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Issue #23                                                    November 2015 
MGH Community Health Needs Assessment
Assessment priorities unveiled
 
Substance use, particularly the opioid epidemic, and public safety/crime and violence, remain the top two health issues for Chelsea, Revere and Charlestown, according to the 2015 Community Health Needs Assessment conducted by CCHI. In 2015, 80 percent of survey respondents chose substance use as their top health concern, up from 70 percent in 2012. Obesity/poor diet and inactivity continue to be important priorities, followed closely by adolescent mental health as an emerging health concern. Education, the environment and housing, all of which are social determinants of health, are also of concern for many residents. Read more about the 2015 assessment and the implementation plans   here .

 
 MGH participating in Boston city-wide assessment effort


Through the Conference of Boston Teaching Hospitals (COBTH), Boston hospitals and community partners are planning to collaborate around some aspects of community health needs assessments in 2016. All hospitals are required to conduct CHNAs every three years. In addition to the hospitals , the Boston Public Health Commission, the Boston Alliance for Community Health, Health Resources in Action, the Metropolitan Area Planning Council and others are partners in this effort. The goal is to collect some data together and to determine a community health issue for all partners to tackle together based on the data. Ultimately, the group would like a shared data platform that would be accessible to all community partners. Despite just having completed an assessment in 2015, MGH will revisit assessment in 2016 to align with the COBTH assessment process.
Youth Development
MGH Youth Scholars tour colleges in Mass, NH
   
The MGH Youth Scholars are on the road this fall visiting colleges and universities to help them decide where to apply. MGH Youth Programs staff accompanied students and their parents at UMass Amherst Open House activities last month. Students were given a private tour at UMass Boston, where they met Chancellor Dr. Keith Motley. More than 20 10th, 11th and 12th grade Youth Scholars visited the University of New Hampshire and Dartmouth College (pictured here) on November 11. At UNH the students met with the local chapter of the National Society of Black Engineers and heard about student life at that campus.       
Community Health Worker/Navigation
Integrated Care Management Program pilot underway at MGH Chelsea
   
MGH's Integrated Care Management Program (iCMP) has a strong record in providing multi-disciplinary care teams to manage the care of medically-complex Medicare patients. This year, as iCMP assumes risk for complex MassHealth patients through Neighborhood Health Plan, they are partnering with CCHI at MGH Chelsea to test incorporating community health workers into the care team. Twenty patients are enrolled in the iCMP pilot with a community health worker (CHW) who will evaluate patient outcomes. The CHWs help patients overcome any barriers to meeting their health goals. For example, if they experience food insecurity, the CHWs refer patients to the food pantry at MGH Chelsea. CHWs remind patients of appointments, and even accompany patients if necessary. Thus far the outcomes are positive for the patients enrolled in the pilot. No-show rates are down, and the patients are meeting their health goals. CHWs Mary Egan, Pep Silvestre and their manager Erica Guimaraes are pictured here.  


Community Coalitions: Substance Use Disorders 
Charlestown and Revere hold candlelight vigils

As part of National Recovery Month, hundreds of community members gathered in Charlestown at Hayes Square and at the Revere Beach Bandstand to remember those who lost their lives due to substance use disorders, and to give hope to those struggling with the disease. The Charlestown Substance Abuse and Revere CARES community coalitions help sponsor the vigils so that individuals and families who lost a loved one know that they are part of a larger family. At the recent Revere Beach Memorial, a mother kneels to comfort her son as they both remember a loved one.  

S ubstance Use Prevention
Great American Smokeout events held at MGH Health Centers
In Massachusetts, Tobacco-Free Kids estimates that each year 9,300 adults die prematurely from smoking. Smoking rates are higher in Chelsea, Charlestown and Revere than in Massachusetts. November 19th was Great American Smokeout Day across the country, and MGH Community Health Associates held events at MGH Health Centers. At Living TOBACCO-FREE information tables in the Revere and Chelsea health centers, more than 100 patients picked up Quit Kits for themselves and for their relatives. More than 200 health center providers and staff wore buttons (pictured) in English and in Spanish to encourage a conversation between providers and their patients about quitting smoking.
Executive Committee on Community Health
Emilio Carrillo, MD, MPH, Vice President, New York-Presbyterian Hospital, presents to ECOCH
Dr. Emilio Carillo, Vice President of Community Health at New York Presbyterian, presented to the Executive Committee on Community Health on a population health management approach to caring for a neighborhood of 250,000 in northern Manhattan, where residents are primarily from Central America.

After completing a community health needs assessment, the hospital created a network of patient-centered medical homes, developed patient registries, and incorporated community health workers as part of the care team. A paper published in Health Affairs shows significant decreases in emergency department utilization and inpatient hospitalization.

This talk was part of a series that ECOCH is hosting during the coming year. 
For further information please go to our website www.massgeneral.org/cchi