Health Disparities Karen Anderson David Hui Woong Chae Daniel Dohan Malo Hutson Kathleen Klink SreyRam Kuy Gareth Warren Groups II & III
1) Public Policy Problem • The disconnect between academic medical centers and underserved communities has consequences for health disparities.
Dimensions of the problem • Many academic medical centers (AMC) are surrounded by underserved and disadvantaged communities. • Many AMC are seeking to physically expand in ways that impact their surrounding communities causing conflicts and disparities. • Individuals in underserved and disadvantaged communities often lack high-quality, accessible primary health care. • There is a need for more cultural sensitivity and linguistic capability among healthcare providers. • There is economic segregation within surrounding communities. • Lack of investment in local infrastructure, built environment, human capital and social services
2) Rationale for Pursuing this Problem • “Actionable determinants of health…such as environment and social factors disproportionately affect national health.” Schroeder, NEJM 2007 • The contrast between the resource-rich AMC and resource-poor surrounding communities provide the foundation for a demonstration project in reducing disparities in health and healthcare.
3) Stakeholders and Their Positions • Medical institutions: hospitals, AMC, schools of medicine/nursing/public health • City agencies, e.g. dept planning, workforce economic development, public health, transportation, police, housing • Community-centered organizations, e.g. community development corporations, community-based organizations • Professional organizations and associations: AMA, AAMC, state nursing associations • Federal agencies: HRSA, CMS, HUD, AHRQ, CDC, NIH • Social service, training and faith-based agencies, e.g. Jewish Vocational Services • Foundations: eg RWJ, Commonwealth, March of Dimes, local foundations • Local residents, community leaders, doctors, businesses, churches • Local politicians, private developers, Chambers of Commerce
4) Action Plan • Public-private partnership leads to convergence of goals regarding AMC expansion and community development • Stakeholders work together to develop consensus on a community benefit agreement (documented via report) • Pilot/demo project using Title VII funds to show benefit for health and healthcare outcomes • Long term: tie Medicare reimbursement to improvement in actionable social or health indicators that are measureable