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US health care systems can learn from the world

Millions of Americans have the same life expectancy as the American national average in the 1970s, according to a new task force report from the Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai. But surprisingly, there are lessons to be learned by the United States in improving community health from low- and middle-income countries such as Rwanda, Ethiopia, and Brazil that have seen dramatic gains in life expectancy, according to The Task Force on Global Advantage findings.

The Arnhold Institute convened the Task Force, which included health care leaders from the United States and the world, after receiving support from the Robert Wood Johnson Foundation, with a goal to produce a report that clearly identifies a set of global approaches that could yield breakthroughs in the health of America’s most vulnerable communities.

Task Force findings distilled global best practices into five components:

  • Cover & Define: Coverage and access gaps should be mapped at the community level.
  • Anchor & Embed: Primary care health practices should be local anchor institutions that are embedded in the communities they serve.
  • Shared & Actionable Goals: Communities and health systems should track progress and act based upon common goals.
  • Simple Protocols & Accountable Care: A local integrator organization should foster ownership for health management in community settings.
  • Train & Organize: A network of community-based workers should be developed to organize community members, with the goal of identifying the most pressing community health needs.

“The findings hold great potential to improve the health of struggling communities in America. As global experience shows us, struggling communities can achieve breakthroughs if they are included in the design of their care. To equitably improve health outcomes in the United States, we have to find the world’s best solutions and then make them our own,” said Prabhjot Singh, MD, PhD, Chair of the Task Force and Arnhold Institute for Global Health Director. “The Arnhold Institute is committed to advancing the important findings of the Task Force.”

Agnes Binagwaho, MD, PhD, the Vice Chancellor for the University of Health Equity and former Minister of Health in Rwanda, said, “The foundation for a healthy population is community health. As the Task Force found, it is paramount that efforts to improve health are informed by the needs of our communities. The lessons we have learned through rebuilding Rwanda’s health sector have demonstrated how critical it is to equitably invest in our communities to improve health, a sense of well-being, trust, and social cohesion. These efforts have inspired us to create more health solutions with less. We are eager to share these lessons with the world.”

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and President for Academic Affairs of the Mount Sinai Health System, said, “We at Mount Sinai are committed to identifying and embracing the strongest models for community care, regardless of the country of origin. We look forward to working with the Arnhold Institute to advance this important work.”

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