The 14th annual Institute for Public Health Conference may have ended, but the focus on resilience and preparing our public health infrastructure for the future, continues. For this year’s hybrid (live and virtual) conference, the institute convened nearly 400 faculty, students, public health leaders and the public for education and discussion on:
- Fortifying our public health infrastructure for future emergencies
- Increasing public trust in health leaders and processes
- Aligning health care systems so that they are ready when we need them the most
We’re moving forward from one of the most challenging years we’ve ever seen. We were in the 7th inning and now we’re in the lead.Bill Powderly
In his opening remarks, the Larry J. Shapiro Director of the Institute, Bill Powderly, discussed Institute challenges and successes during the past 20 months and plans for moving forward.
Conference guest, Executive Vice Chancellor for Medical Affairs and the George and Carol Bauer Dean of the School of Medicine, David Perlmutter remarked that the School of Medicine is an appropriate place to host the annual conference, especially because in the past 18 months, the school has stepped up to meet pandemic challenges. “Saliva tests, novel antibodies and various vaccine candidates have been tested here; $750m in research grants have enabled WashU to employ 11,500 people annually, and the university contributes more than a billion dollars into the St. Louis economy.” He asked, “How can we create equity in our community and do it in a way that we avoid fragmented approaches with poor solutions? We need to think big and think together.” Watch the dean’s remarks.
Moderated by Dr. Powderly, a Public Health Infrastructure Panel, included Senior Director of Public Health Transformation for the Missouri Foundation for Health, Clay Goddard, MPA; Professor of Medicine in the WUSTL Division of Infectious Diseases & Director of the Center for Dissemination & Implementation at the Institute for Public Heath, Elvin Geng, MD; and, Assistant Professor of International Health at Johns Hopkins Bloomberg School of Public Health, Olakunle Alonge, MD. Panelists agreed that one thing we learned from the pandemic is that local collaboration and decision-making makes a big difference in assessing public health needs and developing solutions. If the infrastructure is not solid, neither will be the crisis management. “It’s not the health part that’s the challenge, it’s the public part,” said Dr. Geng. “Investing in something shared & equitable is the basis of public health & what separates it.”
Chancellor Andrew Martin offered an update about how the university has navigated the pandemic on campus to keep students, faculty and staff safe and he reiterated the importance of making public health a continuing focus for the university. The chancellor explained that the University’s new roadmap to success includes a public health investment phase fortified with educational and translational research. He also called out funding for the School of Medicine from the National Institutes of Health; the fact that WashU is a top Missouri employer; and that the Gateway to Success Initiative (on-going financial aid efforts for all students) generated a 65% return on the last endowment.
At this moment in history, there is nothing more important to lean into than public health.Chancellor Andrew Martin
Jason Purnell, PhD, MPH, vice president of Community Health Improvement at BJC Healthcare, Institute faculty scholar and associate professor at the Brown School, took the podium to outline the BJC Community Health Improvement Strategic Plan. Through broad community and stakeholder engagement, the plan is designed to help improve health access and health equity across the region.
Purnell said the plan’s mission is to “serve all in need starting in the City of St. Louis & in North County, and to maintain accountability in communities that BJC serves.” The plan calls for listening and learning from the community; investing in various efforts that will help close racial wage gaps and advance black-owned enterprises; and becoming a policy advocate, convener and partner to focus priorities on diabetes and healthy food access, infant and maternal health, and school health and wellness.
Too many (people) have had too little for too long.Jason Purnell
Commentary from members of the BJC Community Health Improvement Steering Committee Panel followed. Panelists included: President and CEO of Beyond Housing, Chris Krehmeyer; Executive Vice Chancellor for Civic Affairs & Strategic Planning and Professor of Practice at Washington University, Henry S. Webber, MPP; Professor of Medicine and Alumni Endowed Professor, Division of Nephrology; Associate Dean for Diversity and Principal Officer for Community Partnerships at the School of Medicine, Will Ross, MD, MPH; and Jason Purnell.
Moderated by Vetta Sanders Thompson, PhD, the E. Desmond Lee Professor of Racial & Ethnic Diversity, the panel discussed how an institution’s culture must first be influenced in order for it to change and move forward. Hank Webber noted that the new strategic plan would move BJC “from a medical care organization to a healthcare organization”.
Will Ross added that the St. Louis Region has indicators such as high infant and maternal mortality rates and high incidences of diabetes, showing that “our community isn’t healthy.” Neighborhood revitalization and a “laser focus on social vulnerabilities and disparities in certain zip codes are essential” to combat health and racial inequities, as is a substantial economic and monetary investment in those zip codes. Krehmeyer and Weber also concurred that as the plan is implemented, “we must allow ourselves to be vulnerable and admit mistakes in order to move communities forward.” The live and online audience weighed in with great questions.
A keynote by Leana Wen, MD, MSc, FAAEM, an emergency physician and professor of Health Policy and Management at George Washington University Milken Institute School of Public Health, illuminated the fact that public health plays an extraordinarily important role in the fabric of our communities. Wen said how people receive messaging about crises like the pandemic should be foremost in our minds. “Public health is all about prevention,” Wen said. “Getting science right is necessary, yes, but not sufficient. Winning over public’s hearts and minds is essential.”
Regarding vaccine hesitancy, Wen said she wished the U.S. had delivered the message, “Change is to be expected, especially during a new virus. Medicine is always evolving. This isn’t flip-flopping, this is medicine.” She added that the pandemic has particularly unmasked disparities among people of color, who are hospitalized in greater numbers over White people.
“There is always something bigger/worse that happens and other social issues like homelessness just keep getting pushed aside for the emergency,” Wen said. She added that we first need consistent focus on the everyday social determinants of health (housing, food, employment) that often exacerbate disparities as an emergency happens.
Drs. Wen and Powderly closed the conference with a brief Q&A. Dr. Powderly expressed the need for more time and “more conversations” in the future.