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 Our Geography

MLH Non-MLH Acute Hospitals Created July 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

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

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

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

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

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, 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

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, 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 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 % –> ½  difficulty making housing payments –¼ reduce size of meal due to cost –32% “cost is a major barrier to health care”

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 % –> 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

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

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

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 Private practice LMC Clinic Healthcare Disparities Colloquium

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

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

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 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

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

PARTNERPARTNER Philadelphia College of Osteopathic Medicine (PCOM)

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

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

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

Outreach: Annenberg High School Science Symposium

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

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

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

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

L L Health Career Academy O

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

L L

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

PARTNERSPARTNERS

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

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

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41 Outcomes? Health Career Academy

42 Health Career Academy MLK Graduation Rate 54%

43 Health Career Academy MLK Graduation Rate 54% 100 %

44 Outcomes: Impact on the Medical Students

Atlanta

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

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

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

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

52 Delema G. Deaver Wellness Garden

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

Widener University Stetser Elementary

55 Healthy Me, Chester

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

PARTNERPARTNER West Chester University

Special thanks to

Coming Soon… 59

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

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

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

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