Recapping #PESummit | Empathy + Innovation

"Empathy is something that's essential to us being human beings. The idea to look at our fellow men and women and see pain, happiness or suffering and feel that your self" Evan Peskin, Resident Physician, Conference Attendee.

 

Cleveland Clinic Patient Experience Summit 2018

Empathy + Innovation

EMPATHY

WHERE } YOU } ARE

A two day conference held during June 18-20 in Cleveland, OH

In attendance were stakeholders at all levels across the healthcare space including patients, clinicians, and decision makers. To gain perspectives on empathy through different lenses I spoke with the Cleveland Clinic staff, healthcare leaders, decision makers, and healthcare enthusiasts in regards to defining patient experience #PtExp. As well as predictions and future outlook for technology and humanism in healthcare.

Jessica Crow, MBA Program Manager IV, Center for Excellence in Healthcare Communication

Incorporating Patient Centrism  at the Center for Excellence in Healthcare Communications at the Cleveland Clinic

We focus on communication, empathy and just seeing people as people. Having real conversations, getting to know who they are, understanding their needs, what’s important to them, their families, their backgrounds. So that you can truly figure out how to care for the entire person.

Barriers Hindering Excellent in Patient Experience

Time! Time, is always an issue within communication and medicine. Whatever we do, the feedback we always hear is “well I don't have any time. I don't have time for that. I have to see more patients, or I don't have time to go to a class etc.”. I think that if we were to use some of the skills that we try to have people focus on, it actually saves you time. Time is always a barrier. Productivity; there's always an ask to do more and more with less and less, faster. We’re constantly trying to compete with that. What gets lost at times is that connection, seeing people as people, it then gets very robotic, monotonous, emotionless and cold.

Empathy

When I hear it, what I think of is, somebody hearing me, somebody understanding what I’m going through, somebody almost feeling what I’m feeling and being able to recognize that for me. Not about themselves, not about anything else, but really thinking about what I'm going through at that time and how that must feel. When you get that genuine response in that moment, and feel like their actually listening to me, they actually understand how I’m feeling and that they care.

 

Joaquin Dos Reis, Program Manager, Global Education, Cleveland Clinic

Caring the Cleveland Clinic Way

I care about education, sharing information, I care about others, I care about our patients, our colleagues, caregivers, staff, everyone!

Empathy at the Global Education Department.

Empathy means everything. If you are a Cleveland Clinic caregiver, from the first time you park your car, you are in the Cleveland Clinic, you are a Cleveland Clinic caregiver. Part of that is that we have the opportunity to work with patients and work with colleagues and physicians from all over the world. We connect the dots, we bring international physicians to the Cleveland Clinic to meet our physicians and leaders.

 

Julie Rish, Ph.D., A Clinical Psychologist, Director of Design and Best Practice in the Office of Patient Experience | Director of Communication Skills Training and an Assistant Professor of Medicine at the Cleveland Clinic

Humanism in Medicine

I think that medicine is inherently human. The art of medicine without relationships--- We're not just technicians. Similarly, providing excellent patient experience is about meeting people in a very relational human way. Optimal healing can’t occur without the humanity of medicine and true understanding of another person sitting in front of you, without being able to empathize with your experience. Relationships are healing in and of themselves. When we're connecting as people it's healing to me as a clinician but it's also healing to the person that's sitting in front of me.

Barriers in Healthcare Delivery

There’s a lot of barriers that equal time and task pressure. How can I be present in this moment and not be thinking, three steps ahead or three steps behind but just to be present in the moment? When you do that you can find meaning and purpose in your work. The barrier is how do we overcome those obstacles to create moments of presence, being mindful and truly connecting a human level? In doing so, that's where we can find restoration and purpose and get back to why you chose this profession, this career, this entity in the first place.

Watch/Read The Entire Discussion

 

Richard I. Levin, MD, FACP, FACC, FAHA, President and CEO of the Arnold P. Gold Foundation, a position he’s held since 2012.

Thoughts on Technology & Healthcare

Technological wonders need now to be incorporated as physicians had done for these two millennia into a system of practice and care that shares the responsibility for the care to the extent possible with the patient and the family. I think it's not so far away, it's not so difficult for us to figure out how to do that as long as this is an accepted goal of the entire system with each health system contributing to it to the best that they can.

Read/Watch The Entire Discussion

 

Michael Joseph, PMP is a chronic illness patient from Northern Virginia, currently the founder and C.E.O. of Prime Dimensions and Executive Director of Empathy. Health.

What I can do overall to contribute to the patient journey, patient’s experiences is that's the impetus for empathy.health, part of that was influenced by what's going on here at the conference, Patient Experience Conference with Dr Adrienne Boissy, MD, MA who has been preaching this for quite some time long before empathy.Health came along.

Curating content from that site into ours would be great. In addition to other industry leaders and folks on Twitter that have really contributed dialogue as well. There’s Empathy Princess on Twitter, Merriman. There’s so many people on Twitter even today, the whole #pinksocks movement and tweet chats (#HCLDR) about this. It's a great platform for people to voice their opinions, their frustrations and best practices. Maybe, we can grab some of that and put that collectively on Empathy.Health as a resource.

Watch/Read the Entire Discussion

 

David Watson, MD. A physician surveyor for The Joint Commission

Healthcare Workers & Empathy

I think the empathy for me and the important part of this conference (#PESummit) is what I talked about earlier, thats second victim. These are healthcare workers that are involved in an adverse event. The empathy that needs to be expressed to them is that connection of realizing that they've been in a difficult situation and they need to be supported.

They need to be reassured and they need to know that they went into medicine for the right reasons. They take care of patients because they love what they do and they should continue to have that fire in their eye when they go to work every day to be totally engaged. We know that total engagement leads to less errors so we want our workforce to be engaged.

Watch/Read The Entire Discussion

 

Jason A Wolf, Ph.D. CPXP. Dr. Wolf is the President of The Beryl Institute

Patient Experience & Empathy

We did a research on empathy, compassion, all these kind of things. We asked consumers, to what extent empathy and compassion was important to them. I was actually surprise, it came down the list. I think it's because, empathy is a healthcare centric language. A typical patient and family member out there knows what they want to see. They want to feel listened to, they want to feel like they are being spoken to in a way they understand etc. Those were the things they elevated in terms of importance. For me the lens is not to get stuck in what empathy is but to think about what does it look like in action.

I’m probably less concerned about how we define empathy. How we elevate empathy and the actions that we take to ensure that patients, family members and those that are delivering care feel heard, are communicated to effectively, are engaged in ways that matters to them, then they feel what we believe empathy is. All of those things without having to put a label on it in a way that is about us doing something but more so about engaging the folks in care themselves.

Watch/Read The Entire Discussion

 

Claire Pfarr, Marketing Manager, Oneview

Thoughts on Patient Experience

Patient experience is one of those things I have found where no matter who you are, what walk of life you come from, when you’re speaking to people they all have a patient story. Everybody have a patient story. Whether they were a patient, or whether they were caring for a patient, everybody has healthcare experience that most often that's most often not necessarily a good one. I think that is very telling, but I think that healthcare has the opportunity to really take care of these people and to turn a negative situation into a very positive one.

 

Evan Peskin, Resident Physician | #PESummit Attendee

Thoughts on Empathy in Healthcare

Empathy is something that's essential to us being human beings. The idea to look at our fellow men and women and see pain, happiness or suffering and feel that your self. To be able to truly feel what someone else is going through. It's different from sympathy, it's not just feeling bad for someone else for what their going through. Empathy is truly experiencing or attempting to experience what the other person is going through.

Improving the Patient Experience

We improve the patient experience (as much as it's a cliche) by recognizing that everyone is a patient at one time or another. Even if you’re not the patient sitting in the hospital bed, you’re the family member standing next to your love one there. You improve the patient experience by taking the physician off the pedestal. Physicians should not be autonomous decision makers anymore without any input from patients and family members.

 

Kelsey Crowe, Ph.D | Founder of Help Each Other Out

Dr. Crowe, a plenary speaker at the #PESummit used real life examples of empathy in healthcare that were collected at the Help Each Other Out Empathy Bootcamp  

Empathy Examples

  • It really made a difference when my nurse: stood by my side and made physical contact with me during my biopsy. It was so comforting and reduced my anxiety. Thank you!

  • A UCSF staff person (receptionist, security guard, health aid) made me feel better when: let me lie down on the couch to rest and even dimmed the lights for me.

  • Something my doctor did or said that really comforted me: Gave me a hug.

Dr. Crowe then stated These are often recalled years later.

  • The receptionist/scheduler has been so helpful when: She moved another appointment by 10 minutes so that I could have my very first appointment after diagnosis with the surgeon, without having to wait 3 weeks.

"I can't tell you how often people describe this kind of behavior by schedulers and receptionist" Kelsey Crowe, Ph.D

Read/Watch More on Empathy & Healthcare

 

Social Media Activities & #PESummit 

During the summit Colin Hung posed a crucial question, challenging the glory of patient experience to the #HCLDR tweet-chat community “Have We Reached Peak Patient Experience?”. Read more on Hubberts Peak Theory, Colin's rationale and thoughts on patient experience via the  Healthcare Leadership Blog


For More On The Cleveland Clinic Patient Experience Summit 2018 Check-out

#PESummit | Website

Alisha M Bridges, Psoriasis & Mental Health Advocate

"I asked that elected officials, first find bills that allocate for the N.I.H and C.D.C. for research of chronic illnesses and to look at the bill for step therapy and revaluate and look at your friends and family" Alisha M. Bridges.


Alisha M. Bridges, Psoriasis & Mental Health Advocate

Psoriasis is an autoimmune disease, basically people living on with the condition have an overactive immune system which causes us to create skin cells that we don't need. Now in a normal body that does not have psoriasis the skin cells are created, replaced and die within 28 days. For someone who has psoriasis that cycle is happening within 3 days and the body cannot keep up with that passes in order to properly flake off the dead skin cells.
So with that happening the dead skin cells start to build on top of good skin. If you have psoriasis a lot of characteristics of it will be dry, inflamed patchy skin. It can be painful, it can be very itchy and it can be had a debilitating disease. It’s also associated with arthritis which is another autoimmune disease that is basically your body attacking itself within the joints. A lot of people have a misconception that psoriasis is a skin disease, but given the explanation I just gave as to how it works in your immune system you can see that it's much more than that.
I was diagnosed when I was seven years ago. It came after a case of chickenpox and I had always had plaques of dry skin on my knees and elbows, but at that time we just thought that I was just really ashy. We did not know that I was going to have to face my autoimmune disease a couple years later. After the chicken pox came which was very common when I was growing up in the late 80's early 90’s my grandmother noticed that my skin was not healing like it normally should after someone encounters the chickenpox virus.  So she took me to the dermatologist, they surveyed my skin and based on the look of my condition as well as family history of psoriasis they then been determined that that is what I had. 

Growing Up With Psoriasis  

Growing up with psoriasis as an African-American definitely has some unique challenges. My psoriasis does not look like what is in the textbook and described in the textbook as characteristics of psoriasis. So usually people will say “Well psoriasis is red inflamed patches”. Well for a person of color my plaques were not red, they were brown to a purple color.
So in one instance I've definitely faced some challenges just from a health and medical standpoint, because sometimes doctors didn't even really know if what I had was in fact psoriasis because they weren't well versed in dealing with people of color who had the disease. So that meant a lot of times a lot of misdiagnoses. I’ve been diagnosed with funguses of the skin other conditions of the skin. It was a lot of trial and error as far as different medicines that they would use just to see if something would work.
Based on the medicines that did work sometimes it was determined that I had psoriasis. Now outside of that as far as like quality of life and just interacting with other people it has definitely been a challenge. People have added more misconception when it comes to visible diseases. They automatically think you know you're contagious or I'm going to catch it or something is wrong with you. So that in itself is challenging just as a child living with a visible disease. It was then became my responsibility as a seven year old to have to explain to my peers as well as adults what I was dealing with and that's a lot to put on an adolescence.

Self Esteem  & Living With Psoriasis

It also affected my self-esteem and the want and inability to do things comfortably. And it just has affected my whole entire life. There was not a day where psoriasis did not play a role somehow in my life. It was hard for me to deal with the stress of stigma that came with psoriasis. I internalized a lot of pain and challenges that I faced. I didn’t think that those around me would understand what I was dealing with mental emotionally, not even trusted family or friends.

I kept a lot inside of what I was going through. And often times being in an adolescence I really didn't even know how to properly express those feelings, to articulate in a good way it's of people to tell them how I was truly feeling. You know you don't have many options growing know with psoriasis as a child. There’s not a lot of medical options, there's not a lot of medicines, because they don't want to try harmful substances on kids. So I really suffered emotionally and mentally and sometimes I feel that those components were way more difficult to deal with than the actual physical effects of the condition.

Retrospective Thinking;  Improving Your Overall Health

If I could go back to my younger self who was afflicted with psoriasis, I would definitely say “Don't give up”. I would say that “There is definitely a light at the end of the tunnel” and I will also tell her “To allow herself to be used where it hurts”. I feel like a lot of times difficult challenges in our lives or hurtful challenges in our lives are the things that give us purpose. I would definitely tell her “Do not give up. Allow psoriasis to give you purpose, to give you passion and to inspire others”.
I will also tell her that “There will be people who love and accept her despite her disease and that people will embrace her and people will be inspired by her story”. So just keep pushing experience, because a lot of what I've been through, a lot of the stories that I have and testimonies to give to people only came because I allow myself to experience life. Although some of those experiences were difficult, they were uncomfortable, it’s all for a greater good and a greater purpose. 

Blogging & Psoriasis

For years I hid the fact that I had psoriasis, one of which I was embarrassed, I felt alone and I felt as though people were not understand. About eight or seven years ago I just had this epiphany and I ended writing a blog post on a psoriasis support group entitled My Suicide Letter. And so the My Suicide Letter was not about a physical death, it was not about taking my own life, but it was about killing those parts of me that were insecure, that had fear, that had shame that just was embarrassed due to my disease. To kill those parts of myself so that I could truly live.
It really was nothing planned out, it was just something that I wrote in the spirit of the moment and decided to share in the psoriasis support group, because I felt like other people there could understand and could relate to those feelings that I gave within the letter. Well it almost went I guess viral on the psoriasis community and got passed along and so many people were inspired. The National Psoriasis Foundation reached out to me and invited me to their conference that was taking place that next year. I went there for the first time in my life I've seen people who have psoriasis.
I still don't really see people of color, but I finally met others who were living with this disease. Even an elementary teacher that I had seen at school when I was younger, he has psoriasis and he was at that conference.  We passed each other every day and did not realize that we both were battling the same disease because many of us live with psoriasis do so in secret. So during that conference they had a workshop about blogging and getting your story out to writing.
At that time I thought to myself “Well that's something I am comfortable with and that I can do, because I can write, share my feelings, shut the computer and go on about my day”. I don't have to be overwhelmed with like negative comments that she might feel in person and you know if I'm not comfortable with something I can just delete the post then move on about my day. So it started off as kind of like a safety net, writing behind a computer and just post on my feelings online anonymously. And then it grew into something much bigger and it really gave me the power to not only tell my story online but to tell it to anybody who I feel like needs to hear.

Patient Activism

My life and decision to become a patient advocate for psoriasis as well as mental health has given me purposes and passion and I feel like at this point in my life I'm exactly where I need to be. Every morning and I get up and do this where whether is at a conference or speaking in or message and someone online or blogging. I feel like this is where I am supposed to be, like this is where I’m most comfortable, where I’m most happy, where I find the most joy. It also has empower me to take even more consideration of my health and advocate for myself when it comes to medical professionals and doctors. I know what medicines are currently out, I know the side effects of those medicines. I have a voice in the decision of treatment options for myself. I understand the risks and I'm able to speak up for myself when I'm speaking to doctors and nurses, which a lot of people are afraid to do. Being a patient advocate definitely empowers me to just care for myself as well as others, because I know on the large spectrum of things that this will help all patients, not only ones just psoriasis but living with any type of chronic illness. The first step is to have patient advocates be the voice for the people who are kind of afraid to speak out for themselves.

Discrimination & Psoriasis

We live in a society that is very driven by physical appearance, so I having a visible disease like psoriasis definitely brings about a lot of discrimination and bullying even among grownups, it's not just kids. I have been made fun of by my peers when I was younger and I have even been made fun of by grownups on the job. When you have a visible disease it really makes you a target, and it make you an easy target because it's something that people can see and can talk about. Like if you have something like let’s say diabetes where if you don't tell anybody they absolutely don't know that you're dealing with that. Since psoriasis can be seen it causes people to isolate.
I have lots of friends who have been discriminated against at pools, they have been asked to leave and ask to bring documentation proving that what they had was not contagious. I was discriminated against at work one day a guy came up to me and told me that I was a very pretty girl but I had ugly skin and that is literally the words that he said to me.
I even remember being a college student and having to share a bathroom with my suite mates and the embarrassment of my skin flaking and no matter how much you tried to clean up behind yourself, you always left a party behind when you're living with psoriasis. That causes people to isolate, causes them to be by themselves because it's easier just to keep to yourself, compared to having to always explain what is going on with your health. And it's easier to be by yourself because you don't risk being discriminated against, teased and really just hurt emotionally by those around you.

Combating Isolation Through Patient Advocacy

There are a variety of ways that patients can advocate for themselves as well as others. From one I feel it's very important to connect with the National Psoriasis Foundation because they have an array of resources that you can use that you probably wouldn’t even know existed if it wasn't for the N.P.F. They have a one to one mentor which allows you to connect with other people.
They also have programs which allow you to reach out to your congressmen and your state if you want to advocate against step therapy or if you want certain funding to go towards research for psoriasis. That's kind of on a large scale. Another point is to get involved in support groups. We isolate a lot when we have this condition and when you isolate you’re energy of like wanting to do stuff for yourself decreases. But if you have a network around you like others with psoriasis, even if it's just online, you will start to feel empowered.
I started to feel empowered when I realized I wasn't alone and I was not by myself and I had a network of people that could help me along even when I didn't feel good emotionally or physically. Support groups are really important and they will kind of keep you aware of the latest trends that's happening in the psoriasis community.  I will also say being honest with your medical professionals. Keeping track of everything that you you have going on, how you feel, treatments that you're willing to take and treatments that you are not willing to take.
That when you get in that doctors office there is no deliberating. This is what I want to do, this is what I'm willing to do, and this is what I'm not going to do. Speak up for yourself when you go to a doctor's office it is not a dictatorship, it's a relationship. That’s like what I like to say. It’s just like you’re looking for a spouse. You tell your spouse your needs they tell you their needs and you work together to accomplish a common goal. That is the same process that it should be when you are choosing a doctor for you.

Social Media & Patient Advocacy

There are lots of ways to advocate for oneself. There are a lot of pros and cons to social media. On one hand I'm thankful for social media and the internet because without it you wouldn't that be here today. I found my voice using online platforms such as Twitter, Facebook, blogs and Instagram. It allows you to connect with other patients to see that you're not alone and it just allows you to really express yourself. On the other hand social media can be very depressing. I talk to my therapists about this all the time.

That's how I feel  although and I'm sure studies already show that there is probably an increase of depression and anxiety due to the increase of social media. For one you're bombarded constantly with the opinions of others, opinions that a lot of times people want to even have the courage to say in person but because it's an online platform they feel like they'll never ever meet you or they can hide behind a totally fake profile. They feel that they can say whatever they want no matter how insensitive it is. It also gives you kind of a false glimpse of what's really going on in a person's life.

Typically people are only going to put when there have been success online, nobody's like oh---some people you know will cry wolf and say that they're having a horrible day. But a lot of people who post you know list their relationship is like “Me and my wife or me and my husband we’re just having an amazing time and I just look so happy” and you're wondering why you can't I have that. But behind the scenes they're going through just all kinds of mess. So on one spectrum social media is great especially for Patient Advocates, on the other spectrum social media can be very overwhelming and you really have to kind of balance out how you use it in create boundaries and do what's comfortable for you.

Building A Support System

For adults living with psoriasis there are a few ways that you can build a support system. First start with your friends and family. The friends the family I would like to say are your backbone. I live with psoriasis for so long and I was afraid to tell those around me how I was truly feeling, but when I got older and got more into my advocacy I realized I missed out on the opportunity to really be supported and empowered by those around me. Your family your friends can't empower you if they don't know that something is wrong. 
If they don't know what you're feeling, if they don't know what's going on in your life. I would say start with you with your friends and family so that they can get the tools in order to help you be successful physically, mentally and emotionally. That's first. The other thing that I would like to encourage those to do is again find a support group, whether it's online or in person. There are a lot of platforms to which will allow you to share your deepest, darkest and most intimate secrets of living with this is the that you may be afraid to share with family and friends.
Other people with psoriasis won't judge you and we 100% get it. So I think that's very important in being an adult with psoriasis. Thirdly I would like to say treat your disease, whether it's holistically or whether it's with prescription medications, but don't go without treatment. When you go without treatment you increase your risk for of the diseases like heart disease, diabetes, diseases of the eye and definitely mental health issues.
That’s number one depression. So make sure you are actively attempting to treat your condition. If you're worried about concerns of price, talk to your doctor, there are many patient resources out there that will help you to get the treatment that you need. And try holistic approach, if you don't want to do medicines. Now usually those take a lot longer to work, but your life in your health depends on it.
Please do something. I would just say don't give up. You know something doesn't work, if someone's not receptive to your story, to your struggle, keep it moving because there's something that will work and there's something----there’s someone who will embrace you. So that’s the advice that I would give for adults living with psoriasis.

The Role Of Elected Officials In Funding & Resource Allocation for Psoriasis

Elected officials can help with the progression of treatments and cures for psoriasis and by making sure that they allocate funding to the NIH and CDC. When they're doing different research initiatives in order to figure out the cause of these chronic illnesses. Even if it's one particular chronic illness, like psoriasis, a lot of times when they reach discovery with our condition at least two discoveries and realizations for other conditions.
I would also like to say reevaluate the terms and conditions of step therapy. Step therapy is basically where patients are required to use cheaper treatments before they are allowed to use the more expensive ones and a lot of times that can be hard on the patient. They’re putting in their body medicines that aren't going to work for them, they're increasing their risk of symptoms and side effects and they're also wasting a lot of money and a lot of time.
 I asked that elected officials, first find bills that allocate for the NIH and C.D.C. for research of chronic illnesses and to look at the bill for step therapy and revaluate and look at your friends and family. How would you feel if it was your son, your daughter, your wife, your husband, as they were in the predicament because honestly they could be in the predicament, because chronic illnesses like psoriasis can come at any point in one's life.

Plea To Change Societal Perceptions of those Living with Psoriasis

Psoriasis is a condition that one cannot help. We do not choose to have this disease or this condition. It is not contagious. It is not something you can catch by touching someone, by having sex with them, it is an auto immune disease, which means that something within our immune system has gone haywire. I would like to encourage people to provide compassion and empathy for those that they see who are different from them.
It just does not have to be psoriasis, because of this condition any time I see someone struggling with something I'm able to empathize. I would like to also pass along the message that any chronic illness can happen to anyone at any given time. You could be perfectly healthy right now in your life and tomorrow be diagnosed with the disease that you now have to live with for the rest of your life. So, please consider how you treat others, what you say and how that may make them feel and consider that it could be you one day or someone close to you that you love.
I’m Alicia Bridges and I am a psoriasis and mental health advocate. You can find me on www.beingmeinmyownskin.com or any social media network @AliciaMBridges. That’s for Twitter, Instagram, Facebook or YouTube. My purpose in life is to be the voice for the voiceless to inspire others with my story in hopes that I create empathy and compassion among those who are the least understood.

Advancing Health Equity In The United States

V1: Director of Health and Wellness, Ginny Mantello, MD discusses social determinants of health, health initiatives and polices implemented to advancing health outcomes on Staten Island.

 

We want to make sure and be mindful that every individual deserves the right to be healthy. Health is a fundamental right and how do we help people regardless of income and race attain their highest level of health. Theres a big push from the city and state departments from the CDC to the borough presidents office. The key is for residents to be engaged but also understanding what in their community is lacking and then reaching out and engaging with  their local governments, also perhaps with the city and state governments, whether it be by phone or social media or in person Ginny Mantello, MD. 

 

V2: Assistant Commissioner, Bureau of Systems Partnership - Javier Lopez, MPA discusses food policies, strategic partnerships and other initiatives taken by the NYC Department of Health to advance health outcomes in NYC.

We as government have to be technical assistants, thought partners and leaders because we have expertise in areas that our colleagues and neighborhoods may not have the time to invest in. If we're really thinking about long term a lot of the funding and a lot of the work has to reside with the communities and neighborhoods that we serve Javier Lopez MPA.

 

V3: Deputy Director CUNY Urban Food Policy Institute, Craig Willingham, MPH discussing " The CUNY Urban Food Policy Institute Guide to Food Governance in New York City".

 

Often times the distribution of certain types of stores and by extensions, certain types of foods really comes down to both the market perception; In the case of supermarkets, supermarket operators or in the case of whole sale distributors those people who go around to have a sense of what they think folks in a given neighborhood would to want to buy Craig Willingham, MPH.

Article Link | Guide to Food Governance in NYC

 

V4: Brooklyn Borough President Eric L. Adams discussing his role in both advocating and allocating resources to advancing health outcomes in Brooklyn

When you go to some of the health issues and you dig deeper into the report that Dr. Bassett put out, you must really look at the report and separate it from those issues that are beyond our control, theres not much that we can do about and those issues that are not within our control. It doesn't matter who's the borough president, major, or the commissioner of health is; we want to empower people to deal with their health issues. When you do that you begin to empower people to take control, to move away from the old way of thinking. When you look at the major 15 reasons Americans die, 13 of those 15 are clearly preventable; health disease, diabetes, colon cancer, high blood pressure etc. all of those items are preventable.

If we empower people to have lifestyle changes. In the process, they will be ensuring that they have, preventative health care and not so much focus on adequate healthcare, to give them a pill or a needle or injection, or an operation that will treat the symptoms and not the underlining cause. We're not doing that, we're not doing that city wide, we're not doing it and really educating people on how the things they put in their mouths are the things that are causing them to be placed in a hospital at a earlier rate. That is my focus. My focus is to really use my personal victory over diabetes, to turn around, how we think about health care and truly move towards a more proactive health care system Eric L Adams.

 Link: Community Health Profile Report

 

 

V5: Bronx Borough President Ruben Diaz Jr. discussing advancing health equity in the Bronx.

About 100,000 more Bronxites are working today than the day that I took office. Last year the crime rate was the lowest since the early 1950's in our borough. 2017 was actually our 5th straight year of under 100 homicides, we're down to 72. I don't really know how you celebrate that, as 1 death is one too many. If you use the national metrics system of 1 homicide per every 100,000 residents, when compared we're safer than Philly, Baltimore, Dallas, Boston, D.C, Chicago.

You don't even have to compare us to Detroit, that was what we used to be 30/40 years ago. Because of that we've seen an increase in our tourism, development, job creation, etc. I give you that overview because there's been a tremendous, body of work done by the elected officials, both present and past. Community leaders, community activist and advocates, non profit organizations, etc. It feels good, and theres a lot to brag about but the one area I cannot brag about is health" Ruben Diaz Jr.

 

V6: Aletha Maybank, MD, MPH, Deputy Commissioner and Director of The Center for Health Equity, discusses the Health Department’s work to eliminate health inequities in New York City.

I think its a very important to really recognize the role of government, organizations, institutions and policies and how all of that, a lot of times makes it very difficult for folks to fully harness the power that they have, in order to create health that is good in one community such as Brownsville as compared to the financial district. When you have investments that you don't have as control over what are you supposed to do? Thats frustrating for people, they have to worry about their day to day Aletha Maybank, MD, MPH.

Links: One NYC Report | TCNY 2020

 

V7Melanie Ferris | Research Manager discusses "Community engagement to advance health equity: Strategies and tips".

 

One of the initiatives that I've been working to evaluate is one thats funded by the Center for Prevention of Blue-cross Minnesota. The initiative is their health equity and prevention initiative. An important and critical part of their work has been community engagement, about half way through the initiative, we asked representatives from each of the agencies to come together and really talk about what community engagement is, how to use it in their work, and to help us put together a list of tips and strategies about authentic community engagement and how that can be used to advance health equity.

The seven key ingredients; 

  1. A focus on relationships

  2. Transparency in goals scope and expectations

  3. Listen to understand 

  4. A goal of fostering community capacity

  5. Activities that bring people together

  6. Strategic partnerships that bring people together

  7. Awareness of organizational capacity

 Link: Strategies & Tips Article 

 

V8: Sheryl Weir, MPH | Section Manager | Health Disparities Reduction and Minority Health Section | Michigan Department of Health and Human Services. discussing advancing health equity in Michigan.

Unless we understand this broader concept of systems and social determinants, then we will just be putting bandages. For us I think one of the things that is pretty interesting in this department is that three years ago we were Department of Community Health, and there was a Department of Human Services, we rarely interfaced. We were merged about three years ago, and as you can imagine it was pretty major. Department of Community might of been 2300 strong, and Human Services was much bigger and so you're merging two cultures.

I'm really encouraged because what its given us an opportunity to do is to say, well here are multiple determinants that we can impact; human services, services to children, and those kinds of things. Connect those to health services. We can have a bigger impact of addressing social determinants by being one department. We have to work together and I'm so pleased to say theres been some interesting collaborations in this department around issues of racial justice, social justice and how do we use what we have and what we know in our resources together to really try to improve the life experience for our most vulnerable populations Sheryl Weir, MPH.

 

V:9 Tari Hanneman,MPA | Director of the Health Equality Project at the Human Rights Campaign Foundation discusses advancing health equity for LGBTQ population.

 

The big difference in rural verses urban is obviously going to be access to care and the number of providers that are available; and then whether or those providers are going to be LGBTQ friendly. If you have a huge menu of providers to choose from you're likely to find some that are going to be LBGTQ friendly, culturally competent and aware, but, if you have a very small slice thats going to be a lot harder. In some places you may only have one hospital in town and it may be a critical access hospital, its the smallest of the hospitals there are and it may not have the capacity to really invest in the best policies and practices around LGBTQ competencies.

In some places there are no providers we work with a lot of youth gender clinics, working with transgender youths and a lot of times we hear of families having to travel hundreds of miles to go to a clinic". In regards to policy "The Equality Act would provide consistent and explicit non discrimination protections for LGBTQ people, across all key areas of life; employment, housing, public spaces, public accommodation services, federally funded programs and jury service Tari Hanneman.

 

V 10  Noel Brathwaite, PhD, MSPH, Director | Stephanie Slowly, MSW, LCSW-C, Deputy Director | David Mann, MD, PhD, Epidemiologist | Kimberly Hiner, MPH, Program Administrator | Office of Minority Health and Health Disparities, Maryland Department of Health.

The office has a multi part mission. When we look at the mission there are five aspects to our mission. 1. We leverage resources of the department. 2. We also want to provide some guidance to the department relative to policy decision. 3. Strategic initiative influencing the strategic direction of the department. 4. We want to engage in what we call health equity consultation. As well as 5. external communication. Our vision is to really ensure that health across all population groups in Maryland is equal and that people are enjoying their daily life and enjoying wellness in Maryland" Noel Brathwaithe, PHD, MSPH.

From the perspective of how we approach understanding minority health disparities, it comes from the way we look at the data. We can think about four layers, in which we can use data to kind of understand the flow from health to disease within any population. We can track the disparities on all of those four levels. The end point level is essentially, things like death rates and hospitalization rates, the kind of pain, suffering and disability that people experience from having different disease and other bad health outcomes"  David Mann, MD, PhD.

The Diabetes Prevention Program DPP, is a national program provided through the CDC, the state of Maryland has been really champions of this where they've deployed this program throughout the state. We have within our office, the Minority Outreach Technical Assistance program. That is a program where we fund local community based organizations. If you look at the structural level of government, we're the state and most times the state funds the local health departments. What we've decided to do is to bypass the local health department, in this particular initiative, and really fund those community based organizations" Stephanie Slowly, MSW, LCSW-C.

Language and language barriers play a role in health disparities in Maryland. Understanding that Maryland has a very diverse population, we need to meet our clients where they are. In addition to providing medically trained interpreters during medical appointments and translating medical information our office has specially undertaken several projects and initiatives that will work with healthcare providers and those that are working with these communities i.e our MOTA program" Kimberly Hiner, MPH.

Links: MOTA | Health Equity Internship Program | Cultural & Linguistic Competency | Data