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Mayo Clinic Medical Science Blog – an eclectic collection of research- and research education-related stories: feature stories, mini news bites, learning opportunities, profiles and more from Mayo Clinic.

May 8, 2015

Bridging Health Care Delivery and Community Health – An Opportunity to Reduce Health Disparities?

By Elizabeth Zimmermann



Amenah Agunwamba, Sc.D., is a Health Sciences Research Fellow in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
Last month, I and 1,500 other researchers and clinicians from across more than 20 different disciplines, convened in San Antonio for the Society of Behavioral Medicine’s 36th Annual Meeting.sbm1

Chaired by Dr. Lila Finney Rutten, who is also the scientific director for the Population Health Science Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, the conference focused on “Advancing the National Prevention Strategy through Behavioral Medicine Innovation” with specific attention to promoting population health through community health efforts and research.

On planning the event, Dr. Rutten said: “The Program Committee and our SBM President, Dr. Lisa Klesges, worked very hard to identify plenary speakers who could speak to the larger social issues that unite the multidisciplinary perspectives at SBM around the shared goal of improving population health.”

True to her words, the meeting covered critical issues in population health and medicine. As a social epidemiologist, I found myself in familiar territory – presentation topics ranged from communicating about social determinants of health to tobacco and stress to racial/ethnic disparities in health care. I found several presentations to be particularly insightful, and that resonated well with my own research on health disparities.

The Minnesota Commissioner of Health, Edward Ehlinger, M.D., delivered a significant charge in his keynote address to change the narrative about what creates health. He stressed that to advance health equity and address health disparities, clinicians and researchers needed to expand the dialogue from a focus on access to care to an understanding on how socio-environmental factors also play an important role in creating health. Providing insights on how neighborhood factors and adverse childhood experiences in early life impact life expectancy, he argued that policies needed to include these critical determinants of health.

Disparities between racial/ethnic minorities, rich and poor, persist and even widen in one of the world’s richest and most powerful nations; a reality check that collides with the myth of an American dream of opportunity and mobility. Dr. Ehlinger cited how Minnesota is making some strides in addressing these gaps by increasing the minimum wage, an example of how income inequalities would no longer be accepted.

But there is much work to be done – in Minnesota and around the world.

After Ehlinger’s talk, Dr. Akochi Agunwamba, a family medicine physician at the Mayo Clinic Health System location in Belle Plaine, Minnesota, raised the issues he faces daily with his patients in trying to consider the underlying socio-economic factors that play a role in their treatment, and his desire to provide holistic care within time-constraints.

I have often found myself discussing these same issues with clinicians, especially the Population Health Science Scholars. How can we bridge the gap between what happens in a clinical setting and what’s happening in the community? Perhaps recognition that a patient’s context matters, is the first critical step.

Dr. Judith Ockene from the University of Massachusetts Medical School, delivered a Master Lecture wherein she discussed how to build strong, trusting relationships with patients by communicating about social and behavioral concepts, and linking clinical teams to community resources. Essential to meeting patient needs, Dr. Ockene advocated that a connection be made between clinicians and community groups.

The Kern Center has, and is expanding, efforts to include more community involvement in our research. “There is growing recognition within the clinical community that health is shaped in large part by factors outside the clinical encounter.” Dr. Rutten says, “The Kern Center, and its Population Health Science Program, is heavily involved in research and professional activities that emphasize the multiple determinants of health, including behavioral, social, and environmental influences.”

Dr. Rutten also emphasizes how Mayo Clinic’s role as a founding member of the Institute of Medicine’s Round Table on Population Health Improvement shows commitment to moving the national discussion of health toward one that acknowledges the need for multi-sector engagement to change the environments that support health and health behavior.

sbm2In fact, Mayo Clinic clinicians and researchers are actively producing significant work relevant to community health, some of which was presented at SBM (read more about Mayo’s presence at SBM 2015). For her strong leadership, achievements and service, Dr. Rutten received the C. Tracy Orleans Distinguished Service Award at the conference as well.

Several other Kern Center Population Health Scholars and faculty are also leading the way. Dr. Jane Njeru’s commitment to understanding the needs of the Somali community in Rochester, Minnesota, and Dr. Brian Lynch’s work in the local schools, Olmsted County Public Health Services, and Community Education on collaborative research efforts aimed at reducing childhood obesity, are perfect examples of clinicians working in and dedicated to community health. Additionally, Dr. Robert Jacobson works with local schools on childhood vaccination.

While I and my colleagues at Mayo Clinic claiming a research focus in social epidemiology form a small group, we find it an exciting and compelling time to be collaborating with clinicians on innovative community health efforts. It is here, at the intersection of health care delivery and community health, where progress is promising in addressing critical health disparities and creating better population health.

So, let’s build this bridge!


To learn more about current research and obtain ideas for practice application, consider attending Mayo Clinic’s Delivery Science Summit, September 16-18, 2015, in Rochester, Minnesota.

Tags: About, Center for the Science of Health Care Delivery, Events, Lila Rutten

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