March 2017

UCSF Center for Vulnerable Populations (CVP) in Review Dean Schillinger MD Professor of Medicine University of California San Francisco San Francisco General Hospital

1 Reducing Health Disparities and Addressing the Unmet

Health Needs of Vulnerable Groups!

Disclosure

Some of the content of this talk come from a textbook of the care of vulnerable patients that I am a co-author of (Schillinger)

Vulnerable Populations Defined

Vulnerable Populations are subgroups of

the larger population that, because of

social, economic, political, geographic,

structural and historical forces, are

exposed to “greater risk of risks”, and are

thereby at a disadvantage with respect to

their health and health care.

3 Mechanisms By Which Social Vulnerabilities Affect Health Outcomes

Schillinger et al 2017. McGraw-Hill

Common Social Vulnerabilities V iolence and trauma

U ninsured

L iteracy and Language

N eglect

E conomic hardship/food insecurity

R ace/ethnic discordance, discrimination

A ddiction

B rain disorders, e.g. depression, dementia

I mmigrant

L egal status

I solation/Informal caregiving burden

T ransportation problems

I llness Model

E yes and Ears

S helter

What are We Up Against? Reversing The Inverse Care Law

“Access to and quality of healthcare is inversely proportional to the needs of

the population”

- Tudor-Hart, 1971

Jerry Garcia

“Somebody has to do something, and it's just incredibly pathetic that it has to be us!”

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We engage in a broad scope of research and implementation projects that enable creative and innovative solutions to persistent health disparities and challenging problems in our community.

WHO WE ARE

Goals we share with the UCSF and San Francisco community:

§  We value health§  We embrace equity and diversity§  We promote innovation

WHAT DRIVES US

Everything we do is driven by the pursuit of health and health equity.

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An iterative process ensures we continuously learn and refine ideas with our partners.

ITERATIVE PROCESS

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We focus on a range of research areas to uncover more effective solutions.

AREAS OF FOCUS

Community

Health & Social Policy

Patient-Centered Care

NurturingPartnerships

We partner with change agents for scientific, policy, clinical care, and community health promotion initiatives

Multi-LevelPerspective

Our scientific inquiry reflects multiple influences on health throughout thelife-span

ResearchInnovationsWe develop rigorous methods to improve the relevance of science to populations and policies

Driving Awareness

We promote system changes that make health information more accessible to all using cutting-edge communication tools and technologies

ELEMENTS OF OUR APPROACH

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CVP CONCEPTUAL MODEL

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We bring a rigorous approach to three key focus areas that address a broad range of issues affecting vulnerable populations.

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CASE STUDY

In partnership with St Mary’s Center and an active community board, CVP is studying the causes and consequences of the growing population of people over 50 who experience homelessness.

The HOPE HOME study examines why older adults become homeless, what happens to their health, and what the best options are to improve housing stability and health.

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CASE STUDY

The campaign, a collaboration between CVP and Youth Speaks, pairs world-class youth poets and leading health professionals to change the diabetes conversation and instigate social action.

The Bigger Picture aims to end Type 2 diabetes in young people.

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CASE STUDY

In San Francisco, Berkeley, and Mexico, CVP faculty have studied the effectiveness of soda tax policies in preventing Type 2 diabetes, heart disease, and obesity.

CVP’s pioneering work on the health effects of sugar-sweetened beverages has extended from research to policy.

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Since our founding in 2006, CVP has grown tremendously—moving from a virtual center with just three faculty members to a brick-and-mortar center carrying out innovative research with broad impact locally, nationally, and internationally.

GROWTH

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HOW HAS OUR FACULTY GROWN?

Our faculty numbers have grown steadily overthe last 10 years.

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31 Faculty membersin 2017

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HOW MANY PAPERS HAVE WE PUBLISHED?

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~115 Grants

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Grant and philanthropic funding to core faculty since joining CVP

HOW MUCH FUNDING HAVE WE RAISED?

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$100 Million

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Federal Center Grants

CASE STUDY

Through research in the outpatient clinics at ZSFG, CVP’s Ambulatory Safety Center for Innovation (ASCENT) is designing, testing, and implementing technology and organizational solutions to make medical care safer.

CVP has created a network to share and collaborate on innovative practices among 21 public hospitals across California.

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CASE STUDY

EatSF was formed as a result of strong partnerships between CVP, the City and County of San Francisco, and community based organizations such as the Curry Senior Center.

EatSF is a healthy food program, providing low-income San Franciscans vouchers for free fruits and vegetables.

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CASE STUDY

Through activities at the institutional, faculty, and student levels, SF BUILD enables students from underrepresented groups in science to draw from their unique personal experiences to successfully pursue a career in biomedical research.

SF BUILD is a partnership between San Francisco State University and CVP to enhance the diversity of the biomedical research workforce.

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WHERE WE ARE

CVP is based at Zuckerberg San Francisco General Hospital, known as the heart of the city.

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176 Mentees by our core facultysince joining CVP

WHOM HAVE WE MENTORED?

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LOOKING AHEAD

Looking to the future, our priority is to deepen and expand our partnerships to achieve measurable health outcomes in San Francisco and beyond.

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CVP Core Faculty

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CVP Associate Faculty

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CVP Affiliate Faculty

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CVP Staff

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Melissa AkersTanushree Banerjee

Cissie BoniniClaudine Catledge

Roy CherianPamela CoxsonEugene FairleyJessica Fields

Sarah FineGato Gourley

David GuzmanAxel HerreraStephen King

Gem LeSarah LiskerBrookelle Li

Sanjana MarpadgaGeorge Matta

Laura MillerPamela OlsenStacy Osua

Joanne PenkoAlana PfeffingerClaudia Ponath

Jana PowellJudy Quan

Belkiz QuintanillaFrancisco Quintanilla

Nicholas RianoKate RadcliffeChristina Rios

Sophie RosenmossEric Steinbrook

Lina TieuGabriela VanegasPamela Williams

January 2017

Thank You!

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