December 3, 2013

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The United States spends $2.7 trillion on health care each year; approximately 60% of this health care spending is a result of people’s behaviors and their environment, which are shaped by where they live, work, and play; the food they eat; the amount of exercise they get; and other everyday choices that they make.

The Summit brought together State and national leaders to discuss opportunities to advance population health in New York State and provide insight into public health approaches. Presenters offered recommendations on how stakeholders from various sectors, including health systems, health insurers, businesses, local public health departments, and community-based organizations, can work together to improve health and eliminate health disparities and inequities in health status based on race, ethnicity, language, cultural background, gender identity, and disability status. There was a focus on the social determinants of health, such as income, employment status, and educational background, as important underlying factors impacting health.

The first panel, moderated by NYHealth President and CEO James R. Knickman, set the stage for the discussion by reviewing current NYSDOH initiatives, the role of public health in population health, and the importance of stakeholders from all sectors in a partnership approach.

Dr. Nirav R. Shah, Commissioner of the New York State Department of Health, gave an overview of what it takes to ensure that people and communities are healthy and that this depends on having access to all aspects of public health, including community-based services, safe neighborhoods, access to healthy foods, and supportive housing. He highlighted the State’s Prevention Agenda 2013–2017 as the blueprint for action for all stakeholders. The underlying principles of the Prevention Agenda 2013–2017 are that addressing health disparities and the underlying social determinants of health are necessary steps to improving health status. Dr. Shah outlined three interlinked components to make this happen: prevention, population health, and partnerships.

Dr. Jeffrey Levi, Executive Director of the Trust for America’s Health, offered a national perspective on population health. He stressed that communities, in addition to local, state, and federal governments, need to support population health efforts—without the support and involvement of the community, any efforts to improve population health will fail.

Dr. Thomas Farley, Commissioner of the New York City Department of Health and Mental Hygiene, presented data demonstrating that environmental interventions, such as the Clean Air Act, are the most important factors in improving population health. Environmental interventions are more cost-effective as compared to clinical interventions. Dr. Farely outlined how his department has worked with hospitals and other stakeholders in the Take Care New York initiative.

Daniel Sisto, former President of the Healthcare Association of New York State, offered the hospital perspective on population health and described the new reality that hospitals face—the need to lower health care costs, reduced inpatient services, and increased need for primary care services will mean hospitals must operate under new business models or run the risk of becoming obsolete. Hospitals must engage their communities to understand their health needs and to be a force for environmental and policy change.

Following the first panel, Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention, participated in a conversation moderated by Dr. Richard Besser, ABC News. The conversation centered around which stakeholders need to be involved in population health and the necessity of getting all the key parts of a community involved. Dr. Frieden also answered questions from the audience on a range of topics, including media involvement in public health efforts, how to address the State’s prescription drug abuse epidemic, and gun control as a public health issue.

A second panel, moderated by Dr. Jo Ivey Boufford, President, New York Academy of Medicine, focused on two local efforts in New York to engage stakeholders in partnerships to improve public health. Dr. Boufford gave an overview of the Prevention Agenda 2013–2017, which provides a blueprint for local community action to improve health and address health disparities across the State. Panelists representing two community-based efforts—one in Syracuse and one in the Bronx—discussed their different approaches and how they formed partnerships with stakeholders.

The afternoon session began with a legislative panel discussion, moderated by Dr. Shah, with Senator Kemp Hannon, Chair of the New York Standing Committee on Health, and Assemblymember Richard Gottfried, Chair of the Assembly Health Committee. Senator Hannon and Assemblymember Gottfried discussed the role that the public sector can play in population health, what factors are necessary to improving the social determinants of health, and how policy can help build resilient communities.  They reviewed the legislature’s role in improving population health and their roles as the health leaders in the legislature to encourage a health-in-all-policies approach to policymaking on many legislative committees.

The final panel of the afternoon, moderated by Dr. Jeremy Nobel, Medical Director, Northeast Business Group on Health, focused on the role of employers in population health and what businesses can do to improve employee health and reduce health care costs. Fikry Isaac, Vice President of Global Health Services at Johnson and Johnson; Jeffrey Kraut, Senior Vice President of Strategy and Business Informatics at North Shore-Long Island Jewish Health System; and Dr. Kyu Rhee, Vice President of IBM Integrated Health Services described health initiatives at their companies and what role employers can take in advancing a culture of health in the workplace. Andy Stern, former President of the Service Employees International Union, explained the impact that health has on the performance and productivity of the workforce, and how poor health affects not just the individuals, but the companies they work for.  He challenged businesses to make their wellness programs focus on positive incentives and not inadvertently penalize some employees.

Dr. Knickman offered closing remarks and summarized the key themes of the summit, including the need for evidence-based interventions and the need to build up the evidence; the importance of strong partnerships and collaborations across many sectors; the need to put communities at the forefront of population initiatives as they are the engines that drive the “culture of health”; and the importance of addressing income and other social inequities, which are some of the main contributors to poor health in communities.

Support for the event was also provided by the Healthcare Association of New York State, the Greater New York Hospital Association, the Community Health Care Association of New York State, the New York Academy of Medicine, the New York State Association of County Health Officials, the New York City Department of Health and Mental Hygiene, and Health Research Incorporated.


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