Data will play a critical role in shifting the nation’s focus from disease care to preventing and protecting the United States from health threats, Centers for Disease Control and Prevention’s Mandy Cohen said during the June 26 installment of the Health Policy Forum. Johns Hopkins.
Cohen joined Johns Hopkins School of Nursing Dean Sarah Szanton for the quarterly event, held in person for the first time since its inception during the pandemic at the Hopkins Bloomberg Center in Washington, D.C. During the conversation, which was also broadcast live, Cohen and Szanton advocated for a prevention-based system that promotes care for all people and eliminates disparities.
“You can’t solve problems you don’t see,” Cohen said. With better data and evidence, health care providers and systems at all levels—local, state, and national—can take a proactive approach to health threats, identify communities that need help, and determine which treatments and the measures work or not, she said.
“Look at the CDC evidence and data,” she urged health teams. “We can be a partner in helping you think about what to spend your dollars on and how to do it in a smart way. There are things you shouldn’t spend your dollars on, too. Use that evidence.” As former secretary of the North Carolina Department of Health and Human Services, Cohen, an internal medicine physician, led the state’s response to COVID-19 and won praise for promoting data-based decision-making, equity and transparent communication. . Cohen became CDC director in July 2023. She identified three current CDC focus areas:
Ready our response to health threats, from the virus that causes bird flu to extreme heat and gun violence
“To be that response agency for the country and to keep us safe, we need some core capabilities … in a disease-agnostic way,” Cohen said. “Our HIV data was here, COVID data here, malaria there. How do we think to bring[ing] some of them together because we are all working with communities and individuals who may be affected by COVID, influenza and [other conditions]. How to do [we] … merge data to identify trends related to?
Strengthening mental health services
“Mental health, we know, is always strained during an emergency, whether it’s a hurricane or a pandemic,” Cohen said. “… We are seeing more substances on the market that are more potent. [Last year alone,] we lost 100,000 people to overdoses [and] 50,000 to suicide. We can do better.” Data visibility is key.
Support young families
A health system based on prevention starts with better support for young families, Cohen told the audience. “How to create a system that can think about upstream causes [of] how my patient ends up here with diabetes or [another] chronic disease? What are the ways in which we could have prevented this?” asked Cohen. “The data tells us what shapes your health patterns throughout life—[and] which actually happens in the first years of life,” she replied.
With these three areas of focus come other CDC initiatives, including work on the social determinants of health, Cohen told the crowd of nearly 100 Johns Hopkins students, faculty, staff and members of the public in person, along with nearly 200 tuning in distance. “We know from our data that your zip code determines your lifelong health patterns more than your genetic code,” Cohen said, noting a waiver she created to help individuals pay for housing, food and transportation as part of an innovative Medicaid program in the North. Carolina. “We have an evaluation to show that not only is it helping people stay healthy, but it’s saving money.”
Szanton brought a new pilot program to Baltimore, Neighborhood Nursing, a collaboration between community organizations and the schools of nursing at Johns Hopkins, Morgan State University, Coppin State University and the University of Maryland. Through the program, nurses and health workers meet with individuals in homes, schools and neighborhood gathering places such as libraries and barber shops to learn about and support their health needs. “We’re trying to turn primary care on its head,” Szanton said. “We often see in primary care [only those] that come to us. If you don’t feel well, you leave, but what about the elderly person who is housebound – or homeless?”
Baltimore is a great place, Szanton continued, and suffers from high rates of opioid overdoses, a reality her team has seen firsthand in its door-to-door work through Neighborhood Nursing. “We very quickly added fentanyl test strips, Narcan, and we’re really taking overdose prevention to the streets,” she said.
The CDC is committed to helping cities like Baltimore fight overdoses, Cohen said. “We have invested in an overdose data action platform that allows us [send] dollars to communities like Baltimore,” Cohen said. The platform provides not only “real-time data on overdoses, but also what are those substances in communities that may be more potent and cause more harm to people, so people can react faster. .”
Additionally, the platform helps communities understand what works and what doesn’t. The data show, for example, that in addition to fentanyl and Narcan test strips, recovery care in emergency rooms is important. “Emergency departments are where the broken parts of our system show up,” Cohen said. “But we have best practices from CDC-funded and evaluated projects where we know what works,” she said, urging people to consult CDC’s information and resources on health topics that include everything from from the impact of drought on health to the prevention of high cholesterol.
Cohen’s talk was the 12th event in the Health Policy Forum series, which began in fall 2020 to highlight the university’s engagement with key leaders on health and health care policy issues. The Health Policy Forum Series is co-hosted by the Bloomberg School of Public Health, the Carey School of Business, the School of Nursing and Johns Hopkins Medicine.
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