Cautionary tale of health disparities in the age of precision medicine

by Kirsten Bibbins-Domingo, PhD, MD, MAS

 

Many of us do not routinely read the genetic literature, but for those of us interested in health disparities, a study in this week’s NEJM and its implications are critically important. 

Science and Public Health on Trial

by Dean Schillinger, MD

Our purpose in writing this piece was to alert the scientific, clinical, and public health communities about the outcome of the landmark decision regarding warning notices on advertisements for sugar sweetened beverages (SSBs) and explain its legal underpinnings. We also wanted to show this as an exemplar of how industry-misappropriated scientific language and scientific methods to hijack science and public health and obfuscate scientific truth and introduce controversy regarding associations between their products (in this case SSBs) and health harms (in this case obesity, diabetes, and tooth decay). Finally, we wanted to highlight the importance of such policy efforts for improving the health of at-risk populations, including children, ethnic minorities, and individuals with limited health literacy.

Click below to read the full JAMA viewpoint:

http://jama.jamanetwork.com/article.aspx?articleID=2542158

Citizen Engagement in Precision Public Health

By Courtney Lyles, PhD and Kirsten Bibbins-Domingo, MD, PhD

At the Precision Public Health Summit held this week at UCSF (sponsored by the Bill and Melinda Gates Foundation and the White House Office of Science, Technology, and Policy: see), we were inspired by many great discussions and ideas.  While the field is still figuring out how to define and conceptualize the core elements of “precision public health,” a broad interpretation that is relatively simple and straightforward includes:  a discipline for using the best methodologies and datasets to tailor interventions (from medical screenings and treatments, to community wellness and prevention programs, to science-informed advocacy and policy) that better meet the needs and priorities of local communities and individuals. 

Dean Schillinger Receives 2016 James Irvine Foundation Award

Congratulations to our Chief of the Division of General Internal Medicine on receiving the prestigious James Irvine Foundation Award!

Below is his acceptance speech and a link to the UCSF article about the award:

Digital literacy and what it means for healthcare

by Courtney Lyles, PhD

Should healthcare organizations be taking a major role in increasing the overall digital literacy of their patients? 

In my last post I talked about how most patients in our health system, the SFHN, want to use the internet to manage their health care and health, but don’t have the proficiency they need to be able to do so. I wanted to take that idea one step further. If our patients often can look something up on Google but don’t know how to use an email account (which is often required for signing up to access your electronic health record online) – should we be providing them with basic technology classes?  The answer I keep coming back to is “yes,” and here are a few reasons why:

Partnerships to Prevent Violence: ARISE

By Leigh Kimberg, MD

Each day, an overwhelming majority of our patients arrive in clinic wishing that their healthcare providers would ask them questions about how their personal relationships affect their health and, more specifically, whether an intimate partner, family member or other person has hurt or threatened them.  And, despite the requirement by the Affordable Care Act that all women and girls be offered interpersonal violence (IPV) (intimate partner violence and sexual assault) screening, brief counseling and referral, healthcare providers and healthcare systems have not institutionalized this practice.  “Aspire to Realize Improved Safety and Empowerment” (ARISE), a partnership program newly funded by the Office of Women’s Health in the US Department of Health and Human Services, will fully institutionalize these life-saving practices in the San Francisco Health Network primary care system.

“Where Can This Person Go?”: A Plea for the Expansion of Medical Respite Services

 

by Soraya Azari, MD

While recently working in the hospital I was often asked by my interns and medical students: “so where can this person go?”  An example: a 53 year old homeless man, wheelchair-bound from prior injuries, who had his wheelchair stolen during an assault, which led to pneumonia and hospitalization.  He quickly improved with intravenous antibiotics, was medically stable, and no longer met criteria for inpatient hospitalization.  So then the question is where should he go?