For the 84 million Americans — that’s 1 in 3 adults—who have prediabetes, most do not even know that they have it. With prediabetes, blood sugar levels are higher than normal, greatly elevating the risk for type 2 diabetes, heart disease and stroke.

Prediabetes, however, can be reversed and presents a tremendous opportunity for prevention efforts. If caught early, simple lifestyle changes such as losing weight if you’re overweight, eating healthier, and exercise can have lasting results.

Because food insecurity at any level is associated with prediabetes in the US adult population, food insecure young adults are – and should be – targets for early clinical intervention.

Communities Lifting Communities (CLC), in partnership with the Ventura County Community Health Needs Assessment (CHNA) Collaborative, and HealthBegins, worked together to design an Upstream Quality Improvement Campaign to address diabetes and the social determinants of diabetes in Ventura County.

The Ventura County CHNA Collaborative consists of Adventist Health Simi Valley, Camarillo Healthcare District, Clinicas del Camino Real, Community Memorial Hospital, Gold Coast Health Plan, and the Ventura County Health Care Agency Departments of Public Health and Ambulatory Care.

Over a six-month period (August 2018 – January 2019), the pilot partnership helped stakeholders in Ventura County design targeted campaigns to better understand the diabetes population and chart a path toward meaningful data collection and measurable results.

To develop these targeted campaigns, known as Upstream Quality Improvement (QI) Campaigns, stakeholders receive facilitation, tools, training and technical assistance from HealthBegins, a consulting and technology firm dedicated to improving care and the social determinants of health. HealthBegins’ “Get Ready, Get Set, Go Upstream” framework provides hospital and community partners with an easy-to- follow structure for teams to utilize as they plan and implement their work.

“Healthcare is moving from a flat-earth to round-earth paradigm,” said Kathryn Stiles, director of community integration at Adventist Health Simi Valley. “Our high- energy collaborative is filled with great potential for the grassroots advocacy necessary to move this upstream effort forward.”

Quick start campaigns in Ventura County quickly realized that prediabetic adults should indeed be the priority population and identified food insecurity as the region’s social determinant of health.

A few early-win interventions highlighted the need to identify prediabetic patients in residency clinics, free clinics, case management populations, senior nutrition programs and patients referred to health education programs. Additionally, incorporating consistent data tracking such as Hunger Vital Signs Screening into workflows, electronic health records and intake forms was critical.

Erin Slack, an epidemiologist with the Ventura County Health Care Agency and chair of the Ventura County CHNA Collaborative, said, “Going upstream and tackling prediabetes is our greatest impact opportunity. Our ability to engage clinics, share data across health systems and expand resources is vital to this effort.”

She added, “Innovative new resources to address social needs are what our communities require most. Imagine being able to offer a prescription for food at a local Farmer’s Market.”

Moving forward, partners and stakeholder participants will continue to identify and improve processes and outcome measures in collaboration with community agencies. New education and training programs for clinical and front-line staff are being developed to improve workflow, and exciting new community-based food resource partnership opportunities are being explored to assist patients with tools that enhance healthy living.

The Communities Lifting Communities diabetes prevention and food security initiative focuses on developing and implementing a comprehensive community prevention strategy to address diabetes and the social determinants of diabetes.

FAST FACTS

• More than 100 million Americans live with diabetes (30.3 million) or prediabetes (84.1 million)
• Only 11.6 percent of adults with prediabetes knew they had it
• 1.5 million Americans are diagnosed with diabetes each year
• Diabetes is the seventh leading cause of death in the United States
• 25% of Americans 65 years or older have Type 1 or Type 2 diabetes
• $327 billion was the estimated total cost of diagnosed diabetes in the US in 2017

Sources: The Centers for Disease Control and Prevention; American Diabetes Association

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org.

A number of Southern California hospitals are taking action to help solve America’s food waste problem by offering food recovery programs that assist the needy and impoverished.

In 2016, Kaiser Permanente launched its Southern California Food Redistribution Initiative. As of today, 12 of its 15 hospitals are actively participating. The program began in 1989 when Kaiser’s Riverside facility first partnered with a local charity to feed those in need.

John Yamamoto, vice president of community health and government relations for Kaiser Permanente Southern California, said food rescue partnerships provide a simple solution that has a multipronged impact. “We are trying to extract the most value from the day-to-day function of serving food in order to address a community need, be good environmental stewards and reduce waste in our operations, which allows us to improve affordability for our patients,” he said.

Kaiser Permanente measures its community impact through pounds of food donated, carbon dioxide emmissions prevention, and number of meals provided.

Kaiser permanente Southern California Food Redistribution Initiative Results

Food Recovered
2017 = 74,892 LBS
2018 = 72,559 LBS

Meals Served
2017 = 62,410
2018 = 60,466

Greenhouse Gas Emissions Prevented
2017 = 40,666 LBS
2018 = 39,400 LBS

Kaiser Permanente’s food recovery program partners with local food rescue organizations. The Food Services Director at each campus acts as lead contact and is responsible for developing and coordinating a food pickup schedule, which can vary from daily pickup to a couple of days per week.

Employees support the program knowing the positive difference their work will have in increasing food access for those who are homeless or simply cannot afford a healthy nutritious meal.

Hospitals can simultaneously realize a financial savings by participating in a food recovery program. Specifically, reduced food waste can result in a hospital spending less on disposal fees to haul away food that is otherwise safe for consumption but can no longer be served or sold within a hospital.

“Simply put, it’s the right thing to do, with fewer barriers than most realize,” said Justin Joe, director of community health improvement with Providence Health & Services’ Little Company of Mary Medical Center in Torrance.

Two of Providence’s six hospitals are fully participating in food recovery and redistribution programs, with the rest of its facilities at varying stages of readiness and scaling up quickly.

Concerns about liability issues have created unnecessary barriers to program participation. In fact, both Congress and the California Legislature have enacted legislation that protect food donors from potential civil and criminal liability.

A hospital can partner with a local nonprofit organization or locate a third-party nonprofit food rescue organization that will pick up and deliver food to other agencies.

Both Kaiser Permanente and Providence have partnered with Food Finders, a multi-regional food bank and food rescue program headquartered in Lakewood.

On pickup days, a volunteer from Food Finders or a representative from the recipient agency picks up donations from the medical facilities and drives them directly to the agency. To curtail the program’s carbon footprint and foster connections within communities, food travels no more than a few miles.

Brief transportation times also help ensure that food remains at a safe temperature. Donations are covered and refrigerated prior to pickup and are either served immediately or refrigerated on arrival. Food Finders uses its own refrigerated trucks for larger deliveries.

Once delivered, agencies have the pleasure of serving fresh minestrone or lasagna to guests. And food service workers in the medical facilities, who would otherwise have disposed of this food, know that they have contributed to the health of their local community.

FAST FACTS

NATIONAL

• 42 million people in the US are food insecure An estimated 40 percent of food is wasted in the United States

CALIFORNIA

• 4.9 million Californians are food insecure
• 12 billion pounds of food waste are disposed in CA landfills each year

WASTED FOOD CONSUMES:

• 21% of all fresh water 18% of crop land
• 19% of all fertilizer
• 21% of all landfill volume

Employees support the program knowing the positive difference their work will have in increasing food access for those who are homeless or simply cannot afford a healthy nutritious meal.

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org.

Diabetes, heart disease and obesity are the top three health challenges facing adult residents of Martin Luther King, Jr. Community Hospital’s service area. But there’s another, non-medical factor that also negatively impacts the health and wellbeing of many who live in the South Los Angeles community and can aggravate the severity of their chronic medical conditions – food insecurity.

While doctors can prescribe medications and order treatments for diabetes, heart disease and obesity, there is no “prescription” to alleviate food insecurity. Or, there wasn’t until the hospital launched its “Recipe for Health” food program in March 2019 in partnership with its nonprofit affiliate MLK Community Medical Group.

The program is based on the idea that fresh, nutritious food is also an important medicine that can help heal the body. After being screened for the program, patients are given a food voucher, designed to look like a prescription, by their Medical Group doctor. Then, they bring the voucher to the hospital to pick up a package of fresh fruits and vegetables from the Food and Nutrition Services Department. The package, which is good for one week and can feed up to four people per household, also includes easy, healthful recipes.

“We wanted to provide a service that, by addressing our patients’ food insecurity, also helps their health needs,” said Lauren Espy, manager of community programs at Martin Luther King, Jr. Community Hospital. “It’s something that’s really needed in our community.”

South Los Angeles residents do not have widespread opportunities to make healthy food choices compared to other areas of Los Angeles County, and this has an adverse effect on their overall health. The community consistently has a high prevalence of chronic diseases. It also has the second-highest age-adjusted mortality rate in the county, with 726.6 deaths per 100,000 residents. This rate is 22.4% higher than the average for the county (593.5) and 50.3% higher than West Los Angeles, which had the lowest reported mortality rate of the county’s eight service planning areas. Additionally, South Los Angeles has higher mortality rates for almost all leading causes of death when compared to LA County and California overall.

To be eligible for the Recipe for Health program, patients must have one of the following chronic health conditions: prediabetes, diabetes, hypertension, heart disease or obesity – plus food insecurity.

In addition to receiving food vouchers, program participants can attend a variety of wellness classes, including a grocery store tour, cooking class or nutrition education class. The tours and classes are provided by the hospital’s program partners. Cedars-Sinai Health Habits Program offers the grocery store tours. LA Care’s Lynwood and Inglewood Family Resource Centers provide free health education and exercise classes and SEE-LA’s Pompea Smith Good Cooking/Buena Cocina Nutrition Education Program provides cooking classes at the farmer’s market it holds every Wednesday at the hospital.

To date, approximately 140 patients have enrolled in the program, 77 of whom are considered active participants. While it’s still too early to show data-driven results, there is anecdotal evidence that the program is effective. “People who work at the Medical Group say patients are telling them they find the program valuable,” Espy said. “They’re noticing that
their blood pressure levels are down. They’re saying they have more energy, which is helping them to cope better with everyday life. They’re definitely finding benefits in it.”

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org.

In many communities, hospitals are the only place where individuals experiencing homelessness can receive medical care. As California hospitals contend with the dramatic growth in homeless patients, they must comply with a new state
law (SB 1152) implemented in January 2019, which requires them to provide homeless patients a meal, clothing and vaccine screenings prior to discharge. Hospitals must also try to find homeless patients a bed at a safe destination, offer transportation and document the steps they have taken to do so.

Patients who are homeless, frail or live alone, or have unstable housing, can occupy hospital beds for weeks or months — long after their acute medical problem is resolved. Meanwhile, acutely ill patients may wait days in the emergency department (ED) to be moved to a floor because a hospital’s beds are full.

California has a staggering number of homeless people compared with the rest of the country. The state’s homeless population last year was almost 130,000, nearly a quarter of the national total. As the number of homeless people continues to grow, California hospitals are committed to doing even more to care for them by creating collaborative partnerships within their communities.

“All of us in the community – social service organizations, fire, ambulance, other providers – need to work together to provide better solutions for how we treat our most vulnerable patients, including the homeless and individuals with behavioral health issues,” said Joe Avelino, CEO of College Medical Center in Long Beach. “Only by working together can we develop and share truly effective best practices.”

College Medical Center is working hard to eliminate barriers that exist between first responders and medical providers. This includes building relationships and asking tough questions about how to improve care coordination at the local level.

Avelino personally visits local fire and police stations, asking, “What can we do better, and are we meeting your expectations?” As a result, College now prioritizes patients dropped off in the ED by Long Beach Police and Fire Departments to reduce wall times, allowing first responders to get back on the street faster. Other area social service organizations College collaborates with include Lutheran Social Services, The Salvation Army and the Long Beach Rescue Mission.

Additionally, College – and other California hospitals – are employing their electronic health records to streamline processes, using automated forms for admissions, transfers and warm hand-offs. Simple shifts such as including forward-thinking language in their transportation agreements and homeless patient checklists are showing great results.

College is also involved in an innovative collaboration with two other Long Beach area hospitals, Dignity Health St. Mary Medical Center and MemorialCare Long Beach Medical Center. Hospital representatives meet regularly to discuss new ways of delivering care to vulnerable patients.

“Working collaboratively with our community partners helps align our overall mission of ensuring that we
are providing quality care to our community,” said Carolyn Caldwell, President and CEO of Dignity Health St. Mary Medical Center. “We have found our working relationship with College Medical Center allows our teams to work toward ensuring that our patients are receiving the highest level of care in the appropriate setting.”

College also has begun partnering with an organization called ButterFLi to improve transportation opportunities for vulnerable patients no longer in need of acute medical care.

ButterFLi utilizes mobile and web technology, along with customer service representatives, to match service providers to customers. Unlike Uber and Lyft, users can book rides by phone — without downloading an app. ButterFLi partners can accommodate people who use wheelchairs or gurneys — or ambulatory riders. The service offers lower rates than traditional ambulance transportation businesses.

“The ButterFLi transportation program has proven invaluable to us,” said Avelino “This service grants us the peace of mind to trust that our patients are getting the warmest hand-off possible.”

ButterFLi is a HASC-endorsed business partner. For more information about ButterFLi, go to HASC’s website at http://hasc.org/endorsed-business- partners or contact Darryl Sanford, HASC’s Director of Member Relations and Association Services, at (213) 538-0772 or by email at dsanford@HASC.org.

Fast Facts

HOMELESSNESS IN CALIFORNIA

129,972 individuals

• 6,702 family households
• 10,836 veterans
• 12,396 unaccompanied young adults (aged 18-24)
• 34,332 individuals experiencing chronic homelessness

Figures are as of January 2018 and reflect individuals experiencing homelessness on any given day. Source: Continuums of Care Report to the U.S. Department of Housing and Urban Development

HOMELESS IN THE HOSPITAL

• Homeless patients made about 100,000 visits to California hospitals in 2017, up 28% from 2015.
• More than one-third of those visits involved a diagnosis of mental illness. By contrast, 6% of all hospital discharges in California during that time involved a mental health diagnosis.
• Los Angeles County, with 35,234, saw the most discharges involving homeless patients in 2017.

Source: The Office of Statewide Health Planning and Development

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org.

Huntington Hospital is partnering with its Pasadena neighbors—Young & Healthy and the Pasadena Unified School District—to spearhead Trauma-Informed Care, a program designed to address the impact trauma (both physical and emotional) has on the community’s well-being and healthcare in general.

Trauma-Informed Care is an approach that involves understanding, recognizing and responding to the effects of all types of trauma. It emphasizes physical, psychological and emotional safety for both patients and providers, and helps survivors rebuild a sense of control and empowerment.

Funded by the UniHealth Foundation through a multi-year grant, the Pasadena program is in its infancy, but early results are most promising. And all entities are committed to making it a success.

“This initiative seeks to reduce the prevalence of trauma in our community,” said Lori J. Morgan, MD, Huntington Hospital CEO. “Emotional trauma is increasingly recognized as a healthcare epidemic. Nearly 20% of all Americans have suffered levels of trauma that place them at higher risk for a large array of health problems ranging from severe obesity to heart disease to depression to suicide. A trauma-informed approach involves understanding how traumatic experiences and stress impact our patients, which enables us to respond appropriately and supportively.”

To date, Huntington has trained 3,400 employees and 200 physicians in all aspects of Trauma-Informed Care. It has become mandatory training for staff and part of orientation for all new hires. According to Cathi Chadwell, Executive Director of Philanthropy at Huntington Hospital, Trauma-Informed training began with the emergency room staff and has since become part of the workplace fabric. “This program is transforming the way we deliver heartfelt, compassionate care to our patients and their families,” Chadwell added.

The hospital’s medical staff, as well as community physicians, receive information about emotional trauma’s impacts on physical health, and how to strengthen care for patients who have experienced trauma.

FAST FACTS

CHILD ABUSE/NEGLECT

• About 1 in 7 children experienced child abuse and/or neglect in the last year
• Children living in poverty are 5 times more likely to experience child abuse and/or neglect
• $124 billion – estimated lifetime cost of child abuse
  and/or neglect

INTIMATE PARTNER VIOLENCE

• Nearly 1 in 5 women and about 1 in 7 men have experienced severe physical violence from an intimate partner
• About 1 in 5 women and 1 in 12 men have experienced contact sexual violence by an intimate partner
• 10% of women and 2% of men have been stalked by an intimate partner
• About 1 in 6 homicide victims are killed by an intimate partner
• $3.6 trillion – estimated lifetime cost of intimate partner violence

SEXUAL VIOLENCE

• Nearly 1 in 5 women and 1 in 38 men have experienced completed or attempted rape
• $122,461 per victim – estimated lifetime cost of rape

YOUTH VIOLENCE

• 1 in 5 high school students reported being bullied at school in the last year
• About 14 young people die from homicide every day
• More than $21 billion – estimated annual cost of youth violence

Source: Centers for Disease Control and Prevention

“This program is a tool for the hospital’s staff to understand a patient’s needs—particularly difficult and upset ones,” said Debora Jackson, the hospital’s Patient Relations and Customer Service Manager. “The staff training is impactful. We now have a better understanding of why some patients act the way they do and can treat them more appropriately.”

The school district plays a vital role in the success of Trauma-Informed Care. According to Ann Rector, Director of Health Programs with PUSD, all teachers and staff are being trained through a program entitled SCHOOL (Smiling Calm Hearts Open Our Learning) Kids Yoga & Mindfulness Training. She said the students’ world is changing rapidly due to social media postings that can be traumatic. In all, 27 schools have had training sessions for more than 600 teachers and support staff including nurses and psychologists.

“Bringing Trauma-Informed Care to the schools has helped us forge new pathways,” said Rector. “Many of our students come to school with challenges ranging from poverty to immigration issues. That’s a challenge for the teachers—helping students who have encountered trauma for most of their lives. Teachers need to provide positivity as opposed to punishment.”

Mary Donnelly-Crocker, Executive Director of Young & Healthy, a Pasadena non-profit agency that provides care for underserved children, agreed. She said that for many students acts of defiance are actually acts of self-preservation due to the traumas they have encountered. She also believes early childhood stress is an indicator of future outcomes and sees the schools as a key component in the program’s success.

“Aside from the home, children spend most of their time with their teachers,” Donnelly-Crocker said. “We need to shift the attitudes of teachers, and the school district is doing a terrific job of that. We need to forge new methodologies through the schools and pay attention to trouble signs. We need to lose the thought of what’s wrong with this child, and replace it with happened to them in their lives to cause them to act this way.”

Through their efforts in implementing Trauma-Informed Care, the three organizations are working closely together to make the Pasadena community stronger and emotionally healthier.

For additional information about Communities Lifting Communities, contact Karen Ochoa, CLC Project Manager, at (213) 538-0765 or kochoa@hasc.org.

Close to 70 attendees joined HASC President/CEO George W. Greene, Communities Lifting Communities (CLC) Executive Director Susan Harrington and a slate of expert speakers at the Jan. 24 launch of  Cherished Futures for Black Moms & Babies.

Held at Good Samaritan Hospital in Los Angeles, the event went beyond a ceremonial kickoff with deep discussion on the issues impacting African-American moms that create significant contrasts in maternal and birth outcomes across color lines.

Dr. Deborah Allen of the Los Angeles County Department of Public Health outlined the social and cultural influences that hit communities of color that can produce elevated infant mortality and other negative health outcomes for moms and babies.

Finding innovative solutions to support employees during the COVID-19 pandemic, USC Verdugo Hills Hospital is partnering with Sodexo to launch an in-house grocery delivery service – and is moving to the widespread use of iPads to connect patients with staff and family members.

HASC’s Communities Lifting Communities community health initiative regularly shares stories on innovative solutions to challenges that face member hospitals and their neighbors. To submit a story, contact CLC executive director Susan Harrington (below). While not every story can be developed into a feature, all will be carefully reviewed and considered.

This month USC Verdugo, in partnership with the food services provider, launched an in-house grocery delivery system. Employees can place grocery orders for staple items such as milk, eggs, fruits/vegetables, and frozen items twice a week. Employees pick up their ordered items in the hospital’s cafeteria and can pay with a credit card, cash, or payroll deduction. The program was piloted with 10 people recently, and the first week of operation it had 25 orders.

“The goal of the program is to identify barriers and reduce the impact they have on a staff member’s ability to come to work, as they are caring and providing for their families,” said Kenny Pawlek, chief operating officer, USC Verdugo Hills Hospital.

As part of the project, he made storage adjustments to make room for some supplies. Multiple benefits result from the effort, however. These include supporting its hospital staff and patients, reducing the effect of social isolation, reducing the use of PPE and exposure.

USC-VHH is also using videoconferencing to help patients communicate with staff and family. Through iPads in patient rooms, staff are able to remotely monitor patients more often, reducing PPE and exposure. Patients also have been allowed to use the devices to stay connected with their family members — which reduces anxiety as family members worry about loved ones.  Hospital leadership is exploring additional ways to leverage technology to support patients and staff. There are plans to use tablet devices to reduce the effects of social isolation for patients by planning health-focused entertainment for exercise. Another initiative is underway to provide family members access to patient updates by phone once a patient has been admitted or dropped off at the facility.

Social isolation is a strain for both hospital employees and patients that can decrease wellness.  Pawlek recommends that hospital leaders walk around to do in-person check-ins with staff to see what else can be done to reduce the stress and worry that accompanies the pandemic. Through the Care for the Caregiver program at Keck Medicine of USC, hospital staff also have access to free counseling support and housing arrangement to decrease risk to family at home.

“Families are incredibly nervous and adding more strain on our employees and physicians at all levels who have committed to taking care of our community. Therefore, it’s up to us to create the easiest and safest environment in order to take care of our people,” Pawlek explained.

To learn more, contact Susan Harrington, executive director of HASC’s Communities Lifting Communities community health initiative.

Contact:
Susan Harrington
(562) 884-2383
sharrington@hasc.org

Op-ed by Dana Sherrod, MPH

Last week, in the midst of the COVID-19 pandemic, organizations, advocates, and policymakers across the nation were virtually celebrating the third-annual Black Maternal Health Week (April 11–17) and deepening the conversation about black maternal health in the U.S. While progress has been made, data shows that black mothers and their babies disproportionately experience higher rates of adverse birth outcomes compared to other groups.

The innovative community investment strategy models outlined in the report have made a mark in multiple regions across the U.S. but have been slow to spread to Southern California. Emerging partnerships between public health departments and hospitals seek to change that. Through a review of more than 100 resources and case studies and 30 key informant interviews, the new report identifies best practices where partnerships and investment strategies address the root causes of health inequities and improve community health.

Download the PDF Report

The Cherished Futures team stands in solidarity in the fight against the perils of racism in its many forms, and we affirm our commitment to advancing system changes that protect Black lives.

Dear Cherished Futures Collaborative,

Our hearts and minds, along with many of you, have been grappling with pain and grief at the senseless deaths of George Floyd, Breonna Taylor, Ahmaud Arbery and the innumerable other Black individuals whose names did not make national headlines. The fight against the dehumanization and devaluation of Black lives dates back generations, and the call for justice and equity rings as true today as it did for our ancestors.

Both the COVID-19 pandemic and police violence have taken the lives of Black people at disproportionate and unjust rates; an inequity rooted in the structural racism woven into the fabric of our institutions and systems. The premature deaths of Black people have laid bare what researchers and public health experts have long known: racism is a public health crisis.

Dr. Barbara Ferrer, Director of the Los Angeles County Department of Public Health, and former Chair of the Public Health Alliance of Southern California recently stated:

“We know that black Americans fare worse than other groups on virtually every measure of health status and it has become all too common to blame this on individual behaviors when in fact the science is clear: The root cause of health inequities is racism and discrimination and how it limits access to the very opportunities and resources each of us needs for optimal health and well-being.”

The Impact of Trauma and Grief on Black Mothers’ Bodies

A powerful article published by Vox, highlights that Black mothers are living in an especially troublesome time — sandwiched between the current public health threat of COVID-19 and the longtime reality of police brutality, a double- bind of racism.

“As Black mothers, grief is embedded in our being. It accumulates and manifests as body aches and pains. But many of us have never been taught how to deal with it so it doesn’t become yet another risk to our health.”

This racialized stress, grief, and trauma contribute to the “weathering” or accelerated aging and deterioration of Black women’s bodies. A recent study published by researchers at Ohio State University noted that Black and Hispanic mothers exist in a state of “high alert to the possibility that their child will encounter unfair treatment.” The potential consequences of this stress are factors like slower blood pressure recovery, increases in inflammatory markers, and worse sleep patterns.

A Call for Transformative Solidarity: 3 Things Hospitals and Health Systems Can Do

In the midst of these difficult times, we need what Michael McAffee, President and CEO of PolicyLink calls “transformative solidarity.”

• How are you and your team taking a stand against racism?
• Let us know by responding to this article! We want to share your actions with others!

Here are 3 short-term actions providers, hospitals, and health systems can take to move towards solidarity and support our Black communities.

1. Stand Against Racism: Recommended Messaging for Taking a Stand
As shared by Cherished Futures Collaborative member, Dr. Melissa Franklin, organizations, and activists across the state have been taking a vocal stand against racism, and more are encouraged to do so.
Hospitals and health systems have spoken out about
racism and participated in the June 5th White Coats for Black Lives demonstration in honor of George Floyd.
Below are sample statements that can be
posted on your website and social media pages or can be customized and expounded to include action steps your hospital or
health system is taking to address racism. The important part is condemning racism and being willing to call out racism against Blacks/African Americans:

• We acknowledge the pain and suffering that anti-Black racism causes and continues to cause.
• We speak out against racism in all of its forms.
• We speak out against oppression.
• We speak out against the recent killings of unarmed Black
• We speak out against the recent killings of unarmed Black people, most recently Ahmaud Arbery, Breonna Taylor, and George Floyd.
• We stand in solidarity with those who pursue equity, justice, human dignity for all, and an end to racism.

For more inspiration, read Dr. Elaine Batchlor’s, CEO at Martin Luther King Jr. Community Hospital, powerful statement “It’s Time for a New Social Contract.”

2. Create Space for Dialogue at All Levels of Your Organization
Below is a sample letter shared by a physician champion in the Cherished Futures Collaborative. Consider creating a similar letter to be distributed in all departments at every level of your institution.

Dear Colleagues,

I’m sure many of you have been affected by national events sparking renewed discussion of structural and individual racism affecting Black Americans. The slayings of Ahmaud Arbery, Breonna Taylor, and George Floyd have occurred on a backdrop of health inequities, in which Black Americans are facing a disproportionate burden of disease in the COVID-19 pandemic. This itself occurs on a backdrop of long- standing health inequities, including higher maternal morbidity and mortality, higher burden of major chronic diseases, and shorter life expectancies.

In Medicine, it has never been possible to draw any boundaries between what is happening “out there” and our own practice. Disease, violence, the toxic and cumulative effects of hate and discrimination – these all bleed into our practice, sometimes literally. It’s incumbent on us, therefore, to show a high standard in addressing issues such as racism directly and boldly. To that end, we are offering a few opportunities and resources.

First, let’s gather and talk. While we are sending this message to our own department, it does not reach or include members of the Black community, who it affects the most, because we lack such representation here. Why we lack such diversity is a conversation to have, now. Why it’s important that we do is a conversation to have, now. And having the commitment to equity has to mean more than the occasional conversation here and there. So the conversation should be focused on how we move to action.

Second, let’s educate ourselves. We’re putting a short reading list below. These texts are foundational, not definitive; they will allow the start of productive conversations about how to address racism. The “advanced courses” on racism actually occur in real life, as we grapple with how to combat it in our work and lives.

Third, let’s as an institution be the ones to reach out. Please know that our Black colleagues and trainees are suffering, not only because of the events and what they evoke, but because of the blithe silence of their colleagues and leadership. Reach out with a quick message of support. Do not ask for help or education; that responsibility is ours alone, and they do not need any additional burden. But let members of our community know they are seen, supported, and that their fight is our fight.

Sincerely yours,
XXXX

Suggested Starting Reading List
• How to be Anti-Racist, Ibram X. Kendi
• So You Want to Talk About Race, Ijeoma Olou
• White Fragility, Robin DiAngelo
• Between the World and Me, Ta-Nehisi Coates

3. Strengthen Community Partnerships and Communication
The Institute for Diversity and Health Equity an affiliate of the American Hospital Association, highlights that some hospitals and health systems are working with trusted partners such as faith-based organizations and other community-based organizations, to expand their reach into neighborhoods most impacted by inequities, particularly in the midst of COVID-19.

The Cherished Futures and African American Infant and Maternal Mortality (AAIMM) networks can help strengthen the communication channels between hospitals, providers, and the Black birthing families they serve. Visit
www.blackinfantsandfamilies.org to stay connected to the birth equity work happening throughout Los Angeles County.

About Cherished Futures for Black Moms & Babies
Cherished Futures for Black Moms & Babies (Cherished Futures), an initiative led by the Hospital Association of Southern California, Communities Lifting Communities, and the Public Health Alliance of Southern California, is a multi-sector collaborative that aims to reduce Black infant mortality and improve patient experience and safety for Black mothers and birthing people in South Los Angeles, South Bay, and the Antelope Valley. Guided by the data and grounded in Black women’s experiences, Cherished Futures brings together decisionmakers from local birthing hospitals, public health departments, health plans, and Black women from the priority communities to co-design systems-change solutions at the clinical, institutional, and community levels.