By Sunita Mutha, MD, FACP, Director of Healthforce Center
In my last post, I promised to share what Healthforce Center is excited to focus on in 2022 as we celebrate our 30th anniversary. For three decades, we have been committed to advancing health equity, developing health leaders, and examining the health care workforce in support of effective policy and more equitable care.
This year, our personal lives, workplaces, and the health care system will continue to be impacted by the COVID-19 pandemic. I recognize the tremendous burden that health care workers have borne. I’m optimistic that we can turn this crisis into an opportunity to improve health care access, delivery, and equity.
How? The pandemic has shown us the weaknesses in our health care system. It has also highlighted how health is determined by more than clinical care; in the case of COVID, our vaccination status, viral exposure, illness trajectory, and mortality are influenced by the jobs we have, where we live, and the social needs that affect our health.
According to the Centers for Disease Control and Prevention (CDC), only 10% of factors affecting premature death are related to clinical care, and 30% of factors relate to genetics. This means that 60% of factors contributing to premature death are based on a combination of social or environmental factors (20%) and behavior (40%).
Affecting improvement in this 60% will require community-based solutions that address the social determinants of health: housing security, food security, mental health, and support to change behaviors. Which is why the launch of CalAIM marks a sea change with a broad approach that looks upstream from clinical care to consider the many other factors that impact health.
It's remarkable to witness a state as large as California turn its attention and resources to these important factors. Already the field has been preparing and making in-roads to establish partnerships among health care and community-based organizations that are supported by information sharing, referral systems, and data tracking.
I'm excited to see how Healthforce Center's well-established partnerships and expertise will support the changes underway. Some examples are:
- As we continue to reckon with racism and bias in our systems and ourselves, Healthforce Center will host an open community event with nationally renowned Dr. Camara Phyllis Jones on "Naming Racism" on May 19. This half-day event to commemorate our anniversary will provide participants with greater skills to advance racial health equity.
- Healthforce Center is embarking on a significant redesign with the California Health Care Foundation of the California Improvement Network to reorient the network's efforts toward improving health delivery in concert with community-based services. Watch for details on the redesign this summer! We will also release a new CIN toolkit on strategies to advance racial health equity this April. Join CIN to get updates.
- Change in care delivery, whether it's partnering with CBOs or guiding an organization to become more anti-racist, requires confident and skillful leadership. We will continue to develop leadership capacity across the health care workforce by launching a fifth cohort of the Cedars-Sinai Managing to Leading program for Los Angeles community clinics (applications are due March 25); initiating a leadership training program for UCSF's National Clinical Scholars Program; and updating the curriculum for the California Health Care Foundation's Health Care Leadership Program, which recently launched the 21st cohort.
- COVID-19 brought to the forefront that burnout isn't just happening among physicians but also among nurses, technicians, and workers at all levels. The pandemic has shown how work environments in health systems affect the well-being of workers, whose capacity to deliver safe, patient- and family-centered care plays a central role in achieving health. We will advocate for our recommendations for future investments in well-being support for health workers.
- The pandemic has dramatically increased demand for mental health and substance use disorder services at a time when undersupply was already a concern. We are helping health systems, county behavioral health agencies, and community-based organizations understand supply and demand for behavioral health professionals and identify options for meeting demand through alternative provider roles and channels. Current Healthforce Center projects include an assessment of the workforce needs of California's public behavioral health system and an examination of the contributions of paraprofessionals (e.g., peer providers).
These examples show how Healthforce Center and our many partners have pivoted to support the changes underway. We have joined the field in advancing community-based provision of social needs to move health promotion upstream. This year, we will continue to support these conversations and collaborate on solutions. How can we help your organization move forward on its strategies? I’d love to hear from you.
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Sunita Mutha, MD, FACP, is the director of Healthforce Center at UCSF. For over a decade, she has been engaged in transformational leadership in health care with a special focus on emerging leaders and inter-professional training.