The dedication of George Mason University’s new Population Health Center in Fairfax on Oct. 18 was the latest step in an ambitious journey for College of Health and Human Services Dean Germaine Louis.
When Virginia’s largest public university recruited the National Institute of Child Health and Human Development’s former director of intramural population health research in October 2017, the administration tasked her with guiding the university’s work in the public health field.
The product of more than two years of planning and construction, the College of Health and Human Services’ Population Health Center will provide healthcare to underserved populations as well as research and workforce training opportunities for faculty and students.
Mason envisions its Population Health Center as the foundation for a future accredited college of public health, which would be the first for a university in Virginia, according to Louis.
“The population health center isn’t just another center,” Louis said. “Rather, it is designed to be where academics and practice meet, so that each may inform the other. We need good science, empirical evidence, and practiced insight to effectively deliver public health.”
Located on Mason’s Fairfax campus next to the Peterson Family Health Sciences Hall, the 3,500 square-foot Population Health Center aims to fill gaps in not just healthcare access and delivery, but also the talent pipeline for public health workers.
According to the College of Health and Human Services, nearly 8 percent of Northern Virginia residents do not have health insurance, and more than 16 percent of residents live in areas that are considered islands of disadvantage, meaning they face social and economic challenges like poverty and a lack of safe, affordable housing that negatively affect their health.
A Virginia Commonwealth University Center on Society and Health report commissioned by the Northern Virginia Health Foundation and published in November 2017 identified 15 islands of disadvantage in the region, many of which are in close proximity to affluent neighborhoods, as with the Culmore area of Bailey’s Crossroads sitting blocks away from Lake Barcroft.
Northern Virginia’s islands of disadvantage are disproportionately home to people of color, and factors like living conditions, income, and education play just as much a role in an individual’s health as the availability and quality of healthcare, which accounts for only 10 to 20 percent of outcomes, the VCU and Northern Virginia Health Foundation report found.
Virginia legislators tackled access issues by voting in May 2018 to expand the state’s Medicaid program, a move that Virginia Secretary of Health and Human Resources Daniel Carey says has extended coverage to more than 325,000 additional people since it became effective on Jan. 1.
Still, gaps in coverage persist for people who are not citizens, among other groups.
The GMU Population Health Center was designed to address those gaps in Northern Virginia and potentially beyond, since it is outfitted with telehealth space and equipment supplied by a donation from the O’Shaughnessy-Hurst Memorial Foundation.
A Mason and Partners Clinic for people who are uninsured, immigrants, and refugees opened in the Population Health Center in August, expanding the university’s network of free health clinics to 10 locations in Fairfax and Prince William counties.
The clinics have provided about 14,000 people with services ranging from screenings and school physicals to medical home placement referrals and wellness workshops, according to Louis.
The Population Health Center MAP clinic is the largest yet with five patient exam and treatment rooms, six behavioral health interview rooms, a telehealth remote care and consultation room, a clinical laboratory, and a phlebotomy room.
It will focus on specialty care services, starting with women’s wellness exams, and school and sports physicals, according to Mason.
The Population Health Center also houses a community wellness hub that will connect clients with resources for medical care, food assistance, housing, and other social services.
Established with a $500,000 grant that Kaiser Permanente gave to Mason in May, the community wellness hub is a shared space for the nonprofit health system’s partners, specifically the Inova Partnership for Healthier Kids, NOVA Scripts, and Northern Virginia Family Services.
“Even with Medicaid expansion in Virginia, which is so important, we will still have populations that don’t have access to coverage, and that is a real barrier to care,” Carey said. “This health hub that’s…anchored here at the center is an important part of reaching those underserved populations.”
Kaiser Permanente director of community health Tonga Turner says that, for many individuals, navigating the healthcare system is one of the biggest challenges to receiving care. Co-locating different organizations removes that barrier, letting people address their needs all at once instead of having to make separate trips.
With more than 770,000 members throughout Virginia, Maryland, and Washington, D.C., Kaiser Permanente sees its collaboration with Mason as a way of helping cultivate a workforce that understands the social determinants of health, not just the science behind it, according to Turner.
University students will be able to work with professionals in the community wellness hub both hands-on and as observers as they interact with clients.
“Bringing us in this space with an institution like George Mason University…allows us to expose students to culturally competent care and the social determinants of health early on in their career, so that when they do hit the streets, when they do hit the workforce, they are sensitive to the needs of the community, and they have experience in how to deal with that,” Turner said.
The Population Health Center’s emphasis on the social determinants of health – conditions like socioeconomic status or the availability of clean water that affect a person’s health – reflects a broader shift in mindset for those who study and practice medicine.
The goal is no longer to simply treat an injury or cure a disease, but to keep people healthy by supporting their overall wellbeing and improving conditions in the communities where they live.
George Mason’s decision to prioritize public health, which the Centers for Disease Control and Prevention Foundation defines as the science of protecting and improving the health of people and their communities, was spurred in part by necessity.
With the American population aging, the U.S. Bureau of Labor Statistics projects that healthcare employment will grow 14 percent over 2018 levels by 2028 with the addition of about 1.9 million jobs in the next decade, more than any other occupational group.
Carey says that the Commonwealth’s biggest needs include bolstering its behavioral health system and diversifying its health workforce, making it more equipped to tackle inequity issues such as racial and ethnic disparities in maternal mortality rates.
In contrast with the silos often ingrained in higher education, where medical schools can focus exclusively on dentistry or nursing, for example, the health and human resources secretary sees promise in the GMU Population Health Center’s inter-professional approach as a means of developing a well-rounded talent pipeline capable of addressing the state’s health challenges.
“I think that is a model that we need to spread,” Carey said. “It’s done in other locations in the Commonwealth, but I tell you, the commitment here to that model is just fantastic.”
Louis says that interest in public health has dramatically increased in the past couple of decades, so the healthcare field’s pipeline issues are more the result of limited opportunities than a lack of demand.
Mason and Virginia Tech have undergraduate degrees in public or community health, and public health professionals has begun offering students more development training, like internships and job shadowing.
The Population Health Center’s integration of academic study and research with experiential learning opportunities sets it apart from those existing programs, Louis argues.
MAP Clinic co-director Caroline Sutter has been charged with overseeing the center’s workforce development efforts. She serves as co-director of the center, along with Dr. Rebecca Sutter, who oversees inter-professional care delivery, and Dr. Alison Cuellar, who oversees faculty-led research initiatives.
According to Louis, Mason’s health undergraduate and graduate students will be able to enroll in courses at the Population Health Center for one to three credits.
Administrators are also working to enable students to pursue certifications in telehealth, risky health screenings, and other specialized areas.
The center has already gotten involved in research, lending support to a “Mason: Health Starts Here” study on the health and well-being of university students. The study is primarily funded by a $500,000, five-year grant from the Mason Institute for Biohealth Innovation and is supported by the College of Health and Human Services and the Department of Psychology.
While most of the funding for the Population Health Center came from the college, the project budget was supplemented with research grants and donations from private individuals and organizations, including Kaiser Permanente and the Claude Moore Charitable Foundation.
The Claude Moore foundation operates a scholars program that encourages students to pursue healthcare careers and is working with the Northern Virginia Area Health Education Center to support the Population Health Center’s workforce development efforts.
“Working together, we can prepare the next generation of public health practitioners and researchers,” Louis said. “Our graduates will be career-ready, which is a basic tenet of the Mason strategy, and we envision a College of Public Health that will be a destination for faculty, for researchers, and for students seeking careers in public health.”