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.

 
Best,

Rishi Manchanda