Summer 2020 Newsletter

Sympathy and strength to all the parents juggling stay-at home schooling!

Introduction

Welcome to the Summer 2020 newsletter. You can find past newsletters with additional background materials, and different stories and initiatives on my website and in my LinkedIn articles or posts. Join me in identifying and coordinating initiatives that advance health, health equity and community and healthcare redesign.

Shannah’s Insights and Reflections

This newsletter covers months four and five of COVID19. We are experiencing opening and re-closing or sticking with social distancing depending on where we live. The monotony yet necessity of daily living during COVID19 is my rationale for a combined Summer newsletter spanning July and August. I’m not able to keep my rosy outlook from the June newsletter because much of the news, particularly around the surge and resurgence of the pandemic is not good and disproportionately continues to affect people of color and underserved communities. I have included a few promising care and services models that offer hope.

I will start off with a link to the late Representative John Lewis’ words for us to hear at his funeral.  As I posted when his opinion piece was published… in his final days, he gives us hope and is the example of leadership, even in death, that we desperately need.

I also want to take a brief moment to recognize all parents at the start of the 2020-2021 school year for meeting the challenge of back to home school! You are another segment of the unsung pandemic heroes facing a sustained living condition that affects you and your children’s mental and physical health. This Vox article should help everyone relate.

The is a growing trend of municipalities and states declaring racism a public health crisis. Unfortunately sustain incidences of police brutality have fueled this trend. More diverse organizations and institutions finding ways to embrace anti-racism may help turn the tide of brutality and could enable reform and sustained improvement in our communities and in the country. A Refinery29 article discusses how this declaration is only the beginning, but an important first step to allocating resources and taking strategic actions.

On August 28th the 2020 Commitment March was held marking 57 years since the March on Washington and Martin Luther King Jr.’s I have a dream speech.  This march elevated demand for change to enact justice and healing. See some of the coverage here. It is an important example of the momentum of the movement since the murder of George Floyd and continued brutality including the most recent senseless shooting of Jacob Blake. The protest was designed to acknowledge the realities of and constraints to safely protesting during the pandemic and give voice and truth to the racist reality of our country.  Change is long overdue. Racism is a human and public health crisis.

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June 2020 Newsletter During COVID19

One of many examples of the mixed emotions on this Independence Day

Introduction

Welcome to the June 2020 newsletter. You can find past newsletters with additional background materials, and different stories and initiatives in my LinkedIn articles and on my website. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign. I’m still dispensing with the newsletter subsections and concentrating on ways to address disparities and inequities.

Shannah’s Insights and Reflections

Month three of largely COVID19 lockdown. I’ve decided in honor of Independence Day, I’m going to provide an optimistic overview of all of the potential positives that can come out of our current state of oppression that has 3 strong drivers: the pandemic, the economy and systemic racial injustice. I use the term oppression in recognition that this weekend’s celebration commemorates the 13 colonies declaring independence from the oppression of the British Monarch. Many are not celebrating this year’s Independence Day because too many people in our nation do not have the freedom they should.

For those of you who know me, you know that a rosy outlook is a bit uncharacteristic, because I’m more a tell it like it is, don’t sugar coat it, kind of gal. Nevertheless, I am also passionate about transformation and believe we are at a critical juncture where we can choose a new and improved path for all people.

I live in a county and state that have embraced caution in reopening and erred on the side of keeping people safe. Our numbers continue to decline, but the US numbers are headed in the wrong direction. The upside perspective is more of our society needs convincing that the risks of the pandemic are greater than the benefits of reopening as quickly as possible.  We are seeing leaders recognize the need for caution and reversing their early opening decisions. Let’s hope this is the start of a reverse trend.

The growing cases continue to reflect inequities and disparities in our health system and in our country, underscoring the need for a reckoning with systemic, structural and cultural racism. There is a growing silver lining that I hope to portray in this month’s newsletter. The intersection of the pandemic, economic crisis and social injustice is sustaining pressure for much needed change and improvement. This is a growing perspective across the nation. As a country we can be much better than this and now is the time for change!

MORE

I have a wish list of additional changes to the ones we’re starting to see. Some of these I’ve mentioned before:

  • Embrace the discomfort of today’s protests, pandemic and economic uncertainty to examine how we can change our thinking, our culture and our actions.
  • Provide substantially larger and sustained investments in the social services and local community infrastructure in all underserved communities. These investments need to be independent of Healthcare investments.
  • Enable grassroots involvement and approval for all community improvements. Top-down solutions are not the answer.
  • Repurpose excess building capacity to provide affordable housing and alternatives to nursing homes as companies and communities regroup and the number of people working in offices and urban centers shrink.
  • Deliver healthcare and long-term services and supports in homes and communities. We need to fundamentally change long term care design that was already an underlying cause of death in our aging population.
  • Provide living wages for all workers.
  • Provide resources, supports and respite for all caregivers – parents, childcare providers and unpaid caregivers for family and friends who need assistance with daily living (ADL and IADL).

Share your personal or community stories by connecting via LinkedIn or email kossoncare@starpower.net I welcome suggestions in all topic areas, particularly community driven models.

A personal or individual story

My 23-year old son went to most of the protests in the DC metro and Baltimore area the first two week in response to George Floyd’s murder. As a mom I definitely had misgivings about the risks of the police response to protestors and the risks of exposure to COVID19. I am also incredibly proud of him for standing up for his beliefs. He has helped me re-ignite my own inner activist. We don’t always agree, but we are helping eachother think and act in ways that will be part of the solution for systemic change in our own community and through policy and political change.

Health disparities and inequities

Below are some of the areas where we are already seeing change and improvements.

NEJM Cataylst article perhaps says it best (emphasis added):

“Together, the medical and social consequences of Covid-19 are unprecedented in our lifetimes. The impact on essential resources will be experienced by a far larger subset of the population than the health crisis itself due to the sharp downturn of the economy and deep inequities that pre-date Covid-19. This situation presents us with the opportunity — and the obligation — to clearly name the problem and rewrite — for good — how health care, public health, human services, government, community members, and the private sector can work together to design multiple interventions to address inequities and to improve health care and the related social determinants of health.”

We are already witnessing significant impacts from the protests across the country regarding social injustice and racism. Many experts along with most people we talk to in our communities say it feels and indeed is different.  Businesses, cities, counties and states are taking action in response to both the protests and the sustained disparities of the pandemic, in cases of COVID19 and deaths. Here are some of the positive actions, policies and business outcomes:

  • Arrests and civil actions against police that have murdered blacks
  • Changes to laws that insulate police brutality
  • Communities linking referrals for social needs to COVID19 screening calls
  • Cities and counties declaring racism a health crisis
  • Corporations supporting the George Floyd protest and reexamining what they can do to enable change. The more visible and accountable companies, communities and leaders become regarding true equity and addressing past wrongs the greater the change will be.
  • A recent Pacific Business Group on Health survey indicates nearly 2/3’s of employers will focus more on social determinants of health and 45% will consider benefit redesign to address health inequities.

Technology has been an important asset for healthcare systems’ responses to COVID19, specifically telemedicine and web conferencing that has enabled many people struggling with the isolation of lock downs and social distancing. Here are just a few additional examples of technology improvements:

  • “Clear Arch Health, a provider of mobile personal emergency response system (mPERS) and remote patient monitoring (RPM) technology, announced a new program designed to address both emergent medical needs and social determinants of health (SDOH).”
  • Artificial intelligence was highlighted at the Aspen Ideas Festival (see events below) as bringing transformation to many aspects of life along with needed data analytics. (There are some risks that I’ll discuss in future newsletters.)
  • The extensive transition to virtual visits proved that this method of health care access is viable and sustainable. It may have even improved access and engagement in mental health services.

Many of you likely have your own examples of improvements in the midst of today’s chaos. Please share the newsletter and connect via LinkedIn or email kossoncare@starpower.net with your reactions and input.

RECENT & UPCOMING EVENTS

The Aspen Ideas Festival discussed the problems and solutions of our time in an engaging and positive way. I encourage anyone looking for hope and inspiration to look at the schedule and watch what interests you and perhaps what feels most foreign to you that might give you some new perspectives.

Background and Definition

I have chosen the phrase “Living Conditions” rather than social determinants of health (SDOH) to make the concept more accessible.  This focus tracks with the Centers for Disease Control and Prevention’s SDOH definition “as conditions in the environments in which people live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Go here for more information from CDC on its organizing SDOH framework in Healthy People 2020

May 2020 Newsletter during COVID19

Introduction

Welcome to the May 2020 newsletter. You can find past newsletters with additional background materials, and different stories and initiatives in my LinkedIn articles and on my website. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign.

Shannah’s Insights and Reflections

Two months of COVID19 and lock down/social distancing in Montgomery County Maryland while states and counties create a patchwork of openings, sustained lock down or social distancing and many things in between. Meanwhile individuals and leaders vary in their willingness to continue safe practices.

Added to the pandemic is the long overdue collective outrage over police brutality and the sustained injustices against individuals and communities of color in our society. Is the political landscape we each live in another important social determinant? Having a true voice in how policies and programs are shaped that fosters hope and the belief that each of us can influence change. More fundamentally, whether individuals can trust law enforcement and safety institutions to protect their rights and safety is a sustained uncertainty for Blacks and communities of color.

Sadly, as the pandemic exposes the systemic disparities and inequalities of our communities and health system for communities of color; we experience a harsh reminder of how racism is still a fundamental driver of life and health disparities through the brutal police murder of George Floyd.

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April 2020 Newsletter during COVID19

Introduction

Welcome to the April 2020 newsletter. You can find past newsletters with additional background materials, and different stories and initiatives in my LinkedIn articles and on my website. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign.

Shannah’s Insights and Reflections

We’ve experienced a sustained month of COVID19 and lock down/social distancing. It has also been a jarring exposé on health disparities and the implications of living conditions on individuals’ and families’ health status, health risks and access to care. I am again breaking away from my standard reporting this month and instead will highlight the ways the pandemic exposes the many drivers of health disparities and our need to address the fundamental inequities across all segments of our society.

Inequalities, prejudices and social and economic disparities lay the disastrous foundation for the disparate risks, impacts and treatment experienced by African Americans, Hispanics, immigrants, low income people and communities and elderly populations. This past month coverage focuses on the need for data. There is a growing voice that the disparities not only result from social determinants and comorbidities, but prejudice and discrimination. Unfortunately, how individuals and institutions treat individuals can be influenced or dictated by factors that should have no role in testing, treatment or services. Gaining true insight on this aspect will also be data dependent.

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March 2020 Newsletter During COVID-19



Photo by Anshu A on Unsplash

Introduction

Welcome to the March 2020 newsletter. You can find past newsletters with additional background materials, and different stories and initiatives in my LinkedIn articles and on my website. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign.

Shannah’s Insights and Reflections

Nothing in March is business as usual and this newsletter is no exception. I gather my intel on living conditions and health from google alerts. The first Coronavirus online story that surfaced (based on my search terms) was on March 8th about the first case in Kansas and that she was isolating at home. Just this statement underscores how living conditions or social determinants will be part of the fabric in which people manage through this pandemic. “Isolating” and “home” are two fundamental factors for how individuals who test positive will fair. Do they have a support network, albeit remote, that will help them through this challenge? Do they have a home in which they can isolate/self-quarantine, manage needed services and resources and avoid infecting others?

There was no further mention in my alerts until a COVID-19 Q&A on the 20th and an article identifying protection for rideshare drivers. This article discussed helping drivers know if they have been exposed to the virus, particularly medical rideshare drivers who are critical for patients needing rides. Drivers are at greater risk for exposure from patients and in turn are potentially exposing others.  The drivers may also want riders to wear protective gear that is increasingly difficult for even healthcare workers to get. Since that story the intersection of the pandemic and living conditions was regularly reported.

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November 2019 Newsletter

Introduction

Welcome to my November 2019 newsletter. You can find past newsletters in my LinkedIn articles and on my website with some additional background materials, different stories and initiatives that might be of interest. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign.

This month you can read about: Bernard Tyson; Detroit medical students caring for the homeless; Oversight for the $1.5B ANC Healthcare trust in NC; alternatives to provider centric community initiatives such as land trusts, collaborative networks and public health initiatives; the role of CHCs in disasters and prevention; CMS changes in Medicaid flexibility and delay in consumer access regulations; hospital system investments in communities; Aetna/CVS’ loneliness program; US life expectancy downturn; Neighborhood Atlas and Healthify’s latest investment round.

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May 2019 Newsletter

Introduction

Welcome to the May 2019 monthly newsletter. You can find past newsletters in my LinkedIn articles and on my website with some additional background materials, different stories and initiatives that might be of interest. Join me in improving and coordinating initiatives that advance health, health equity and community and healthcare redesign.

This month you can read about: My recent blog on why asking for help shouldn’t be so hard; Fannie Mae’s innovation awards for improved housing; several stories about the substantial impacts of poor living conditions on healthcare in hospitals, FQHCs and primary care and the breadth of needed changes; More initiatives from Cerner and Kaiser and Blues plans investing in Solera Networks; a Health Affairs’ article on the need for further research; and many surveys from different vantage points.

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