Behind the Scenes

silos

It’s been a few months since I’ve posted a blog post and for that I realize that it’s time to reflect back my latest endeavors and my progress since then.  I’d like to take a moment and turn the same questions that I posed to the previous people I’ve interviewed and answer those questions myself.

1) Tell us about Switch/Health and how you envision this blog serving an unmet need.

Switch/Health is the culmination of all my experiences in the field of public health and my observation that the internet acts as a double-edged sword at times.  The vast amounts of information on the internet can result in a daunting task of selection.  In my own experience, I can spend hours doing research for any one specific topic, but still not have the motivation to start writing or making progress towards completing the task at hand.  This paralysis due to too much choice or options is summarized in an easily digestible way by Barry Schwartz in a humorously informative TED talk.  His argument: too much choice is at times overwhelming.  Some of the most successful models and ideas are broken down to its simplest forms.  I enjoy going to places like Roti or Chipotle at times because I don’t have any extra decision-making energy to figure out what to eat and their menu limits the amount of choices I need to process in order to have lunch.  I read an article in which President Obama saves time and energy in the decision-making process by having two different color suits, black  or navy, so his morning routine becomes more efficient when picking out what to wear.  His time and energy is better served leading our country.  So my impetus for developing this blog was along the same lines – as a professional working to improve the health and well-being of individuals, I wondered, “what can I do to make my job more efficient?”  My sincere hope is that people find this blog with all its content, resources and links as a useful and valuable site to help them find what they need in a more efficient manner way.

The second driving motivation for me to start this blog: the way infrastructure is set up on the federal level, which more than likely translates into state and local governments – silos.  My experience working in government made me more aware of how complex it truly was.  A glimpse of any federal agency’s organizational chart will illustrate this further – here’s one that I looked at for 4 years: HHS organizational chart.  Organization and structure is important and I won’t attempt to argue the merits of how any governing body or company is organized.  But what I would like to focus on is the mere fact that the number of units in the chart is overwhelming.  Additionally, I would argue that having so many separate entities makes collaboration between them that much more difficult.

When I think about what a successful program looks like, I take pride in conducting a thorough search of what has and hasn’t been successful.  And when I explore these case studies, I always try to view them from different angles.  In the past year I’ve not so much taken my public health hat off as I’ve also put others on.  I realize that the field of public health has been around way longer than people really know, but only now does it get the acknowledgement that it deserves.  I also realize that other industries have also been around for many years and that there is wisdom that can be leveraged in any field, including public health.

Our healthcare system is one of the costliest in the world, if not the most.  We spend too much per person on healthcare than any other nation, but a higher sticker price doesn’t always lead to better health outcomes.  This fact, among others, is especially troubling when our nation has other issues to address, which don’t always receive the same attention and ultimately, the same amount of funding as our health care industry does.

Switch/Health is an idea that breaking silos could improve our country as a whole, specifically to reduce costs related to health care while improving the quality of care we receive.  Creating value with less by leveraging the best ideas and wisdom from the following: research, policy, innovation, public health in action and sustainable funding models.

So that’s where I am now.  I’ve come a long way from the pre-med student who then bought into the principles of public health who then discovered advocacy and policy in DC then managed and developed health and wellness programs for the government.  Now my focus is on creating solutions from the local level.  And I’m excited about the journey ahead.

2) What inspires you on a daily basis, especially when things get hard?

I try to focus on gratitude and service.  With gratitude, I focus on the things I have, rather than the things I don’t.  As for service, I try to volunteer whenever I have free time.  Since moving to Durham, NC, I have made more of an effort to be involved in a few different community-based organizations to serve residents that may need a helping hand.  When I see people slipping through the cracks – either in health care or employment or housing or education – I can’t resist the urge to offer whatever help that I can provide.

Also, TED talks and music helps me get started on a daily basis – there’s nothing like some inspirational talks and ideas and a solid playlist to keep me moving forward.

3) What do you think it will take for our society to view health more seriously?  As in, why is health lower in priority to careers and education and relationships?

I really think it comes down to a higher level of personal awareness and how we can each contribute to the larger society as a whole.  I’m a firm believer that we each have something to offer the world, it just takes some time to understand what that is and accepting it fully then using those skills to make positive changes in our lives and to those around us.  Health is such a complex and daunting concept confounded by so many variables.  If we can tackle it first on an individual level – former acting Surgeon General Boris Lushniak considers it an act of patriotism to get ourselves healthy – then our society can progress slowly.  The next wave would be to work on a more collective basis to address the factors that indirectly affect health in certain populations, such as un/underemployment, homelessness, transportation, built and social environments and education, among others.  It is our natural tendency to focus on careers, education and relationships, but I would argue that valuing our health is as important.  Viewing health as a resource to do all the things we want to do in our lives is a concept that we should each embrace.  I’ve read and heard many stories where individuals describe periods of their lives in which they focused only on their career or relationships at the expense of their own health and well-being and have paid the price for it – from stress-related disease or other physical manifestations of burnout and exhaustion.  When we start to value our health in the overall picture of work and life, I strongly believe that we won’t regret the shift.

And it can be something as simple as taking a walk during a break during the day or breathing exercises after a long day.

4) What are some things/concepts/ideas you’ve seen either here in the U.S. or abroad that, if disseminated in an effective way, would change how people think about their own health?

Social entrepreneur Navi Radjou had a powerful TED talk that I watched a couple weeks ago. He highlights the innovative techniques that people in India and other developing countries, where resources are severely limited, that are solving common issues.  The mentality of doing more with less or leveraging what is available is a concept that I embrace and remains ingrained in my mind when thinking about current and future projects.  If we could each harness the same attitude when it comes to health and wellness on the individual and population levels, I know we could turn the corner on reducing costs of health care while improving overall quality of life.  It just requires a more conscious and creative thought process than the status quo.

5) What are the current needs in your city as they relate to social determinants of health (ie SES, poverty, access to care, transportation, safety, etc.)?  Social determinants of health are any factors that directly or indirectly affect health.  For example, being homeless could cause stress and malnutrition which could drastically affect one’s health.

I moved to Durham, NC from Washington, DC in November and I’d like to address both cities in my response.

First, since I lived in Washington, DC for almost six years, I think there are a lot of resources to serve the needs for a majority of the residents.  There are, however, many opportunities.  Living in a city the size of DC, provides the opportunity to see and interact with many different populations – from the elected officials all the way down to underprivileged homeless residents.  While there are significant resources available for the underprivileged, it is not difficult to notice the struggles of homeless residents.  I found myself, on many occasions, thinking about the reasons they were (or remained) homeless and wondered if they knew about the resources available.  In some conversations, some were living at shelters, but those were often full and had waiting lists.  My former neighbor often provided temporary housing and access to a shower, clean clothes and food to those she interacted just blocks away.  I think about how many more individuals could be helped, at least temporarily, by the kindness of a friendly and concerned neighbor; one who spoke with empathy and kindness and the desire to help.  I realize that mental health has been inextricably tied to homelessness.  So, more than anything, I hope mental health, homelessness, unemployment and other social issues could be viewed as interconnected and addressed in that same manner.

What initially attracted me to move to Durham was the openness and collaborative spirit of its residents.  I attended an entrepreneurial “startup” weekend in August in which teams were given 54 hours to develop an idea into a viable product to pitch to investors.  The locals on my team were extremely helpful and positive and made me feel at home as a visitor.  After subsequent visits and meeting more like-minded individuals, I knew it was the right place to be for both professional and personal growth.  In one visit, I met Dr. Sharon Elliott-Bynum, executive director of a holistic clinic, CAARE, Inc., based in downtown Durham.  When I toured CAARE, Inc, I understood that this was the model for healthcare in the future.  It addressed the social determinants that can indirectly affect health outcomes and also provided ambulatory care to those needing it.  Although I’m still new to the area, I have seen the impact that Dr. Bynum and CAARE, Inc. has on local residents.  I see the opportunity to use this as a model to branch out in other cities and continue to work with Dr. Bynum to expand its reach on the local level.  This innovative approach breaks silos and epitomizes the do more with less attitude.  And it’s working.  CAARE, Inc is celebrating its 20th year anniversary this year.  Dr. B describes how she’s seen nonprofits and companies alike come and go, but CAARE, Inc has remained.  The model we’ve been looking for to improve quality of life on the local level without the exorbitant price tag exists.  It’s just been under-the-radar and the people making it work have been, for the most part, doing it behind the scenes.

“We are quite rich enough to defend ourselves, whatever the cost. We must learn now that we are quite rich enough to educate ourselves as we need to be educated.” –Walter Lippman

I know that we have the resources to do many great things.  I think it’s time that we made a priority to use those resources in a meaningful way.

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