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Community Health:  A Look Back and Plans for the Future

Dr. David Guzick, M.D., Ph.D. February 03, 2006

This newsletter is next-to-last in the series that takes stock of where we stand in our four mission areas—a review of highlights from the year that just ended, and a look to the future.  We have already addressed the research and education missions in the December 30, 2005 and January 6, 2006 newsletters.  We will now take up community health, and finish next week with an offering on the faculty's clinical activities.

Looking Back

Our commitment to community health has been quite extensive and longstanding over the years, but the depth and breadth of these efforts were not fully recognized regionally or nationally, or even at the Medical Center, until we took an inventory of these projects in 2003.  We were able to identify 159 local community health research projects with over $39 million in funding and more than 70 department-led outreach initiatives.  These projects encompassed education, research and clinical service.  By documenting these efforts in a compelling fashion, in 2004 we were the medical school chosen to receive AAMC's Outstanding Community Service Award.  Also in 2004, Community Health was formally named the 4th mission of the University of Rochester Medical Center, and in 2005, community health was incorporated as a formal part of the strategic plan effort that is underway across all mission areas.

Many of our community health efforts are based on priorities identified by the community.  Our goal is to combine the strengths of the medical center with those of diverse community partners to identify, plan and provide much needed research, education and service.   During 2005, many of the programs, services and individuals dedicated to improving community health in Rochester were recognized for their positive impact.  Some of these were:

  • Eastman Dental Center, which received the 2005 Community Health Improvement Award from the Health Association of New York State for their work in increasing access to oral health care through a mobile dental office on wheels known as the "Smilemobile";
  • Dr. Kaczorowski
    Dr. Jeffrey Kaczorowski, Associate Professor of Pediatrics
    Awarding Dr. Jeffrey Kaczorowski, Associate Professor of Pediatrics, to be the Principal Investigator of the new Community Pediatrics Training Initiative of the American Academy of Pediatrics.  This in part represented recognition of his achievement in establishing a national model for a Residency program that is aimed at expanding medical education efforts to include community-oriented services and education;  and
  • The annual Innovation in Prevention Award from the U.S Department of Health and Human Services.  This was presented to The Center for Rochester's Health, for its Healthy Living Program, a church-based health program in partnership with the Center for Lifetime Wellness.  The Center for Rochester's Health is a joint initiative of the Medical Center and the Monroe County Health Department.
  • The School of Medicine was awarded the 2005 AAMC Caring for Community Grant to further the UR Well program, a student run clinic at St. Joseph's that seeks to improve access to health care for the uninsured.
  • Dr. Szilagyi
    Peter Szilagyi, MD, Professor of Pediatrics
    The Racial and Ethnic Disparities in Immunization Initiative (READII), directed by Peter Szilagyi, MD, Professor of Pediatrics, was awarded the 2005 Excellence in Immunization Award by the National Partnership for Immunization.  READII is a wonderful example of a joint URMC-community initiative that incorporates both community based research and a successful community intervention that has become a national model.
  • Massachusetts General Hospital and Harvard Medical School invited us to present our work on the integration of the community health mission into our other mission areas of research, education and patient care. As a result of this visit, MGH was inspired to conduct a hospital-wide inventory of community health activities similar to the process that we used here at URMC. 
  • AAMC asked us to serve on the review team for the award applications submitted for the 2005 Outstanding Community Service Award.  Two of our highest-ranking applications, Medical College of Wisconsin and University of California, Davis, received the 2005 award.
  • URMC's efforts on a project known as "Get the Lead Out," or GLO, was recently recognized by an award from the Coalition to Prevent Lead poisoning at a community event celebrating the recent change in the city's lead ordinance.  This ordinance now requires lead safety inspections before occupancy will be allowed in rental properties. The Monroe County Executive has also pledged to incorporate the code's provisions in pre move-in inspections of homes of families on public assistance.
  • Financial support from the community through fundraising:  net proceeds from the 6th annual Community Health Golf Tournament amounted to over $100,000 for community health programming.

Moving Forward

In setting the course for the future, a five-year strategic plan to advance the community health mission of the URMC is being finalized (Figure 1).

COMMUNITY HEALTH: OVERARCHING GOALS

Through community based activities & partnerships, improve health & quality of life and reduce health disparities.

COMMUNITY HEALTH MAJOR STRATEGIES

Integrate community health improvement and quality of life initiatives with clinical services to address risk factors and barriers associated with poor health, health disparities and disease.

Conduct research and program evaluation to understand further the etiology of poor health and the effectiveness of interventions.

Educate students, residents, fellows, faculty, staff and the community on disease-specific risk factors, as well as environmental and social factors that influence the prevention/onset of disease.

Create and sustain community partnerships to define and modify factors that contribute to major diseases and overall quality of life.

Implement a defined organizational structure to facilitate integration of community health with the other mission areas and departments across the Medical Center.

Seek funding to support community health research, service and clinical programs related to community health.

Advocate for changes in public policy that help to improve community health and reduce barriers to access.

Pat Chiverton, RN, PhD, Dean of the School of Nursing
Pat Chiverton, RN, PhD, Dean of the School of Nursing

To develop this plan, a Community Health Executive Committee was convened by Dr. Evarts to build upon the strategic planning efforts that had been undertaken by a faculty committee chaired by Pat Chiverton, RN, PhD, Dean of the School of Nursing. 

Building meaningful and sustainable community-academic partnerships remains a primary focus of URMC‘s strategic plan, along with continued integration of  community health with the research, education and clinical service missions to address risk factors and barriers associated with poor health, health disparities and disease in the community.

 


The plan also calls for a number of new initiatives, such as:

  • reducing utilization of the Emergency Department and in-patient care for conditions that could be managed through ambulatory care;
  • further developing preventive care as part of standard medical practices in the community; developing a comprehensive education plan to educate the community about the key risks to health; and
  • ensuring the ongoing involvement of diverse community members in the planning and implementation of major research, education, clinical and community service programs.

You will note that one of the goals of URMC's Strategic Plan for Community Health is to implement a defined organizational structure that will facilitate integration of community health with the other mission areas and departments of the Medical Center.  In the coming weeks, there will be an announcement related to just such a defined organizational structure.

I think you will agree that, having won the 2004 AAMC Excellence in Community Service Award, we didn't rest on our laurels in 2005!  Moreover, I hope you agree that there is excitement about our community health initiatives for 2006 and beyond.

Meliora,

David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry