Local public-health officers perform many tasks, including inspection of restaurants, checking the water quality at beaches, promoting immunizations, and coordinating the local response for communicable disease outbreaks.
But another role is growing in importance — working with local doctors and hospitals to help improve community health.
Acting state Health Commissioner Cathleen Bennett sees the traditional work of public-health officers overlapping more and more with healthcare providers who are receiving more of their payments based on managing the health of entire populations of patients, rather than for the volume of services they provide.
“Population health doesn’t work if you’re going to say that it’s only about dealing with people when they have a chronic condition that has flared up, or if they have an acute, emergent situation that requires hospitalization,” said Bennett. “It’s something more.”
That something more includes examples across the state of the kind of collaboration that Bennett foresees becoming more common. They include hospitals reaching out to public health officers for assistance in assessing the health needs of their communities and sharing information.
But much work remains to be done, with many local officers saying that they haven’t heard from nearby health systems.
‘Population health villages’
Both public health officers and healthcare providers have roles to play in what Bennett described as “our population health village” – the combined community effort of medical, business, social-service, government, religious, and other organizations to improve the health of residents.
Bennett wants her department to “knit together” the work of local health officers with that of providers. Traditionally, there has been “a pretty big distance” between the two groups, she said.
“It does matter, and you should be collaborating if you want to actually improve health outcomes in our state,” Bennett said, noting that her own department has been working to improve the internal cooperation between public health services and the Division of Health Facilities Evaluation and Licensing.
Bennett, who was promoted to her position by Gov. Chris Christie in early August, spoke about healthcare-public health collaboration at a recent gathering of roughly 100 public-health officials at the New Jersey State League of Municipalities conference.
She asked for a show of hands of how many participants had heard from their local hospitals about population-health initiatives, and most raised their hands. But when she asked if the hospitals had asked them for help with these initiatives, only a few hands remained up.
“You have the hospitals, and when they realized that they had to do this thing called population health, they went to their first partner … primary care,” said Bennett. This in turn led to involvement of pharmacies and local blood-test laboratories.
Healthcare beyond hospitals
“Where’s public health in the mix?” Bennett asked. “If you want to actually keep people well and healthy, is that really happening in the place you only want to go to when you’re sick? I mean, that’s really the essential question.”
Since public-health officers often are engaged in a wide range of activities to promote local residents’ health, they’re well-positioned to help providers, Bennett suggested.
Bennett said some cities have made progress in bringing hospital CEOs together with local health officers. She pointed to the Trenton Health Team as an example of how this can work. City of Trenton Health Officer James Brownlee oversees an office that’s been involved in this organization since it started.
“One of the things that’s really great that they do is say, ‘What is the health of our community? What do we need to focus on, and how do we do it collaboratively?’” Bennett said.
The 2010 Affordable Care Act requires hospitals to conduct community health needs assessments and adopt a strategy to meet those needs every three years. Bennett said that local public-health officers, as they have in Trenton, can play a valuable role in conducting these assessments.
Bennett said state Department of Health senior officials are putting the same emphasis on collaboration.
“We have put as our central challenge improving population health,” working with health systems, she said.