Highlights of PHI's Impact in 2017
January 22, 2018
PHI is dedicated to improving health and wellness by discovering new research, strengthening key partnerships and programs, and advancing sound health policies. Over the past year, we worked with communities across the U.S. and around the world to address some of the most critical emerging threats to public health. To produce cutting-edge research, to harness the power of data and technology, to defend healthcare and improve health equity, to build capacity among those working on the frontlines of our most pressing health issues—and much more.
Here are highlights of our impact in 2017:
The opioid epidemic is having a devastating impact in communities across the nation, fueling a dramatic increase in premature deaths. In 2017 PHI conducted an assessment of the California Health Care Foundation’s network of opioid safety coalitions to identify what strategies are working at the local level. PHI found that more than 90% of coalitions facilitated adoption of safer prescribing guidelines, more than 75% increased access to naloxone to reverse overdoses, and more than 50% expanded use of medication-assisted addiction treatment. Learn more from the report, Tackling an Epidemic: An Assessment of the California Opioid Safety Coalitions Network.
PHI also announced that beginning in 2018 it will take a leadership role to manage and build capacity in the California Health Care Foundation’s California Opioid Safety Network. PHI’s Center for Health Leadership and Practice (CHLP) will work with a broad spectrum of stakeholders to shift how we talk about addiction, manage pain, and ensure that the most important tools — safer prescribing practices, medication-assisted treatment (MAT) and harm reduction strategies such as making naloxone more widely available — are acceptable, accessible, and affordable to all. Forty VISTA volunteers a year will join the effort, helping to deepen community outreach and engagement.
Image: Adam from UK
In April, PHI's California Environmental Health Tracking Program (CEHTP) published a high-profile study estimating that nationally, only 64% of children with elevated levels of lead in their blood were identified. In California, only 37% of children with elevated blood lead levels were identified.
This study was cited in the bill analysis for AB 1316, a bill the California legislature passed with unanimous support requiring the Department of Public Health to revise regulations for when children are tested for lead exposure. For the first time, doctors will be required to consider factors including proximity to lead smelters or freeways or drinking from lead-contaminated plumbing, which could expose the child to lead. The state will also have to ensure that children with high levels of exposure receive the appropriate interventions.
The public health department estimates that implementation of AB 1316 may result in 300,000 more children being tested for lead each year.
The sugar-sweetened beverage tax in Berkeley, California, is working as intended. That's the conclusion of a study published in 2017 by PHI and the University of North Carolina—the largest evaluation of the tax when it was published, covering 15.5 million supermarket checkouts. It found that the volume of sugar-sweetened beverages sold in Berkeley declined significantly, by 9.6%, in the year following implementation. Because sales for healthier beverages also rose, there was no negative impact on overall beverage sales at studied local businesses. Overall grocery bills (consumer spending per checkout) did not go up.
An additional PHI analysis found that a year and a half after passage of the tax, food sector sales tax revenue rose by 15% in the city, and 469 new food sector jobs were created—an increase of 7.2%. These study findings received widespread national coverage in top outlets such as The New York Times and TIME Magazine, in publications outside the U.S. including The Guardian, and in local outlets where soda taxes were being actively considered, such as The Seattle Times. That city went on to pass a soda tax two months after PHI's findings were published.
As a growing number of cities and jurisdictions legalize medicinal and recreational use of marijuana, PHI expanded its work in 2017 related to cannabis regulation and utilization. PHI's Lynn Silver launched the Getting it Right from the Start: Local Regulation of Recreational Marijuana project to develop and test policies and recommendations with the goal of preventing use among youth and reducing harms related to marijuana use. The project carries out research in locations where recreational use has already been legalized, and has developed tools such as model local ordinances for licensing, marketing and taxation that can be used by representatives of jurisdictions considering legalized recreational use. Learn more about Getting it Right From the Start.
PHI's CA4Health hosted a 3-part Understanding Marijuana web forum series focused on understanding the effects of marijuana on our health and how to address the long-term residual consequences of its criminalization in our communities. Attorneys, law enforcement, racial justice organizations, researchers and city officials from across the country discussed what legalization means for health and public health, and how cannabis legalization will impact and present opportunities in poor, previously incarcerated, and people of color communities. Catch up with recordings of all 3 Understanding Marijuana web forums.
PHI's Alcohol Research Group, which has conducted several studies in recent years on marijuana use, also published new research in 2017 finding a sharp increase in marijuana use in the U.S., particularly among women, whose rate of use has doubled since 1984. The researchers concluded that the higher usage rates are a reflection of society becoming more tolerant and accepting of marijuana use, rather than a direct result of medicinal or recreational marijuana legalization. Learn more about the study.
After leading a campaign two years ago to increase the legal age of marriage in Guatemala to 18, advocates with PHI’s Rise Up successfully pushed for the closure of a loophole in the law in 2017, ensuring that no minor may legally be married for any reason. Rise Up began funding several Guatemalan partners to advocate for a law to end child marriage five years ago. Rise Up leaders collaborated with a coalition of civil society partners to push the Guatemalan Congress to pass a national law banning underage marriage. That law contained a loophole, however, stating that minors could still be married with permission from a judge—meaning girls could still to be forced into early marriages against their will.
Rise Up leaders continued fighting for girls' rights by advocating for an amendment to the law, and in August 2017, the Guatemalan Congress repealed the child marriage loophole. Now, no Guatemalan minor may legally be married for any reason, no exceptions.
For the past 17 years, PHI's FACES for the Future has operated school-to-career programs for disadvantaged youth in California, providing comprehensive services including health careers training, academic enrichment, psychosocial support and intervention, and youth leadership development. In 2017, FACES expanded its programs outside California for the first time, launching new multi-year healthcare internship and leadership development programs in Albuquerque, New Mexico, and Denver, Colorado.
The Albuquerque program serves students from Native American Community Academy, South Valley Academy, and Health Leadership High School; the Denver program partners with Manual High School, Denver Public Schools, and the Denver Health System. FACES also held summer workshops with students in Detroit, Michigan, and is actively working to launch a full academic year program there. FACES now serves nearly 1,000 students per academic year. Evaluations show that a full 100% of FACES students graduate high school, compared with only 40% of their peers in some communities. Nine out of 10 are accepted into post-secondary college or training, and a large number plan to go on to pursue healthcare and health-related professions.
Learn more in FACES' 2017 Year In Review.
The Public Health Institute has supported many policies over the years, but the outpouring of support and advocacy from our public health partners, network and allies in 2017 to preserve health coverage for millions of Americans was unprecedented. From letters to emails, social media shares to phone calls, PHI's community took tens of thousands of actions on behalf of their own health and to protect the health and wellbeing of people they may never know. And it paid off. Thanks for these actions and those of others across the country, efforts to repeal the Affordable Care Act during 2017 were defeated.
Repeal of the ACA and the accompanying Medicaid reductions would have stripped health coverage for millions of people and would have gutted the Prevention and Public Health Fund. Quality health care is critical in creating healthier populations, and PHI will continue advocating for policies to ensure that high-quality health care is affordable and accessible to all.
In the last year PHI's Regional Asthma Management and Prevention (RAMP) program made significant strides in mobilizing school-based health centers (SBHCs) in the environmental management of asthma. RAMP built the capacity of over 450 SBHC staff through trainings in 6 states and through national webinars, equipping them to improve asthma management and prevention for up to 2 million children. The program also developed the Asthma Environmental Interventions Guide for School-Based Health Centers and disseminated it to over 3,000 people; supported 18 SBHCs in the implementation of asthma environmental interventions; and developed and disseminated 10 case studies to show what works.
RAMP also focused on supporting Community Health Workers (CHWs) as vital health professionals in asthma prevention and management, advocating strongly for a California bill authorizing Medi-Cal reimbursement for CHWs and others to provide asthma education and in-home environmental assessments—a bill that passed through every legislative vote with bi-partisan near-unanimous support.
Telehealth holds the potential to improve healthcare systems by utilizing new technologies to increase access to quality, efficient health services, particularly for populations that are rural, lower income, or that have limited mobility. PHI's Center for Connected Health Policy (CCHP) develops and advances telehealth policy solutions, and this year CCHP provided several significant, unbiased policy analyses and recommendations, including the nation's most comprehensive and updated report on state telehealth laws, regulations and Medicaid policies—with information for all 50 states and the District of Columbia.
CCHP also highlighted the significant potential telehealth technologies such as Virtual Directly Observed Therapy (VDOT) hold. An article published by CCHP staff demonstrated the outcomes of California public health departments using VDOT to treat patients with tuberculosis, one of the most widespread infectious diseases in the world. Having a medical professional or public health worker present to directly observe a patient ingest TB medicine is the recommended method of treatment, yet it is highly inefficient, costly and labor intensive. CCHP found high satisfaction among both patients and providers who used VDOT to monitor this step in the process—suggesting its potential to fight infectious disease while minimizing costs and time.
When state leadership in Vermont and California decided to explore the Accountable Communities for Health (ACH) model—which enables collaboration across multiple sectors to address critical community health issues—they partnered with PHI's Population Health Innovation Lab (PHIL) to design and facilitate a Learning Laboratory for 10 communities across each state, using a tailored curriculum to test the ACH model for each site. Learn about PHIL and its Peer Learning Lab.
PHI's Kevin Barnett utilized the ACH model in launching the California Accountable Communities for Health Initiative (CACHI), which brings together hospitals, public health, schools, public safety agencies, parks, local businesses, and local residents to improve population health by aligning interventions for maximum impact, promoting prevention, and organizing resources to focus on the most effective community health strategies.
Barnett also began the Center to Advance Community Health & Equity (CACHE), which provides evidence-informed tools and technical assistance to support strategic health improvement approaches in communities where health inequities are concentrated, and spearheads the California Future Health Workforce Commission, which brings together top leaders in the health, education, and workforce development sectors to help the state close the gap between the health workforce it has and the workforce it needs. Co-chaired by Janet Napolitano, president of the University of California, and Lloyd Dean, president and CEO of Dignity Health, the Commission marks the first time that top statewide leaders from these sectors have coordinated efforts to address this issue. Commissioners will draft a master plan to bolster the health workforce with an emphasis on primary care, behavioral health, and care for the aging. Learn more about the Commission.