By Delia Ward 

Health is central to a good and productive life for everyone. And when leaders at the University of Washington were considering how best to focus the energies of a great university, they decided to make population health the center of the most expansive, visionary plan in the University’s 155-year history.

“We believe we have a moral imperative to improve the health and well-being of people here in Washington and around the world,” says UW President Ana Mari Cauce. “Together with partners across the University, region and globe, we will find solutions to the world’s greatest health challenges, improving the health of our planet and of all the people who call it home.”

This bold vision is embodied in the University’s new Population Health Initiative, which aims to help everyone, everywhere, lead a healthy life.

Ali H. Mokdad, Ph.D., UW professor of global health at the UW Medicine-based Institute for Health Metrics and Evaluation (IHME), notes that population health is a strong focus in many areas at the UW: social work, arts and sciences, built environments, law, business and many others. And, of course, at UW Medicine and the School of Public Health, and in the department they jointly administer: the Department of Global Health.

“The UW is already doing stellar work in the population health arena,” says Mokdad, the vice chair of the president’s new Population Health Initiative Executive Council. “This initiative and the University’s fundraising campaign offer us the opportunity to work together in a focused, united way — so that everyone has the chance for a boundless future.”

The human condition

The first thing that executive council members like Mokdad stress is that population health is a broad topic, including human health and major health determinants such as social and economic equity and environmental resilience.

In short, with this 25-year-long initiative, the University of Washington intends to take on and improve the human condition.

“We envision a world in which there is equity with respect to health and quality of life.” ­— Judy Wasserheit, M.D., MPHRead more about Wasserheit’s passion for equity.

The University is meeting this challenge with enormous capacity in data collection and analysis, which will frame problems and assess solutions. It’s addressing it with unparalleled experience in working with underserved populations and in rural and urban areas. And it’s approaching population health with the reputation — and resources — associated with being one of the best research universities in the country, one with a wealth of expertise in areas that range from environmental science, to the humanities, to medicine.

Paul G. Ramsey, M.D., the CEO of UW Medicine, knows that his colleagues are eager to address the new challenges posed by the president’s bold initiative. After all, the mission of UW Medicine is to improve the health of the public.

“Very few places have the scale or the commitment to discovery that UW Medicine has,” he says. “We want to make sure that everyone — faculty, staff and students — can contribute to this initiative to their fullest ability.”

Data and real-world solutions

IHME, administratively based in UW Medicine, has been working on population health since its founding in 2007. Seattle-based investigators collaborate with hundreds of researchers worldwide to collect and assess data on trends in human health at the regional, state and community levels. One of the results is the world’s most comprehensive analysis of health data: the Global Burden of Disease report.

Resident Mackenzie Carpenter, M.D., is learning the practice of family medicine from Dick McLandress, M.D. ’74, in the Kootenai Clinic in Coeur d’Alene, Idaho — part of UW Medicine’s five-state regional medical education program, WWAMI.
Photo: Clare McLean

This study, updated annually, is the work of 2,000 collaborators in approximately 130 nations, and its findings are being used by policymakers in countries around the world. India, Rwanda and China, for instance, are allocating health funding and addressing issues ranging from child mortality to pollution. And the data can reveal some surprising connections.

“At the national level, one country can look quite different from another,” says health economist and IHME Director Christopher J.L. Murray, M.D., D.Phil. “But once you start looking locally, you find counties in the U.S., for example, that share characteristics with areas around the world.” Meaning: a population health intervention that works in one region may also work halfway around the globe, or right here in our own backyard.

Murray and his colleagues already regularly provide findings and analysis to UW Medicine, to the School of Public Health, to Pres. Cauce and to the UW’s Office of Global Affairs. And they’re looking forward to engaging more partners once the Population Health Initiative comes fully online.

“IHME is at the ready to provide scientific data and analytical insights on a range of topics, from diseases, to injury, to education levels, to income levels,” says Murray. “We’re here to help drive real-world solutions.”

Everything we do

When Emiko Tajima, Ph.D., thinks about population health in the Seattle area, she thinks about people who have nowhere to live. According to a count conducted by the Seattle/King County Coalition on Homelessness in 2015, approximately 10,000 people in the King County area were homeless, either in shelters or on the streets.

“If we want to be serious about population health outcomes locally, addressing the housing situation and economic stability is really critical,” says Tajima, an associate professor in the UW School of Social Work. The school is addressing these and other topics, in part, through student education.

“We do the best we can to recruit students from within the communities we want to serve,” says Tajima. And the school does not limit itself to local service. For instance, associate professor Tracy Harachi, Ph.D., helped Cambodian students establish that country’s first undergraduate degree in social work.

“In some ways,” says Tajima, “everything we do relates to population health.”

The same holds true for faculty in the Department of Psychiatry and Behavioral Sciences at the UW School of Medicine.

Innovations that work in one part of the world can work in others. Resident Josh Lacsina, M.D., is shown here working at a district hospital in Naivasha, Kenya —part of a Kenyan project modeled on UW Medicine’s five-state medical education program, WWAMI. Both programs focus on medical training in rural settings.
Photo: Paul J. Brown

“IHME estimates that mental disorders account for about 23 percent of all health-related disability worldwide, much more than diabetes, heart disease or cancer,” says Jürgen Unützer, M.D., MPH, the department’s chair.

And, like Tajima, Unützer and his colleagues are doing something about it. Last year, the department established a new Division of Population Health, whose faculty collaborate with scientists in medicine, public health, social work, global health and the graduate school to improve the mental health of populations worldwide. Locally, they’re collaborating with the School of Social Work to train providers in suicide prevention and improve training for people who work with foster children, with the School of Education to improve school-based mental health services, and with Computer Science & Engineering to use technology to reach more people with effective mental health care.

Collaboration within the University of Washington is one of the department’s strengths, notes Unützer. And external collaboration is equally important.

“Locally and in our five-state region, we partner with communities and community-based healthcare providers — and we also partner with low- and middle-income countries around the world,” says Unützer. “In fact, much of what I’ve learned about effective care comes from watching people in low-resource settings, where many people need care, but where there are few specialists. They have to find smart, creative, human solutions that make the most of the resources they have.”

Population health is all about this kind of human capital and connection. “If the Population Health Initiative helps drive greater collaboration so that we can benefit from all the strengths of the University, we could do a lot more good together,” says Unützer.

More than we can imagine

“I think about cities a lot,” says Thaisa Way, Ph.D., UW professor of landscape architecture and landscape historian in the College of Built Environments. They can be dangerous places, magnets for inequity, illness and pollution; bad for human and environmental health. Way, however, is quick to point out the flip side. “If we plan cities right,” says Way, “we can have an incredibly positive and productive impact.”

“All the faculty here at UW are trying to make the world a better place.” ­— LuAnne Thompson, Ph.D.Read more about Thompson’s work on climate change.

Way is the director of a group called Urban@UW, which aims to make Seattle a model city, one that is a healthy, opportunity-filled place for all its residents. Other members of the faculty at the College of Built Environments also pursue population health projects: Ben Spencer, M.A., MLA, for instance, works with the Department of Global Health and communities in Peru and Cambodia to design shared public spaces. Another faculty member, Branden Born, Ph.D., studies food security.

“We think about how place impacts human and environmental health in really broad ways,” says Way. Even so, she thinks that the Population Health Initiative will open the door wider, bringing together new combinations of academics, policymakers and the public to take on intractable, intertwined issues such as poverty, climate change and political upheaval.

“We have an amazing capacity to think differently if we let ourselves,” says Way. “I think we might do things we never imagined we could do.”

All aboard

“I see the Population Health Initiative as an expansion of the University’s existing role,” Paul Ramsey says. “It takes the terrific work already being done by the Department of Global Health and the School of Public Health, by IHME and by other practitioners, and broadens it to include our entire community.”

For Wasserheit in global health, the Population Health Initiative feels like the next evolutionary phase for a department founded a decade ago.

Looking at the big picture. Working with communities. Realizing that the local informs the global, and the global informs the local. Knowing that a public university has a responsibility to its community and feeling the deep moral imperative that the University of Washington can and should give something to the world.

“This initiative really frames an opportunity for all of us,” says Wasserheit. “It’s time for everyone to get on board.”

 

A Great Moment for Population Health

Christopher J.L. Murray, M.D., D.Phil, Director, IHME

In late October 2016, the Population Health Initiative at the University of Washington received a transformative gift, one that will advance the UW’s efforts to improve health and well-being around the world, from the Bill & Melinda Gates Foundation.

“We are grateful and honored to receive this generous support from the Gates Foundation, which recognizes that the UW is among a small subset of institutions equipped to tackle the health challenges we face on a global scale,” said President Ana Mari Cauce about this $210 million gift for a new facility.

The 25-year Population Health Initiative, announced by Cauce last May, is designed to improve human health, environmental resilience, and social and economic equity here in our region and around the world.

“This is a transformational gift,” says Paul G. Ramsey, CEO of UW Medicine. “And it’s being directed to an initiative that is a perfect fit for the mission of UW Medicine. It’s a tremendous vote of confidence in the University’s and UW Medicine’s work to improve population health.”

This contribution is the third substantial investment the Bill & Melinda Gates Foundation has made to population health. The first two gifts were made a decade ago, when the foundation created the Department of Global Health, a collaboration between UW Medicine and the School of Public Health. It also founded the Institute for Health Metrics and Evaluation, a world leader in researching and analyzing global health trends to help policymakers make informed decisions on health interventions and government spending. Both groups bring scientific rigor, a deep belief in social justice and a broad network of global collaborators to their work.

With this investment from the Gates Foundation, the University of Washington will construct a building that will house the Department of Global Health, IHME and portions of the School of Public Health, as well serving as a hub for faculty and student collaboration across a range of disciplines — from medicine and the health sciences to education, engineering, environmental sciences, law, the arts, humanities, social sciences, business and beyond.

“This gift will help set the path for population health at UW Medicine and the University of Washington, and guide us in making life better for everyone, everywhere,” says Ramsey. “It is a great moment for human health.”

Learn more about the Population Health Initiative at washington.edu/populationhealth.

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