Stories from Texas Medicine, February 2018

The State of Health in Texas - 04/24/2018

At the beginning of the 20th century, the major health threats to individual and community health in the United States were infectious diseases, injuries due to unsafe workplaces, diseases due to poor nutrition, and poor maternal and infant health. During the next 100-plus years, tremendous advances were made in longevity and health status. As the impact of certain historically significant diseases decreased, however, the pattern of public/population disease burden became dominated by chronic diseases such as cardiovascular disease, diabetes, asthma, and cancer. In Texas in 2015, chronic diseases made up the top four causes of death. Public health professionals are largely focused on identifying the risk factors for these chronic diseases via enhanced morbidity and mortality surveillance. In addition to health care providers and the health care sector, a cross-section of other stakeholders, including businesses, communities, and social services, must work collaboratively, creatively, a...


Population Health Management - 04/19/2018

Since the practice of medicine began, the role of physicians in preventing and treating disease and fostering overall well-being has been irreplaceable. Even as we fast-forward to 21st-century medicine ― with cutting-edge technologies, global connectivity, advances in medical practices, and state-of-the-art diagnostic and treatment tools ― the simple act of laying a trained physician’s hands on a patient remains at the core of today’s health sector.


The People in Population Health - 02/22/2018

Certainly, individual behaviors matter, and individual responsibility is critical, particularly for chronic illness prevention. However, population health dwells less on what individuals decide and more on making sure that the proper choices exist in the first place. It is about having a framework so that people have the resources to be empowered in making the best decisions, and it ensures that our precious health resources are allocated in the most efficient manner.


MD Anderson's Population Health Approaches to Cancer Prevention - 02/01/2018

Texas's size and unique population demographics present challenges to addressing the state's cancer burden. The University of Texas MD Anderson Cancer Center is one of 69 National Cancer Institute-designated cancer centers across the United States. While these centers traditionally have focused on research, education and training, and providing research-driven patient care, they are in a unique position to collaboratively advance population health through cancer control. Unlike the traditional academic model of a three-legged stool representing research, education, and patient care, MD Anderson's mission includes a fourth leg that incorporates population health approaches. MD Anderson has leveraged state- and national-level data and freely available resources to develop population-health priorities and a set of evidence-based actions across policy, public and professional education, and community-based clinical service domains to address these priorities. Population health approaches c...


Measuring and Managing Population Health - 02/01/2018

Health care delivery and health promotion require timely, accurate, and useful information. Nowhere are useful data more needed than population health management. Although mountains of health-related data exist, useful information is often diffuse, poorly organized, and often inaccurate and incomplete, and doesn't serve those providing health care to individual patients, managing care for groups of patients, or promoting health for communities. Information and communication technologies are rapidly evolving to enhance population health management. These tools include electronic health records, health information exchanges, patient portals and personal health records, telemedicine and virtual health tools, the internet and social media, mobile devices, and wearable sensors. We describe each of these emerging health technologies and their future opportunities for enhancing population health.


Improving Health in Hard-to-Reach Communities - 01/25/2018

The health impact pyramid offers a framework for considering the relative significance of socioeconomic determinants of health and for prioritizing interventions that may be effective in improving health outcomes in hard-to-reach and rural populations. Barriers to health care delivery in rural settings are outlined with examples provided. Demonstration projects in East and West Texas are reviewed. Those programs reach unique populations such as agricultural and migrant workers and those with mental illness by using innovative approaches, such as the use of specially trained community health workers and telehealth and telemedicine. Having a health impact on hard-to-reach groups and rural populations is largely a function of overcoming numerous barriers. Adopting a population health approach that engages the community in overcoming those barriers is likely to be more effective in producing improved health outcomes.


Understanding the Language of Public Health - 01/22/2018

Learning how to take care of a patient never ends. Medical school and residency taught me the science of medicine or letters in the alphabet. The first five years in practice taught me there was an art that swirled around the science or how the letters fit together to make words. The last 10 years taught me how the science and the art are best appreciated with an audience or how words make up poetry and novels in many different languages.


Addressing Health Disparities - 01/22/2018

Knowing Neighborhoods' Specific Needs a Step Toward Improved Care Commentary — February 2018 Tex Med. 2018 114(2) 8–10. By Vincent Fonseca, MD If we are to improve the health of


Mental Health: A Call to Collective Action - 01/22/2018

Each of us now knows that mental illness is medical illness, just like diabetes, cancer, or cardiovascular illness. And each of us knows that contemporary mental health care is rooted in science. Next, we must insist upon prevention, early intervention, and aggressive treatment for people who endure these potentially devastating disorders.