Strategies to Advance Public Health
The COVID-19 pandemic put community health in the spotlight. According to federal data, Black, Hispanic/Latino and Indigenous Americans are 1.1 to 1.7 times more likely than white, non-Hispanic Americans to contract COVID-19. But the factors that led to these statistics were in place long before the virus appeared. During National Public Health Week, we seek to bridge the gaps in care that the pandemic highlighted.
Many of the issues the American Public Health Association highlights during this week are intertwined with the larger community ecosystem, and these issues must remain a priority. "When it's not at the center, it's really easy to make microdecisions to push it off," says Jodi-Ann Burey, Equity Advocate and Host of Black Cancer: The Podcast. "But at the other end of that deprioritization of racial equity is someone's life."
Healthcare organizations have the opportunity to advocate for their communities to improve public healthcare outcomes. Here's how.
Mental health is a vital component of public health, but those services can be hard to access. Patients may not know how to ask about what they're experiencing, or they might be afraid their concerns won't be taken seriously and thus opt not to seek help. "When someone has mental health-related issues, they're less likely to be compliant with their physical health," says Latoya Hamilton, a public health leader studying the intersection of mental and maternal health. An integrated care model, she says, offers a more proactive, preventative solution.
Integrated care delivers behavioral and mental healthcare alongside physical care delivery. An integrated care model in a hospital setting supports more holistic recovery, but integrated care can be just as vital in well visits. When a patient has an opportunity to address mental health concerns during a regular checkup, physicians and behavioral health experts can collaborate to prevent a patient's condition from escalating.
Don't just listen to the national, generalized public health narratives. Don't assume, for instance, that Black communities aren't seeking the COVID-19 vaccine exclusively because they're wary of it. What other barriers might be preventing them from accessing the vaccine? "It's the job of folks in public health to know what's happening in your community," Burey says. "To see the whole system better, you need to see your microsystems."
Evaluate public health data in the communities you serve to get a better sense of what their specific needs are. Compare public data with internal data to determine where you have gaps in care. Invite community representatives to the table to provide qualitative data. "Have community stakeholders meet with them, providing their input," Hamilton says. "Translate that into policy so you can push the needle forward." For example, maternal mortality rates among Black women are incredibly high. To mitigate this in their community, a healthcare system might implement a stricter policy on prescribing caesarean sections or add doulas to the maternity team to function as patient advocates.
You can't just treat the patient who walks through your door. Really pushing improvement in public health requires organizational investment in the larger community. You must treat the whole person as a product of their community and reach back out to make the community better. "Understanding and operationalizing the social determinants of health become that path," Burey says. The Center for Community Investment recently partnered with the Catholic Health Association to develop a toolkit to help you invest in the communities you serve.
Take an active role in lobbying for the community. Keep up with local legislation that will impact your patient population, including bills concerned with environmental health. Lend your voice and status in the community to solving problems that are harming your patient community.
Only a holistic, structural approach to community care can take your public healthcare delivery to the next level. You can't improve community health outcomes without addressing environmental racism, for instance, or treat mental health without acknowledging the vast differences in experiences for different communities. Use this year's National Public Health Week to re-center community health as an organizational imperative.