I received my Master of Public Health degree when the silos among the core disciplines of public health—epidemiology, biostatistics, health policy, social and behavior science, and environmental health—were high, and for leaders in each discipline, quite territorial. Almost a decade later, I find those silos even higher than ever before, and in our academic community of ever-increasing competition (trans. available grant funding!), demarcating the boundaries that separate us often takes precedence over efforts to promote the public’s health.
Consider, for example, a friendly exchange between two of my friends, a prominent physician and a prominent epidemiologist, who were deliberating on whether the clinician’s role in delivering particular services ought to be characterized as “doing public health.” Sadly, neither of my friends read p.46 of chapter 2 of my textbook on public health policy, which articulates my humble opinion on the relationship between medicine and epidemiology as follows:
“The term medicine is given equal weight with epidemiology in the title of this chapter not as an affront to the traditional dichotomy that relates medicine to individual health and epidemiology to population health but rather to emphasize the indispensable role that health care providers, and physicians in particular, play in advancing public health. Physicians are the frontline responders who deliver care, but they also play an integral role in diagnosing illness, offering best practice guidelines, advancing research by identifying potential determinants of health at the biological and even societal levels, and preserving quality and safety in care. These distinct roles are emphasized in this chapter… and in the case studies [that follow]. Of course, the majority of the case studies in this book illustrate the breadth of public health beyond the clinical realm, and the role of epidemiology in elucidating upstream determinants that are removed from the downstream delivery of care. Nonetheless, the role of medicine in public health—and particularly its linkage with epidemiology—is essential.” But this arranged marriage between epidemiology and medicine is hardly radical and often falls back on a biomedical paradigm that I will concede, as a nod to my epidemiologist friend, is not always aligned with overarching public health prerogatives.
So what, then, is an excellent example of a partnership that exemplifies a true multidisciplinary, interdisciplinary collaboration for securing the public’s health? Enter the medical-legal partnership and our very own Health Justice Project (HJP). If there is anyone worthy of being declared a hero of this kind of collaboration, it is the program’s Director, Emily Benfer, who founded and has spearheaded this partnership between the HJP legal clinic through the School of Law, with the Erie Family Health Center, comprised of 12 community-based health centers in Chicagoland, to provide free legal assistance to Erie patients to overcome the social, legal, and systemic barriers that prevent long-term health and stability for low-income individuals and families in Chicago. The HJP has represented over 1200 patient-clients, resulting in $561,553 in payment and forgiveness of medical expenses for clients, and $547,235 in Medicaid reimbursement to healthcare institutions based on the project’s Medicaid successful denials appeals.
This fall, Prof. Benfer piloted the first cross-campus interdisciplinary Health Policy Advocacy course, co-taught by myself, Allyson Gold (School of Law), and Dr. Greg Gruener of our School of Medicine, involving law, medical, and public health students working together to represent a non-profit organization to respond to health disparities on a national level. Given its success and appeal among the students, we will offer this course again in spring 2014.
Prof. Benfer and I also initiated a project that explores the medical-legal partnership as a potential locus of research on social determinants of health. For those familiar with the literature, physician-epidemiologist Michael Marmot, who incidentally delivered the keynote address at this year’s American Public Health Association annual conference, articulated 3 pathways relating social structure to health outcomes vis-Ã -vis material, occupational, and socio-environmental pathways. Our project builds upon this model to elucidate the precise association of different social, environmental, and material indicators with the development or exacerbation of existent health conditions among low-income communities residing in Chicago. We also submitted two grant proposals of what we hope will be many more to come in the months and years ahead to support these kinds of inquiries.
Our projects draw from the ‘PEEEL’ framework introduced in my textbook, highlighting the role of politics, epidemiology, ethics, economics, and law to effectively address public health policy problems in research, education, and practice. Through these educational, research, and practice initiatives, we seek to further develop what I believe is one of the few multidisciplinary, interdisciplinary partnerships that captures the spirit and service that is public health.
Wishing all of you a Merry Christmas and Happy Holidays in the weeks ahead as I sign off for 2013.
Consider, for example, a friendly exchange between two of my friends, a prominent physician and a prominent epidemiologist, who were deliberating on whether the clinician’s role in delivering particular services ought to be characterized as “doing public health.” Sadly, neither of my friends read p.46 of chapter 2 of my textbook on public health policy, which articulates my humble opinion on the relationship between medicine and epidemiology as follows:
“The term medicine is given equal weight with epidemiology in the title of this chapter not as an affront to the traditional dichotomy that relates medicine to individual health and epidemiology to population health but rather to emphasize the indispensable role that health care providers, and physicians in particular, play in advancing public health. Physicians are the frontline responders who deliver care, but they also play an integral role in diagnosing illness, offering best practice guidelines, advancing research by identifying potential determinants of health at the biological and even societal levels, and preserving quality and safety in care. These distinct roles are emphasized in this chapter… and in the case studies [that follow]. Of course, the majority of the case studies in this book illustrate the breadth of public health beyond the clinical realm, and the role of epidemiology in elucidating upstream determinants that are removed from the downstream delivery of care. Nonetheless, the role of medicine in public health—and particularly its linkage with epidemiology—is essential.” But this arranged marriage between epidemiology and medicine is hardly radical and often falls back on a biomedical paradigm that I will concede, as a nod to my epidemiologist friend, is not always aligned with overarching public health prerogatives.
So what, then, is an excellent example of a partnership that exemplifies a true multidisciplinary, interdisciplinary collaboration for securing the public’s health? Enter the medical-legal partnership and our very own Health Justice Project (HJP). If there is anyone worthy of being declared a hero of this kind of collaboration, it is the program’s Director, Emily Benfer, who founded and has spearheaded this partnership between the HJP legal clinic through the School of Law, with the Erie Family Health Center, comprised of 12 community-based health centers in Chicagoland, to provide free legal assistance to Erie patients to overcome the social, legal, and systemic barriers that prevent long-term health and stability for low-income individuals and families in Chicago. The HJP has represented over 1200 patient-clients, resulting in $561,553 in payment and forgiveness of medical expenses for clients, and $547,235 in Medicaid reimbursement to healthcare institutions based on the project’s Medicaid successful denials appeals.
This fall, Prof. Benfer piloted the first cross-campus interdisciplinary Health Policy Advocacy course, co-taught by myself, Allyson Gold (School of Law), and Dr. Greg Gruener of our School of Medicine, involving law, medical, and public health students working together to represent a non-profit organization to respond to health disparities on a national level. Given its success and appeal among the students, we will offer this course again in spring 2014.
Prof. Benfer and I also initiated a project that explores the medical-legal partnership as a potential locus of research on social determinants of health. For those familiar with the literature, physician-epidemiologist Michael Marmot, who incidentally delivered the keynote address at this year’s American Public Health Association annual conference, articulated 3 pathways relating social structure to health outcomes vis-Ã -vis material, occupational, and socio-environmental pathways. Our project builds upon this model to elucidate the precise association of different social, environmental, and material indicators with the development or exacerbation of existent health conditions among low-income communities residing in Chicago. We also submitted two grant proposals of what we hope will be many more to come in the months and years ahead to support these kinds of inquiries.
Our projects draw from the ‘PEEEL’ framework introduced in my textbook, highlighting the role of politics, epidemiology, ethics, economics, and law to effectively address public health policy problems in research, education, and practice. Through these educational, research, and practice initiatives, we seek to further develop what I believe is one of the few multidisciplinary, interdisciplinary partnerships that captures the spirit and service that is public health.
Wishing all of you a Merry Christmas and Happy Holidays in the weeks ahead as I sign off for 2013.
