2018 CONFERENCE SUMMARY
“ACTION TOWARD HEALTH EQUITY: CONVERSATIONS WITH LOCAL LEADERS”
More than 400 students, faculty scholars, staff, community public health leaders and St. Louis community members attended the 11th annual Institute for Public Health (IPH) Conference on Oct. 31st at the Eric P. Newman Education Center on Washington University Medical School Campus. Introduced by Chancellor Mark S. Wrighton, with opening remarks by William G. Powderly, MD, the Larry J. Shapiro Director, Institute for Public Health; director, Global Health Center; and the Dr. J. William Campbell Professor of Medicine; and, co-director, Division of Infectious Diseases, Department of Medicine, the half-day event featured fast-paced presentations from local leaders, accomplished public health professionals, Washington University scholars and others focusing on the intersection of public health and health equity.
Moderators for the Q&A were Bethany Johnson-Javois CEO of St. Louis Integrated Health Network and former managing director for the Ferguson Commission and Will Ross, MD, professor of medicine, and associate dean for diversity, Washington University School of Medicine.
As health equity has been prioritized in the fields of public health and global health, the 2018 conference theme Action toward Health Equity seemed to resonate significantly with audience members.
Presenters Nicole Hudson, assistant vice chancellor, Academy for Diversity and Inclusion and Vetta Thompson, PhD and E. Desmond Lee Professor of Racial and Ethnic Diversity for the Brown School, elaborated on how the public might help address and change public health and health policy. “Interests in rural and urban America aren’t that different,” Dr. Thompson said. “Many people don’t act [toward health equity in their communities] because they don’t have the knowledge or language they think they need to get action in the legislature. We need to work together.” “We need internal analysis and truth telling!” added Nicole Hudson.
Presenter Samantha Stangl, programs manager for the Mass Incarceration Community Education Initiative at Clark-Fox Family Foundation discussed the fact that 50% of people in U.S. prisons and jails have some sort of mental health condition when they enter prison for which they receive treatment yet, once they’re released, public mental healthcare is woefully inadequate or not affordable. “We should not rely on prisons as the delivery model for mental health care,” Stangl said. “It’s unfortunate that the largest providers of mental health services in the U.S. are prisons.”
She and other panelists suggested that public health officials need to build better relationships with community leaders who are more likely to invest in what is valuable to them. According to Stangl, building a public health case for investors which shows the value of quality mental health care in and out of the prison system could be instrumental in helping lower recidivism rates.
Cynthia G. Dean, CEO and director of programs at Missouri Bootheel Regional Consortium said, “One size doesn’t fit all in terms of solutions. We must understand our communities and their challenges.”
Panelists agreed that there is no single solution to health inequity but, for individuals and public health institutions alike, pushing outside of the day-to-day comfort zone, asking tough questions and creating relationships with those who can help, is a good first step.
“You may not want to go hang out in North St. Louis, but how will you understand [community] needs if you don’t?” said Alayna Sibert, a 2017 participant of the Institute for Public Health Summer Research Program, operations manager for the North City Food Hub, and an advocate for resolving food inequity in underserved north side neighborhoods. “Volunteer in these neighborhoods, see what they need, and you’ll understand them better,” Sibert said.
Sibert also suggested that corporations can help bridge the gap between underserved neighborhoods and urban areas by providing badly-needed fundraising resources for community non-profits who might not otherwise have the tools. Assigning a pro-bono grant writer to in-need organizations in low-income communities was cited as one such resource. “Many organizations serving the poor don’t have people who understand how to write a grant. Corporations have people who do this on a daily basis and might lend a hand, but, they have to get to know the community first, to see what the needs are.”
“Also, ask the hard questions,” said Jorge Riopedre, president and CEO of Casa de Salud, which provides low-cost clinical and mental healthcare to the region’s uninsured immigrant community. “There are gulfs between us but there are also intersections. Show these corporations those intersections, give them indicators of impact and motivators so they can acknowledge and more importantly, fund underserved communities’ critical needs.”
In remarks concerning how Washington University is promoting health equity, Institute for Public Health Director William G. Powderly, MD, said, “We all need to be held accountable. The Institute for Public Health and the conversations we’re having today are needed to connect our campus community with the external community and to convene urban and rural communities in order to hold each other accountable.”
Panelists also agreed that having a diversified workforce and community partnerships plays a key role in providing health equity. Moderator Dr. Will Ross added, “We need more diversity in higher level roles so we’ll look like the communities we want to be.” Dr. Vetta Thompson concurred, “Many people don’t see diversity at a higher level of an institution as a component of equity however, analysis of and action on diversity at these levels is a significant step toward achieving equity.”
“What skills should public health students have in order to take action and make a difference towards health equity?”
Panelists gave the following suggestions:
• Understand underserved community issues and challenges by immersing yourself into communities that are different from your own;
• Before your employment, learn systemic organizational challenges and how they work, so once employed, you can be more effective in helping influence those working to achieve balance towards health equity;
• Volunteer in neighborhoods you don’t normally frequent. You’ll understand them and their needs better.
“Is there an intersection between traditional models of healthcare and new models? What are the current trends?”
Presenter Melodie Donatelli, executive director – access, for the Center of Clinical Excellence at BJC Healthcare discussed current advances in traditional healthcare and how newer models, such as virtual healthcare, are particularly helping rural communities where many miles often separate patients from the closest hospital. Donatelli also discussed efforts in the BJC HealthCare system to infuse health equity indicators into patient care and the institutional decisions that impact patient care.
Panelist Tim McBride, Bernard Becker Professor at the Brown School and co-director of the IPH Center for Health Economics and Policy noted that as doctor and nurse shortages in rural communities increase, medical facilities are now opting to use certified community health workers to help with the heavy load of rural healthcare needs.
Donatelli added that in order to encourage a younger pipeline of career healthcare professionals, more school-based healthcare programs are being implemented. In these secondary school programs, students spend time engaged in a health track with a local hospital and paramedics can be seen conducting community visits with neighborhood patients, bringing healthcare to their door while exposing neighborhood children to the high-impact nature of a healthcare career.
Attendees to this year’s conference ranged from students and off-campus public health professionals to, scholars and funders. Lisa Potts who recently started her career in behavioral health, said she enjoyed the conference because of her interest in the integration of behavioral health with public health. She said she appreciated the “passion and in-depth knowledge” of the conference presenters and is anxious to discover more about “what’s next” and how she can help bring equity to patients in her career path.
School nurse and nurse coordinator for St. Louis Public Schools, Surilla Shaw said she attended the conference to learn more about the intersection between rural and urban healthcare. She sees first-hand the huge inequities between available nurses and the care offered in rural vs. urban areas. Solutions to these problems should be grouped together rather than tackled separately, she said, but she learned “some valuable ideas” about how she can help influence more health equity on the job.
Overall, 2018 Institute for Public Health Annual Conference attendees and presenters alike agreed, there is much to be done to combat public health inequities. It starts with individuals who convene with groups who can connect with their communities and ignite city and state government to collaborate with their constituencies to ultimately take action. But as one speaker put it, “Agitation outside of relationship is irritation.” Only through education, assessment, engagement and most importantly the formation of relationships, can change toward health equity begin. The Institute for Public Health will continue its mission to be a connector, convener and catalyst to this end.
2018 IPH Annual Conference Poster Session:
The conference concluded with a judged poster session featuring poster abstracts outlining research projects funded by the Institute for Public Health. Poster session participants were tasked with illustrating the significance of their research question or topic and clearly explain its relevance to public health, their approach and methods used, and subsequent results and conclusions.
Lead Author: Stephanie Mazzucca, PhD
Co-Authors: Renee G. Parks, MS; Rachel G. Tabak, PhD, RD; Peg Allen, PhD, MPH; Maureen Dobbins, PhD, RN; Katherine A. Stamatakis, PhD, MPH; and Ross C. Brownson, PhD
Poster: Assessing organizational supports for evidence-based decision making in local public health departments in the United States: Development and psychometric properties of a new measure. View poster.
Lead Author: Jean-Francois Trani, PhD
Co-Authors: Bakhshi, Parul, PhD, DEA (M. Phil) (WashU); Mozaffari, Alan (WashU); Sohail, Munib (NRSP); Rawab, Hashim (NAC); Kaplan, Ian (NAC); Ballard, Ellis, MSW, MPH (WashU); Hovmand, Peter, PhD, MSW (WashU)
Poster: Strengthening inclusion in learning through empowerment of rural school stakeholders in Pakistan and Afghanistan: Piloting and testing community-based system dynamics
This project was supported in part by funds from the Institute for Public Health at Washington University in St. Louis. View poster.
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