“Attaining health equity is an eye-opening and often difficult pursuit. If leaders do the hard work necessary to eliminate inequities, they will inevitably face hard questions and choices, have their assumptions challenged, and experience many uncomfortable situations. But if we’re serious about providing the best care to all our patients, then we must also be serious about providing all our patients — regardless of their social position or other socially determined circumstance — with the opportunity to attain their full health potential. That is the very definition of health equity.”
Community health workers (CHWs)—lay people who engage in efforts to improve the health of their communities—have been proposed as a way to fill the global health human resource gap by extending services to hard-to-reach populations in remote areas. This concept note provides a brief history of CHWs, considers issues in CHW program design, and outlines future directions for research and funding.
Learning objectives: This concept note aims to further students’ and instructors’ understanding of community health workers presented in the Cases in Global Health Delivery collection.
We don’t know exactly how many older American Indian and Alaska Native (AI/AN) people have the slowly progressing memory problems and difficulties in activities of daily living that we know as dementia, but we do know that in every Tribal community there are people with dementia and family members and others caring for them. High rates of diabetes, heart disease, stroke and traumatic brain injury and the aging of the AI/AN population likely add to the burden of dementia in AI/AN communities. Health professionals working in Indian Country tell us that in AI/AN communities, as in the U.S. population as a whole, dementia is often not recognized and when it is recognized it is often more advanced.
Dr. Finke discusses the IHS partnership with the Memphis Caregiver Center at the University of Tennessee Health Sciences Center to provide training and resources to public health nurses, community health representatives and other support staff in more than 50 communities. Once trained, staff can become certified Caregiver Coaches, with skills and tools to support family members who are caring for elders with demential.
Care for the caregiver is one of the most effective and important treatments available for persons living with dementia. With REACH into Indian Country, the IHS is working to bring that treatment to every tribal community. Click here for more information on REACH into Indian Country .
Rx Foundation partner Dr. Shantanu Nundy and the Human Diagnosis Project were recently profiled in JAMA, highlighting their efforts to empower the global medical community by combining the collective intelligence of doctors with machine learning.
In 2017, the Human Diagnosis Project launched the Human Dx Alliance for the Underserved, a partnership of many of the nation’s top medical societies, institutions, and boards dedicated specifically to expanding physician access for those who cannot afford it. The Alliance includes the American Medical Association, National Association of Community Health Centers, and the American Board of Internal Medicine, among others. The group intends to help close the specialty care gap by building a national electronic consult (eConsult) service where U.S. safety net physicians can get the information they need from specialists to provide the best care for their patients. Read more about this effort in the Atlantic, Scientific American, and Wired.
Lead author Avery Plough, senior author Dr. Neel Shah, and an exceptional team of co-authors recently published their findings on the Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes in Obstetrics & Gynecology (also known as the Green Journal). As described in this press release, the results of interviewing 118 nurse and physician managers at 53 hospitals around the United States about the management of labor and delivery floors are complex. Their study is the first to link management of unit culture, nursing, and patient flow to maternal health outcomes, including cesarean deliveries.
The Rx Foundation supported this work with a grant to Ariadne Labs at the Harvard T.H. Chan School of Public Health.
“ICoHN is a collaborative learning system to support existing and new communities of practice. With an overarching goal of improving health and healthcare service, this network has three aims: (1) to discover and explore the meaning and application of the idea of service coproduction in diverse sectors of the health system, (2) to pilot these emerging insights in real professional development, healthcare service and community settings, and (3) to share lessons learned to promote “cross-fertilization” and further dissemination of improvements and innovations.”
Community Solutions, an Rx Foundation grant partner, is one organization featured in a recent article in the CT Mirror newspaper. ‘The health care that happens outside the doctors office‘ describes CHW Nadia Lugo’s work to bridge the medical and social service systems for residents of the Northeast Hartford neighborhood who are seen frequently at the ER. The article also details state level efforts to develop a sustainable funding strategy for CHWs, to standardize the role, and better incorporate CHWs into the health system.