1. A Health System’s Approach to Healthcare Disparity: Populations, Pipelines and Partners Barry D. Mann, MD Chief Academic Officer, Main Line Health May 6, 2015

2. 2 Our Geography

3. MLH Non-MLH Acute Hospitals Created July 2012 19301 1931219333 19087 19406 19405 19428 19085 19035 19010 19073 19008 19063 19064 19026 19083 19096 19004 19072 19041 19003 19066 Riddle Hospital Paoli Hospital Bryn Mawr Hospital Lankenau Medical Center Chester County Montgomery County * Used for the Community Health Needs Assessment Delaware County Philadelphia County Main Line Health: Our Geography and Service Area

4. The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code 4 Geography & Income

5. The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code 5 Geography & Income

6. The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code 6 Geography & Income

7. The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code 7 Geography & Income Philadelphia - 67 th Montgomery – 2nd

8. County Health Rankings for Pennsylvania: Health Outcomes* * Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute Philadelphia - 67 th Montgomery - 5 th LMC Bucks – 10 th Delaware - 41 st New Jersey Health Status Source: PHMC Southeastern Pennsylvania Household Health Survey, 2010. Adults Self-reported Health Status – Fair Or Poor LMC serves both relatively healthy and unhealthy populations: Montgomery County ranked 5th and Philadelphia County ranked last at 67 th in the State. A greater percent of persons in the Urban West area report having poorer health as compared to other LMC areas and Southeastern PA (SEPA). 8 The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code Health Outcomes : 50% Length of Life & 50% Quality of Life

9. County Health Rankings for Pennsylvania: Health Outcomes* * Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute Philadelphia - 67 th Montgomery - 5 th LMC Bucks – 10 th Delaware - 41 st New Jersey Health Status Source: PHMC Southeastern Pennsylvania Household Health Survey, 2010. Adults Self-reported Health Status – Fair Or Poor LMC serves both relatively healthy and unhealthy populations: Montgomery County ranked 5th and Philadelphia County ranked last at 67 th in the State. A greater percent of persons in the Urban West area report having poorer health as compared to other LMC areas and Southeastern PA (SEPA). 9 The 67 th vs. the 5 th : Your zip code is more powerful that your genetic code Health Outcomes : 50% Length of Life & 50% Quality of Life

10. 10 Lankenau Medical Center: Addressing the health needs of our most vulnerable populations Lankenau Medical Associates –West Philadelphia –28% uninsured. –median income = $29,107 –college degree - 25.8% –> ½  difficulty making housing payments –¼ reduce size of meal due to cost –32% “cost is a major barrier to health care”

11. 11 Lankenau Medical Center: Addressing the health needs of our most vulnerable populations Lankenau Medical Associates –West Philadelphia –28% uninsured. –median income = $29,107 –college degree - 25.8% –> ½  difficulty making housing payments –¼ reduce size of meal due to cost –32% “cost is a major barrier to health care” LMA  Patient-Centered Medical Home

12. Education LevelProjectPartners Graduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine High SchoolAnnenberg Science Symposium 16 regional high schools High SchoolHealth Career Academy4 high schools 4 medical schools High SchoolHealth Career AcademyAtlanta Houston ElementaryHealth Education Center Lankenau ElementaryHealthy MeChester/Upland School District Widener University Rising High School Students MLH-WCU Sumer Science Academy West Chester University Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

13. Education LevelProjectPartners Graduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine High SchoolAnnenberg Science Symposium 16 regional high schools High SchoolHealth Career Academy4 high schools 4 medical schools High SchoolHealth Career AcademyAtlanta Houston ElementaryHealth Education Center Lankenau ElementaryHealthy MeChester/Upland School District Widener University Rising High School Students MLH-WCU Sumer Science Academy West Chester University Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

14. Do we practice with disparities of care? 14 Project Residencies Fellowships Medical Student Health Advocates Annenberg Science Symposium Health Career Academy MLH-WCU Sumer Science Academy Healthy Me Health Education Center Nursing Student Health Advocates Healthcare Disparities Colloquium

15. 15 Private practice LMC Clinic Healthcare Disparities Colloquium

16. 16 Hematology-Oncology Gastroenterology: Medicine Private practice LMC Clinic Healthcare Disparities Colloquium Cardiology

17. 17 Hematology-Oncology Gastroenterology: Medicine Private practice Diagnosis to Treatment Surveillance Colonoscopy Surveillance Mammography LMC Clinic Healthcare Disparities Colloquium Cardiology AICD Referral

18. 18 Hematology-Oncology Diagnosis to Treatment Cardiology AICD Referral Gastroenterology: Surveillance Colonoscopy Medicine Surveillance Mammography Race Ethnicity Gender Age Sexual Orientation Healthcare Disparities Colloquium

19. 19 Hematology-Oncology Diagnosis to Treatment Cardiology AICD Referral Gastroenterology: Surveillance Colonoscopy Medicine Surveillance Mammography Race Ethnicity Gender Age Sexual Orientation Healthcare Disparities Colloquium + Socioeconomic Status

20. Strategy: Can we assist our patients of lower socio-economic status by resolving non-medical barriers to care? 20 Project Residencies Fellowships Medical Student Health Advocates Annenberg Science Symposium Health Career Academy MLH-WCU Sumer Science Academy Healthy Me Health Education Center Nursing Student Health Advocates Healthcare Disparities Colloquium

21. 21 Lankenau Medical Student Health Advocates Program Addressing Non- Medical Barriers to Care

22. PARTNERPARTNER Philadelphia College of Osteopathic Medicine (PCOM)

23.  Food assistance  Commodities  Childcare  Utilities  Adult education  Health insurance  Public benefits  Housing  Job training  Smoking cessation non-medical barriers to care

24. 24

25. Patients: –325 Encounters –550 *Many patients have multiple needs for follow-up Outcomes?

26. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementaryHealthy MeChester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

27. Outreach: Annenberg High School Science Symposium

29. Symposium Elements Research a Topic Link with Hospital Liaison Presentation –Didactic –Creative Arts –Ethical Principles Collaboration (as opposed to individual achievement) 29

30. P B L L L P L B P L R 16 high schools 11 years 2,500 students Annenberg Science Symposium at Main Line Health

31. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementaryHealthy MeChester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

32. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementaryHealthy MeChester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

33. L L Health Career Academy O

34. 10 th grade Emergency Room Theme –Emergency Room Scenarios –Risky Behaviors Health Career Academy

35. L L

36. PARTNERSPARTNERS Lankenau / PCOM Overbrook High School West Catholic Temple Univ. School Of Medicine Lincoln High School Jefferson Medical College Chester High School Drexel Univ. School of Medicine M. L. King High School

37. PARTNERSPARTNERS

38. 11 th grade Public Health-Related Modules –Nutrition/Obesity/Diabetes –Hypertension/Heart Disease –HIV/STIs –Cancer Screening –Trauma and Violence Prevention Health Career Academy

39. 12 th grade Health Career Academy Community Health Needs Assessment Health Fair for Community

40. 40

41. 41 Outcomes? Health Career Academy

42. 42 Health Career Academy MLK Graduation Rate 54%

43. 43 Health Career Academy MLK Graduation Rate 54% 100 %

44. 44 Outcomes: Impact on the Medical Students

45. Atlanta

46. 46

47. Atlanta Houston Cultural Adaptation of the Health Career Academy for Hispanic Youth and Partnership Development in Houston, TX

48. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementaryHealthy MeChester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

49. Lankenau’s Health Education Center: putting children on the correct path 49

50. 50 Over 20 years of serving children and families Last year: 7,000 visitors 175 classes General health Nutrition Fitness, Substance abuse Safety Bullying Health Education Center regional resource promoting health and wellness

51. 51 Over 20 years of serving children and families Health Education Center regional resource promoting health and wellness 509 schools 220,00 visitors

52. 52 Delema G. Deaver Wellness Garden

53. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementary Healthy Me Chester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

54. Widener University Stetser Elementary

55. 55 Healthy Me, Chester

56. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementary Healthy Me Chester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

57. PARTNERPARTNER West Chester University

58. Special thanks to

59. Coming Soon… 59

60. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementary Healthy Me Chester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

61. Main Line Health + Villanova Nursing Nursing Health Advocates Visiting Low-Income Mothers to Improve Child Development 61

62. PhilanthropyEducation LevelProjectPartners AnnenbergGraduate Medical Education Residencies Fellowships MLH-Graduate Medical Education Pennsylvania Dept of Health Undergraduate Medical Education Medical Student Health Advocates Philadelphia College of Osteopathic Medicine MerckHigh SchoolAnnenberg Science Symposium 16 regional high schools AetnaHigh SchoolHealth Career Academy4 high schools 4 medical schools AetnaHigh SchoolHealth Career AcademyAtlanta Houston DeaverElementaryHealth Education Center Lankenau ElsevierElementary Healthy Me Chester/Upland School District Widener University Elsevier/PharmaRising High School Students MLH-WCU Sumer Science Academy West Chester University PROPOSED: Women’s Board Peri-partum, Early Childhood Nursing Student Health Advocates Villanova University The Impact of Philanthropy on Education and Disparities

63. Thank you!