Overview

An editorial by the S4A investigators at Johns Hopkins Bloomberg School of Public Health calls for reforms to the chronically underinvested public health system. Read "Being Accountable for Capability-Getting Public Health Reform Right This Time" in the American Journal of Public Health to learn why.

doi: 10.2105/AJPH.2022.306975

Overview

In 2016 and 2017, the New York City Department of Health and Mental Hygiene established Neighborhood Health Action Centers (Action Centers) in disinvested communities of color as part of a place-based model to advance health equity. This model includes co-located partners, a referral and linkage system, and community space and programming. In 2018, we surveyed visitors to the East Harlem Action Center to provide a more comprehensive understanding of visitors’ experiences. The survey was administered in English, Spanish, and Mandarin. Respondents were racially diverse and predominantly residents of East Harlem. The majority had been to the East Harlem Action Center previously. Most agreed that the main service provider for their visit made them feel comfortable, treated them with respect, spoke in a way that was easy to understand, and that they received the highest quality of service. A little more than half of returning visitors reported engaging with more than one Action Center program in the last 6 months. Twenty-one percent of respondents reported receiving at least one referral at the Action Center. Two thirds were aware that the Action Center offered a number of programs and services and half were aware that referrals were available. Additional visits to the Action Center were associated with increased likelihood of engaging with more than one program and awareness of the availability of programs and referral services. Findings suggest that most visitors surveyed had positive experiences, and more can be done to promote the Action Center and the variety of services it offers.

Policy Points While the coronavirus pandemic has underscored the important role of public health systems in protecting community health, it has also exposed weaknesses in the public health infrastructure that stem from chronic underfunding and fragmentation in delivery systems. The results of our study suggest that the public health system structure can be strengthened through the targeted implementation of high-value population health capabilities. Prioritizing the delivery of value-added population health capabilities can help communities efficiently use limited time and resources and identify the most effective pathways for building a stronger public health system and improving health outcomes over time.

Overview

S4A investigators at Johns Hopkins University look for a correlation between total non-hospital health spending by county governments before the pandemic, and how fast a county was able to control the first wave of COVID-19 from March to June of 2020. The research team finds substantial variation in county and state health spending in the US. While county level non-hospital health spending before pandemic was not associated with early control over COVID-19, state level spending on hazard preparation was in some model specifications.

Read the full article in ScienceDirect to learn more about their findings.

https://doi.org/10.1016/j.ssmph.2022.101027

Overview

California implemented the Whole Person Care (WPC) Pilot program under “Medi-Cal 2020,” a Section 1115 Medicaid Waiver program designed to coordinate the care of high-utilizing Medi-Cal beneficiaries across medical, behavioral health, and social service sectors. The COVID-19 pandemic stay-at-home orders began in mid-March 2020, during the last year of WPC implementation, and disrupted California’s plans to transition WPC enrollees into a new program under the California Advancing and Innovating Medi-Cal (CalAIM) initiative. Read this policy brief to learn the impact of the pandemic on WPC implementation, enrollment, and health service utilization.

Pourat N, O’Masta B, Haley LA, Zhou W, Chuang E. 2022. Whole Person Care Program Successfully Navigated Around COVID-19 Challenges in 2020. Los Angeles, CA: UCLA Center for Health Policy Research.

Parents and Children Together-St. Louis (PACT-STL) aims to develop, implement, and evaluate strategies to prevent child maltreatment and reduce entry into the public child welfare system. Convening medical, public health, and social services organizations at state and regional levels, PACT-STL aims to reduce health and service disparities for children in families with lower risk referrals to child protective services (CPS). The initiative collaborates with a network of child and family service agencies, including health, mental health, housing, and child welfare organizations.

PACT-STL employed a system dynamics group model building (GMB) approach with organizational leaders of partner agencies to develop a deeper understanding of patterns of current agency collaboration. Two GMB workshops were held via Zoom to elicit barriers and facilitators to meaningful collaboration among child and family service providers, and to identify strategies to promote enhanced collaboration within the network. The GMB workshops were organized by a design team of members of the PACT-STL team and the Social System Design Lab, including members from Vision for Children at Risk and faculty and students at the Brown School at Washington University in St. Louis. The findings of the workshops were shared in two June 2021 reports: a brief version is available here and a more detailed version is available here.

Overview

An article published online on August 12, 2021 on Governing.com entitled, "What Will It Take to Recruit and Retain Public Health Workers?," examines how state spending on key public health activities has been flat or in decline since 2008, and what strategies stakeholders are exploring to meet the need for essential workers. Read the article in full by clicking here.