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The newspaper of The Johns Hopkins University June 11, 2007 | Vol. 36 No. 37
Taking the Pulse of Urban Health

Pediatrician Robert Blum, a faculty member in the School of Public Health, is an expert on societal influences on the health and welfare of adolescents.
Photo by David Colwell

New director of Hopkins institute looks to grow Baltimore initiatives

By Greg Rienzi
The Gazette

As the new director of the Johns Hopkins Urban Health Institute, Robert Blum plans to do a lot of reaching out this summer — but he doesn't need to reach far (Hopkins and East Baltimore will do).

Blum, who has served as the institute's interim director since May 2006, recently sat down with The Gazette to discuss the future plans for the institute and his goals as director.

A pediatrician and expert on societal influences on the health and welfare of adolescents, Blum will coordinate the efforts of the university and Johns Hopkins Health System, in collaboration with the community, to improve the health of residents of East Baltimore and other economically stressed parts of the city. The Urban Health Institute, established in 2000, also seeks to promote evidence-based interventions to solve urban health problems nationwide.

The institute's objectives are to serve as the community's primary portal to JHU, a repository of Baltimore health data and information, and a forum that brings together university and community leaders around a range of issues. It also seeks to participate in community planning, program development, research and evaluation efforts; develop an urban health education curriculum linking undergraduate, graduate and postdoctoral trainees; and initiate long-term sustainable interventions that improve the health and well-being of citizens of East Baltimore.

Blum, the William H. Gates Sr. Chair of the Department of Population and Family Health Sciences in the Bloomberg School of Public Health, said that he plans to broaden university and community representation in a revised organizational structure for the institute. He also wants more university staff, faculty and students involved with UHI's mission, and plans to initiate a small grants program that will support innovative collaborations between the university and community in research, program development and new urban health and development courses.

He talked about these initiatives and more, such as making the center and its work more visible, and user-friendly.

Q: I'm wondering what health issues — the big problems — the institute is focused on now.

A: We are not approaching our work from the perspective of problem reduction. Rather, we have been asking the question, What needs to be put into place to change the trajectory for children, youth and families in our community?

Where we have been investing a lot of our work is with East Baltimore Development Inc., working to bring the intellectual resources of JHU to the effort of developing a human support and service network that improves the outcomes for children, youth and families. Together, we have received support from Friends of the Family in Baltimore City to set up a family support center for parents and children, birth to 3 years of age. We are working with an entire consortium on a planning grant that will result in a community pre-K through grade 8 school and health campus that would include the first new school building in Baltimore in more than a generation. And as part of that effort, we are working with a wide range of community and university health providers to develop a coordinated and integrated health service network for all young people and their parents in our community.

Q: Can you give me some examples of the institute's work? Projects or programs that came out of Johns Hopkins' involvement, or that we initiated?

A: We have developed a model community health worker project under the direction of the associate UHI director, Chris Gibbons, that trains 10 paraprofessionals from the East Baltimore community to provide health supervision to local residents, especially seniors who have chronic conditions. In this program, the CHWs [community health workers] assist East Baltimore citizens register for health care, obtain insurance coverage, monitor blood pressure and medication compliance and assist those who are too frail and vulnerable to obtain the health care services they need. This model is becoming the basis for new initiatives that we are planning in collaboration with the East Baltimore Medical Center for women about to deliver, as well as with the East Baltimore health initiative that is part of the planned community school and health campus.

Q: Are there other university-community collaborations?

A: The UHI is part of a network of 16 colleges and universities in Baltimore that all have an interest in and a commitment to improving collaborations with their communities. How that work is done and what the priorities are vary substantially. We meet on a monthly basis to share information and develop cross-cutting collaborations.

Q: What are your plans for the first few months as the new director?

A: We plan to launch a newly designed Web site and have that come online by the end of the summer. We also have a group here led by Dr. [Bernard] Guyer [the Zanvyl Krieger Professor of Children's Health at the School of Public Health] conducting a review of all published health research done in Baltimore since 1990. This large body of research has been identified, reviewed and extracted; now it will be made available in tabular form on our Web site. We see this as both a university and community resource that people will be able to use and access.

Q: In the announcement of your appointment, you mentioned that you will be assessing the future work of the institute. What more can you say right now?

A: Yes, we recently held a meeting that was a community and university conversation on how to structure an institute like the UHI. At the meeting, we were looking at best ways of structuring our work, and collaborating with the community. We had an extraordinarily wonderful array of concrete suggestions. We are just beginning now to synthesize all this, and by the end of August, I think, we'll be moving forward on many of the suggestions.

Q: Can you offer up any specifics that came out of the meeting?

A: First, we talked about how we really want to bring in more of the community as part of our academic ventures. One way of fostering that is giving small grants to the faculty who team up with community members or organizations to develop new courses here, at both the undergraduate and graduate level, whether it's in urban development, housing, health or application of the arts. We want to be very broad, inclusive of both liberal arts and the health sciences.

We also envision a small grants program for students in partnership with community groups to conduct community research. Students at Homewood or the schools of Nursing, Medicine or Public Health can team up with a community organization for a pilot study, to analyze existing data that the agency might have or to undertake a survey that can be used for program development. And we envision having a similar grant program for faculty and community members. Here, a plan for sustainability will be critical. What the UHI can do is to help jump-start collaborations, but we never will have the resources to sustain them.

What we are looking to do through these mechanisms is to create bridges, through the use of $5,000 and $10,000 grants, which will spur innovation and collaborations. We're very excited about this.

Q: In terms of the new courses, how do you see these forming?

A: For example, our faculty have been working with community groups on health care for the uninsured. I could see a terrific course in public health on that topic. I could envision faculty members getting together with community leaders in health care for the uninsured, and collaboration on a course that covers this area. We also have faculty who work on fair labor and fair wage legislations, low-income housing issues. So I could see us fostering courses in any of those areas or on the topic of race, poverty and the community.

Q: Who else do you want to reach out to?

A: One other area we've begun to move toward is our work with the faith community around health issues facing East Baltimore. Early in May, we convened a panel that included senior leadership of the East Baltimore campus — deans Edward Miller [of the School of Medicine] and Michael Klag [of the School of Public Health], David Nichols [vice dean for education in the School of Medicine], Ron Peterson [president of The Johns Hopkins Hospital and Health System] — Jack Shannon [president and CEO of East Baltimore Development Inc.] and roughly 50 or so ministers from the community. We wanted to begin a dialogue with them and make some momentum with concrete suggestions of how we can help the community.

Q: Why this group?

A: One of the constants in the community is the faith leaders. They have both tremendous influence and are extremely knowledgeable about the needs of people in the community. To have an ongoing dialogue for sharing information with them, I think, is essential.

Q: What size staff do you have, and do you plan to grow?

A: Right now we have a core staff of a coordinator, Amy Gawad; an associate director, Dr. Chris Gibbons; and a postdoctoral fellow, Dr. Nadra Tyus, but we are planning to bring in a communications specialist. We just recently were informed by the Macht Foundation that we will be receiving a grant that will allow us to bring in someone who can fill this role, someone who can share information with all constituencies in a more timely and sophisticated manner than we've done in the past. In general, we plan to be much more proactive.

Q: Will the staff grow much more?

A: We will want to add one additional new position. This would be an information specialist who anyone in the community can call and get any information they need as it relates to Johns Hopkins University. One of the questions we hear so often is, How can I speak with someone at Hopkins when I have a question? It is a big issue, and we hope to have someone who will field all of those calls and questions and will either have the answer or get back to the caller with the information that they are requesting. Someone with knowledge of not just the institute's work but all of the university, and the work we do at all the divisions.

Q: You said you plan to look at the organization's structure. Can you elaborate on that?

A: The exact shape or form of the UHI I am not positive of yet, but one of the things we are thinking about is a coordinating council comprised of individuals from across the university and the surrounding communities. It would certainly have strong representation from the hospital, schools of Medicine, Nursing and Public Health, as well as the Homewood schools. And it would also have representation from community-based organizations, philanthropic organizations, political leadership, the faith community and leaders in East Baltimore. Of course, there are specifics to work out, but I'm thinking about a broad-based group of about 10 to 12 people that can help steer the institute and its work.

Q: What UHI success stories do you like to point to? Ones you would like to duplicate?

A: Let me start by saying that the university is not just a collection of schools; it's about individuals. We need to showcase some of the extraordinary and excellent things that our people are doing in the community and with this institute.

What often strikes me is that when we go out and work in the community, people say that's not Johns Hopkins working, that is so-and-so working, and the perception is that the individual is working on his own behalf. They disconnect the person from the institution. As a university, we need to tell our story better. We need to showcase the successes, the tremendous contributions that we are making in a range of areas.

I think, for example, about the great work Philip Leaf [professor in the Department of Mental Health at the School of Public Health] has done on the mayor's violence task force, or Alan Green's [associate professor in the School of Education] work in conflict management. This is the kind of work and success stories we can build on. We just need to let people know, and some of that is certainly the responsibility of the Urban Health Institute.

Q: Has the institute's mission changed at all since its founding seven years ago? Broadened, sharpened?

A: The central mission of the institute really remains unchanged, which is to serve as a bridge between the university and the community, which in reality are multiple communities. It's about bringing together the human capital that JHU has to offer to help serve the community, which the university is very committed to. It's a very strong partnership, and we need to continue to work at it and make it stronger.


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