On Thursday, October 16, 2014, Philippe Bourgois, PhD, Professor of Anthropology and Family and Community Medicine at the University of Pennsylvania, and Brian Work, MD, MPH, Professor of Internal Medicine at the University of Pennsylvania and Director of Prevention Point Philadelphia, sat down with the CPHI’s Deputy Director, Sara Solomon, MPH, RD to talk about their experience and research in the field of substance abuse.
On Saturday, November 8,2014 the Wharton Undergraduate Healthcare Club (WUHC) hosted its first-ever conference at the International House on Chestnut Street. The club’s stated goal is to improve healthcare and cultivate leadership, and the conference was intended to explore the future of the healthcare industry. The organizers of this event asked if I would be willing to moderate a panel on “The Changing Role of Pharmaceuticals” – one of four panels happening in the afternoon portion of the conference. As a first-year Master of Public Health student, I wanted to take advantage of the opportunity to learn more about the Wharton community’s perspective on health, as well as gain experience as a panel moderator. Thus, I accepted their offer.
The panel consisted of four current and former members of the pharmaceutical industry: Debbie Cooper, Ph.D., a former pharmacologist for Merck, Wyeth, and GlaxoSmithKline; Baali Musisi Muganga, US Development Director for Aesica Pharmaceuticals; Andrew Reaume, MBA, President and CEO for Melior Discovery; and Richard Hoddeson, MBA, former VP of Finance for Pfizer. The conference’s keynote speaker was Dr. Roy Vagelos, former CEO and president of Merck Pharmaceuticals as well as the former chairman of the board for the University of Pennsylvania. As someone at the conference put it, there were certainly several “heavy-hitters” in attendance. No big deal, right?
In a previous life (a.k.a. the last five years), I taught high-school level Biology. Believe it or not, moderating this panel was remarkably similar. First, I had to do my share of class prep before showing up. As a rule, I like to be over prepared, rather than run out of material halfway through a discussion. Therefore, I spent the weeks leading up the conference drumming up possible questions from various sources. Second, once I’d settled on several “juicy ones”, I practiced rephrasing them multiple different ways, in case anyone asked for clarification. I asked my friends and colleagues for advice, and for possible responses, so that I could better direct conversation on the day of the panel. Lastly, I wanted my lesson to be engaging for those involved, so I poured over the résumés of the panelists, and tried to imagine which questions would fit them best.
After discussing the role of the moderator with my research mentor, and then attending the CPHI’s Peter Singer talk, I realized that the panelists were only part of the equation: the panel discussion would be followed by a “brief” Q&A from the audience. This turned out to be the most difficult component, particularly when one of the audience members interrupted the discussion to make a rather well rehearsed question (cough, statement), which I unfortunately had to cut off. During the post-discussion, official Q&A, I again had to facilitate some question clarification. Should I ever moderate another panel, it might be a good idea to collect questions ahead of time and screen/translate them.
Moderating this panel and attending the conference were excellent experiences, and I am thankful for the WUHC for making it all possible. Obviously, I learned a lot about pharmaceuticals and healthcare in the 21st century. Perhaps more importantly, I got to see the personal side to two industries that are often perceived as profit-driven. As a future public health worker, I have a better understanding of the necessary collaboration between the public and private sectors, and can better appreciate the process that drives innovation in healthcare. For those interested, more information can be found at www.uhcpenn.org. If anyone wants to hear more about the panel discussion, please contact me at firstname.lastname@example.org.
Written by: Matthew Kearney, MPH Candidate 2016
The Leonard Davis Institute, a co-sponsor of the CPHI Seminar Series, recorded The Robert Wood Johnson Foundation’s President and CEO, Risa Lavizzo-Mourey, talk for those who were unable to attend. Listen to her speech as well as her sit-down interview with a Robert Wood Johnson Foundation Clinical Scholar.
PHILADELPHIA–The Center for Public Health Initiatives kicked off its seminar series with Dr. Risa Lavizzo-Mourey MD, MBA lighting a flame in the hearts of faculty and students here at the University of Pennsylvania.
Dr. Lavizzo-Mourey is the CEO and President of the Robert Wood Johnson Foundation, the nation’s largest philanthropy devoted exclusively to health and health care. She holds more than 30 years of experience as a medical practitioner, professor, policy-maker, and non-profit executive.
Lavizzo-Mourey opened the seminar series with warm welcomes and thanks, expressing her delight to return to her alma mater; “It’s great to be home.”
Before sharing her foundation’s vision and charge for shifting our nation’s focus towards health, she first shed light on the stark realities we face.
Our Nation’s Current Health status
Approximately 75 percent of the country’s 17 to 24 year old youth are currently ineligible for military service, largely because of education, obesity, and physical ailments that make them unfit for the armed forces, according to a report recently presented to Congress by a group of retired military leaders.
She pointed out that improving quality of life and maintaining health starts at birth. Statistics show that the zip code where we are born in and reside may determine our life expectancy. She displayed a number of alarming U.S. statistics, highlighting in particular our nation’s capital, Washington D.C.. Metro area residents living in the predominantly affluent Montgomery County, Maryland, have an average life expectancy of 84 years whereas miles away in downtown D.C. the average life expectancy is seven years shorter.
Another troubling statistic is that 4 out of 5 physicians agree that addressing patient social needs are as important as dealing with medical conditions, yet an alarming majority of physicians admit they don’t know how to effectively address them.
Shifting Towards a Culture of Health
“A shift in this magnitude starts with an idea. Think back to the 1970’s, recycling was not part of our culture. Now it’s instinctive to recycle, because we made it easy. Recycling now is on every sidewalk and if we throw away a bottle in the trash, most of us feel guilty.” She also gave a great example of the 911 emergency response system and how years ago such a system never existed. Now, every child knows to dial 9-1-1 for an emergency.
Then Lavizzo-Mourey, turned to the faculty and students,
“We are the nation’s largest philanthropy dedicated to health. But we don’t make policy. We don’t sell anything. We don’t deliver any healthcare services; the only power we have is to invest in you.”
So how can we build a culture of health together? How can we ingrain healthy habits into our culture such that being healthy and staying healthy become instinctive? How can we turn around the stark reality that the zip code that we reside in may restrict our life expectancy? How can we create adequate social support systems to improve quality of life preventing re-admissions that plague hospitals throughout the nation? How do we start right here in the city of Philadelphia?
A vision this large will take a concerted effort from all members of the community, health care, social work, government, education, business, places of worship, and families to tackle the barriers to create an environment where a culture of health will thrive.
If each one of us does our part, small victories will turn into national success.
Written by: Amy Rajan, MSN/MPH Candidate 2016
CPHI Fellow and University of Pennsylvania School of Social Policy & Practice Professor, Susan B. Sorenson, will receive the 2014 Bridge of Courage Award from Women Organized Against Rape. The Bridge of Courage Award recognizes exemplary leadership and commitment to promoting awareness, education, advocacy, and policy research to end sexual violence.
Full article: http://www.upenn.edu/pennnews/news/social-policy-researcher-penn-honored-woar-s-bridge-courage-award
As Director of Programs, Ms. Iyer will manage all aspects of the Foundation’s grantmaking program, which will total $3,000,000 in 2014. In addition, she will oversee Metta Fund’s community collaborations and partnerships. She will play a key role in achieving the Foundation’s mission of creating a healthier San Francisco. Ms. Iyer has recently been elected to sit on the SFHIP Steering Committee representing the Philanthropic Community seat.
A passionate advocate for low-income communities and communities of color, Ms. Iyer most recently worked for the San Francisco Foundation, beginning her tenure as Multi-Cultural Fellow and moving into Community Health program grants. A native of Philadelphia, she has worked for the Philadelphia Department of Public Health, and the New York Department of Health and Mental Hygiene.
I was ill prepared for the two-hour hike up the long, winding dirt road of the third community I was to survey. My flip-flops were chaffing my worn feet, and red lines were hastily forming around the border of my tank top. By the time I reached the final house, I wanted nothing less than to ask yet another woman about her cervix. But the family kindly ushered me into their living room and placed a cup of coffee on the table beside me. The woman I was supposed to interview, however, lay asleep on the couch, nothing more than a small swelling under several large blankets. “She has breast cancer,” her family whispered to me as I sipped my twelfth cup of coffee that day and tried to recall how far away the last house with a latrine was. “The doctors say she came too late and there is nothing they can do to help her.”
My main objective this summer was to conduct a women’s health needs assessment in the communities of Restauración, Dominican Republic and Tilori, Haiti, where Philadelphia-based NGO Federation for International Medical Relief of Children has been working since 2012 to improve community health. Through qualitative interviews with key stakeholders and quantitative surveys with women who had recently given birth, my goal was to gain a deeper understanding of the women’s health care situation in both communities. The information I gathered would then be used to help inform the development of an antenatal care program. Both the Dominican Repub
lic and Haiti have relatively high maternal and neonatal mortality rates and proper prenatal care has been shown to help reduce such deaths.
Although I have not yet completed any analyses, I believe the narratives I took away, between collections of quantitative data, yield just as important a story. That woman, a mother of three now slowly dying of breast cancer under the heap of blankets, had been to the local rural clinic with concerns of pain, but had been turned away with nothing more than ibuprofen. By the time she had traveled the four hours to the closest specialist, her family told me, the cancer had already progressed too far. The presence of advanced cancer treatment centers in the large cities of the DR does not help rural women who have limited access to screening.
And for the women living across the border in Haiti, access is even poorer. My Haitian-Creole translator who assisted me during my visits to those communities would often get frustrated when I asked her to translate questions like “Have you ever heard of a pap smear?” or “Have you ever had a breast exam?” “You know what her response will be,” she would argue. She was usually right.
Restauración is a small town of about 7,000 habitants, located in the second poorest province of the DR. Only 12km from the Haitian community of Tilori, it is a popular place for Haitian migrant workers who cannot find jobs in their own country to set down roots.
In theory, this short distance also enables Haitians, who are unable to find the health care they need in the small rural clinic of Tilori, to access it 25 minutes down the road in Restauración. And while many ultimately do, the process is not so simple. For me – a white American female – crossing between the two countries required nothing more than a nod to the guards resting lazily at each of the three checkpoints along the road between Restauración and the bridge to Haiti. But for Haitians without papers, the short trip can be difficult and costly, with each guard usually requesting a “fee” of $100 pesos (about $2.30 USD). Even getting my Haitian translator back into Restauración, where she has lived and worked now for several years, was often a struggle. Although it never ended up costing us anything, the exercise almost always put my Spanish to the test.
Sadly, the journey was not the only deterrent. Many of the Haitian women I spoke with, including those who lived in the DR, were often met with such discrimination at the Dominican health centers that they regularly delayed or even declined seeking care. For these women, proximity to health care services did not translate to access.
One Haitian woman I spoke with summed it up this way: for a pregnant woman facing complications during labor, access to emergency obstetric services requires a four-hour drive to the closest Haitian hospital, or an expensive commute through the DR where care is not even guaranteed. With vexation, she added, “What kind of decision is that?”
Written by: Tara MacDowell, MPH