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Chair's Hour with Dr. J. Sunil Rao

Special Guests: President Frenk, Dr. Abraham and Dean Ford 

On the morning of March 20, 2019, graduate students began walking towards room 989 in the Clinical Research Building. They were heading to the room where their main classes and grand rounds take place, but on that morning, they were not heading to class. They were about to attend Chair’s Hour, a much-anticipated, student-only semester event.   

Once every spring semester, the Department of Public Health Sciences coordinates Chair’s Hour, a two-way dialogue event between students and J. Sunil Rao, Ph.D., department chair and director of the Division of Biostatistics.

“For the first half of the hour, we talk and provide different perspectives on science and on what is going on in public health. And then it shifts back to students, where they can ask questions on any topics that they would like to talk about,” Dr. Rao said. “It could come from any sphere related to public health, their experiences as students, or where they would like to go with their careers.”

This semester’s Chair’s Hour had the same format, but this time, Dr. Rao and students were joined by President Julio Frenk, Dr. Edward Abraham, executive vice president and CEO of UHealth, and Dr. Henri R. Ford, dean of the Miller School of Medicine.

“We were able to do something special this time around, where we had three distinguished guests, all with very interesting connections and perspectives on public health and population health,” Dr. Rao said.

As students listened intently during the first half of the event, President Frenk, Dr. Abraham, and Dean Ford spoke about their insights in public health, such as population health, precision medicine, social determinants of health, health policy, and health systems.

President Frenk began his talk by emphasizing that public health professionals have taken the role of connecting the dots between different fields, such as integrating clinical medicine and population health.

“When I think about public health, there are two big areas. The conditions and the response to those conditions. When we study conditions, we study diseases and risk factors,” Frenk said. “Public health is more than public service. We take society as our patient. We do what is done in medical practice, diagnosing a problem and through evidence-based research, we decide the best way to respond.”

As Gabriela Pages, an MPH candidate listened, she felt most inspired by the president’s views on public health.

“It inspired me when President Frenk said that he considers society to be his patient,” Pages said. “He has always said that this is a 'public health moment', but I really enjoyed hearing him elaborate on that phrase and expressing that social determinants in relation to diseases currently hold the greatest potential impact for mankind.” 

Following President Frenk’s talk, Dr. Abraham spoke on the determinants of health, precision medicine, and on implementation science, all of which he said have touched public health in a direct way.

“South Florida is a unique place in the United States, as we now have Medicaid advantage. Patients with all kinds of backgrounds come to our emergency rooms, to our ICUs, and we also have destination travel, where patients travel here for care,” Abraham said. “How do we best take care of patients? How do we approach patients at risk for disease and change the way that we treat them? It’s something we face every day, from a societal and financial standpoint.”

Dean Ford, who became dean of the Miller School of Medicine in June 2018, expressed his excitement for being invited to Chair’s Hour and focused his portion on the importance of studying and pursuing a career in a field like public health.

“Living in Brickell gives someone 15 more years of life than living in Overtown, even though Overtown is right next to our health system,” Ford said. “What leads to this disparity? This is why public health is so critical. You are stepping into a career with the greatest impact on mankind right now. This is not something one sector can handle, this requires the allies of all health care professionals. Everyone has a role to play.”

The second half of Chair’s Hour consisted of various questions from students to the distinguished speakers. Questions ranged from how to approach disease within public health to the social determinants of health when it comes to violence and the role of public health professionals in intervening in those cases, as well as on climate change and universal health care.

Addressing disease within public health

President Frenk said that to address disease within public health, “we are moving towards value-based healthcare, moving to treat the individual patient, and providing a top patient experience, while also acting at the population level. It’s stopping people from getting sick in the first place."

A health system that is value-based focuses on patient health outcomes, reducing the effects of chronic diseases, and on helping patients live healthier lives through evidence-based initiatives. 

The All of Us project, an NIH research program that has 25 institutional collaborators, including the University of Miami, is a major component that is helping in achieving those goals. The goal of the program is to gather data of 1 million participants from different backgrounds in the U.S. to enable more individualized treatments to handle diseases and to create prevention strategies.

Social determinants of health

When a person who goes to the ER after experiencing domestic violence, Dean Ford emphasized that public health professionals, as well as professionals in other fields, can make all the difference in their world.

“Anyone in the ER that comes in regarding a domestic violence situation, we have the responsibility to not send those people back. We have to be aware of the source of the problem. We also need law students because they can advocate for better housing situations for our patients. We can’t send patients back to environments that are unfit for a healthy lifestyle. In order for our students to be true health advocates in every dimension, they need to understand the social determinants of health."

Universal health care

Regarding the question on universal health care systems, President Frenk spoke on the importance of having an evidence-based perspective.

“It’s become one of the most important topics in public policy. Having evidence-based conversations first is the starting point. And then we can engage in the realism of implementing an idealistic situation. From a pure evidence-based standpoint, single-payer systems tend to be more efficient.”

Frenk added, “I do believe a universal solution is a good solution. To me in the United States, the best alternative is to build on the affordable care act. There was something called a public option, where people could buy into health care. Bring back the public option. Use that to regulate the commercial payers. Covers pre-existing conditions."

Climate Change

Students also asked questions on climate change, as it has become a major health determinant. They are aware of the importance of being prepared to treat its effects, especially in the realm of public health. 

"Recent articles connect climate change to health. This includes the effects of extreme weather, such as hurricanes and other storms and rising sea levels that also have major effects on environmental conditions and access to clean water," said President Frenk.

Dean Ford added, "We are looking at all those dimensions, at the fundamentals of medical science and the essentials of health care, and all other issues, like climate change, that impact global health, so that we can equip our students with the tools that they need."

As the event came to a finish, students enjoyed engaging with University leaders and appreciated having an event like the Chair’s Hour.

“I appreciated the speakers taking the time to come and share their insights and expertise with students. It is a great opportunity to learn about issues that professionals currently working in the field are noticing and their perspectives on how to tackle new challenges and take advantage of opportunities. Events such as these allow students another opportunity, outside of their typical routines, to get a glimpse into different aspects of the public health field,” said Natalie Robles, an MPH candidate. 

Daniel Samano, M.D., an MPH candidate, added, "It’s always a great opportunity to have the University leaders engage with students. Through their words, we learn and have a sense on how they think and lead the University."

Written by Amanda Torres
Posted on May 9, 2019