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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!”
CVP in Review 10
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.
11 CVP in Review
An iterative process ensures we continuously learn and refine ideas with our partners.
ITERATIVE PROCESS
12 CVP in Review
CVP in Review 13
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.
CVP in Review
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.
16 CVP in Review
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.
17 CVP in Review
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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20
HOW HAS OUR FACULTY GROWN?
Our faculty numbers have grown steadily overthe last 10 years.
CVP in Review
31 Faculty membersin 2017
21
HOW MANY PAPERS HAVE WE PUBLISHED?
CVP in Review
CVP in Review 22
CVP in Review 23
~115 Grants
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Grant and philanthropic funding to core faculty since joining CVP
HOW MUCH FUNDING HAVE WE RAISED?
CVP in Review
$100 Million
CVP in Review 25
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.
26 CVP in Review
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.
27 CVP in Review
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.
28 CVP in Review
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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31
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.
CVP in Review
CVP Core Faculty
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CVP Associate Faculty
33 CVP in Review
CVP Affiliate Faculty
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CVP Staff
35 CVP in Review
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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