June 2018: The Surgeon General just called for more Upstreamists: What comes next?


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Vol 1 Issue 4

Dear friends,


If you had any lingering doubt that Upstreamists have a voice — that our calls to implement upstream care widely have become a growing movement — be reassured. Last week, the U.S. Surgeon General, Dr. Jerome Adams, made that very call himself at the annual meeting of the American Medical Association. You can watch him tell a lively adaptation of the Upstreamists’ classic “Three Friends and a River” parable, and cite the work of HealthBegins, at 18:30 here.


This call to action from the country’s leading spokesperson for health speaks to the systemic approach that’s needed when we set out to address social needs. The challenge is big, so it’s natural to try to approach it in bite-size pieces, with small projects.


What we’ve found, however, is that upstream efforts work best when they are strategic, comprehensive, and coordinated. In other words: this work requires not just projects, but campaigns.


A campaign involves tapping not only existing staff, but bringing new people and voices to the table. Beyond achieving specific outcomes, a campaign has the ability to build capacity and change culture.


What a campaign need NOT be, though, is daunting. It’s entirely possible to set forth a comprehensive strategy for addressing social needs, identify opportunities for early wins, and then start tackling them one step at a time.


We know because we see more health systems and community partners making this type of bold commitment every week. For example:


  • Providence St. Joseph Health, which serves a large swath of the western U.S., is integrating the social determinants of health into its system. With support from HealthBegins, each region will identify one social determinant to focus on.
  • The Connecticut Hospital Association last month boldly chose to tackle three big social needs: food, housing, and transportation. We provided a workshop to help CHA hospitals learn how to begin that work.
  • With Communities Lifting Communities and HealthBegins, hospitals and community partners in California’s Ventura and Long Beach are designing Upstream Quality Improvement campaigns to improve diabetes and its social determinants.


One last note: We’re taking a summer break! (That is, our webinars and newsletter are.) We won’t host a webinar or publish a newsletter in July but will be back in August, ready with fresh resources to help you move medicine upstream.


I hope you, too, can make time this summer to take a break and fuel your own wellness. As the Surgeon General reminds us, Upstreamists deserve to relax and recharge every once in a while, too.


Rishi Manchanda

New from The Upstreamist, the HealthBegins Blog:

Charting a Course for Social Determinants of Health

Healthcare systems are talking about moving upstream. The Upstream Strategy Compass can help them get there.

A One-Time Medical Assistant Empowers Rural Clinics to Meet Social Needs for the Homeless

Upstreamist in Action: Dana Valley discovered early in her career how intimately social needs affect medical health, especially for the homeless. Now she spearheads a data-driven effort to identify and meet those needs — and shares the new social-determinants questionnaire that her clinics use with patients.

The Simple Intervention That’s Helping Solve Social Needs in One of America’s Most Diverse Counties

Pharmaceutical companies first used this technique to weave their products into doctors’ prescribing habits. Now social-medicine advocates are adapting it to improve upstream care. In one California clinic, this Community Health Detailing increased referrals to social services more than 15-fold in just four months.

We’re taking a summer break in July! Watch for our next webinar on racism, equity, and social determinants of health in August.

Upcoming Events: Find HealthBegins Here

UCLA/Johnson & Johnson Health Care Executive Program
July 17 | Los AngelesExecutives of community health centers participate in an 11-day, intensive management development program at the UCLA Anderson School of Management.

North Carolina Hospital Association Summer Meeting
July 20 | Asheville

Chief executives, physicians, and senior leaders from member hospitals and health systems come together to celebrate NCHA’s work over the past 100 years under the theme: “The Changing Face of Healthcare.”

Upstream News

Curated highlights of happenings affecting upstream care. Links are not endorsements.

It’s Time to Rethink the Anatomy of Physician Behavior
Health Affairs Blog

Is It Getting Harder to Care for Poor Patients?
New York Times

Are Social Determinants the Missing Key to Improving Health?

Durham Advocates: Racism Still Fuels Communities’ Food Access, Health Disparities
North Carolina Health News

Southern Jamaica Plain Health Center: Improving Health Equity With a Racial Justice Framework (VIDEO)
Intercultural Productions

America Has a Health Care Gap, and Insurance Alone Won’t Fix It
Huffington Post

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