care.

Lastly, McCllellan closed with examples of funding and collaboration opportunities currently available in this time of competing fiscal priorities and financial constraints. The full report from the RWJF Commission to Build a Healthier America is available here. Interestingly, as part of ongoing discussions at the RWJF on how to best address the health priorities, the Foundation recently made the difficult decision to conclude ten of its human capital programs, including the Clinical Scholars Program, of which this author is currently a funded scholar.  Read more about the changes coming to the RWJF Human Capital Programs here.

 

Community Health and Disparity:  Moving Beyond Description

This breakout session moderated by Darrell Gaskin of Johns Hopkins’ Bloomberg School of Public Health was not your run-of-the-mill “Oh no, health disparities exist” rant fest. Instead, health disparities solutions were adeptly identified and supported with hard data and sustainable answers.

Brian Smedley led off the discussion, illuminating his work with creating Place Matters. Place Matters, which, consequently is also repeatedly highlighted in the recent report of the RWJF Commission to Build a Healthier America, is based upon the premise that that “it takes a village.” It harnesses the existing resources of local communities to address health disparities.  Smedley also discussed the utility of health impact assessments (HIA), which act as vehicles to communicate issues of health to federal, state and local policy-makers.

Jeff Brenner, well-known community organizer, MacArthur Genius Award Winner, and founder of the renowned Camden Coalition offered insight into community organizing as an answer to health disparity.  He highlighted that organizing in the community can force academic medical centers to be more accountable to underserved communities. Adding this caveat, Brenner cautioned that academic medical centers will never be at center of the fight to end health disparities as they are essentially profiting off of disparities and contributing to them on a daily basis. Innovation, he argued, is impossible when you have income disparity among physicians to the tune of hundreds of thousands of dollars, and the driver of salary inflation is overuse and over-ordering of medical tests, procedures, and operations.

M. Chris Gibbons of the Bloomberg School of Public Health’s Urban Health Institute closed the session by offering further suggestions about how to move the field of health disparities research and intervention forward.  He identified eHealth and technology solutions as innovative ways that health disparities can be both documented and addressed. This session was a refreshing departure from the norm. Health services researcher and policy wonks can look forward to more “walking the walk” from these three innovators in health disparities research.

by

Loren Robinson, MD

 Dr. Loren Robinson attended Spelman College where she graduated Summa Cum Laude with a degree in French. She completed her medical degree at Duke University School of Medicine and subsequently the Combined Internal Medicine and Pediatrics program at UNC Chapel Hill. Dr. Robinson’s research interests focus on the ways in which the built environment, specifically building abandonment and blight affect health. Dr. Robinson currently is a Robert Wood Johnson Foundation Clinical Scholar based out of University of Pennsylvania. Her comments reflect her own opinions and not that of the RWJF or the University of Pennsylvania.