1. Health Disparities Groups II & III Karen Anderson David Hui Woong Chae Daniel Dohan Malo Hutson Kathleen Klink SreyRam Kuy Gareth Warren

2. 1) Public Policy Problem The disconnect between academic medical centers and underserved communities has consequences for health disparities.

3. Dimensions of the problem Many academic medical centers (AMC) are surrounded by underserved and disadvantaged communities. Many AMC are seeking to physically expand in ways that impact their surrounding communities causing conflicts and disparities. Individuals in underserved and disadvantaged communities often lack high-quality, accessible primary health care. There is a need for more cultural sensitivity and linguistic capability among healthcare providers. There is economic segregation within surrounding communities. Lack of investment in local infrastructure, built environment, human capital and social services

4. 2) Rationale for Pursuing this Problem “Actionable determinants of health…such as environment and social factors disproportionately affect national health.” Schroeder, NEJM 2007 The contrast between the resource-rich AMC and resource-poor surrounding communities provide the foundation for a demonstration project in reducing disparities in health and healthcare.

5. 3) Stakeholders and Their Positions Medical institutions: hospitals, AMC, schools of medicine/nursing/public health City agencies, e.g. dept planning, workforce economic development, public health, transportation, police, housing Community-centered organizations, e.g. community development corporations, community-based organizations Professional organizations and associations: AMA, AAMC, state nursing associations Federal agencies: HRSA, CMS, HUD, AHRQ, CDC, NIH Social service, training and faith-based agencies, e.g. Jewish Vocational Services Foundations: eg RWJ, Commonwealth, March of Dimes, local foundations Local residents, community leaders, doctors, businesses, churches Local politicians, private developers, Chambers of Commerce

6. 4) Action Plan Public-private partnership leads to convergence of goals regarding AMC expansion and community development Stakeholders work together to develop consensus on a community benefit agreement (documented via report) Pilot/demo project using Title VII funds to show benefit for health and healthcare outcomes Long term: tie Medicare reimbursement to improvement in actionable social or health indicators that are measureable