Tag Archives: health

Public Health in Action – Seas of Change

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We’re nine days into the new year. Nine days into a fresh start, a clean slate. Many shared in eager anticipation and relief for 2016 to be over and done with in both mainstream and social media. But even though we’ve entered 2017, a magic reset button wasn’t pressed. The same issues we faced 10 days ago will still be the same issues we face this year and for many years after.

I imagine that Jason Roberts faced the same realization over a decade ago. Issues do carry over, year after year, unless something or someone shook things up. Earlier today, I watched Jason’s story as a regular citizen in a neighborhood of Dallas, Texas. His curiosity led to endless questions. The single most important question that kept popping up was “why not?” Why can’t things be different? With a mix of curiosity, resourcefulness, creativity, determination and passion, he made significant, long-lasting impacts that improved the quality of life in those Dallas neighborhoods, block by block.

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I was born in 1983 and I spent most of my childhood before the internet ever existed. I grew up playing sports outside, trading sports cards, playing video games and reading comic books. I was even caught up in that Pog epidemic of the 90s – try explaining Pogs to a teenager nowadays and they’d probably tell you “there’s an app for that”.

Terry and Justin Raimey grew up on comics too, and they were also passionate about food. Their passions fused when they co-founded Black Streak Kitchen.

Terry shares a snapshot of their story below.

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Me: How did you end up doing the work that you’re currently doing?  Describe your journey to your current roles as co-founders of Black Streak Kitchen (BSK).  Describe why you’re passionate about improving health behaviors in youth through nutrition education…why others should care about the work you’re doing.

Terry L. Raimey: Justin and I have always had an interest in health, wellness and cooking. Our mom and dad cooked everyday when we were kids, so we never really ate out. When we moved out of our parents’ home, we carried on the tradition of cooking for ourselves – creating new dishes by combining fresh meats, vegetables, fruits, grains and spices.

I am a writer and Justin is the artist and graphic designer of everything Black Streak Entertainment (Black Streak Kitchen’s parent company). We wanted to do something new and unique with our stories and artwork, something no one else in the comics and animation industry had ever done.

One day, I saw an ad for one of those grocery/recipe delivery services and thought it would be really cool to apply our artwork to something like that, and gear it towards kids, teens and families. So, we created Black Streak Kitchen as a source to teach kids, teens and families that cooking healthy can be delicious, while also teaching them how the ingredients can benefit their bodies and minds.

I love to cook and create new dishes by fusing unorthodox fresh ingredients and flavors. I love how eating healthy makes me feel and look; it’s very satisfying to me. And I want everyone to experience that satisfaction.

According to a study published in the Journal of the American Medical Association, the amount of children with type-2 diabetes, which is associated with obesity, jumped more than 30% from 2000 to 2009. When we were growing up, diabetes was an ‘old-person’ disease and obesity was a grown-up problem, but today, these conditions are affecting our children. One of the best way to combat America’s failing health grade is through cooking and nutrition education. Black Streak Kitchen provides cooking and nutrition education while making the presented material fun and entertaining.

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Image of recipe from Black Streak Kitchen

 

Me: What inspires you on a daily basis, especially when things get hard?

TLR: Seeing the reactions of the people we introduce to our brand, getting messages and comments from parents on how our app and comics teach them and their kids so much about cooking and nutrition, and even getting props from chefs and nutrition professionals is what motivates us to keep pushing. We pray and work hard, so it’s a true blessing when the Lord answers through the words of people who enjoy our brand.

Me: Can you tell us more about your collaboration with educators and any key outcomes or success stories from your comic books?

TLR: Well, our first comic doesn’t drop until January 15, but as far as collaborators, we’ve been blessed to have some accomplished chefs come on board. Chef Ed Harris will be featured as a Character Chef in our first issue, presenting his recipe “Roasted Cauliflower Stir Fry”. Chef Harris is the winner of Food Network’s ‘Chopped’ season 4 and ‘Iron Chef International’. We are also collaborating with Chef Robert Stewart, winner of ‘Guy’s Grocery Games’, ‘Cutthroat Kitchen’ and star of OWN Network’s ‘Raising Whitley’. Another collaborator of ours is Chef Ethan Taylor. He is the owner of ‘Great EETS’ catering in Los Angeles, CA. He works as a personal chef for numerous A-list celebrities, like Justin Beiber, Jamie Foxx and Mary J. Blige. All of these professionals have great elements to bring to our brand and help us succeed.

Me: What role do you envision comics and visual art having in educating youth?  How much of an impact did comic books play while you two were growing up?  Where do you foresee BSK in the next 5 or 10 years?

TLR: The use for comics and art are limitless. Fusing education with whimsical and visually appealing artwork grabs kids’ attention like nothing else, so it’s the perfect marriage. When were kids, we were big fans of comics. I read every monthly Spider-Man series in publication, and Justin was a big fan of Japanese manga. Comics sparked my imagination and took me on adventures that I could never experience in real life. As a matter of fact, we are still big comic fans!

In 5 to 10 years, we will have a home delivery service where we will deliver our recipe comics and the ingredients for our recipes to families homes. We will also have a cooking and nutrition animated series featuring our characters and signature Black Streak style. Having Black Streak Kitchen product lines through licensing is also a goal of ours.

Me: What are the current needs in the city live in as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

TLR: We live in a suburb outside of Youngstown, Ohio. Youngstown used to run off of the steel industry, but once the steel mills shut down, the city was hit hard. Unemployment is high, schools have been shut down, public transportation is limited, there are no grocery stores to purchase healthy food, and there is little opportunity to succeed – it’s quite depressing.

Giving back is important to Justin and I, so we want to sponsor the establishment of community gardens in urban neighborhoods where fresh produce is hard to come-by. Establishing community gardens provides a sustainable food source for the neighborhood residents to draw from. It also helps bring the community together and helps the youth of the community learn a constructive skill that will benefit them for life.

We want to build our own kitchen entertainment empire, while also helping people in need, in particular, black youth.

Public Health in Action – A Silent Health Crisis

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Of all the things in the fields of both public health and healthcare that pique my interest and attention most, it’s health disparities, specifically the numbers 5 and 7.  In a country as productive and innovative as ours, it’s a particularly vexing reality check whenever I’m faced with those two numbers, which I’ve listed below along with their respective contexts.

5  – the difference, in years, of life expectancy between genders

*Life Expectancy at Birth in 2013: Female 81.2 years  Male 76.4 years

**Races considered: Hispanic, White, Black

5 & 7- the difference, in years, of life expectancy between females & males respectively

*Longest life expectancy to shortest in each gender

Health disparities are the end products of a variety of complex factors including, but not limited to the social determinants of health: SES, transportation, access to healthcare, employment, etc.  Additionally, they are also impacted by biological (our genes and family history), social (our culture and networks) and environmental (our physical surroundings) factors.  Lastly, health disparities are impacted by individual health behaviors and lifestyles.

The numbers 5 and 7, to me, represent a collective challenge: how can we bring these numbers down, thereby reducing  health disparities in our country?  What other perspectives do we need outside the fields of public health and healthcare to reduce health disparities?

My conversation with Steve Petty, Corporate Director for Community Health Improvement at INTEGRIS Health could offer some insight to the issues I’ve raised above.

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Me: How did you end up doing the work that you’re currently doing?

Steve Petty: I have been working in health care for 29 years.  I started in a marketing/public relations role and several other areas and have worked in community and employee wellness for the last 20 years.

In community wellness, our mission (the same as INTEGRIS Health) is to improve the health of the people and communities we serve.  Our department works in many at-risk, minority and under-served communities.  The state of Oklahoma has very poor health indicators for about everything you can possibly imagine.  We are working to provide health, wellness and health education services to those most in need, but to also educate people in general about the need to take care of themselves – know their health numbers (blood pressure, cholesterol, etc.), to get routine and regular exams, among others.

One area that continued to grab my attention was comparatively poor health indicators for men.   It was alarming to discover that such few men actually went to a regular doctor or health provider, let alone had access to any type of screenings.  INTEGRIS had been doing a Women’s Health Forum for many years then.  Most of their outreach efforts were for women who had insurance (employer-based or from retirement) but a majority of them were proactive with their health for the most part.

Two of my colleagues and I developed a proposal that would address men’s health in a different way that wasn’t intimidating to men, but still covered all aspects of their health and education.  Our leadership liked the idea, but a few seemed skeptical that we would be able to attract men to a health event.  We were confident that we could succeed if we tied it to something they were interested in, so, naturally, we partnered with the local sports radio station and used humor to make it a different kind of health event.

In our first event in 2004, over 300 men attended our event and we’ve had steady attendance ever since.  We continue to add more events and health screenings which have proven successful and have replicated many of these screenings and events in our rural communities where we have smaller hospitals and populations with limited access to health education programs and services.

We started planning our event back in 2003 and realized there wasn’t a lot of information on men’s health events anywhere.  Through internet searches, I stumbled upon the Men’s Health Network (MHN) webpage.  We finally found a resource to help us secure health education literature for our upcoming men’s health conference and MHN’s Jim Boyd and Scott Williams were crucial partners in planning that event and others since.  MHN has been one of our biggest supporters and partners in our efforts to improve the health of men and boys in Oklahoma.  The partnership has given me the opportunity to present our program and services across the country and at the 2009 International Society on Men’s Health in Vienna, Austria.  I’ve served on several committees through recommendations by MHN, and that’s how I got involved with the American Public Health Association (APHA) Men’s Health Caucus (MHC).  I was fortunate enough to be involved with the caucus early and have served in several positions since its inception in 2008.  I currently serve as the chair for the MHC and represent our group in the APHA’s Caucus Collaborative.

Me: What inspires you on a daily basis, especially when things get hard?

SP: I’m inspired by all the work being done which focuses on the health of men and boys.  It’s amazing to see how awareness and interest to keep men healthy has escalated over the years among government officials, businesses, marketing professionals and the public as a whole.   I’m also inspired by all of the great programs and services we’ve implemented here in Oklahoma, not just for men, but to improve health outcomes for the entire population, including children, senior citizens and minority populations.  We have a long way to go to show impact, but we are slowly making progress throughout the state.

Me: Can you share some of the progress you’ve made at INTEGRIS as it relates to men’s health outreach?

SP:  A large percentage of men have only limited contact with physicians and the health care system as a whole. Men not only fail to get routine check-ups or preventive care, but often ignore symptoms or delay seeking medical attention when sick or in pain. These poor health habits take their toll – beginning at early ages and rising significantly as males reach retirement age.

Because INTEGRIS is determined to raise awareness of this “silent crisis” and turn the tide, we’ve implemented an innovative men’s health initiative, Men’s Health University (a.k.a. Men-U). It’s designed to educate men and their families on the importance of men taking charge of their own health. Established in 2004, Men-U consists of free screenings and information, physician seminars, an annual wellness fair, (the 2006 event drew more than 700 people), and this website devoted solely to men’s health.

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By bringing men back into the health care system, INTEGRIS is helping them overcome one of their biggest health risks – that of just being a man. And knowledge is power. Even if males are aware of just two numbers, blood pressure and cholesterol, and take active steps to lower them if either reaches an unhealthy range, it can make a huge difference in their longevity.

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Me: Describe your vision for Integris Health.  Where do you see Integris and/or MHC in 1, 5 or 10 years and what kind of impact do you plan to make?

SP: My vision for INTEGRIS Health is really coming together for our community.  INTEGRIS is one of the few health systems in Oklahoma that gives back to the community in such a substantial manner.  We are finding new partnership and collaborative opportunities with agencies and organizations who have similar missions.  Additionally, we continue to explore innovative ways to make an impact on the health and wellness of our communities by sharing resources and services with partners like the Regional Food Bank, Oklahoma City County Health Department, the local Federally Qualified Health Center, churches and colleges.  All of these groups are coming together to hold events, offer services, programs and share resources, all of which help us improve the lives and health of our targeted communities.  I hope in the next year, our work to develop a comprehensive health, wellness and education resource center will come to fruition.  I hope we can replicate this model across our service areas in the next 5 to 10 years.  This will make a huge impact on patient access, especially if we can get other hospital systems to join with us.

Me: What are the current needs in Oklahoma City as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

SP:  The needs in all of these areas listed above are, unfortunately, not being met in many areas.  We observe access to care being a recurring obstacle for many individuals.  People can’t afford health insurance through the Affordable Care Act and/or their co-payments, so they have to use our emergency departments as a clinic or their healthcare provider.  We have about 19 free clinics in the metro area that are at capacity due to unmet needs of populations with limited resources or circumstances – uninsured, undocumented and underprivileged.

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Oklahoma, as a state, faces many challenges as documented in their annual state report, however, passionate community leaders like Steve Petty and his colleagues are working diligently to improve health outcomes at the local level.

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” –Margaret Mead

If you’re interested in learning more or working with Steve to improve health and well-being in Oklahoma, contact him at Stephen.Petty@integrisok.com.

 

Public Health in Action – Actions Speak Louder Than Words

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Source: article.wn.com

Muriel Bowser was sworn into office this past January and remains focused on delivering a fresh start for the District of Columbia (DC).  Mayor Bowser, a native of Washington, pledges to tackle problems past mayors haven’t: chronic homelessness, economic divide and disappearing affordable housing.  Engaging residents through community forums for their input and new ideas appear to be a long-term strategy for progress.  One such initiative that caught my attention was the 1 Billion Steps Challenge (currently at 3 million), under the larger FitDC umbrella.  The FitDC website serves as a resource and platform to engage residents on nutrition and fitness.  Currently, ten coaches are in place to motivate residents to improve their health and well-being.  I connected with Darryl Garrett, appointed the “Senior Coach” for older city residents (In 2013, individuals 65 and over comprised 11.3% of the population), and asked him a couple questions.

Let’s see the world of health and well-being from Darryl’s perspective.

Me: How did you end up doing the work that you’re currently doing?  Describe your journey from your work in the federal government to your leadership in health coaching in the DC community.

Darryl Garrett: I spent 25 years at CIA and then took an early retirement at 48. I then worked for a couple of defense companies before becoming an independent consultant working inside the intelligence community (IC). I’ve been doing that for about 12 years and was wondering what to do with the last third of my life. I continue to enjoy the mission and people in the IC—it is more like a calling than a job—but thought it would be fun to do something different.

About four years ago I and my wife started working with a terrific trainer—Deshaye Tillman—and I became inspired by the transition that occurred as he helped people become healthier. So I started studying to be a personal trainer and applied and got into the third running of Georgetown University’s Health Coaching Certificate program. That program will end in September. Then I will see if I can start a business of health coaching, while continuing to work part time in the IC.

At about the time I was starting the health coaching program at Georgetown I saw a news story about DC Mayor Bowser’s FitDC initiative. I applied to be one of the community health coaches and was blessed to be picked as the FitDC coach representing seniors. It has been an absolute blast working with the FitDC team: it is a diverse and interesting group that mirrors the city, I think. And as an old CIA hand who avoided the public light, it has been an amazing experience going to photo shoots and getting my first Twitter account!

Me: What inspires you on a daily basis, especially when things get hard?

DG: I try to remember that it is not my life, but life and I am a part of it. I try to make the best of it but at the end of the day billions of people go to sleep without thinking about me and my problem at all. I am not the center of the universe. I also have several networks of friends and colleagues that I rely on for support.

And sometimes I drink a little bourbon and have some popcorn!

Me: What do you think it will take for our healthcare system to improve?

DG: I remember being on a consulting team for a large IT company that had several retired military flag officers. One of them was also a doctor and had been the Surgeon General for his branch of service. He once said something that stuck with me: “Everyone knows that the US medical system is broken. And no one wants to fix it because everyone knows how to make money from it.” I took that to mean that the system is so complicated that any reforms upsets the revenue flow, so there is some group or groups who will oppose almost any change.

So I don’t see that changing radically in the near future. However, estimates are that 60-70% of chronic diseases could be eliminated or at least controlled by lifestyle choices. Many of our most severe challenges—diabetes, obesity, cancer, smoking, high blood pressure—can be effectively combated with exercise, healthy eating and adhering to medication plans.

When I started training at 60 years old, my bio markers after a few months dropped into a normal range where they had not been since my late 30s. That is the power of exercising and eating healthy food.

Me: Why is holistic and community health so important?

DG: People often have the information on how to stay healthy or prevent a disease, and yet many people cannot do it. I think there are several reasons for this:

  1. People don’t like to feel they are being told to do something. They often get resistant.
  2. People know the large goal “exercise more” but struggle with breaking it into small, actionable steps.
  3. People start and encounter relapses, obstacles and challenges and give up.
  4. Once starting it is hard to continue something long term on your own.

So community health can help to break down these challenges. Health coaching can help a person visualize something that is powerful for him or her: so instead of “I need to exercise.” The vision is “I want to be able to play with my kids at the park like the other moms.” Setting a powerful vision of health helps a person relate why they are doing something new and perhaps difficult to something that is important to them.

Working with initiatives such as FitDC and other DC and community programs also make it easier to stick to a program. Hard programs can be made fun and having buddies give you a team to help you overcome obstacles, break down goals into small steps, and stick to a plan over the long term.

Me: What are the current needs in DC and where you live, as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)

DG: DC, like many cities, has areas of great access to healthcare and healthy food, and other areas where that access is a struggle. As a representative for the senior residents I know that some of them cannot drive and must rely on public transportation. While the city has a robust transportation system, it can be hard to carry many bags of groceries on a bus or metro…and relying on cabs can be expensive for some. Seniors sometimes can be challenged by navigating the healthcare system and understanding complex medication regimes, which can lead to poor adherence to treatment plans.

That is why I am proud to be part of an initiative that will help focus attention on the importance of moving and eating healthy. We currently have a Billion Step Challenge in which each ward has a community “Ward Walk”, and citizens are encouraged to log their steps each day. We hope to get to a billion steps in the next year.

Public Health in Action – Leveraging Health IT to Improve Outcomes

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In the broadest sense, Health Information Technology (HIT) is applying IT to health care in order to improve patient outcomes, quality of life and reduce health care costs.  The field is growing and fast.  By 2017, the field is predicted to yield over $30 billion.  And it’s not hard to find.  A recent visit to Apple’s app store can be overwhelming – even after filtering the apps down to “health.”

Healthcare providers, from hospital systems to individual healthcare professionals, as well as healthcare payers (consumers, government, insurance companies) have bought-in to the promising field.  Startups keep popping up.  Health is a primary focus in various innovation challenges.

In the bigger picture of improving our healthcare system, I think HIT has the potential if leveraged the right way.  I recently interviewed Dr. Ryan Shaw, professor at Duke School of Nursing on his thoughts about the field and its potential in improving our healthcare system.

Here’s Ryan!

Me: Tell us about your past experiences in work, research and academia and how it ties to your current role.  Also highlight your interests in the field of Health IT and what Health IT could lead to in terms of health outcomes.

Ryan Shaw: My undergraduate studies began in computer science and mathematics. After 2 years I switched into nursing. It’s a strange transition but I wanted to go into a career path where I felt I was making a difference in people’s lives. After becoming a nurse, I went back to school to get a masters in informatics at NYU while working as a nurse in NYC. This allowed to merge healthcare and the IT side.

At the end of my master’s program, Duke University just so happened to offer an Information Technology fellowship as part of a PhD program for nurses. I applied for the competitive program and received the fellowship. I ended up working for Duke’s Health Company “Duke Health Technology Solutions” while studying for a PhD at Duke.

Following that, I eventually landed a job as a Professor at Duke’s Nursing School. I love this job and it allows me to do both science and education. On the teaching side, I teach in our masters informatics program. On the research side I discover how to use novel technologies and their data to help patients’ self-manage chronic illness. This is exciting work and allow me to work with an interdisciplinary team of physicians, pharmacists, psychologists, nurses, and IT gurus.

Discovering knew knowledge that will be applied in healthcare is extremely rewarding. While working as a clinician I was able to impact each of my patients lives, research allows me to have a much broader reach of impacting many more lives and creates knowledge that other people will build upon. Our world is changing, and information technology is becoming an integral part of peoples’ everyday lives and thus their health as well. My team and I capitalize on this social change and leverage technology as a conduit to improve health. It’s really cool.

Me: What inspires you on a daily basis, especially when things get hard?

RS: Academia is tough. There are real no work hours and no day is ever complete. I could work 24/7 every day for a year and still have more to do. A lot of what you propose is rejected and people don’t value it. Grants that you work months on don’t get funded, manuscripts are rejected, and sometimes you sit in the office asking yourself if you really do make a difference. In discovering knowledge, there is often nowhere to go to look for an answer. Scientists create answers, we seek to answer the unknown and discover more. You need a thick skin and perseverance is of the most important traits needed.

I drive inspiration from my family, I work through stress by exercising (I run a lot and use to be big into triathlon), and view this video from Apple to get me going.

The video reminds me that innovators are the ones who change world and those who succeed are the ones who keep trying even when they fail.

Me: 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?

RS: Honestly, health doesn’t come first for many people – and likely won’t ever. Families, safety and financial security usually come first. And in my opinion, that’s probably OK. We need to eat, pay our bills, and survive. These all impact our health. That’s not to say health isn’t important, it’s critical.

For people to take health more seriously, is really going to have to come from the top. In my opinion, there is too much focus on the individual and treatment of health. It’s really societal and public value. We need a greater investment in communities and public health. We’ve created infrastructure that supports poor habits. I think many people forget that physical infrastructure and urban planning are so important. If we make it easy to drive your car to the drive thru down the street, then that’s what people will do. We need sidewalks, urban planning that encourages walking, and a cultural shift that values these things. This is happening, but for so long we’ve focus on suburbs, building a society that is car centric, and making delicious food easy to get. It’s just so hard to change individual healthy habits when the structure around you suggests the opposite.

Me: What are some things/concepts/ideas/insights you’ve learned from your research that can help improve health outcomes in individuals and on a population-level?

RS: Some of the concepts we’ve learned is that technology needs to be designed with the end user in mind. A lot of technology and how it functions is useful for young people and techies. But those aren’t the people who are most in need. The people in need, and the most expensive people in healthcare, are those with chronic illnesses (obesity, diabetes, hypertension, etc.). These are the people that could benefit the most from novel technologies and their data – and they are of all ages, young and old.

We need technologies that truly fit into their daily lives and we need to create infrastructure in the care delivery system that is able to use newer technologies such as wearable devices. As of now, we don’t have this structure. But its possible. If all of our patients monitored their daily data, software could manage most people and guide them in self-management of health behaviors. If people don’t correct those behaviors, it could be bumped up to a nurse or pharmacist to help them. And then after that, it could be bumped up to a physician. This would allow for true population management and would be cost-effective. It would also allow physicians to have a better understanding of their patients’ day-to-day lives when they actually see them in the clinic. This may enhance medical decision making. Check out the article, Mobile Health Technology for Personalized Primary Care Medicine, that we wrote on this.

Me: What are the current needs in your city as they relate to social determinants of health (i.e. 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.

RS: The Raleigh-Durham is certainly trying to address some of these social determinants of health. For example, transportation wise we are trying to get in light rail that will have stops next to low-income housing. The bus system is being revamped to meet more people’s needs.

In terms of access to care, the affordable care act has and is helping with a lot of this. But North Carolina chose not to expand Medicaid as much as many other states, to access to care is still an issue for many people.

The city of Durham is quite focused on measures to alleviate poverty and help with homelessness. There is more focus on adding in sidewalks so people don’t walk in the street for safety reasons, they’ve been building affordable housing, and are pushing measures that new development including a % of low-income housing.

Public Health in Action – Mobilizing for Collective Impact

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At one point or another, you’ve probably heard the phrase, “think global, act local.”  That phrase has always stuck with me, but context is everything.  Living in Durham, the phrase has resonated with me so much more than it has in the past.  I regularly consider how my actions may affect my local community.  And after living and working on the national level, I see more clearly now that the issues are either solved or propagated at the community level.

I started following the non-profit, DurhamCares, a few weeks ago after they were mentioned in the same tweet from another mutual Twitter-er (who also happens to be quite active in the community).  Long story short, I had a great conversation with one of the staff members at DurhamCares and feel strongly that their mission closely aligns this blog – disrupting the status quo by reducing silos.  DurhamCares understands that issues are interconnected and leverages skills that have produced results in other industries, specifically business and journalism, and applies them seamlessly in a non-profit environment.

On to the interview with Elizabeth Poindexter, Marketing Coordinator of DurhamCares!

Me: Tell us about your past experiences in journalism and the path you’ve gone through to get to DurhamCares.  Also, mention the skills you’re leveraging at your previous roles in your current one.  I plan to introduce DurhamCares, but feel free to describe the future vision of it in terms of communication and marketing strategy.

Elizabeth Poindexter: I am a 2010 graduate of the School of Journalism and Mass Communication at University of North Carolina at Chapel Hill. After graduation, I worked for three years as a digital journalist and bureau chief for two television news stations and one newspaper. I learned a skill set in the journalism school that I’ve found to be applicable in other settings. Learning how to shoot and edit video, take photographs, and write well are valuable skills I still use at DurhamCares. At DurhamCares, we focus on content creation and content marketing strategies. Working as a one-man-band reporter taught me why people care about issues, how to mobilize communities, and how good content is part of that effort. While reporting, I saw stories making a difference, and I am thrilled to continue that work at DurhamCares.

I use very similar skills even though I’ve switched career paths. DurhamCares works to fully understand the scope of issues our community faces. Each DurhamCares issue-based marketing campaign has months worth of research behind it, so we can best understand the most compelling facts about each issue. In addition to research, we work to show people why they should care, which is why storytelling is important. DurhamCares also creates issue-based content, including infographics and videos, and I’ve led production for those projects. Overall, working as a journalist taught me the value of content creation. In my current role at DurhamCares, I focus on marketing that content to our target audiences to mobilize volunteers and donations toward Durham’s nonprofits.

Me: What inspires you on a daily basis, especially when things get hard?

EP: We’ve worked since summer 2013 to fully develop our issue-based collaborative marketing campaigns, which we solidified in early 2015. Our marketing campaigns leverage the concept of collective impact. We know of a few other organizations around the country leveraging collective impact to impact community development, and we’re testing that model here in the Triangle. Our marketing campaigns went through several iterations, and we are constantly learning how to best bring nonprofits together and focus on a single issue while applying this concept of collective impact to our work. As we’ve developed our campaigns, it is gratifying to hear when nonprofits have used a campaign tactic to bring in donations or to recruit more volunteers. I come to work every day knowing I’m making a difference, whether I realize it or not.

Me: 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?

EP: DurhamCares plans to launch a marketing campaign around the issue of health care access in May 2015. We’re counting on experts to help us author what that campaign should look like, but I’ve learned a lot already. In my opinion, health is a necessary building block for other aspects of our lives. Health care and health access have many implications in our lives and can impact our careers, education and relationships in the long-term. Both mental and physical health play a huge role in our community’s success. I believe prioritizing health issues our neighbors face could lead to building a healthier community in the long term.

Me: What are some things/concepts/ideas/insights you’ve learned in journalism that have helped you at DurhamCares?

EP: Storytelling is at the core of journalism. People are a lot more likely to connect with issues if they feel an emotional connection, and people are less likely to remember statistics and facts. I focus on storytelling at DurhamCares, and we try to show people how issues are relevant in their lives, even if it’s not immediately obvious. From a more practical standpoint, learning about content production and content management are also valuable skills to have. DurhamCares also has a strong social media presence, which we use to raise issue awareness. Lastly, networking with Triangle media outlets and knowing how reporters work is valuable in raising awareness through more traditional news outlets.

Me: 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.

EP: DurhamCares focuses on nine different issue areas, including senior care, health care access, and youth. We’ve learned over the past couple years that each issue is connected to another in some way. I attended a conference a couple of years ago, and one woman’s story stuck with me. She lived in unaffordable housing, which is a growing issue in Durham as plans for light rail transit are made. This woman had battled mental health issues because of her living situation. I’ve realized a lot of these issues operate on a continuum. Perhaps the woman was previously homeless, unable to find a safe, affordable place to live. Maybe she had no choice but to live in unaffordable, substandard housing, which developed over time into a mental health issue. Unaffordable housing can result in frequent moving, which can result in an unstable home life, unstable schooling, etc., for families. It’s up to the community to care about issues that impact everyone so we can plan for a great future in Durham.

Public Health in Action – Walking the Walk

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Jonathan Bonnet, MD
Duke Family Medicine, PGY-3

I was fortunate enough to attend the National Physical Activity Plan Congress last week in Washington, DC and was inspired by many of the leaders working in the field of physical fitness and activity.

One program, in particular, really caught my attention.  Walk with a Doc (WWaD) has a simple idea: encourage physical activity in the community by walking alongside physicians.  I think it’s safe to say that the last time each of us had a visit with our doctor, he/she discussed our health behaviors and/or lifestyle, which more than likely included a question or two about how active we have been.  Physicians also typically encourage their patients to get active, eat healthier, cut back on alcohol intake and to stop smoking.  What impressed me the most is the extra step WWaD takes to engage with their patients and local communities.  They encourage their patients to walk alongside them.  By being outside and actually leading by example, I strongly believe that physicians not only connect with their patients on a higher level by building rapport, but it also makes the visit less formal and transactional.  If I were a patient and walked alongside my doctor and we chatted about things other than health and medicine, I would feel that much more comfortable and more willing to share any issues that I was having.  By re-shifting the context in which providers interact with their patients, using this less formal, social setting can have profound results.

I had the pleasure of meeting and interviewing Dr. Jonathan Bonnet for this blog post and I feel privileged to share his story with you all.

Me: Tell us about the path you’ve gone through – college/medicine/residency – and what captured your interest with Walk with a Doc.

Jonathan Bonnet: Sports had always been a large part of my life growing up. It wasn’t until undergrad at Ohio State University (OSU), when I fell in love with exercise and physical activity. I ended up majoring in exercise physiology, working in the exercise labs at OSU, and ultimately becoming a personal trainer and interning at Anytime Fitness. The ability to change lives with physical activity inspired me to do more for health and pursue a career in medicine.  As fate would have it, in my first year of medical school at OSU I discovered the national nonprofit  organization, Walk With a Doc (WWaD). Ironically their national headquarters was located in Columbus, OH.  Although the name had initially caught my attention, the people and program inspired me to get more involved and stay involved indefinitely.  I was struck most by the simplicity of the program, as well as the open invitation to the entire community.  The premise was simple: bring doctors and healthcare professionals together and practice what medicine preaches.  I loved the idea of literally ‘walking the walk’ with patients and the community.  The walks are a fun, social event, with the added benefit of everyone getting their daily exercise, too.  After getting involved with the local walks as a medical student, I initiated an Ohio State Walk With a Future Doc program with my peers. My passion for the program as well as my interest in promoting physical activity has continued through residency. With the support of the Duke Community and Family Medicine department, we launched the Duke Family Medicine (WWaD).  Although the walk targets the patients with obesity, it is open to everyone, including the Durham community at large.

Me: What inspires you on a daily basis, especially when things get hard?

JB: I am continuously inspired by the patients I see, my community, the WWaD leadership, and above all else my family and friends. When I see the people around me, with life situations much more challenging than mine, rise up and make the best of their circumstances, I feel truly inspired to help others do the same. I have been incredibly blessed in my life and have a passion to help spread and promote health and happiness to everyone around me.  Seeing family, friends, and loved ones suffer the consequences of largely preventable chronic diseases is devastating.  Research has already shown that lifestyle behaviors – being physically active, eating a healthy diet, not smoking, and maintaining a healthy weight – can prevent 80% of the chronic diseases we face.  This failure to translate what we know into what we do drives me to help make a difference. I firmly believe we can make a difference.  It won’t be easy, but it will absolutely be worth it. Dennis Waitly said “there are two primary choices in life: to accept conditions as they exist or accept the responsibility for changing them.”  I have chosen the latter.

Me: 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?

JB: In general, health is something that everyone, who has it, takes for granted. It is not until we lose our health, that we realize how precious and valuable it is. I think it is also important to realize that health encompasses more than merely being “not sick” or working out everyday. Health encompasses the physical, mental, social, emotional, and spiritual aspects of life. Health is much more difficult to measure than education, career accomplishments, or relationships.  One of my favorite quotes is that not everything that can be measured, counts, and not everything that counts, can be measured.  Health is a somewhat ambiguous part of life that is difficult to assign value, and it is not something that generally changes overnight.  The gradual loss of health, or what I would prefer to say, lack of vitality, makes it difficult to have a sense of urgency and need to prioritize health when it comes to day-to-day decisions. Eating unhealthy food or not being physically active any single day has minimal effect on long term health. It is the cumulative effect of the day-to-day decisions that promote or impair “health.” Humans are much better at understanding and appreciating short term consequences and that is why health tends to fall lower on the list of priorities for many people.

Changing this societal view on health is tough.  Culture and social norms dictate much of this. People who sacrifice sleep for their jobs are idolized. We tend to measure success by material goods, achievements, awards, and honors, rather than the parts of life that matter most: family, friends, health, etc. It is not something that will change overnight, but it has to start somewhere with someone.  That someone is you, me, and people like David Sabgir, who started WWaD. It doesn’t have to be profound. Simply deciding to embrace the challenge of being the healthiest version of you possible, is an incredible start. If there is demand, government, businesses, and societies will change. It will take an honest conversation with ourselves about what truly is important in life, followed closely by an enthusiasm, passion, and dedication to practicing those values everyday.

Me: What are some things/concepts/ideas/insights you’ve noticed that have helped/hindered health-related outreach and education in communities?  Specifically from a provider perspective.

JB: As a provider, one of the most challenging aspects of care is to really understand the situation and environment a patient is coming from.  It is difficult to do more than graze the surface of what a patient’s living situation and day-to-day life actually looks like in a 15-minute visit. Although it is easy to be idealistic and think everyone can adopt healthy lifestyles, the truth is that the choices we make are subsequent to the choices we have. Frankly, I have patients who do not have healthy options. It is choosing between two bad choices, and that makes it tough.  Oftentimes, it takes multiple office visits and getting to know patients very well before they feel comfortable discussing many of the underpinnings that contribute to their health, or lack of it. Patients are prideful and often times want to “please” their doctor by saying they take their medicine as prescribed and eat healthy, when in reality, the situation may be entirely different.  We know that social determinants of health play a far bigger role than the one-on-one medical care a physician provides, but these are “messy” issues, that do not have quick fixes. Aside from solving world poverty, I think the single best thing we can actually do in health care is to take the time to not talk, but actually listen to our patients and their stories. It is not until we understand our patients values and what drives them, that we are able to facilitate them in making the best decisions for their health.

Me: 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.

JB: As with any community, the social determinants of health play a much larger role in the well being of its members than anything that can be done by a doctor in a single office visit. Access to healthy nutritious food and water, medical care, areas to be physically active, education, shelter, and resources are all critical pieces of health. The Durham community is no different. There are individuals suffering from any and all of the aforementioned components. Obesity is arguably the most pressing health issue this country has ever faced, and social determinants contribute significantly to this. Although it is multifaceted, it has been exciting to be part of a residency program that understands these issues.  At Duke, we started a Walk With a Doc to facilitate physical activity among our patients, staff, and community. Additionally, we brought the Veggie Van program to the Duke Family Medicine Clinic every Thursday afternoon. The Veggie Van offers subsidized fruits and vegetables to the community in an effort to make healthy food affordable and accessible to everyone. We are also collaborating with the Durham Public Health Department to identify and offer other services that are beneficial to the community. None of these interventions alone will solve the problem, but it is our hope that the collective effort will yield meaningful changes in the health of our community.

Behind the Scenes

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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.