Welcome

Moving Healthcare Upstream (MHCU) is a collaborative effort started by the Nemours Children’s Health System and the University of California, Los Angeles (UCLA) Center for Healthier Children, Families & Communities.

MHCU was launched in 2014, via inaugural funding from the Kresge Foundation.  Though work funded by Kresge ended in 2018, Nemours continues to maintain the MHCU website and communications to spotlight upstream work in the field.

Moving Health Care Upstream is based on the belief that health systems can effectively address persistent and costly health inequities by moving “upstream”- working in collaboration with community-based organizations to address the root causes of disease. MHCU seeks to accelerate the adoption of upstream strategies that produce large-scale, sustainable population health improvements, with an emphasis on improvements among children and families.

The various areas of work within MHCU share a common focus: supporting hospitals and their community partners in testing and scaling upstream health improvement strategies, and sharing “what works” to inform the field and accelerate the upstream movement in the field as a whole. The MHCU Learning Network includes health care entities and their community partners from nearly every state in the nation. Recent areas of work include: Using Transformational Leadership to Move Health Care Upstream; Policy Leadership for Health Care Transformation; Building Community Resilience; MHCU Policy Learning Labs and the MHCU Improvement Network. The health care organizations and community groups participating in these MHCU initiatives are acknowledged within the web pages for each.

CLICK HERE for a two-page overview of MHCU.

CLICK HERE for a diagram of the original MHCU Learning System.

Moving Health Care Upstream is part of a national movement to improve population health outcomes by focusing on social determinants of health. CLICK HERE to access “Mapping the Movement,” an interactive map created by teams from 100 Million Healthier Lives and Community Commons, which provides free, up-to-date information about the programs, services and people working in every state and around the world to improve lives and health outcomes by 2020 and beyond. Moving Health Care Upstream is proud to be part of the 100 Million Healthier Lives movement, and proud to shine a spotlight on the work our affiliated communities and partners by adding them to this global resource on request.

Leadership and Advisors

Debbie Chang (Nemours Children’s Health System) and Neal Halfon (UCLA Center for Healthier Children, Families & Communities) are co-principal investigators for Moving Health Care Upstream.

Debbie Chang, MPH, is Senior Vice President of Policy and Prevention and a Corporate Officer for Nemours Children’s Health System. Ms. Chang works to leverage Nemours’ expertise and experience to spread what works through national policy and practice changes to improve the health and well-being of children nationwide. She co-directs Moving Health Care Upstream, a national collaborative network to test, develop and spread innovative population health strategies. Ms. Chang’s work on population health, child health systems transformation, Medicaid, SCHIP and Nemours’ prevention-oriented health system including its CDC Pioneering Innovation award-winning statewide childhood obesity program has been widely published. Ms. Chang holds a master’s degree in Public Health Policy and Administration from the University of Michigan and a bachelor’s degree in Chemical Engineering from the Massachusetts Institute of Technology.
Email: deborah.chang@nemours.org

Neal Halfon, MD, MPH is a Professor of Pediatrics, Public Health and Public Policy and founder and Director for the Center for Healthier Children, Families and Communities at UCLA. Dr. Halfon’s research has spanned clinical, health services, epidemiologic, and health policy domains. For more than a decade, Dr. Halfon has worked with national, state and local initiatives aimed at improving early childhood systems. He has also played a significant role in developing new conceptual frameworks for the study of health and health care, including the Life Course Health Development (LCHD) framework.

Dr. Halfon has initiated and conducted numerous research studies examining the quality of health services available to young children, as well as the development and implementation of population focused early childhood systems building initiatives, including the design and development of MCHB’s Early Childhood Comprehensive Systems (ECCS) Initiative, and most recently the Transforming Early Childhood Comprehensive Systems (TECCS) Initiative that is working with over 40 communities and their local United Ways to improve early childhood development by transforming systems of care for young children.  Over the past 15 years, Dr. Halfon has also had a strong commitment to addressing the developmental origins of health and disease and how the health development process unfolds across the life course. Dr. Halfon has also sought to build a stronger network of researchers interested in exploring the developmental origins of health and disease through the MCH Life Course Research Network. He received his MD at the University of California, Davis, and his MPH at University of California, Berkeley. He completed his pediatric residency at UC San Diego and UC San Francisco. Dr. Halfon was a Robert Wood Johnson Clinical Scholar at both UC San Francisco and Stanford University. Email: nhalfon@ucla.edu

Moving Health Care Upstream was launched with guidance from an Advisory Board of subject matter experts. (Organizational affiliations at the time of MHCU’s launch are listed below.)

• Raymond Baxter- Health Policy Advisor
• Renee Canady- Michigan Public Health Institute
• J. Emilio Carrillo- Weill Cornell Medical College
• Larry Cohen- Prevention Institute
• David Erickson- Federal Reserve Bank of San Francisco
• LaShonna Goodman Grant- Crystal Stairs Head Start
• James Hester- Principal, Population Health Systems
• Charles Homer- US Department of Health & Human Services
• George Isham- HealthPartners
• Anthony B. Iton-  California Endowment
• Jeff Levi- Trust for America’s Health
• Peter Long- Blue Shield Foundation of California
• Rishi Manchanda- HealthBegins
• Jim Marks- Robert Wood Johnson Foundation
• Sarah Martinez– Parent Representative and Systems Coach
• Bobby Milstein– ReThink Health
• Mary Pittman- Public Health Institute
• Tony Rodgers- Health Management Associates