December 2021 Newsletter

Introduction

Welcome to my December 2021 Living Conditions and Health 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

It is the season of predictions and I marvel at how so many organizations and individuals still seem inclined to make predictions after living through the unprecedented and unpredictable past 2 years. I will take my prior stand of stating my hopes for the coming year that could be within our collective capabilities.

  1. The pandemic becomes the needed wake up call for our country and the world to approach life and humanity as the fragile gift that it is.
  2. All people living in the US have access to resources and services that enable living conditions that are secure and circumstances in which they can have a “fair and equitably opportunity to live” (borrowed from the Tulsa article below).
  3. Our country’s commitment to health equity and the elimination of structural racism will be codified in laws and programs so that there is no going back.
  4. Healthcare access is recognized as a right and all healthcare providers are supported to enable needed equitable access.
  5. Politics return to civil discussions that make the rights and needs of all Americans the driving priority.

Sadly, or perhaps by necessity the Omicron variant has put us all back in the realm of uncertainty and inequity as many struggle to get tested, to get results, to avoid unknowingly infecting friends and family.  The good news is it is proving to be milder for most people testing positive. The New York times reported US deaths have passed 800,000 and cases rose above 50 million. The impact of the pandemic continues to disproportionately affect people of color and underserved populations. The response to the pandemic is our daily reminder of how politics in many states are ignoring the stark realities of the pandemic. Let’s hope we see an improvement in 2022.

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November Newsletter

On Thanksgiving we should pay tribute to all of the unsung Native Americans

Introduction

Welcome to my November 2021 Living Conditions and Health 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

Do you know someone with Long COVID? It is bad enough to have these challenges and symptoms, but to then be stigmatized and isolated will only make it worse. This BMJ opinion piece highlights the challenges and offers ways to support people with Long COVID.

Lancet Public Health article on the tremendous impact of Adverse Childhood Events (ACEs) is disheartening, yet vital for increased awareness. The article leads off by stating “it is estimated (globally) that one out of two children ages 2-17 suffer some form of violence each year.” The article cross referenced a meta-analysis estimating 89.9% of adults who are homeless have at least 1 ACE and 53.9% had 4 or more. Preventing childhood violence should be a top priority in all countries and communities.

This is the first article I’ve seen highlighting workers comp as an area that could substantially benefit from addressing socio-economic factors. I’m sure there have been activities, but perhaps not covered in the press. This aligns with more employers recognizing the role of social determinants of health on workers generally and potentially underlying risks of workplace injuries.

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October Newsletter

My dog’s Halloween outfit!

Introduction

Welcome to my October 2021 Living Conditions and Health 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

The prolonged pandemic and its disparate impacts on health and the economy continue to fuel needed changes in how many stakeholders think about health services and the living conditions that negatively impact individuals and communities. The politics and misinformation that influence our country’s ability to embrace needed and sustained changes make the progress feel fragile. This months’ entries seem to support this perspective, but that may just be my bias.

An article, and the recent Bipartisan Policy Center report it reviews, discuss the need to expand flexibility for investing in Social Determinants of Health (SDOH) focusing mostly on Medicaid, but also seeking to address silos across Medicaid, Medicare and CHIP.  The report also addresses funding, research, and workforce needs for implementing non-medical and preventive services that have evidence of success. The recommendations are a critical set of steps in the right direction. Equal attention should be given to the many other silos of social services and community infrastructure supports and the many other Federal programs that have overlapping and adjacent service capabilities.

The Transforming Public Health System Data Commission report on Charting a Course for an Equity Centered Data System was supported by the RWJF. It establishes the importance for change, the steps and processes taken to formulate the findings and recommendations and calls to action for a broad range of stakeholders. The Commission and the report represent a substantial undertaking among organizations and consultants to look across the problems laid bare by the pandemic and worsened by systemic racism and related inequities that resulted in the declaration of racism as a public health crisis. This quote from the conclusion emphasizes the significance of inadequate data:

“The Commission recommendations make it clear that in our current system, data on health inequities are divorced from the history and community conditions that shape poor health outcomes, resulting in an incomplete picture of who is most impacted and why.”

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April 2021 Newsletter

Spring is a time of renewal and new beginnings, a baby owl in Rock Creek Park

Introduction

Welcome to my April 2021 Living Conditions and Health 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

April was Minority Health Month and there were many programs and announcements highlighting what public and private organizations are doing to address health equity. Many discussions were grounded in the health inequities of COVID19. These are important and valuable initiatives, but the inequities are not unique to health and healthcare. One article describes the many ways, the health system collects the disparities of structural racism. Structural racism is rooted in: lacking access to critical resources and supports that provide needed basic living conditions; and, historic social injustices and inequities in all aspects of life. An article in the Hill on the need for an increased minimum wage that offers a living wage is another example of ongoing policies that disproportionately impact minorities. These negative social determinants have been present for decades, if not centuries and will require sustained and increased efforts to fix.

The current minimum wage is inadequate for individuals and families to live on. MIT’s Living Wage Calculator shows that “A single-mother with two children earning the federal minimum wage of $7.25 per hour needs to work 138 hours per week, nearly the equivalent of working 24 hours per day for six days, to earn a living wage.” This was based on 2019 data and is likely worse due to increase prices resulting from the pandemic.

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March 2021 Newsletter

My weeping cherry tree was a gift in March

Introduction

Welcome to my March 2021 Living Conditions and Health 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

March felt different one-year into the pandemic. The increase in vaccinations is starting to bring hope and allowing people to reconnect in-person. This is a critical first step for individuals and families who have been isolated. Unfortunately, the vaccination rollout challenges and distrust, continue to create uncertainty about reaching national vaccination goals.

There continues to be misinformation about the vaccines and efforts to dissuade people from getting the vaccine. The Public Health Collaborative has a misinformation alert tool that keeps people up to date on the misinformation and provides resources to help combat such information. They have also developed a vaccine misinformation management field guide. I think of myself as someone who is keeping up with the field and the misinformation, but there is much more happening than I had realized.  In the age of social media, there are so many more information channels for anyone around the globe seeking to manipulate information.

Drew Altman CEO of the Kaiser Family Foundation (KFF) posted about “Where to Start to Build Vaccine Confidence.” If you want vaccination information coverage from KFF go to their COVID19 vaccine monitoring dashboard.

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2020 Yearend Newsletter

Introduction

Welcome to my 2020 year-end 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

Yearend of a year we could not have predicted and that will have impacts for many years to come feels unsettling. There are many opportunities to make fundamental changes that will promote health equity and upstream investments in living conditions. These could strengthen our country and communities if embraced and sustained. There is enormous work to be done if we choose to take a bold path, but the benefits would be worth it.

Two year-end inspirational highlights. The first is the story of Jack Geiger MD who sadly recently passed away. It shows that with determination, enabling improved living conditions as a part of the healthcare mission can and has been done in more difficult times than ours. In the early 60s he established and transformed community health centers in South Boston and the Mississippi Delta with a social medicine model that addressed social and economic needs.

The second highlight is community fridges to help feed hungry neighbors. The number of community-led stocked refrigerators has increased at least 500% in the past 8 months and the movement shows a combination of contributions and partnerships that include volunteers, restaurants, stadiums and financial donations coming together to make everyone better off.

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