As 2020-2021 has painfully illustrated, deep inequities in our nation persist and are growing. Systemic racial and issues related to race and economics deeply impact the ability of individuals and groups to access health care, benefit from healthy environments and practice healthy habits that help them prevent and manage potentially damaging conditions.
Part of the University of California Health (UCH) approach to addressing health disparities is through population health initiatives and collaboration across health centers to make our efforts more effective. These initiatives are aimed at breaking down issues that make it harder for certain populations to have similar health outcomes as others for the same health condition.
At University of California Health, we embrace what is known as the “triple aim.” These are three connected goals to improve people’s individual care experiences, reduce the average per person cost of care and build healthier communities more equally across the State.
Using Data to Improve a Population’s Health
With six academic health centers, UCH sees nearly two million unique patients a year across a variety of patient populations and regions of California. With multiple experts in different disciplines, we use this large volume of data to spot trends across groups of patients — and health conditions — by studying anonymous data about their experiences and outcomes.
The U.S. health care system is the most costly in the world and accounts for a growing percentage of the gross national product. This trend is economically unsustainable and has not led to significant improvements in individual or community health.
Reducing a patient's cost of care cannot be achieved by shifting the cost to other payors, such as employers or the government. Improved coordination of care, for example, can reduce unnecessary expenditures while also improving patient satisfaction and clinical outcomes. Through our practice of analyzing data and sharing best practices across UCH, we are striving for optimal individual outcomes that reduce costs associated with process inefficiencies and waste.
How Where You Live Affects Your Health
To better target opportunities for improving health, UCH is investigating the effects of where someone lives on their health. This work uses models such as the Area Deprivation Index (ADI), California Healthy Places Index (HPI) and the Centers for Disease Control and Prevention’s Social Vulnerability Index (SVI).
When combined with health data from our academic health centers, these models identify areas with significant gaps in health and areas that would especially struggle to recover from public health emergencies.
Using these health data insights, we can determine how multiple factors contribute to our patients’ health. These include neighborhood characteristics such as access to healthy foods, socioeconomic factors like area unemployment or segregation, air quality and other environmental exposures and even the convenience of the nearest pharmacy. And, drawing upon experiences of natural disasters and public health crises, California’s public hospital system can respond more effectively in emergency response and crisis recovery efforts.
We use this information across the UCH system to improve management of chronic conditions, such as diabetes and high blood pressure, and increase our preparedness for the unexpected.
UCH Population Health Initiatives
Using Research to Inform Patient Care
The research capabilities of UC and UCH were at the forefront of our response to COVID-19. We developed a secure HIPAA set of clinical information that researchers across the entire UC system used to rapidly compare treatment options from previous patients to help future patients. UCH also worked with the California Department of Public Health (CDPH) to create the COVID Modeling Consortium, a forum in which nearly 150 UC faculty work with CDPH modelers and public health experts to help inform the state’s pandemic response. All of these actions ultimately led to better outcomes in a fast-moving pandemic.
Providing Accessible Health Education and Training Across California
All UCH schools emphasize public service and caring for communities that have traditionally faced barriers to care or inadequate public health resources. One example is our UC Programs in Medical Education (UC PRIME) model. UC PRIME supplements medical school training with additional curriculum that helps prepare graduates to more effectively deliver care to and advocate for groups who do not regularly have access to quality care. UC PRIME also plays an important role as a social mobility ladder. The program encourages students from these same communities to pursue a medical degree: Sixty four percent of PRIME students are from groups underrepresented in medicine and many are first-generation college students.