With his donation of funds to establish a School of Medicine and Dentistry in 1920, philanthropist George Eastman directed the University to use the skills and talents of faculty and students to “make Rochester one of the healthiest communities in the world.”
His vision lives on in the second decade of this millennium. The University of Rochester Medical Center continues its mission to make the local community healthier through patient care, education, research and community outreach. Over the past decade, the Medical Center has further strengthened its commitment as initiatives have evolved, from the launch of the Project Believe health campaign 10 years ago, to URMC leadership in 2004 naming community health a key URMC mission, to the creation of the Center for Community Health two years later. Since 2006, the center has grown, with multiple community based programs and research projects, to a staff of 60 with grant funding totaling approximately $6 million per year.
This represents an institutional commitment to community health that today is sharply focused on the prevention of chronic diseases, including heart disease and diabetes. At the Center for Community Health, we pay attention to social, behavioral, environmental and clinical issues, in an effort to reduce or eliminate the impact chronic diseases have on the health of Americans at large and in our community.
The Center for Community Health in February 2010 launched a new endeavor to address chronic disease prevention, to support individuals who seek to make healthy lifestyle changes. The Healthy Living Center addresses the gap between a person’s desire and their capacity to make meaningful, lasting changes that improve their health and help prevent chronic diseases.
Over the past year, the Healthy Living Center’s programs and clinical trials have seen increasing interest from community members, businesses seeking assistance for employees, and UR faculty and staff members.
- One of the Healthy Living Center’s largest programs to date, which treats individuals with high cholesterol, is attracting significant interest. Participants join the three-month program, which is sometimes extended depending on their risk level, and accept support from lifestyle counselors to address nutrition needs, weight loss options and physical activity.
- The diabetes prevention program counsels individuals who have been diagnosed with pre-diabetes. In an effort to prevent diabetes through lifestyle changes, participants are coached on how to lose weight – in most cases 5 percent to 10 percent of their body weight – and incorporate 150 minutes of moderate-to-vigorous activity per week into their schedule. The process means a serious investment of time and energy but has been proven effective in different cultures throughout the world. If they continue to adhere to the Diabetes Prevention Program, it is estimated that 60 percent will avoid diabetes and its complications.
- The tobacco dependence program You, Tobacco, and Your Health helps those who use tobacco improve their health, regardless of their desire to stop. Individual counseling is provided, along with a treatment plan that includes four contacts by phone or in-person with tobacco dependence counselors and two visits with medical staff. The proven approach focuses on a patient’s experience of stopping tobacco use, management of withdrawal symptoms, assessment of medication options, relapse prevention, and ongoing support.
- The Healthy Living Center also offers mindfulness-based stress reduction, a seven-week program that helps participants handle stressful events in ways that result in more balance, stability and personal satisfaction. The program cultivates mindfulness (moment-to-moment, non-judgmental awareness), which helps people respond to stress with more clarity and wisdom. About 100 people have participated thus far.
Overall, more than 700 employees have been referred to the Healthy Living Center programs over the last 10 months. Over the next year, the programs will expand and offer services to the Rochester community as well as increasing the numbers of employees served.
Medical Center experts are focused on reducing the incidence of obesity in both adults and children in the Rochester region. The second leading cause of preventable death in the United States, obesity affects 60 million adult Americans and 9 million children and teens, and contributes to the risk of breast cancer, heart disease, Type II diabetes, hypertension and stroke.
- The Center for Community Health and other URMC departments helped form a coalition of community organizations, government and business entities in an effort to fight adult obesity through a new project, Healthy Rochester, which debuted in 2010. In one of their efforts, more than 30 partners are developing workplace strategies to help employees at local businesses make healthier changes during their workday, which hopefully will translate into long-term lifestyle changes. The coalition has developed a tool kit that consists of ideas for change to create a healthier workplace. In addition to worksite interventions, Healthy Rochester will address environmental and policy interventions to increase physical activity and improve nutrition in our community.
- URMC also is partnering with a coalition of local community organizations, government and business entities to fight childhood obesity. Created three years ago, Healthi Kids is changing policies and practices with several current initiatives. The coalition has targeted improving food in the Rochester City School District. Healthi Kids worked with district leadership and attracted a new food contractor that is an advocate for healthy eating. There are 34,000 kids in the district, and nine in 10 are eligible for free or reduced breakfast and lunch. Changes were made to the menus and more healthy food choices are now being offered. Modifications to menus can affect a substantial number of students. Those involved admit it will take years, but change will come as a result of long-term transformation of lifestyle and attitudes adopted by the school district, parents, and the students themselves.
- Healthi Kids also is now launching a campaign to bring back recess to the city school district. It is advocating a policy that ensures students get 20 minutes of active recess each day to fight obesity and promote a healthy lifestyle. It also is working with several inner city neighborhoods to create “playability plans” – plans that better utilize existing space and look at the design of neighborhood playgrounds and other available locations, to make them safe and inviting places for kids to stay active.
Both Healthy Rochester and Healthi Kids illustrate that primary prevention can work by using policy change and advocacy to improve health.
Many URMC departments and programs are working hand-in-hand with community partners to improve the health of Rochester-area residents.
- The Department of Psychiatry introduced PEARLS (Program to Encourage Active and Rewarding Lives for Seniors) with Eldersource, a joint venture of Lifespan of Greater Rochester and the Catholic Family Center. Based on a national model, the project trains social workers and care managers to screen for depression and use a therapy, known as problem-solving therapy, that has been shown to help older adults with depression by teaching methods for identifying and solving problems. The goal for PEARLS is treatment of 150 people a year.
- URMC clinician-researchers from the Department of Infectious Disease and the Center for Community Health were involved in one of the largest studies about Methicillin-resistant staphylococcus aureus (MRSA) infections, one of the leading health care-associated infections that plague the nation. There are an estimated 1.7 million cases of infections in the U.S. each year, with 99,000 ending in death at U.S. hospitals. Findings released in August regarding the CDC-led, four-year study show that the number of MRSA cases fell by as much as 17 percent between 2005 and 2008 in nine communities that were studied, including Monroe County. The data indicate that efforts to curb the spread of the dangerous bacterial infection, including improved maintenance of central lines, is working although more research is required to better understand risk factors that contribute to infections.
- URMC’s Golisano Children’s Hospital received a $300,000 grant from the New York State Health Foundation to better health issues for children in foster care. The new project, Fostering Connections, is based at Starlight Pediatrics, Monroe County’s foster care clinic. It represents a more comprehensive approach to caring for children in foster care by delivering onsite primary care and mental health services and parent training.
Inaugural Satcher Awards
In 2010, the Center for Community Health’s inaugural Dr. David Satcher Community Health Improvement Awards recognized URMC faculty and staff who have made significant contributions to health in the greater Rochester region through research, education, clinical services and outreach efforts.
Peter Szilagyi, M.D., M.P.H., professor and chief of the Division of General Pediatrics, who was recognized for his successful program to eliminate disparities in immunization rates.
Katrina Korfmacher, Ph.D., assistant professor and deputy director of the Community Outreach and Education Core of the Department of Environmental Medicine, who was instrumental with the Coalition to Prevent Lead Poisoning in devising and implementing outreach, education and advocacy activities focused on reducing lead exposure. These efforts culminated in a historic lead abatement ordinance passed by the City of Rochester.
Mardy Sandler, L.M.S.W., chief social worker and clinical manager for Community Outreach at Strong Memorial Hospital, who developed a comprehensive, multiservice home visitation program called the Parent and Child Training Program (PACT) to address the physical and psychosocial health needs of families at risk. She also developed Baby Love, a home visit program created in 1988 that has reduced infant mortality, premature births, low birth weight rates, and neonatal intensive care unit admission rates.
The awards are named in honor of David Satcher, M.D., Ph.D., who served as the 16th Surgeon General under President Bill Clinton. Satcher, who participated in the 2010 award ceremony, received medical training at URMC in the 1970s and has served for many years as an advisor to the University of Rochester on public health issues.
Health-e-Access Captures AHA award
The American Hospital Association awarded the University of Rochester Medical Center’s pediatric telemedicine program, Health-e-Access, with a prestigious AHA NOVA Award. Heath-e-Access was launched nearly a decade ago as a novel way to use a web-based telemedicine system to connect youngsters in child care centers, schools, or community centers to a pediatrician or nurse practitioners in the child’s primary care medical home. Special devices for patient examination allow the health care provider to perform remote diagnosis and consultation based on high resolution images, audio recordings (for lung sounds) and video conferencing.
The program encompasses 23 community-based sites, four of which are open after hours, as well as mobile units and teledentistry.
Health-e-Access also was honored with a Leadership Award for Community Benefit Excellence from VHA Inc., a national network of not-for-profit health care organizations dedicated to the provision of quality care to their communities. It was one of three programs nationwide to receive the VHA recognition.
Anti-Violence Partnership Lauded
The Healthcare Association of New York State (HANYS) honored the Rochester Youth Violence Partnership, based at the University of Rochester Medical Center, for its efforts at reducing violence and improving community health. The program is one of only three that HANYS spotlighted for its 2010 Community Health Improvement Award.
The Rochester Youth Violence Partnership (RYVP) is a hospital-based violence intervention program that targets trauma victims under the age of 18 when they are treated at the Medical Center for a knife or gun injury.
Established in 2006, the RYVP is a partnership headed by the Medical Center’s regional trauma program and supported by 28 local non-profit, government and service-based organizations. The Medical Center serves as the “first responder” by treating injuries and identifying at-risk patients. When the patient is stabilized and the psychological and social issues identified, a coordinated series of law-enforcement and community partner-led interventions occur to help prevent additional violent episodes.