Category: Systems Thinking

Strategic Skill Area

Moving Public Health Practice Upstream: The Role of Local Health Departments in Protecting Immigrant Health
Illustration of Colorful People

Course Objective

  • Explain the definition of “working upstream” in public health
  • Identify barriers and benefits to “working upstream”
  • Describe the “upstream” factors that impact the health of immigrants in America
  • Explain state and local strategies to promote inclusion and the role of the health department in those strategies
  • Describe the unique barriers that “new Americans” may face when accessing services in communities

Date: June 6, 2017

Presenter:
Emily Franzosa, DrPH, MA
Senior Researcher
CUNY Graduate School of Public Health and Policy


Immigrants face many unique challenges in accessing the same public services and rights that non-immigrants may take for granted. This includes challenges in accessing health care, education, public benefits, and workers rights and protections. These challenges are largely due to “upstream” factors such as governmental policies, which means that it is very important for public health professionals to also work “upstream. In this webinar, Dr. Emily Franzosa discusses the barriers and benefits of working “upstream,” specifically in relation to immigrant health. She describes some state and local strategies to promote inclusion and improved access to resources, and the role of the health department in these strategies. Examples of inclusive services through New York’s Municipal ID (NYCID) program, Nashville’s Welcoming America program, DACA, and Pre-Health Dreamers (PHC) are also discussed.

Crossing the Quality Chasm in Public Health
Illustration Showing Efficiency, Cost and Quality

Course Objective

  • Define the components of continuous quality improvement (CQI) and describe its applications.
  • Articulate the rationale for recent promotion of quality improvement frameworks in public health policy and practice.
  • Identify resources, including online training opportunities, to assist in the incorporation of CQI into your public health practice .

Date: December 21, 2016

Presenter:
Thomas I. Mackie
Assistant Professor, Department of Health Systems and Policy
Rutgers University School of Public Health


This presentation will provide an introduction to a continuous quality improvement framework, the rationale for promotion of quality improvement in policy and practice, and tools and resources to facilitate incorporation into your public health practice.

Public Health and Mental, Emotional, and Behavioral Health Webinar Series, Part IV: Transformation of New York Mental Health System to A Medicaid Managed Care Model
Paper Cut Out

Course Objective

  • Describe the role of managed care and behavioral health integration for addressing the needs of individuals with mental health challenges.
  • Identify critical elements for health plan engagement with mental health services in Managed Care.
  • Explain Health and Recovery Plans (HARP Services) in Medicaid Managed Care and how community work force can work to integrate HARP Services into health care.

Date: September 22, 2016

Presenter:
Glenn Liebman
CEO
Mental Health Association in New York State, Inc.


In this webinar, Glenn Liebman of the Mental Health Association in New York State discusses the transformation of the New York State mental health system into a Medicaid managed care model. Mr. Liebman provides a historical context for the reform, describes the changes that will occur to funding streams as a result of the reform, and implications of these changes.

Supportive Housing to Address Social Determinants: Cross-sector Collaborations and Funding Possibilities
Man Sleeping Outside on Ground

Course Objective

  • Gain a better understanding of housing as a key social determinant and the impact housing interventions have had in healthcare outcomes and costs
  • Learn about strategies to effectively understand, target and define frequent user population for population health interventions
  • Identify key stakeholders to implement a frequent user initiative including key lessons learned, challenges and best practices

Date: September 6, 2016

Presenter:
Kristen Miller
Director
Corporation for Supportive Housing


In this webinar, Kristen Miller, Director of Corporation for Supportive Housing, discusses housing as a social determinant of health, describes the supportive housing model, and provides examples of how to use data to identify and target individuals in need of supportive housing.

Strategies to Advance Health Equity: How Health Departments Can Promote Living Wages
Words on a Page

Course Objective

  • Explain the rationale for expanding public health practice to change living conditions to promote health and equity;
  • Consider action on living conditions to be part of their scope of work;
  • Identify some of the conceptual and organizational obstacles state and local health departments face in addressing living conditions;
  • Explain how to apply the “upstream” strategies to define and achieve feasible goals in their own practice.

Date: August 8, 2016

Presenter:
Nicholas Freudenberg
Distinguished Professor of Public Health
City University of New York School of Public Health

Emily Franzosa
Senior Researcher
City University of New York School of Public Health


The social determinants of health, or the structures and economic systems that shape patterns of wellness and illness, can be considered “upstream” that then influence downstream factors like obesity and teen pregnancy. Upstream factors are broad, deeply entrenched in our society, and can appear daunting to change. While public health often focuses on individual-level health behaviors, this approach requires a high level of effort from the targeted individual and has little influence on widespread population health. Health departments are increasingly moving upstream to tackle the core issues that affect the communities they serve. Income is one upstream factor that has a large impact on health and wellbeing. This module details how raising the minimum wage is a public health issue and provides a case study of one health department that used research, communication, and advocacy to influence an upstream factor of health.

Housing as an Intermediary Determinant of Health and Points of Intervention to Reduce Disparities
Person Sleeping on Bench by Water

Course Objective

  • Understand the importance of housing and housing systems as intermediary determinants of health.
  • Identify opportunities for public health policy and programmatic points of action in housing and housing systems to improve individual and community health.
  • Learn from cross-sectoral initiatives involving local and state health departments that have targeted housing and residential environments as strategic points of intervention.

Date: July 5, 2016

Presenter:
Angela Aidala, PhD
Research Scientist, Sociomedical Sciences
Columbia University Mailman School of Public Health

Robert E. Fullilove, EdD
Professor, Sociomedical Sciences
Columbia University Mailman School of Public Health


Housing is where our economic, social, and personal lives come together. In this webinar, Dr. Angela Aidala and Dr. Robert Fullilove discuss housing as an intermediary social determinant of health and health equity. Fundamental determinants of health are macro-level cultural and economic policies, practices and dynamics that affect the socioeconomic position of individuals, groups and communities. These determinants operate directly on us through more proximal ‘intermediary’ determinants like housing to shape health outcomes. Housing links upstream fundamental determinants of health to the more immediate physical and social environments in which we live our lives.

Ahmedabad Heat Action Plan: Improving City Resilience Against Extreme Heatwave
Outside Thermometer

Course Objective

  • Describe the ways in which small pieces of evidence can be generated to influence policies related to climate change
  • Explain how low cost interventions can save human lives
  • Discuss how rapid scale up of a successful intervention can be achieved through advocacy and networking.

Date: April 19, 2016

Presenter:
Parthasarathi (Pertho) Ganguly, MBBS, MD, MPhil
Professor
Indian institute of Public Health, Gandhinagar


This Webinar outlines the Ahmadebad Heat Action Plan developed to combat heat-related illness and mortality in the face of increasing temperatures and frequent heat waves in India. Based on an analysis of local temperature data and awareness levels of vulnerable populations, the action plan set objectives to increase public awareness, train medical officers, engage the media, create a forecast system, and develop a flow chart for action during hot days. As a result, there was an increase in awareness of the risks of heat waves and a reduction in heat-related mortality in Ahmadebad. Dr. Ganguly outlines the steps taken to develop and carry out this action plan as well as challenges and successes along the way.

Climate Change, Extreme Weather, Natural Disaster & Human Health and Integrating Climate and Public Health Data into the Hazard Vulnerability Analysis Process
Damage from Natural Disaster

Course Objective

  • Discuss the research findings of the effects of extreme weather and natural disaster on human health
  • Identify population vulnerability to extreme weather events and climate change
  • Develop evidence-based interventions based on research findings
  • Following the second half of the webinar, participants will be able to:Describe how climate change is altering the way emergency preparedness is conducted
  • Explain how local health departments can incorporate climate change into Hazard Vulnerability Analysis process

Date: April 13, 2016

Presenter:
Shao Lin, MD, PhD, MPH
Professor, Research Director of Global Health Program
University of Albany, New York School of Public Health

Elena Grossman, MPH
BRACE-Illinois Project Manager
UIC School of Public Health


The first half of this webinar focuses on the specific health risks associated with extreme weather conditions. High temperatures and humidity increase hospital admission rates due to respiratory disease, cardiovascular disease, renal disease, and total mortality; conversely, cold temperatures contribute to and increase in asthma and incidence of congenital cataracts. Vulnerabilities due to severe weather, based on post-Hurricane Sandy health evaluations, include but are not limited to mental health and substance abuse, kidney disease, and COPD. The webinar outlines the risks, vulnerabilities, and health burden associated with climate change, and offers next steps for addressing these issues in the future

The second half of the webinar focuses on preparation for the public health impacts of climate change. As a way to encourage emergency preparedness professionals to recognize the impact of climate change in, Grossman encourages requiring them to acknowledge the possibility for extreme and/or severe weather in their Hazard Vulnerability Analysis when applying for CDC grant money. She outlines four pieces necessary for success in doing so, which include: 1) historic weather data, 2) projected weather data, 3) health indicators data, and 4) social vulnerability index data.

An Overview of E-cigarette Use, Product Perceptions, Communication and Policy Issues
Person Smoking E-cigarette

Course Objective

  • Recognize different types of e-cigarettes and specific health concerns associated with them
  • Identify proposed FDA regulations for e-cigarettes

Date: March 16, 2016

Presenter:
Olivia A. Wackowski, PhD, MPH
Assistant Professor of Health Behavior, Society & Policy
Center for Tobacco Studies Rutgers School of Public Health


This seminar will provide attendees with a broad overview on what we know about e-cigarettes, including their different types, their safety, trends in product use, perceptions about these products (including reasons for use and discontinuation), e-cigarette information sources, health warnings, and an overview of policy issues, including proposed FDA regulation for e-cigarettes. The presenter will share findings from various government reports and research studies, including her own work in this area. Throughout the talk, challenges with respect to e-cigarette research and regulation will be discussed

Moving Public Health Practice Upstream to Reduce Inequities
Illustration of Stick Figures

Course Objective

  • Describe why public health practitioners should take on “”upstream”” or distal causes of ill health
  • Describe how public health professionals in state and local health departments can take action on “”upstream”” or distal causes of ill health
  • Describe how public health professionals can become allies of current social movements to advance the efforts for health equity

Date: September 1, 2015

Presenter:
Nicholas Freudenberg, DrPH
Distinguished Professor of Public Health, Faculty Director
New York City Food Policy Center at Hunter College, City University of New York School of Public Health and Hunter College


Traditional public health focuses on downstream forces – those that influence individual behavior rather than those that put people at risk – such as housing, living conditions, air quality, income inequality. These are the things social epidemiologists call the “causes that cause”. In this webinar lecture, Dr. Freudenberg expounds five strategies public health practitioners may use to tackle upstream influences on health in order to challenge health inequities. Skill development and establishing collaborative exchanges with social movements, putting data into the hands of people who can use them in political arenas, and recognizing our own roles as citizens outside of our public health identities are a few of the suggested approaches in this talk. Dr. Freudenberg also discusses the challenges of applying these strategies in public health practice despite the substantial political and social risk often inherent in taking action.

Region 2 Public Health Training Center