Hope, Optimism and Advocacy for the Future
Even in the midst of a pandemic, we have reasons for optimism about transforming child health services to strengthen families to promote children’s optimal health, development and well-being.
In Connecticut, a key resource to support such change is the Office of Healthcare Strategy’s State Innovation Model, which includes the Person Centered Medical Home Plus (PCMH+) program as well as Health Enhancement Communities (HECs) across the state. PCMH+ includes enhanced integration between physical and behavioral health services, encourages culturally-competent services, strengthens care coordination, ensures supports for children and youth with special health care needs, and shares report cards with health care providers. HECs currently involve select communities chosen by the state, which develop and execute community-driven action plans that address poor health outcomes, health inequity, and rising health care costs. Each community establishes a collaborative consisting of residents, community-based organizations, health care providers, health departments, government agencies, social services agencies, housing agencies and schools. The priorities for all HECs include improving child well-being in Connecticut pre-birth to age 8 and improving healthy weight and physical fitness for all residents. These priorities afford child health providers a remarkable platform to transform service delivery.
As we strive to address the challenging needs of families and their communities during COVID-19, we must be mindful of the impact on all providers, front-line and otherwise. Providers’ self-care is bolstered by a feeling of agency and impact. One helpful self-care strategy is to engage in some form of advocacy. Defined most broadly, such advocacy may encompass such diverse actions as writing a letter to the editor, corresponding with an elected official, having a conversation with a colleague, engaging with a professional organization, supporting a community-based organization, and other acts.
Opportunities for such advocacy are plentiful. Mona Hanna-Attisha, the physician who exposed the lead contamination in Flint, Michigan, recently reminded us in a New York Times Op-Ed that, “Babies don’t choose where they’re born.” She offered a checklist of potential issues worthy of our attention and action including universal basic income and living wages, health and safety precautions, paid parental and sick leave, desegregated and well-funded public education, child care as a fundamental right, universal health care untethered from employment, and strengthened, enforced environmental regulations.
To state that these are challenging times is, of course, an understatement. Reference to a “silver lining” seems premature, and even callous, in the midst of such ongoing suffering and uncertainty. Nonetheless, the pandemic has certainly exposed long-standing inequities that demand our attention and our action. Perhaps most importantly, we understand the inappropriateness of longing for a nostalgic return to a “past normal” and acknowledge the daunting challenges of a better future.
The dedication of the Office to strengthening families to ensure that one day, a person’s zip code will no longer determine the quality of their health and life outcomes, speaks to our commitment to critical change. Our sentiment is captured in the lyrics of a Billy Joel song, “Keeping the Faith,” from the album, “An Innocent Man,” released on August 8, 1983: “The good ole days weren’t always good, and tomorrow ain’t as bad as it seems.”
