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Blog Posts from 2018

Welcome to the blog for Health & Medicine. We're a 33-year old 501c3 nonprofit that operates as an independent, freestanding center driven by a singular mission: formulating health policy, advocacy and health systems to enhance the health of the public.

2018

Jun 06, 2018 Written By: Health & Medicine Policy Research Group (HMPRG)

What is Juneteenth? Links, Resources, and Local Celebrations

This year, for the first time in our organization’s history, Health & Medicine is celebrating Juneteenth. Here, we’ve complied some links and resources about the significance of this holiday. If you don’t already, we hope that you or your organization will consider joining us in honoring this important day.

What is Juneteenth?
Juneteenth is the oldest known celebration honoring the end of slavery in the United States. On June 19, 1865, Union General Gordon Granger led thousands of federal troops to Galveston, Texas to announce that the Civil War had ended, and slaves had been freed. While the official date of the Emancipation Proclamation was 1863, it would take two years for the news to reach the remote territory of Texas. Upon Gen. Granger’s arrival, approximately 250,000 Texan slaves had no idea that their freedom had been secured.

Resources:
Participate:
Part of the reason Health & Medicine is celebrating Juneteenth is to promote narrative change and increase dialogue as a step toward recognizing and rectifying historical injustice. We hope you will join us in this celebration either by honoring the day itself or spreading the word over social media and to your network. Please consider sharing these social media messages and adding ones of your own. And don’t forget to tag us @HMPRG.

Sample social media messages:
  • The Fourth of July is not the only Independence Day that deserves to be celebrated. #Juneteenth #HistoryMatters https://bit.ly/2JdXt4N @HMPRG
  • Juneteenth is the oldest known celebration honoring the end of slavery in the United States.  Celebrated on June 19th of every year, marks the day that the last enslaved people in Galveston, Texas learned of their freedom in 1865. How will you celebrate #Juneteenth? https://bit.ly/2JdXt4N @HMPRG
  • Historical context matters to health equity. Celebrating Juneteenth is a step towards recognizing the full scope of American history and the unfinished work of advancing racial justice. How will you celebrate #Juneteenth? https://bit.ly/2JdXt4N @HMPRG
  • Click here to access social media-ready images to accompany your post.
Celebrate:
Chicago has a rich tradition of Juneteenth celebrations. While this is not an exhaustive list, here are a few local celebrations:
Jun 06, 2018 Written By: Tiffany N Ford

Juneteenth is African American Independence Day and it's past time that we celebrate it

For the first time in the organization’s history, Health & Medicine Policy Research Group will be celebrating Juneteenth, a day regarded as the oldest national celebration of African American liberation in the United States. I’m not sure that I can fully describe how valued this decision makes me feel as a Black employee of the organization, but I am going to try.

When I was a little girl, my mother gave me research projects to complete every summer. She said she wanted to keep my brain working, but really, I think this was an attempt at keeping me busy and distracted for the months in between school. Fortunately for her, both goals were accomplished. Her assignments always centered on topics that she knew I would not learn in public school: African American history. I wrote papers about the brilliance of Madame C.J. Walker, the bravery of Ruby Bridges, and the importance of Juneteenth, among many others. Each of these topics expanded my own understanding of myself as a Black girl; however, Juneteenth always confused me. Although I was already out of school for the summer, my 10 year-old brain could never understand why June 19th didn’t have a special note on my calendar. It was such a historic day, but wasn’t mentioned anywhere that I could find with my novice research skills. That was one of the first times that I had to grapple with the realization that many African Americans grow used to: despite our ancestors’ exploitation to build the United States of America, we are still not welcomed, acknowledged, or truly valued in this country.

Juneteenth, celebrated on June 19th of every year, marks the day that the last enslaved people in Galveston, Texas learned of their freedom in 1865. Although you won’t see it on many calendars or acknowledged in mainstream media, June 19th is an African American Independence Day. To have that day largely erased year after year is not only a slight to the little Black girl inside of me and other African Americans alive today, but an ongoing disregard of our ancestors who remained in chattel slavery for an additional two and a half years until the news of their freedom made it to their plantation.  June 19th is their Independence Day.

The definition of health equity that we use at Health & Medicine, coined by Dr. Camara P. Jones, states that health equity is a process of assurance of the conditions for optimal health for all people. The definition goes on to say that achieving health equity requires at least 3 things: 1) Valuing all individuals and populations equally; 2) Recognizing and rectifying historical injustices; and 3) Providing resources according to need. Health & Medicine’s decision to celebrate Juneteenth advances the process of health equity by valuing African American Independence Day equally to that of other important holidays in the U.S. This celebration also works toward recognizing and rectifying historical injustice through narrative change and increased dialogue about the history of that day.

You see, celebrating Juneteenth is about much more than providing an additional day off for employees. Celebrating and acknowledging Juneteenth is an organizational recognition that the Fourth of July is not the only Independence Day that deserves to be celebrated. Celebrating Juneteenth means recognizing American history – my ancestors’ history – and honoring it with the same vigor that we honor other important days, an action that we do not do enough of in this country.

I am excited that Health & Medicine is taking this important step in changing the narrative around Juneteenth. I sincerely hope that other organizations will see the value and follow suit so that maybe one day, other little Black children can look at June 19th on the calendar and know that they live in a country that values them, too.


The author and her family (Tiffany is far right).
May 15, 2018 Written By: Health & Medicine Policy Research Group (HMPRG)

Members of the ACEs Collaborative Participate in National Convening

On April 25th and 26th, Director of the Illinois ACEs Response Collaborative (the Collaborative), Lara Altman, attended the Center for Health Care Strategies’ Advancing Trauma-Informed Care convening in New York City.  

Advancing Trauma-Informed Care is a national initiative led by the Center for Health Care Strategies (CHCS) and funded by the Robert Wood Johnson Foundation, and its goal is to understand how trauma-informed approaches can be practically implemented across the health sector. After hearing about Health & Medicine and the Collaborative’ s work with Trauma-Informed Hospital Collaborative—a group of 16+ Chicago area hospitals working to begin (and advance) the process of becoming trauma-informed systems—CHCS invited members of the Illinois ACEs Response Collaborative to attend the convening.  Marlita White, Director of Violence Prevention and Behavioral Health at the Chicago Department of Public Health, represented the Collaborative on a panel entitled “Integrating Trauma-Informed Care into Strategic Priorities.”
 
Lara and Marlita were excited to be among other leaders in the field of trauma-informed care. They heard from representatives from places like San Francisco Department of Public Health, Montefiore Medical Group, and Greater Newark Healthcare Coalition—all of whom shared their successes and challenges. The discussions reinforced the unique nature of our Trauma-Informed Hospital Collaborative, which is the first such group in the country.  It also highlighted that the process of becoming trauma-informed takes time and resources, and that there is still much to be learned about how we measure impact and financial returns on investment. Lara and Marlita left inspired by the possibilities ahead which will be shared with our partners in Illinois. For those interested in learning more, check out this resource guide prepared by CHCS.

Apr 10, 2018 Written By: Lara Altman

Event Spotlight: The Illinois ACEs Response Collaborative Welcomes Norwegian Delegation

On April 6, 2018 the Illinois ACEs Response Collaborative and the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Health - Region 5 hosted Shared Learning in ACEs, Trauma, and Trauma-Informed Approaches from Norway and Illinois, a day-long summit that brought together a delegation of Norwegian government officials, Chicagoland leaders in ACEs and trauma-informed work, and key federal government officials spearheading these efforts on the national level.

The day was a testament to the incredible collective impact of the Illinois ACEs Response Collaborative members and how we are influencing policy, practice, and systems change. After opening remarks from Douglas O’Brien, CAPT Anna Gonzales, and Michelle Hoersch from HHS, as well as Margie Schaps Executive Director of Health & Medicine Policy Research Group, Commissioner of the Chicago Department of Public Health (CDPH) Dr. Julie Morita spoke about CDPH’s leadership in making Chicago a trauma-informed city.  

Attendees also heard from Inga Marte Thorkildsen, the Vice Mayor for the Department of Education and Early Childhood in Oslo, about the Norway delegation’s progress on making their programs, agencies, and systems more trauma-informed. The rest of the day included sessions on ACEs and trauma work with communities, health systems, youth and schools, and the criminal justice system across Chicagoland. Attendees also had the opportunity to learn about ACEs Connection as well as an innovative online curriculum for medical professionals.

The success of the day hinged on the participation of our Collaborative members, and it was truly an honor work with such dedicated and skilled partners. We also want to thank our partners at the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health – Region 5, Michelle Hoersch and Lesley Craig, who were instrumental to the planning and implementation of the day.

To further share learning from the informative event, we invite you to review conference resources and handouts below:

Mar 28, 2018 Written By: Health & Medicine Policy Research Group (HMPRG)

Schweitzer Fellow Spotlight: Cuidate Project Connects Families with Nature and Healthy Lifestyles

2017-18 Chicago Schweitzer Fellow Maryclaret Ndubuisi-Obi, a student from DePaul University School of Nursing, epitomizes the spirit of the Fellowship through her dedication to service and commitment to health equity. For her Fellowship project, Maryclaret partnered with Roberti Community House (RCH), a community center that serves a distressed neighborhood in Waukegan, where she worked to improve the health and wellbeing of Hispanic women and their families through nature walks, exercise and stress reduction sessions, and health education workshops throughout the year. At the end of her project, Maryclaret interviewed the participants in her Cuidate (“Take Care”) Project and about the experiences they shared.

Community member Estela Perez, speaking with her friend Maribel Godina, who translated for her, shared that before the program she had not used the forest preserves or local parks in Waukegan because she did not know that they were there and did not feel capable of accessing them. For her part, Maribel shared her own experience as a mother living with a disability and struggling with isolation, “I go out now to the different parks. I tell my kids ‘get your jackets, get your coats, let’s go.’ It doesn’t matter if it’s winter or if it’s raining, you can always do these nature walks. Every time you go to these parks, you see something different, which motivates me to go and see what has changed with the different seasons. This motivates my kids as well because, as Estela mentioned, sometimes we don’t know about what we have here—but thanks to Mary, RCH, and the Nature Walk Program, we discovered our own parks and our own community.”

Maryclaret’s project provided exercise and meditation sessions that ranged from Zumba to Mindfulness. Participants Guadelupe Ruiz and Gina shared that the sessions provide a sort of social support group that they have come to rely on for motivation and community. Maribel said that the groups and meditations helped to reduce her stress—and introduced her to breathing exercises that have helped her “to be peaceful and connect with [her] inner self.”  



Another component of Maryclaret’s project included health screenings. She built partnerships with providers to bring culturally-competent services, including language translation, directly to the community—meeting clients in spaces where they were already comfortable, had trusting established relationships, and felt safe.

Finding access to health services and screenings proved life changing for community members like Amor Caracas who, speaking through an interpreter, said, “[I am] very thankful for the people who bring the doctors here to check our blood pressure.” She explained that she was not able to afford testing and did not know where and how to receive treatment, and that the screenings Cuidate provided are important to her health and to the health of her community.

The women talk about the future of Cuidate in hopeful terms and with determination to continue. In fact, they have already started brainstorming improvements and solutions to a scarcity in supplies.

As Gina noted light-heartedly, “We need weights. We have limited supplies so we use cans of beans sometimes to do the exercises, but we do need the weights and materials to do a variety of exercises.”

Their commitment to the community that Maryclaret helped them build is clear, and their determination to continue to feel ownership over their lives, their health, and their community is unmistakable—outcomes we hope all Schweitzer Fellows can foster. We are grateful to the women and families at Roberti House, and to all of our community members at sites around Chicagoland for opening their doors, and their hearts, to our Fellows.   

Feb 14, 2018 Written By: Health & Medicine Policy Research Group (HMPRG)

Learnings from Organizations that are Addressing Trauma

Augmenting a larger 2016 Environmental Scan conducted by Health & Medicine's Illinois ACEs Response Collaborative, in 2018 we set out to offer a more in-depth snapshot of organizations working to address trauma. The resulting report--Learnings from Organizations that are Addressing Trauma--is based on an additional round of 27 interviews included five organizations that were part of the original scan and 22 that had not been previously interviewed. As with the 2016 scan, efforts were made to include organizations representing a wide variety of sectors; those that were at different points along the implementation journey; large and small organizations; those who provide direct service; and those that are facilitators of trauma training.

Interviewees were asked to describe their organization’s journey towards trauma awareness and share how their organization is currently incorporating this awareness. They were also asked to discuss promising approaches, ingredients for success, as well as challenges and barriers. Finally, they were asked to share advice for others who were either starting out or in the midst of introducing trauma awareness and trauma-informed approaches and services into their organizations. Despite the diversity of organizations interviewed relative to discipline, size, geography, and depth of implementation, many common themes emerged.

Here are some key findings:

Ingredients for Success at a Glance
While interviewees shared different approaches to trauma-informed organizational change, the following common themes emerged:
  • Recognize and remember that this type of culture change takes time; that you cannot expect everything at once; and that process slows things down, but is critically important.
  • Another critical ingredient for moving this work forward is finding champions and developing a core group of people to spearhead and maintain the process.
  • Buy-in from every level of the organization is critical to culture change and staff voice should inform the process.
  • Figure out how to persuasively sell the program. Know your audience. Ask yourself what they would respond to and tailor what you present.
  • Intentionally and strategically keep this work on the front burner. Having a smattering of trainings is not enough for this work to take root.
  • Be open to new ideas and learn from others - this work is a shift for everyone and requires an openness to learning.
Challenges at a Glance
Interviewees shared the following challenges and barriers in their journey towards trauma awareness:
  • Limited funding and tight resources are an ongoing challenge given the extraordinary need.
  • Many of the interviewees were leading trauma awareness work as part of another job and few had the resources to have a staff person or team whose sole focus is moving this forward.
  • Frequent staff turnover requires ongoing training on trauma-informed practices and also leads to added stress on supervisors and peers.
  • Time allocation and competing priorities were also seen as a barrier.
  • Not all staff will buy into the changes needed to shift a culture. This may lead to staff and leadership loss.
  • Interviewees recognized that evaluation was important but often lacked funding for evaluation and documentation activities.
  • Growing interest in the impact of trauma is both a challenge and an opportunity. Some organizations may call themselves “trauma-informed” without the depth and long-term commitment this actually requires.

Jan 17, 2018 Written By: Health & Medicine Policy Research Group (HMPRG)

ACEs Policy Recommendations at a Glance

Earlier this month, the Illinois ACEs Response Collaborative released three revised policy briefs on the impact of ACEs in the health, justice, and education systems including promising practices and recommended actions for change. These briefs were developed by members of the Collaborative—system leaders in Illinois who are working from an ACEs-informed lens to improve systems to prevent and mitigate trauma across generations.
 
Rooted in social justice, these briefs are a call to action to move upstream, build resiliency, and recognize how addressing inequity and trauma can improve systems while also building resiliency.

Each brief provides concise, actionable policy recommendations for the sector. Recommendations focus on both small “p” policy changes within local systems and agencies can have an important impact on the people served, as well as large “P” policy at the federal, state and local levels that can build the foundation for preventing and addressing ACEs in a systematic “upstream” approach. The following recommendations “at a glance” reflect an understanding of ACEs and trauma which requires multiple levels of policy change since effectively addressing ACEs requires working within all the contexts in which they occur: families, communities and society.
 
Health Systems and Providers
  • Increase awareness of ACEs and resilience, particularly among policy makers and providers.
  • Support federal and state policy that supports families and communities, such as paid sick time and universal day care.
  • Fund a wide array of family supports especially early childhood programs, including home visiting, so families can thrive.
  • Equip providers and systems with tools to screen for and address ACEs and develop trauma-sensitive health care systems that support patients and staff.
  • Use BRFSS data and proxies for high ACE scores to focus services in high-need geographic areas.  
  • Utilize an ACE and trauma-informed framework in planning, funding and implementing services.
  • Develop innovative plans for use of health care expenditures by institutions and government for trauma-informed practices such as universal coverage for services and programs that help to prevent and treat ACEs/trauma.

Educators and Stakeholders
  • Rethink discipline and encourage strategies that keep kids in school.
  • Support teachers with professional development,
  • in-classroom supports and social emotional learning techniques.
  • Prepare youth to be successful in school by building coordinated supports for youth and families starting prenatally and continuing throughout the lifespan.  
  • Increase parent engagement.
  • Build and support self-regulation skills.
  • Change policy to support safe and trauma-sensitive classrooms.

Juvenile and Criminal Justice Systems
  • Justice systems must seek to be procedurally fair.
  • All staff in all systems must understand the impact of ACEs and must cooperate and collaborate on solutions.
  • Evidence-based screening for ACEs should be in place at each step of an individual’s involvement with the justice system, and staff should respond in trauma-informed ways to address and prevent further trauma and criminal system involvement.
  • Systems must address the trauma faced by their own staff in the course of their work.

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