Lab to Eliminate Disparities

Advancing Health Systems Change

In addition to social determinants of health, inequities are often created or perpetuated through the health care system itself. In order to reduce health inequities, barriers and challenges in the health system must be addressed, including improving access to health care services and quality of care, fair distributions of public health services, and reducing the economic consequences of ill health, such as bankruptcies due to the high cost of health care services and lost income due to illness.

CURRENT PROJECTS:

• Food Insecurity through FoodRx Apporach: https://foodasmedicine.global/

• Climate Change through ClimateRx Approach:  https://www.climaterx.org/

PAST PROJECTS:

• Through the REAL (racial, ethnic and language) Data project, the CEHD has advanced information infrastructure to support research and development of interventions to address health disparities in UTMB’s patient population and Galveston as a whole. The project, supported through the Texas 1115 Medicaid Waiver, allows for stratification of patient outcomes, diagnoses, and quality measures along lines of race, ethnicity, and insurance status to identify and prioritize health disparities. In FY2015, the REAL Data project successfully met 1115 Waiver reporting requirements for October 2014 and April 2015: To significantly enhance the collection of REAL data for patients in UTMB electronic medical record; and to develop and submit the first report on disparities identified in UTMB’s inpatient population and an accompanying improvement plan to address these disparities to hospital leadership. The first disparity report identified three disparities: (1) Low breastfeeding rates among African American and Hispanic females; (2) High rates of low birth weight (<2500g) among African American females; and (3) High rates of ambulatory care sensitive conditions (in hospital encounters) among African Americans. In addition to recommendations to address three reported disparities, the improvement plan details recommended actions to address health disparities in a coordinated way at UTMB. On-time, satisfactory reporting to the Texas Health and Human Services Commission allowed UTMB received a Delivery System Reform Incentive Payment of $ 446,135.

• Jointly with the UTMB Diversity Council, CEHD convened the ‘Health Disparity Leadership Collaborative’ as a multidisciplinary coordinating body across UTMB mission groups. In August 2015, the Collaborative organized the first Health Disparities Leadership Forum for the purpose of creating collaborations to successfully implement best practices that increase quality of care for all. This forum was a high-level executive workshop designed to provide an opportunity for interactive dialogue across departments and mission groups, both internal to UTMB and externally. 35 participants represented the three UTMB mission groups, the Galveston County Health District, and community organizations. In addition to documenting key initiatives within UTMB that identify, monitor and address health disparities, the Forum collected strategies for better coordinated actions among UTMB and community partners.

• REAL Data project team presented two abstracts in 2015 Annual Research Meeting of AcademyHealth, the largest professional group in the area of health services research. REAL Data project also has been selected by HHSC as the poster presentation in the statewide learning collaborative which took place in Austin in August, 2015. It is one of two projects being selected from UTMB where overall has 29 projects, but also one of four projects from Region 2 where has 83 projects in total.

• CEHD made substantive progress on its Social Media and Text Message project, titled UTMB Health Tips, which is also funded through the 1115 Medicaid Waiver. The project is a free service that provides evidence-based tips on topics such as diabetes management, blood pressure control, living a healthy lifestyle, and breastfeeding (to name a few). This service is available to anyone in Galveston County, patients and non-patients alike. We aim to provide accurate, timely, and easy-to-understand health information . For FY2015, CEHD staff have successfully:

  • Operated Facebook and Twitter accounts, a website, and more than a dozen text message campaigns.

  • Created several new campaigns, including six new trivia quizzes.

  • Updated existing campaigns using subscriber feedback.

  • Successfully networked and built relations with several internal and external collaborators, including: Clinical Operations, Information Services, UTMB TEAM Clinic, Employee Wellness, RMCHP, WIC, PMCH, OB/GYN, Behavioral Health, several high schools in the region, and etcetera.

  • For CEHD’s successful reporting of its Social Media and Text Message Health project efforts to the Texas Health and Human Services Commission, UTMB will receive a Delivery System Reform Incentive Payment of $804,159.

  • CEHD published a series of issue briefs and an infographic on closing the “Medicaid Coverage Gap” in Texas. The briefs were designed to educate the community as well as decision-makers at institutional, local, and state levels on why expanding access to affordable health care can benefit the state and reduce health inequities.

Global Health

The LED (former CEHD) recognizes that health inequities occur not only within our own region and nation, but also between countries and of course within other countries, and that many times the dynamics driving health inequities function at global policy levels. Consequently, global health is another key program area for the Center. UTMB is home to well-developed Global Health educational, research, and service initiatives. The LED is proud to partner with other global health actors on campus and across the University of Texas System.

Past Projects:

• CEHD has been proactively engaged with the initiative of the World Health Organization, World Bank, and USAID for developing a ‘Common Roadmap on Health Measurement and Accountability Post-2015’ through developing and submitting a critical review of the draft version. Using a social justice and health equity lens, CEHD’s submission focused on better coordinated and accountable international aid to support the development of health information systems at the country level, full recognition of country-specific priorities, and developing specific measure for health equity as a cross-cutting theme in the health-related sustainable development goals. Based on this submission, CEHD was also invited and participated in the ‘Measurement and Accountability for Health’ event in June 2015.

• CEHD was invited to join the ‘Health Equity Initiative’ as a US-based nonprofit organization with global membership. CEHD staff were also invited to join its ‘Health Equity Initiative Summit’ in February 2016.

• CEHD assisted with the ground work for the newly established global ‘Health and Trade Network’ which will be registered soon in Belgium with CEHD as a founding member. CEHD is invited to participate in the founding assembly in January 2016.

• Jointly with the ‘Office for Coordinating Global Health,’ CEHD initiated a process for developing a database for different UTMB initiatives on Global Health. The database should assist the development of a new global health engagement strategy.

Education & Training

Achieving health equity and realizing the Lab's vision of communities that are healthy, sustainable, resilient, and socially just will not only require action in the present day, but an ongoing commitment from generations of health professionals to come. Therefore, Leadership Training for Social Change in Health is the Lab's fourth key program area. Through training, capacity building, and educational opportunities on issues such as health equity, social determinants of health, and ethical engagement, the Center strives to create a health professional workforce prepared to deal with the challenge of meeting health goals both in the US and abroad.

Recent Project:

• Egyptian Research Scholar & Clinical Observership Program

• The Egyptian Research Scholar & Clinical Observership Program was initiated under an affiliation agreement between the University of Texas Medical Branch at Galveston and the Egyptian Cultural and Educational Bureau at the Egyptian Embassy in Washington, DC. The Egyptian Research Scholar & Clinical Observership Program comprises clinical observership, academic scholarships, educational development training, and participation in UTMB’s regular activities and events. 

• From November 2022 to July 2023, we received ten medical professionals (physicians and pharmacists) affiliated with the Egyptian Ministry of Health and two leading universities in Cairo, Egypt. All of them have secured full scholarships from the United States Agency of International Development (USAID) and the Higher Education Initiative Graduate Scholarships for Professionals research scholars (non-degree program) at US Universities.

• Pictures of the graduation ceremony on June 30, 2023: Ceremony

• UTMB Tour for Asia University Undergraduate Students

• On July 17th, the University of Texas Medical Branch and Dr. Wei-Chen (Miso) Lee were host to six undergraduate students majoring in Healthcare Administration from Asia University in Taichung, Taiwan. They were accompanied by their faculty chaperone, Dr. Yulyu Yeh. Video made by one of the students: 學海築夢 - YouTube

• Dr. Lee was responsible for the planning of this group of students and although it was a short trip they learned a lot about this USA university. They first met with Ms. Connie Holubar, with the Institute for Infectious Diseases and Director of Operations at the Galveston National Laboratory . She talked about the GNL, which amazed this young generation, especially the role GNL plays in every big pandemic. Following that, the students practiced ordering food at the Health Education Center Cafeteria in a crowd of UTMB students. While they were having lunch, Dr. Lee gave a talk about what she does at UTMB and what other key features of UTMB such as the Correctional Care, Area Health Education Center, and Shriners Hospital for Children in Galveston.

• In the afternoon, Dr. Lee led the students to visit a couple of areas on campus including a tour of the GNL, Old Red, and Osher Lifelong Learning Institute (OLLI) . Through Ms. Dana Bechtold’s introduction, the students got to know more about the service for aging populations in the US. Key features in the OLLI included the outdoor gardens, classes to learn the public services and smartphone tips, a library of books and puzzles. The tour was closed by the visit to the Student-Run clinic: St. Vincent House clinic . Before the group arrived the clinic, the students got excited to see a giant cruise setting off. At the clinic, the students learned about the medical and social services provided to underserved populations.

Past Project:

• Holding the directorship for the Health Economics and Policy Theme within the School of Medicine curriculum, CEHD staff educated students by developing curricula and lecturing in a wide variety of classes. For example:
• CEHD organized two 3-hour Practice of Medicine (POM1) lectures on Health Policy and the Social Determinants of Health to around 120 1^st year medical students
• CEHD staff assisted in the Practice of Medicine (POM) 2 course “Humanities, Ethics, and Professionalism,” providing teaching assistance for 6-weeks for approximately 10 students
• Dr. Smith refined and further developed the curriculum and co-directed a 2-week SOM Minimester course titled “Beyond Medicine: Social Health and Human Rights” for 6 2^nd year medical students. Several CEHD staff members we involved in designing hands-on course’ sessions
• CEHD organized a 3-hour workshop on health policy for the SCOPE (Student Continuity of Practice Experience) program with 3^rd year medical students. Dr. Smith lectured on the structure of the US health system
• CEHD assisted with the organization of a 5-week course entitled “Introduction to Medical Humanities” for approximately 20 pre-Med students in JAMP (Joint Admission Medical Program), a state-wide initiative created by the Texas Legislature to support and encourage highly qualified, economically disadvantaged students who are interested in pursuing a medical education. Dr. Smith offered a 90-minute lecture about the implications of the Affordable Care Act on the practice of Medicine and CEHD staff lectured on the Moral Dimensions and Social Determinants to Health
• CEHD assisted with the organization of a 5-week course titled “Creative Expressions Project” for approximately 20 pre-Med students in JAMP and provided lectures on how to create life stories/digital stories
• CEHD began reviewing and adapting PBL cases to integrate policy theme materials for the TIME program
• CEHD supported the Health Policy Dialogue series through identification and recommendation of inspiring speakers and work with the UTMB student AMA/TMA leadership team