The Patient Protection and Affordable Care Act strengthens the emphasis on public health intervention to help community members avoid serious illness and achieve a better quality of life, while reducing health care costs.
At the heart of URMC’s own community health approach is the understanding that a healthy community means more than just the absence of disease. Changing the emphasis of health care from treatment to prevention, promoting healthy lifestyle behaviors, and researching and employing new advances in early detection and treatment are core strategies to positively impact the health of our community. It’s all about collaborating with local employers, health care providers, schools, government, insurers, and community- and faith-based organizations to make health improvements where people spend their time and where direct, meaningful connections are making a difference.
The University of Rochester Medical Center, the Monroe County Department of Public Health and numerous community partners were awarded a five-year, $3.6 million Community Transformation Grant by the Centers for Disease Control and Prevention to develop HEART (Health Engagement and Action for Rochester’s Transformation), an initiative that supports healthy behaviors to prevent chronic disease and reduce health care costs. Rochester is one of only 15 local communities nationwide to receive funding.
HEART will take aim at tobacco use, active living, healthy eating, and high blood pressure and cholesterol within one of the city’s most impoverished areas, its northeast quadrant. HEART will also develop models of preventive care and services for Rochester’s large deaf population.
Among the many HEART initiatives, partners will:
- Create a web-based health assessment tool for local employers and schools to improve existing wellness programs;
- Work to establish smoke-free policies at parks, beaches, college campuses, and multi-unit housing;
- Create a “food hub” at which healthful (and in most cases, local) food can be purchased, stored and distributed to various locations: schools, child care providers, group homes, corner stores, produce carts, farm stands, neighborhood food clubs, and deaf community social organizations.
The URMC Center for Community Health will oversee many of the efforts, while others will be led by the Monroe County Department of Public Health and five partnering community organizations: Finger Lakes Health Systems Agency, Foodlink, YMCA of Greater Rochester, the Rochester City School District and the City of Rochester.
The Greater Rochester Health Foundation awarded $471,600 to the Diabetes Prevention Program (DPP) of the Center for Community Health to expand its lifestyle intervention program to select urban primary care settings in order to reduce the incidence of diabetes. As many as 20 percent of African Americans living in the City of Rochester have diabetes, and medical experts say it is likely that one in three city residents has pre-diabetes and is at risk of developing diabetes.
This is the first time the program will be broadly implemented in clinical practices. Over the course of the three-year grant, 11 primary care settings will adopt the program, starting with Anthony L. Jordon Health Center, Culver Medical Group, East Ridge Family Medicine, Rochester General Medical Associates and Unity Health System. More than 1,000 high-risk individuals are expected to enroll in the program, which provides 22 weeks of group and individual meetings with nutritionists and physical activity counselors, to help individuals to cut their risk factors through weight loss and improved eating habits.
URMC is one of six CTSA (Clinical and Translational Science Award) sites nationally involved in the Sentinel Network grant initiative, led by Washington University in St. Louis. Supplemental funding of $57,000 is helping assess the health needs of 250 underserved individuals in the Rochester community who have limited financial resources, education, and access to health care information and services. They are being linked to services and health education, as well as relevant research opportunities.
To boost community involvement in health research, the Clinical and Translational Science Institute (CTSI) is taking advantage of a $500,000 supplemental grant from the National Institutes of Health to develop OPENDOOR, an effort that includes a new web portal, complete with tools that spur community participation in clinical research at URMC and its CTSI, an interactive phone center where callers can get information on clinical research, and a patient ambassador who helps link participants with appropriate studies. Focus groups with community members and organizations have helped measure current access to health information technology and emerging technologies, such as social media and mobile applications, and gauge unmet health information needs.
URMC departments and programs are collaborating with community partners to improve the health of Rochester-area residents.
Health-e-Access reached a significant milestone – 10,000 telemedicine visits with health care providers since the program began in 2001 with pediatricians at the Golisano Children’s Hospital. The 10,000th visit occurred at Eugenio Maria de Hostos Charter School in Rochester.
Begun as a way to care for children in city child-care programs, the telemedicine program has grown to include every Rochester city school, as well as weekend and after-hours care. It uses the internet and specialized equipment to connect health care providers with sick children at convenient community locations to diagnose common illnesses and prescribe medication as appropriate. It allows parents to avoid missing work or delaying care for their children, and has expanded to include acute care visits for older adults in senior living communities.
Published research supports the effectiveness and efficiency of telemedicine. Only 3 percent of telemedicine visits lead to referrals to higher level of care. Children with telemedicine access at child care or elementary school make 22 percent fewer ED visits than closely matched counterparts.
URMC and the City of Rochester sponsored the third annual Women’s Health Screening Fair at the Market in at the Rochester Public Market. Staffed by more than 200 volunteer nurses and physicians, the fair attracted over 300 women for free health screenings, including tests for cardiac disease, breast disease, diabetes, asthma, stroke prevention, kidney disease, skin cancer, HIV/AIDS, glaucoma, osteoporosis and mental health issues. Additionally, doctors, nurses and pharmacists answer participants’ questions, and resources are offered to those without health insurance.
The Women’s Health Screening Fair at the Market is co-sponsored by Wegmans, MVP Health Care, Excellus, M&T Bank, Presentation Source, Verizon Wireless, and the Rochester Academy of Medicine.
Golisano Children's Hospital at URMC received a five-year, $500,000 grant from the state Department of Health to train pediatricians in how to talk to families about childhood obesity and better track children’s body mass index data.
Golisano Children's Hospital leads the Finger Lakes Obesity Prevention Learning Collaborative, which will work with practices in Monroe, Livingston, Ontario, Wayne and Seneca counties. The grant will allow the team to reach 160 practices and about 400 doctors and nurse practitioners, focusing primarily on hard-to-reach underserved and low-income populations.
Eastman Dental, the clinical component of URMC’s Eastman Institute for Oral Health, continues to reduce disparities in children's oral health. Two newly awarded grants allow Eastman to train and mobilize an expanded oral health workforce in impoverished and rural communities where access to dental care is extremely limited.
A collaborative training initiative between the Pediatric Dentistry and Advanced Education in General Dentistry programs is using a $500,000 grant from the United States Health Resources and Services Administration to help Eastman’s experts train 10 family dentists over a five-year period to gain the clinical knowledge and behavior management skills to comfortably address the unmet oral health needs of underserved children in general dental practice.
A second grant allows Eastman Dental’s pediatric dentists to train pediatricians in assessing oral health risk and, if needed, apply fluoride varnish and provide a timely referral to their patients. They also will develop educational materials for families regarding nutrition, feeding behaviors, oral habits, pacifiers, oral hygiene, topical and systemic fluoride use and oral injury prevention.
URMC played an active role through the Healthy Rochester and Healthi Kids coalitions to advance two key health policy initiatives.
A campaign spearheaded by Healthi Kids was launched to “rescue recess” after learning that many Rochester City School District students didn’t have recess as part of their day. Because recess is critical to the health and fitness of children, volunteers took action – speaking out at school board meetings, sending letters to members, and signing petitions. As a result, a recess mandate was added to the district’s Wellness Policy.
Healthi Kids and Healthy Rochester led a campaign for the successful passage of a Complete Streets policy, which encourages active transportation for children, as well as adults. The Complete Streets policy spells out the need to cater to pedestrians and cyclists – not only cars – when public funds are spent on building or repairing streets. Healthi Kids held a Complete Streets training session and encouraged community residents who attended the training to speak on behalf of the policy at the Rochester City Council meeting, where it passed unanimously.
The Center for Community Health teamed up with the Rochester Cycling Alliance to host the Active Transportation Symposium, to better understand obstacles that keep UR faculty, staff and students from biking and walking to and from the University – as well as to consider what improvements might make “active transportation” like biking and walking more attractive than driving a car to campus. A group composed of state, county, city and university representatives continues to move the project forward in 2012.
The second annual Dr. David Satcher Community Health Improvement Awards recognized individuals who have made significant community health contributions through research, education, clinical services and outreach activities.
The awards are named in honor of the 16th Surgeon General of the United States, who completed his residency at URMC in the 1970s and became a leading voice in the field of public health and public health policy.
- Moira Szilagyi, M.D., Ph.D., associate professor of Pediatrics and medical director of Starlight Pediatrics, recognized for more than 20 years serving children in foster care and pioneering the concept of advanced medical home that has become a model of foster care for the nation.
- Stephen Cook, M.D., M.P.H., assistant professor of Pediatrics, honored for his work in childhood obesity prevention. Cook was instrumental in designing the Healthi Kids initiative and its policy change agenda to reverse childhood obesity, focusing on better school food, safer neighborhood play areas, improved food standards at child care centers, and increasing physical activity in schools.
- Karen Knauf, B.S., program coordinator for the Injury Free Coalition for Kids of Rochester, who has worked at URMC for 25 years in Pediatrics and Emergency Medicine focusing on community outreach and education, including projects with the Rochester Safe Crib and Car Seat Coalition and Habitat for Humanity to provide individualized injury prevention information and equipment.
Violence Intervention Program Honored by AHA
The Rochester Youth Violence Partnership, an intervention program developed by URMC’s Kessler Burn and Trauma Center, was honored with the American Hospital Association’s NOVA Award for its commitment to improving community health. It helps trauma victims under the age of 18 who have been victims of violent crimes. The partnership is supported by more than 30 local community, government and health care agencies. URMC serves as the “first responder” by treating injuries and identifying patients who may benefit from the program. To date, more than 215 youths have been enrolled. Less than 10 percent return to the hospital as a result of violence.
Building Healthy Children Receives HANYS Recognition
Building Healthy Children, a home visitation and treatment program developed in partnership by URMC and its Mt. Hope Family Center, Society for Protection and Care of Children, the United Way and Monroe County Department of Human Services, received honorable mention from the Healthcare Association of New York State (HANYS) for the 2011 Community Health Improvement Award.
The program provides and evaluates preventive interventions for teen families and their children, supplying mothers who have their first child prior to age 21 with parenting education, parent-child attachment and maternal depression therapy, linking them to preventive and specialized health care and support services such as food, housing and transportation. More than 325 families have enrolled in the program since its inception in 2007.
UR Deaf Health Disparities Group Wins National Excellence Award
The National Center for Deaf Health Research (NCDHR) recently won accolades for putting community-based participatory research into action by conducting comprehensive health studies within the underserved deaf and hard-of-hearing population. NCDHR was one of 11 research groups to win a best-practice award from the National Community Committee, which is associated with the Centers for Disease Control and Prevention.