Discover and read the best of Twitter Threads about #populationhealth

Most recents (17)

I'm @RRHDr, a #healthequity researcher & the Founding Director of @CARHEumn. My work seeks to manifest racial justice & liberation by making the invisible visible. This means that I start from the premise that racism is a fundamental cause of health inequity. #HardemanTakeover
Today I'm taking over @ia4phs to talk about #structuralracism and health from methodological innovation for measuring racism to its manifestations in our society from abortion access to policing. Structural racism as a #populationhealth crisis. #HardemanTakeover
Structural racism is a public health crisis, but it's also a FIXABLE problem!

Earlier this year @CARHEumn & @minnpop hosted an event on the measurement of structural racism. A product of that event was this šŸ”„ reading list. #HardemanTakeover
Read 18 tweets
āœØšŸ†• IHME researchers published today in @sciencedirect ā€“ "Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis" using #TB data from the 2019 #GBDstudy. #tuberculosis sciencedirect.com/science/articlā€¦
The researchers estimate that in 20 high-incidence countries, 38 million individuals live in a household with someone with pulmonary #tuberculosis ā€” with children under 5 making up 12% of populations with home exposure.
āž”ļøFindings include: #Zimbabwe, #Mozambique, #Zambia, and #Pakistan have the highest proportion of the population with household exposure.
Read 5 tweets
LOVE being faculty at @MIT this semester for a class on #dataanalytics & #datascience. I tend to PM my mentees, especially women and #blackexcellence to start to prepare questions to ask. Too often people stay silent. Speak up. Never be embarrassed to show #curiosity.
Listening right now to mid-semester progress reports from teams and am feeling like such a proud #datascience #BigData #bigdataanalytics momma. Bear cubs doing good (well AND good in world)

LOVE that this is a space within @MIT that focuses on #SDoH and #equity.
Literally right now, hearing about a study on #socialmedia chatter as a driver of vaccines hesitancy driven by #Twitter - start postulate "cause/effect" by an incident that happens within days after a vaccine - like ppl automatically assume a death is "caused" by vaccine
Read 27 tweets
My last #hackathon & #socialenterprise pitch was to improve minority participation in #clinicaltrials. This trial is has 74% black participants compared to usual 2.5%. Why?

Yes, we do need to expand access. Colon cancer kills.

#MedTwitter #BlackTwitter #NurseTwitter thoughts?
In trials for new therapies however, you see this:

ā€œEven though heart conditions disproportionately affect Black individuals, they accounted for only 2.5% of clinical trial participants in a global trials report by the Food and Drug Administration.ā€

statnews.com/2020/07/22/cliā€¦
So black participants are the majority in WHICH studies?

Having been in executive suite, speaking on #access broadly, I saw non-clinicians use ā€œaccessā€ to shame clinicians on self care or pointing out workplace issues. Yet same administrators would cut number of staff for budget
Read 9 tweets
Further, suboxone has required special training and certification, adding an administrative barrier and creating an added fear barrier among risk-averse clinicians whereas oxycodone can be prescribed easily with the DEA certificate we all have.
Because doctors/prescribers are definitely lacking in administrative burden and CME obligations, we're just twiddling our thumbs eager for someone to ask us to get MORE educated, taking time off from patient care to get this:

medpagetoday.com/psychiatry/addā€¦
The law enforcement side sees doctors through this lens. So doctors seek to limit their risk and liability. I'm all for taking down those who harm patients. I've testified in cases like the ones below for the AG's office as a medical expert.

medscape.com/viewarticle/91ā€¦
Read 7 tweets
Yes, the #vaccine rollout is slow, uneven, not matched to need. "Botched"? That is a bit too strong. Much blame to go around.

American #healthcare is built for silos, turf, acute care, reactive..not #populationhealth #publichealth #prevention. It shows. Why is anyone surprised?
And #MedTwitter, despite your hashtags & publications, when it comes to real life actions inside departments, hospitals, or even on Twitter, all you all do is turf, ego, cliques, us vs them, etc. I am unimpressed. Build *systems* Yes #impostersyndrome makes you crave validation.
I am a #pediatrician and if you need validation, I've got a whole box of stickers for you. I will even let you choose your own sticker. How is that? Because, yes, you are special. You matter. You are wonderful. Happy?

Then after that, could we get šŸ’© done?
Read 12 tweets
We need more doctors who speak up.

Yes, I know we have worked hard to get where we are and are regulated/monitored in so many ways it is scary to deviate and take a risk of censure or discipline. It feels like we are vulnerable, not strong.

Speak up anyhow.
We canā€™t let our reputations or achievements become reasons why we stay silent.

Opposite, what is it all for anyhow?
What does your title mean?

They say you canā€™t take it with you in regards to money. But you arenā€™t going to take your CV with you either.
We canā€™t be telling the most vulnerable to speak up, like those early in career.

While I have yet to understand the details of what went on here, what is reported is deeply concerning.

Even with a good lawyer, this can derail an entire career right at its start.
Read 25 tweets
We are so proud of receiving the Health and Science Award by @NCDiamanteInc Our success is rooted in being an interdisciplinary network that started meeting on March 18, 2020 to respond to the pandemic @GabrielaPedsMD @vivimbmd @ISLA_NC @DurhamPublicSch ImageImage
and went on to appear on many networks, facebook live, radio, and youtube sessions to inform the community in Spanish how to stay safe from #COVID19 @Duke_FamMed @dukeobgyn @DrBevGray @DukeHealth @StethoscopeOn ImageImageImage
Our biggest success is rooted in uniting clinicians, health departments, health systems and government together with the community in safe conversations to improve health. La importancia de identidad y dignidad ImageImage
Read 12 tweets
#ASEchoJC #Tweetorial on #WASE
World
Alliance
Societies of Echocardiography
Normal Values Study

#Echofirst most widely used imaging modality BUT

WHAT IS NORMAL for ā¤ļø size & function?

bit.ly/32pKxAC @JournalASEcho
2/ Prior ā¤ļømeasurement studies:
ā¤ļøused VARIOUS methods- M mode, M mode & simpsons, 2D
ā¤ļøNo standard analysis or core lab
ā¤ļøOnly single race or country/region
ā¤ļø?? State of the art machines or techniques

ā¤ļøNeed for a prospective international observational study #WASE was born
3/#DiversityandInclusion
@ASE360 @escardio #EACVI recommended normal values used all over the šŸŒŽ but only represent normal Caucasian people from USA & Europe

bit.ly/3irijv5 #ASEchoJC
Read 10 tweets
What if the money šŸ’°šŸ’°šŸ’° spent by #academia & #hospitals on hiring people to spy on #SoMe, to police & shame nurses & doctors (even getting some fired for speaking up on #PPE shortage), this policing disproportionately affecting BIPOC, instead spent on hiring BIPOC & on pay gap
This is pay gap I am talking about. What kind of ā€œ#professionalismā€ accepts that Black women must work 7 extra months for same pay?

Professionalism on ā€œyou wore..ā€ is used in sinister ways against Black women in particular

#blackintheivory #MedTwitter

aauw.org/resources/artiā€¦
Puritanism in #medicine, being taught to med students who are given middle author status on a publication conceived and supported by senior faculty and junior editors, is part of this harm. Many Black girls are criminalized & punished for natural hair.

npr.org/sections/ed/20ā€¦
Read 22 tweets
In the U.S. we have a "tough guy" attitude towards health that is seen in many outcomes across #populationhealth metrics. This false dichotomy between economy and health is not new. We have poor sick leave or parental leave. Healthcare a "benefit" of employment.
Not sure why my #MedTwitter peers are so shocked by the way the U.S. has responded to a preventable #publichealth crisis

US docs, selves, want individualism & personal financial gain
over
systems for a common good

@Health_Affairs on AMA vs Medicare

healthaffairs.org/do/10.1377/hblā€¦ ImageImageImageImage
The ā€œgovernment canā€™t tell me what to do for the protection of others - I know bestā€ is a common thread in U.S. history & culture of rugged individualism

I mean, this is a country that started by throwing othersā€™ property in ocean to protest government. history.com/topics/americaā€¦
Read 14 tweets
Letā€™s talk #safetyculture

@TheIHI

Itā€™s a framework for a harm reduction towards all: patients & families as well as all staff

Important:
growth mindset
instead of
fixed mindset

to have needed uncomfortable conversations

#MedTwitter #AcademicTwitter #MedEd #NurseTwitter
This framework has been applied to reducing harm, mostly through medication error (though intended to achieve population health)

Then was expanded to patient experience

Also, cost of care

More recently we have added clinician wellbeing

=quadruple aim

ihi.org/communities/blā€¦
What has not been clearly stated in any of these #safety framework is disparities, structural inequity, or racism

The acute care side of the hospital - money maker - thinks of this as type of safety & #quality

but not #populationhealth

#Implicitbias elicits šŸ™„šŸ˜”šŸ˜“ response
Read 13 tweets
Personal news: after 6 unforgettable years, I am stepping down from my leadership role at @NYCHealthSystem. Mixed emotions to say the least! But most of all I feel grateful to have served the mission of this extraordinary organization.
Please indulge me as I recount some of our proudest accomplishments on behalf of patients. Far and away the most important one was forging this amazing teamā€”
Our vision was to build a better health system, one with a more proactive approach to addressing avoidable human suffering. More on what that means here: hbr.org/2019/10/4-prinā€¦
Read 16 tweets
Our new @IHME_UW updated death projections total 137,184 cumulative #COVID19 deaths (estimate range of 102,783 to 223,489) through the beginning of August. Please follow for analysis. 1/12
covid19.healthdata.org/united-states-ā€¦
This increase is explained primarily by peopleā€™s movements, as captured in anonymous mobility data from cell phones. 2/12
healthdata.org/covid/updates
Our estimates show that, over the last few weeks, five states ā€“ Montana, North Dakota, Minnesota, South Dakota, and Georgia ā€“ have seen at least a 20 percentage point increase in mobility patterns. 3/12
Read 12 tweets
Umbereen S Nehal MD MPH: who is this person? Several people have been asking

A thread

Where am I from? Hooboy.
Letā€™s say, citizen of the world, human ping pong ball. Third culture kid. Genetic mutt

Born: šŸ‡ŗšŸ‡ø
šŸ‡µšŸ‡° parents - when my parents born colonial rule, pre-Pakistan
To thoroughly annoy my Twitter bestie, @DrvanTilburg

Am an ENFP - a cross between Snoopy, Robin Willians, Ellen Degeneres, Dr. Seuss, Charles Dickens, Upton Sinclair

I border on ENTP - love new info and love to challenge in order to break through barriers or limitations
My great-grandfather was given title "Khan Bahadur" (brave). As a judge, a brown man under Colonial rule, he threw the book at a British attorney. "Learn the law" if in his courtroom. Hence my stiff moral backbone

My mom & me:

(She loves this song)
Read 52 tweets
Some personal thoughts on the path forward with #COVID19 recovery. Please follow if interested. 1/10
Weā€™re not out of the woods yet with the first wave of the #COVID19 pandemic, so maintaining #socialdistancing continues to be critical. #stayhomestaysafe 2/10
covid19.healthdata.org/united-states-ā€¦
At the same time, we must accelerate planning at the state and national level for how best to reopen the economy so we can begin to recover. But how? And how do we ensure itā€™s done safely? 3/10
usnews.com/news/economy/aā€¦
Read 10 tweets
1/ So, today was a big day for @DrJRMarcelin and I. We've been developing curricula on "Structural Challenges & Inequities in Healthcare Delivery" for the @UNMCCOM M1 students as part of the Health Systems Science coil.

Thread on this #MedEd project + today's capstone šŸ‘‡šŸ¾
2/ With inspiration from @JonathanMetzl & Dr. Helena Hanson's work on #StructuralCompetency, we wanted to assemble a pilot set of experiences that would give @UNMC students a glimpse into local health inequities, from historical & community perspectives:
3/ We gave the M1s several introductory lectures & assignments focused on big-picture issues like #SDoH & disparities, creating a "structural DDx" for patients, unconscious #bias & #microaggressions, developing structural humility, and #racism in medicine...
Read 11 tweets

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