Moving Health Care Upstream

Why Community Resilience?

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Written by Wendy R. Ellis DrPH (c), MPH; Co-Principal Investigator & Project Director, Building Community Resilience Collaborative; Sumner Redstone Global Center for Prevention & Wellness; George Washington University

Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.

First in a series: The Dallas Story of Resilience Building

When we first introduced Building Community Resilience (BCR) a few years ago, skeptics wondered if our reach was too large. Others found our language over-simplified for the complexity of adverse childhood experience (ACEs) and toxic stress. Nonetheless, we were convinced that the public health issues that contribute to ACEs could not be met by one sector alone. It was and remains our steadfast belief that many of the factors contributing to health disparities and the lack of resilience can be mapped back to the lack of supportive buffers that promote health and wellbeing. Supportive buffers, such as well-performing schools, reliable public transportation, diverse neighborhood retail (i.e. grocery stores, banking, pharmacies, etc.), access to economic mobility, affordable housing, and health care, help a community bounce back from adversity, and provide the foundation for individuals to ‘bounce forward’. [Read more…]

A New Guidebook Shares Foundational Elements for “Working as a System to Optimize Family Wellness”

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Written by Leila Espinosa

Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.

Almost two years ago, the MHCU Initiative launched an Improvement and Learning Network with a vision that of providing members of the Network transformational concepts that they would apply and turn into actions that could work at scale and be shared with others seeking better ways of optimizing family well-being by addressing the social influences on health. Communities that participated in the Moving HealthCare Upstream Improvement and Learning Network set out to design and test innovative care concepts that enable organizations from different sectors to work as a single system to improve family health and social outcomes. We did not have a set of solutions that could readily be adopted. We started with ideas that had strong evidence in other contexts for managing the care of families with chronic conditions, but had not yet been well tested in community systems for addressing family well-being. [Read more…]

New Academic Pediatrics Issue Features Building Community Resilience

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Written by Wendy Ellis, DrPH(C), MPH. Project Director of Building Community Resilience.

Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.

The Building Community Resilience Pair of ACEs tree image grew out our need to illustrate the relationship between adversity within a family and adversity within a community. [Read more…]

Nemours Children’s Health System Reflects on the Journey from Volume to Value

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Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.

In health care and in life, we need to match incentives and expectations. When I was younger, one of my chores was to help empty the dishwasher – I was responsible for the bottom and my sister for the top. The chore was not complete – and the allowance was not received – until both of us completed our parts. It was actually pretty ingenious on my parents’ part; I learned it is not only important to complete my key function of emptying the bottom rack, but also that it made sense to support my sister in completing her key function because it led to a better outcome for both of us. [Read more…]

Medicaid Prevention Pathways: A New Toolkit Developed By Nemours

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Disclaimer: Moving Health Care Upstream is a collaborative effort co-led by Nemours Children’s Health System (Nemours) and the Center for Healthier Children, Families & Communities at the University of California- Los Angeles (UCLA). The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of Nemours, UCLA or the Moving Health Care Upstream initiative.

Nemours is excited to release a new toolkit titled “Medicaid Prevention Pathways”—developed with funding from the Robert Wood Johnson Foundation—for state Medicaid officials and managed care organizations (MCOs) with Medicaid and Children’s Health Insurance Program (CHIP) enrollees. One of the key tools is a Roadmap that illustrates the range of Medicaid and CHIP options that states can use to sustain approaches that link traditional clinical preventive care with community-based initiatives (“clinic to community”) to address chronic disease, and how best to successfully put these strategies in place on the ground. The Roadmap demonstrates through examples how states have extensive flexibility under current law to finance these strategies through Medicaid and CHIP for preventing chronic disease, including childhood obesity, at both the individual and population levels. [Read more…]

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