Linking Health to Communities

Health Affairs held a briefing recently to release their November issue  highlighting the Robert Wood Johnson Foundation’s “Culture of Health Initiative” established to promote improved population health, well-being, and equity. As Alan Weil Editor-in-Chief explained, “The Culture of Health Initiative” provides for a sense of community working across sectors and meeting the needs of the community.”

One of the papers dealing with population health, describes the Community Rx system a University of Chicago medicine-led program to help the residents on the South Side

Stacy T. Lindau MD, Associate Professor at the University of Chicago, lead author for the study titled “Community Rx: A Population Health Improvement Innovation that Connects Clinics to Communities” explained how the Community Rx program works and some of the favorable results.

To initiate the Community Assistance Rx program in 2012, CMS awarded a grant for $5.9 million to the University of Chicago medicine-led program to generate a customized e-prescription as part of an initiative called HealtheRx

To study how to help patients use available healthcare resources in the City, the researchers found that more than 40 percent of the organizations listed in the database providing health sources to help people receive care, actually didn’t have websites.

Also, many patients weren’t always able to fill their prescriptions unless they received their prescription order from their doctor’s office or clinic. Today, patients and doctors are able to utilize e-prescribing to fill or renew prescriptions at any time which makes filling prescriptions faster and easier on the patient.

The e-prescribing program has greatly helped patients who have visited health professionals in nearly three dozen health clinics in the area since it started. Community Rx has generated more than 506,000 customized HealtheRx prescriptions for an estimated 200,000 or more patients.

As Dr. Lindau explained, “The study’s most profound finding and one that motivated me to find a sustainable business model was that more than half of the participants used HealtheRx to help connect someone else to community resources. I’m fascinated by the idea that we might motivate people to take better care of themselves by offering them a tool that makes it easy to help others.”

The backbone of the project is to develop a continuously updated database of community assets to be merged into a patient’s EHRs. In addition, the database was created and updated with a complete listing of health resources by a team of high school students who walked every block of the area each summer to document the regions organizations using a smartphone app.

In another study in the November issue, Glen P. Mays MD, Professor of Health Services and Systems Research at the University of Kentucky’s College of Public Health, and lead author in the study titled “Preventable Death Rates Fell Where Communities Expanded Population Health Activities through Multisector Networks”, examined 16 years of data related to population health.

The study examined a large cohort of communities to measure the extent and nature of multi-sector engagement in population health to find out how community mortality rates were affected. The results of the study show that deaths resulting from cardiovascular disease, diabetes, and influenza declined significantly over time in communities that engaged a broad array of organizations and sectors in population health activities.

The authors in this study suggest that multi-sector engagement strengthens public health service delivery, educates the public about health risks and prevention, and most importantly links individuals to social services based on their needs able to produce even more sizable community wide benefits.

Another study in the November Health Affairs issue authored by Anna U. Morgan MD completing the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania, pointed out how public libraries can play an important role in addressing public health needs in underserved populations.

As Dr Morgan explained, “Philadelphia is the poorest of the nation’s ten largest cities with nearly a third of residents living below the federal poverty level. The cities rates of hypertension, obesity, and diabetes are among the highest in large U.S cities.

The study titled “Beyond Books: Public Libraries as Partners for Population Health” stresses how public libraries are not usually included in discussions about improving population health.

The libraries however are well positioned to be partners in building a culture of health through programming and training library staff to become community health specialists. The training helps the library staff to recognize vulnerable patrons, communicate with them, and guide them to appropriate community-based health services.

She also reports, that the staff is now addressing the needs of many immigrants, people experiencing mental illness or homelessness, issues faced by children and families experiencing trauma  and substance abuse, plus many others seeking assistance. The study suggests that there are a number of health programs if they were integrated in the library system could help.

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