BREWSTER – Breaking previous attendance records, 85 public health partners from 48 different community agencies convened at Putnam Hospital Center (PHC) last Thursday, Sept. 7, for the seventh annual public health summit.
Unlike previous years, the 2017 event focused on a single issue, health equity, and how by building a culture of equity, rather than equality, community health can be improved. Organized by the Putnam County Department of Health with support from Putnam Hospital Center, the event brought together community leaders, public health partners and residents to start a conversation about putting an equity “framework” into action.
“So much of health happens outside our walls,” said Lindsay Farrell, president and CEO of Open Door Family Medical Centers, as she welcomed the group. “It comes from who we hang out with, where we live and where we work.” These social factors determine an individual’s health as much as, maybe more than, what is passed on through a person’s genes. It is these “social determinants of health” in part that account for the fact that the U.S. ranks 28 out of 43 developed nations in the world for life expectancy, despite spending significantly more money per person on health care.
County Executive MaryEllen Odell, Putnam Hospital Center President Peter Kelly, interim Health Commissioner Michael Nesheiwat, MD, and Commissioner Michael Piazza of the department of social services and mental health, were among the community leaders in attendance. County Executive Odell spoke of her administration’s challenge to balance social and fiscal responsibilities while state-mandated programs are being defunded and vulnerable populations such as veterans are being negatively impacted. Mr. Kelly, who assumed leadership of Putnam Hospital just one year ago, applauded Putnam for its community partnerships, stronger than all he witnessed in his thirty years of health care experience.
“Health equity is about determining what an individual, or particular population needs, and then providing that, rather than simply providing the same or equal service to everyone.” said Dr. Nesheiwat. “In public health, we’re doing this when we bring our flu immunization clinics into schools, or to segments of the community where they are really needed.”
Epidemiologist Erin Pascaretti spoke about the collaborative approach labeled “Health in All Policies,” which encourages all sectors to incorporate health considerations into their decision-making. The tactic was endorsed earlier this year by the New York State (NYS) Governor’s Office with a similar plan named “Health Across All Policies,” and a heightened focus on creating age-friendly communities and policies, given the state’s rapidly aging population. The concept accounts for the reality that many social determinants of health are the responsibility of non-traditional health partners, such as housing, transportation, education, air quality, parks, criminal justice, employment and energy agencies.
Keynote speaker Andrea Beltran Ruggiero, senior director of care coordination and wellness at Open Door Family Medical Centers, reported how successful the federally qualified health center has been not only in providing a “medical home” for patients, but also incorporating behavioral health integration specialists into their care plans. For example, Brewster Open Door has increased its rates for depression screening with follow-up from 39 percent in 2013 to 69 percent so far in 2017. This was a needed service for the Putnam population, given the County’s focus on addiction issues, suicide prevention and the high reported rates of binge drinking.
The second part of the summit consisted of viewing a series of clips from “Unnatural Causes,” the acclaimed PBS documentary series. Each clip was preceded by provocative questions, and followed by an interactive discussion. Led by Barbara Ilardi, supervising public health educator at the health department, the session provided eye-opening statistics of our health care system and a segue for the next health equity event on Tuesday, October 17, at Putnam Hospital Center. Titled “Blueprint for Health Equity,” the full-day experience is being organized by HealthlinkNY Community Network, a NYS Department of Health Population Health Improvement Program grantee.
Previous summit gatherings have taken a more task-oriented approach, focusing on the Community Health Improvement Plan, known simply as “the CHIP,” and its priority areas of preventing chronic disease and promoting mental health and reducing substance abuse. However, health funders and partners are realizing that the social determinants of health must be factored in first, if true community health improvement and reduction of health care costs are to be achieved.