Featured Member

Community Comes First

Elizabeth Miller, a medicine/pediatrics physician and medical anthropologist, is Director of Adolescent Community Health at the Massachusetts General Hospital (MGH) Revere Health Center. In that role, she directs the school based health center, teen programming (including an after-school youth center and a school-based dating violence program), and functions as the school physician for the city of Revere. At Harvard Medical School, she is the Associate Director of the Division of Service Learning and Faculty Chair of Community Service Programs, where she teaches and oversees student community service projects.

For Elizabeth, community comes first. She says, “This is not about us (at the medical school or at the hospital), but it’s about the privilege of working with people in communities we serve.” Because of her background in medical anthropology, Elizabeth has a unique perspective on the challenges of providing cross-cultural care and on the effects poverty has on the lives of the people she works with and cares for. CCPH is a critical resource and clearinghouse in her work in community health and community-campus partnerships. “Right now, my favorite part of CCPH is the CBPR listserv but I also LOVE reading the newsletter, and get lots of ideas and grant information from this.”

To sign up for the CBPR listserv, visit https://mailman1.u.washington.edu/mailman/listinfo/cbpr.

Briefly, what is the mission of your organization?
What do you most want people to know about the work that you do and the unique characteristics of your organization?
What are you passionate about in your work? What has motivated you to become involved in community-university partnerships?
What is your dream for the future of your organization and/or community-campus partnerships you're involved in?
What wisdom would you like to communicate to others in this field? What advice would you give to a student or professional just entering into the field?
What is the biggest challenge you face in your work and how are working to overcome it?
If you could give advice to a policymaker what would you recommend?
Why did you join CCPH? How would you describe the organization to your colleagues?
What does “community-campus partnership” mean to you?
What value do you see in being a member of CCPH to meet your future goals for your organization and for the field? What is your favorite part of CCPH?
What strengths and talents do you bring to CCPH?
What has been your biggest challenge at work and how have you overcome it?
What keeps you motivated to do the work you do?

Q: Briefly, what is the mission of your organization?

A: The Massachusetts General Hospital (MGH) Revere Health Center's Adolescent Health Initiative strives to provide comprehensive, holistic care for adolescents in the socially disadvantaged community of Revere, Massachusetts-increasing access to care, celebrating the strengths and diversity of youth, and nurturing social networks of youth. The Initiative links school-based and confidential clinical services with a youth development after-school program (called the Youth Zone), with the support of multiple community partners, including the schools, police, mayor's office, and key community representatives. The Youth Zone provides a wide variety of preventive, educational, recreational, and vocational planning programs and resources that facilitate the development of the innate strengths found in all youth.

Q: What do you most want people to know about the work that you do and the unique characteristics of your organization?

A: What has been most astounding for me over the last eight years has been observing the process of how this program has grown from a small after school program with a once-a-week clinic to a fully staffed, busy five-day-a-week confidential clinic, school-based health center, and teen after-school program. This growth is attributable to a collaboration between a few dedicated people within the main Revere Health Center (a teaching-hospital-affiliated community health center), who are committed to providing excellent care to adolescents, and a group of like-minded community participants and key leaders-a Revere substance abuse coalition, the police, the schools, and the mayor's office. We have been able to develop and nurture trust within this community; as an example, the mayor's office offered us the use of a much larger, more centrally located building for the teen after-school program when we were outgrowing our original space.

Q: What are you passionate about in your work?

A: I love to take care of young people. Although my clinical practice is a medicine/pediatrics primary care practice (from newborn to the elderly), I get the biggest thrill taking care of youth, learning from them about how they view the world, and encouraging them to draw on their assets. I also feel very privileged to work with a lot of people in the Revere community who are dedicated to supporting more resources for adolescents. I love to be involved in coalition building, and being involved in local advocacy. I enjoy also finding some skills that I can offer to various community partners, particularly certain research and evaluation related work. Finally, I have opportunities to work with medical students and residents, and feel very strongly that one can teach students through service to embrace social responsibility as a component of professionalism and their own professional identities. I LOVE hearing students talk about how their service experiences have changed their world views and career plans!

Q: What is your dream for the future of your organization and/or community-campus partnerships you're involved in?

A: I want to ensure that the resources available to youth continue to grow in this community, and that there are high quality after-school programs, job training, and activities available. One of my big hopes for this organization is to see the Adolescent Health Initiative reach many more adolescents in this community, and that we continue to provide the highest quality services and supports to help these youth succeed and be healthy. So, one dream is to have a steady stream of funding (ok, dream on!) and for many more stakeholders to be involved in order to sustain this work. While the teaching hospital continues to support some of the staff involved, I would like to see this work become increasingly more community-based and develop greater sustainability.

Q: What wisdom would you like to communicate to others in this field? What advice would you give to a student or professional just entering into the field?

A: Relationship building and community organizing take time. So, I guess one lesson learned is to be patient.

And a related lesson to that is, take the time to learn from the many stakeholders involved and actively seek input-the rewards are immense.

For students and others just entering into the field, I can't emphasize enough to practice the basic principles of community-oriented care, to reflect on social responsibility and humility as critical characteristics of one's professional life, and to identify the champions and key stakeholders early on.

Q: What is the biggest challenge you face in your work and how are working to overcome it?

A: When I first started, the big challenge was getting buy-in from my own health center's providers that adolescent care was worth doing and that by increasing access to care in the community that we were not "stealing" their patients. At this point, as we have grown, most of the providers have at least acknowledged that these adolescents are likely to be people who would not have come to the health center, and that we are doing meaningful outreach.
The other challenge is making a larger shift in community norms to see youth as an asset in this community, which has been one of the major goals of the substance abuse coalition, Revere CARES, with whom I'm very involved. We have been developing parent outreach messages, helping youth (especially our peer leaders) get more involved in community service activities with greater visibility, and identifying ways to reach families who are not native speakers of English.

Q: If you could give advice to a policymaker what would you recommend?

A: Funding adolescent health focused initiatives (such as school-based health centers, after-school programs, and youth development organizations) are cost effective. These programs help kids stay healthy and stay in school, which means less cost to the health care system and greater benefit to society in the long run.

Q: Why did you join CCPH? How would you describe the organization to your colleagues?

A: I first learned about CCPH when I became involved in overseeing community service experiences for medical students (at Harvard Medical School) as Faculty Chair of Community Service Programs and Associate Director of the Division of Service Learning. I went to the CCPH web site to learn more about what others had done to build campus-community partnerships, what was being done in service learning, and just get the lay of the land. I learned an immense amount and our Division of Service Learning very quickly became members. I think about CCPH as an incredible resource for anything related to community health work, whether it is tools and references for particular topics (such as CBPR), lists of grants and awards, or for examples of model community-campus partnerships.

Q: What does “community-campus partnership” mean to you?

A: 1) Community comes first - this is not about us (at the medical school or at the hospital), but it's about the privilege of working with people in communities we serve.

2) Collaborations and partnerships need to be nurtured, and that means also recognizing that one cannot be complacent about these relationships and must continuously reflect on the co-learning taking place.

Q: What value do you see in being a member of CCPH to meet your future goals for your organization and for the field? What is your favorite part of CCPH?

A: CCPH continues to be a critical resource for me both in Revere with the work with youth and our coalition, as well as at the medical school. I use the CBPR listserv regularly, and end up going to CCPH related resources at least once a week if not more. So the value of CCPH as a national resource and clearinghouse for work related to community health and community-campus partnerships that I can point to in my conversations in clinical, educational, and research settings is immense.
Right now, my favorite part of CCPH is the CBPR listserv but I also LOVE reading the newsletter, and get lots of ideas and grant information from this. Thank you!!!

Q: What has been your biggest challenge at work and how have you overcome it?

A: Not more than 24 hours in a day, I guess. Trying to balance the need to see patients at our health center with my administrative work as the director of adolescent health, teaching at the medical school, and community based research is incredibly hard …am still working on this one!

Q: What strengths and talents do you bring to CCPH?

A: I came into community-based work through medical anthropology rather than public health, so I bring more of an ethnographic fascination with social contexts rather than a traditional public health model. So I think some strengths I bring are an appreciation of the challenges of cross-cultural care and concerns about the complex ways in which poverty impacts and constrains the lives of so many of the people we work with and care for. In terms of skills, my qualitative research skills have been invaluable in doing my community-based work.

Q: What keeps you motivated to do the work you do?

A: My dad always emphasized how important it was to "do the right thing." So I guess that is one of my motivations. I can't imagine not doing work that involves community partnerships and advocacy, so I guess that's what keeps me motivated.

Elizabeth Miller
Director of Adolescent Community Health
Massachusetts General Hospital – Revere Health Center
300 Ocean Avenue
Revere, MA 02151
Tel: 781-485-6350
Fax: 781-485-6391
Email: emiller1@partners.org

2nd address:

MGH Community Benefit, Research and Evaluation Team
50 Stanford St., 9th Fl
Boston, MA 02114
Tel: 617-726-6992
Fax: 617-726-4210

To read about other previous featured members click here.