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BCTR and the new Cornell Center for Health Equity


From right, Drs. Avery August and Monika Safford, co-directors of the Center for Health Equity, celebrate the center's opening with Dr. Augustine M.K. Choi, the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, and Dr. David Satcher, the founding director of and senior adviser to the Satcher Health Leadership Institute at the Cornell Tri-Campus Health Equity Symposium, March 15-16 at Weill Cornell Medicine.

From right, Drs. Avery August and Monika Safford, co-directors of the Center for Health Equity, celebrate the center's opening with Dr. Augustine M.K. Choi, the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, and Dr. David Satcher, the founding director of and senior adviser to the Satcher Health Leadership Institute at the Cornell Tri-Campus Health Equity Symposium, March 15-16 at Weill Cornell Medicine.

Adapted by Sheri Hall for the BCTR from an article by Timothy Malcolm for the Cornell Chronicle

The newly-formed Cornell Center for Health Equity (CCHEq) held its inaugural symposium on March 15 and 16 at Weill Cornell Medicine. Dr. David Satcher’s keynote address emphasized that health equity means “everyone has the opportunity to achieve their highest state of health.”

The CCHEq brings together researchers from Weill Cornell Medicine, Cornell’s Ithaca campus, and Cornell’s Tech Campus in NYC. Together they will work to better understand why health outcomes vary among demographic groups and generate new evidence on how to eliminate health disparities with the goal of achieving health equity for people locally, regionally, and nationally.

Portrait of Jennifer Tiffany

Jennifer Tiffany

Jennifer Tiffany, BCTR’s director of outreach and community engagement is a key faculty member working with the CCHEq. Tiffany also serves as the

executive director of Cornell University Cooperative Extension’s New York City programs (CUCE-NYC) and leads the Community Engagement in Research team at Weill Cornell Medicine’s Clinical and Translational Sciences Center.  These roles enable her to work with the CCHEq to bring together researchers from New York City and Ithaca and to promote partnerships with communities, practitioners, and Cornell Cooperative Extension (CCE).

“At a time when economic inequality within the U.S. and New York state is extreme and rising, working actively to promote health equity is particularly crucial,” Tiffany said. “Partnerships with communities that experience extreme health disparities are vital to this work, as are the kinds of multidisciplinary and cross-campus partnerships the CCHEq seeks to develop and sustain. The BCTR has strong interests, resources, and capabilities in all of these areas.”

Tiffany and Elaine Wethington, an associate director of the BCTR, both participated in the March symposium. Tiffany presented on “Using Geospatial Mapping to Plan and Assess Programs" as part of the session on community-partnered research. She also participated in a panel called "Building a Sustainable Community-Engaged Research Program.”

Portrait of Elaine Wethington

Elaine Wethington

Wethington, who is co-director and director of pilot studies of the BCTR’s Translational Research Institute on Pain in Later Life, has been working for over a year with CCHEq investigators and other Ithaca-based investigators on proposal submissions through the CCHeq. She has also recruited other Ithaca investigators to take part in proposals and other collaborative projects with CCHEq.

“I hope that many other Ithaca faculty follow me in affiliating with the Center for Health Equity,” Wethington said. “Collaboration with the CCHEq is an outstanding opportunity for social scientists to partner on research projects that will have immediate application to improve the lives of New Yorkers living with disadvantage.”

The CCHEq will address disparities in heart disease, stroke, and cancer outcomes in disadvantaged minority communities in the diverse, urban New York City area, as well as in more rural regions of New York state. Working with organizations and providers deeply engaged in their communities, including caregivers and local health centers, the investigators will analyze the role of policy, societal biases, socio-economic status, educational attainment, health care providers, and the home and family environment in overcoming these disparate health outcomes.

For one of its projects, the CCHEq is engaging with Afro-Caribbean communities that increasingly use New York-Presbyterian Brooklyn Methodist Hospital. Using data showing higher prevalence of hypertension among populations of African descent, center investigators are working with colleagues at New York-Presbyterian Brooklyn Methodist to plan events that encourage residents to be screened and receive treatment for hypertension. They hope that these activities will also motivate residents to be screened for common cancers – including breast, colon, and prostate cancers – that are also of higher prevalence in African-descent communities.

Along with that work, the CCHEq hopes to use data collected by Dr. Margaret McNairy, the Bonnie Johnson Sacerdote Clinical Scholar in Women’s Health and an assistant professor of medicine at Weill Cornell Medicine, on the prevalence of emerging cardiovascular diseases in Haiti. Her work may become useful in identifying and promoting treatment of cardiovascular diseases in Haitian communities in New York City, said Dr. Monika Safford, co-director of the Cornell Center for Health Equity and chief of general internal medicine at Weill Cornell Medicine.

In Ithaca, Rebecca Seguin-Fowler, associate professor of nutritional sciences in the Colleges of Human Ecology and of Agriculture and Life Sciences, is seeking to reduce heart disease risk factors among women in the central, upstate, and Finger Lakes regions of the New York. In one project, called Strong Hearts, Healthy Communities, Seguin-Fowler is collaborating with CCE educators and the Bassett Healthcare Network’s Center for Rural Community Health to implement and evaluate a six-month cardiovascular disease risk-reduction program for overweight or obese women who are sedentary. The first phase of this community-randomized trial demonstrated effectiveness in reducing multiple disease risk factors, including weight loss and improved physical activity.

As the CCHEq grows, students in New York City and Ithaca will conduct research and work with fellow scientists and staff members across the two campuses. This aligns with one of Cornell’s strategic priorities, which emphasizes a connection between the medical school and other parts of the university through a distinct focus, in this case improving health equity.

The translational nature of the work, which brings together researchers across Cornell campuses and involves community members, is in line with the BCTR’s mission to speed and strengthen connections between research and practice.

“We want to drill down on this issue, so we are partnering with communities to understand their priorities and perspectives, collaboratively developing interventions based on science as well as community realities, and partnering with community organizations to sustain those interventions,” Safford said. “Cornell has such a broad reach. While we’re at the very beginning stages of our center, tapping into that Cornell community and potentially making an impact regionally is really exciting.”

Cornell Center for Health Equity established - Cornell Chronicle

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Talks at Twelve: Heather Derry and Elizabeth Luth, Wednesday, May 2, 2018

 
portraits of Heather Derry and Elizabeth Luth

Two talks by Behavioral Geriatrics and Palliative Medicine postdocs
Heather Derry and Elizabeth Luth, Behavioral Geriatrics and Palliative Medicine Weill Cornell Medical College

Wednesday, May 2, 2018
12:00-1:15 PM
Beebe Hall, 2nd floor conference room



Stress and Cognition in Clinical Discussions:  Exploring the Impact on Prognostic Understanding for Advanced Cancer Patients
Heather Derry, PhD, T32 Postdoctoral Fellow, Behavioral Geriatrics and Palliative Medicine, Weill Cornell Medical College

For patients with advanced cancer, clinical discussions about prognosis can be stressful.  In addition, patients’ prognostic understanding is often limited, which presents challenges for informed decision-making.  Laboratory-based research provides insight into the ways that stress influences our physical, emotional, and cognitive responses.  Heather will discuss how these responses may interface with clinical discussions in the context of advanced cancer, and future studies to assess the impact of stress and emotion on patients’ understanding of their illness.

Understanding Race Disparities in End-of-Life Care for Patients Living with Dementia
Elizabeth Luth, PhD, T32 Postdoctoral Fellow, Behavioral Geriatrics and Palliative Medicine, Weill Cornell Medical College

Research documents racial and ethnic disparities in end-of-life (EOL) care, where patients from racial and ethnic minority groups receive more aggressive, burdensome care, and have less access to quality-of-life promoting care at EOL. However, disparities in EOL care are not well understood for the growing population of patients with dementia. Elizabeth will share results from two recent studies of race, dementia, advance care planning, and assessments of EOL care quality and how those findings link to her current research on racial and ethnic differences in terminal hospital care and unfavorable hospice outcomes for patients with dementia.

portrait of Heather DerryHeather Derry is a T32 postdoctoral associate in Behavioral Geriatrics at Weill Cornell Medicine’s Division of Geriatrics and Palliative Medicine.  She completed her PhD in psychology at the Ohio State University, where her dissertation work evaluated how physical fitness impacts cognitive function among post-surgery breast cancer survivors.  She also completed a clinical health psychology internship at the Louis Stokes Cleveland VA, with training emphases in geropsychology, primary care mental health integration, and women's addictions treatment.  Heather’s graduate-level research focused on the behavioral and physiological connections between stress, lifestyle factors, and health.  Her current work aims to assess mental health symptoms in seriously ill medical patients during and following hospital discharge, with the goal of enhancing post-discharge mental and physical health.

portrait of Elizabeth LuthElizabeth Luth is a T32 postdoctoral associate in Behavioral Geriatrics and Palliative Medicine at Weill Cornell Medicine. She completed her PhD in sociology at Rutgers University.  Elizabeth's graduate research focused on social and demographic disparities in assessments of end-of-life care quality for deceased older adults. At Weill Cornell, she is extending this work by investigating racial and ethnic disparities in quality of care for patients with advanced dementia near the end of life.


Lunch will be served. Metered parking is available in the Botanic Gardens lot across the road from Beebe Hall. No registration or RSVP required except for groups of 5 or more. We ask that larger groups email Lori Biechele at lb274@cornell.edu letting us know of your plans to attend so that we can order enough lunch.

(1) Comment.  |   Tags: aging    BCTR Talks at Twelve    gerontology    health    healthcare    mental health    race    Weill Cornell   

Talks at Twelve: Mardelle Shepley, Wednesday, February 22, 2017

 
shepley

Mental and Behavioral Health Facilities: Critical Research and Design Recommendations
Mardelle Shepley, Design and Environmental Analysis, Cornell

Wednesday, February 22, 2017
12:00-1:00 PM
Beebe Hall, 2nd floor conference room



Research on the design of mental and behavioral health facilities is available but limited, although the shortcomings of these facilities are well-known. Dr. Mardelle Shepley will describe design features that are believed to positively impact staff, patients, and families in psychiatric environments and provide information related to their presence in existing facilities. Her research project involved both qualitative and quantitative methods. Dr. Shepley will share results involving a variety of topics including the appropriateness of private rooms, deinstitutionalization, access to nature, and open nursing station design. She will also provide guidelines for mental and behavioral health facilities.

Mardelle Shepley is a professor in the Department of Design and Environmental Analysis and associate director of the Institute for Healthy Futures. She serves on the graduate field faculty in the Department of Architecture. A fellow in the American Institute of Architects, she has authored/co-authored six books, including Healthcare Environments for Children and their Families (1998), A Practitioner’s Guide to Evidence-based Design (2008), Design for Critical Care (2009), Health Facility Evaluation for Design Practitioners (2010), Design for Pediatric and Neonatal Critical Care (2014) and Design for Mental and Behavioral Health (2017).

This talk is open to all. Lunch will be served. Metered parking is available in the Botanic Gardens lot across the road from Beebe Hall. No registration or RSVP required except for groups of 5 or more. We ask that larger groups email Patty at pmt6@cornell.edu letting us know of your plans to attend so that we can order enough lunch.

Nursing home residents commonly abused by neighbors


By Heather Lindsey for the Cornell Chronicle:

pillemer lachs

Pillemer and Lachs

Twenty percent of people living in nursing homes are abused by other residents, according to a study by researchers in the College of Human Ecology and Weill Cornell Medicine.

“We were very surprised by the prevalence of aggression,” said senior author Karl Pillemer, the Hazel E. Reed Professor in the College of Human Ecology’s Department of Human Development and professor of gerontology in medicine at Weill Cornell Medicine, who published the findings June 13 in the Annals of Internal Medicine. “We thought it would be common, but we did not anticipate that 1 in 5 people would be involved in a resident-to-resident incident.”

In addition to the physical injuries that can result from these abusive incidents, “the emotional toll that can result from being victimized incessantly can be overwhelming,” said lead author Dr. Mark Lachs, co-chief of the Division of Geriatrics and Palliative Medicine and the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine at Weill Cornell Medicine.

The Cornell researchers and colleagues at the Research Division of Hebrew Home at Riverdale evaluated 2,011 residents in 10 nursing home facilities during a one-month period. Of those individuals, 407, or 20.2 percent, had experienced a least one resident-to-resident incident of mistreatment.

Nine percent of victims experienced verbal abuse. Five percent encountered physical abuse, and less than 1 percent sexual abuse. Another 5 percent suffered “other” types of abuse, such as invasion of privacy and menacing gestures.

The most common types of verbal aggression were screaming at another resident and using foul language. Physical aggression most often included hitting and pushing. Going into another resident’s room without permission and taking or touching another person’s property were common examples of invasion of privacy.

A major risk factor for aggression was cognitive impairment, said Pillemer, who is also director of the Bronfenbrenner Center for Translational Research at Cornell. “You have people who would otherwise not be violent but who have serious aggressive episodes,” he said.

People who were younger and more physically active, meaning they were able to wander into other residents’ rooms, were more likely to be involved in an abusive incident, he said.

Crowding in common spaces such as hallways and lounges also increased risk. Conflict occurred more frequently in the winter months, presumably when patients had limited space to interact indoors, and in nursing homes with lower staffing levels, said Lachs, who is also professor of medicine at Weill Cornell Medicine.

The first steps toward addressing the problem are improving staff awareness and developing clear protocols for dealing with aggression among residents, Pillemer said. Individualized care is also important. Some people who are at greater risk of becoming aggressors may need more supervision than others.

One obstacle to addressing this form of aggression is that regulatory agencies and media have traditionally focused on physical abuse of residents by staff.

“This certainly occurs, and we should have zero tolerance for it,” Lachs said. “But this study suggests that one is much more likely to experience physical or verbal harm from another resident than from a staff member.”

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Talks at Twelve: Barbara Ganzel, Wednesday, May 23, 2018

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Talks at Twelve: Barbara Ganzel

Trauma-informed Hospice and Palliative Care: Unique Vulnerabilities Call for Unique Strategies
Thursday, September 10, 2015

Barbara Ganzel
BCTR, Cornell University

Tags: healthcare,   hospice,   video,  

Trauma-informed Hospice and Palliative Care: Unique Vulnerabilities Call for Unique Strategies
Thursday, September 10, 2015

Barbara Ganzel
BCTR, Cornell University

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Learn about Affordable Care Act December 5


Jennifer Tiffany

Jennifer Tiffany

Working with university, community, and government partners, Jennifer Tiffany (BCTR's Director of Outreach and Community Engagement and CCE's Associate Director-Human Ecology) helped organize a December 5 forum on navigating the Affordable Care Act (ACA) and accessing New York State's ACA health plan marketplace, New York State of Health.

The information session will take place at Tompkins Cortland Community College in the Forum, just inside the main building (main campus, Cortland) from 6:30 - 8:00 p.m. on Thursday, December 5. Cornell Cooperative Extension offices throughout the state will be able to livestream the event. Jean McPheeters, president of the Tompkins County Chamber of Commerce and a trained health access navigator, will talk about her experience as a navigator assisting people to access health plans that fit their needs. Dennis Romero of the Substance Abuse and Mental Health Services Administration will also present. Helene Dillard, Director of Cornell Cooperative Extension will moderate the panel and audience discussion.

Learn about Affordable Care Act December 5 - Cornell Chronicle

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New evidence about medical malpractice


"More than 15,000 lawsuits are filed against doctors in the United States each year for medical malpractice, a claim that medical treatment caused injury or death to the patient, typically involving a medical error."

Read the rest of this post on the Evidence-Based Living blog:

New evidence about medical malpractice

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Talks at Twelve: David Feathers, Thursday, May 16, 2013

 

Physical Access to Healthcare Environments: Ergonomic Analysis for Persons with Physical Disabilities Across the Life Span
David Feathers, Design & Environmental Analysis, Cornell University

Thursday, May 16, 2013
12:00-1:00PM
Beebe Hall, 2nd floor conference room



This talk is open to all. Lunch will be served. Metered parking is available in the Plantations lot across the road from Beebe Hall.

This is a BCTR Innovative Pilot Study Grant recipient talk.

Design of the built environment and synergistic use of accessible technologies within the built environment play key roles in enabling access to preventative and curative healthcare services, especially for people with disabilities. His talk will define the current state of physical accessibility for a sample of healthcare environments in the United States. This project considers physical access across the lifespan, disability context, perceptions of physical barriers, and related physical access outcomes regarding reception of healthcare services for three types of healthcare locations: out-patient/clinic-based service delivery; in-hospital service delivery; and at-home care (self-management). This pilot study initiates a series of considerations regarding physical access throughout the process of receiving healthcare and identifies key areas for inclusive, human-centered research for distributed healthcare delivery across the lifespan.

David Feathers is an assistant professor of Human Factors and Ergonomics in the Department of Design and Environmental Analysis, College of Human Ecology, Cornell University. He is the founding director of the Cornell DAB Lab (Digital Anthropometry and Biomechanics), which focuses on measuring diversity in human structure and function for inclusive design of products and spaces. The DAB Lab uses a combination of traditional and innovative 3D measurement technologies to assess and model human performance with the aim of improving the products and environments we interact with on a daily basis. Dr. Feathers received his B.A. and M.A. in Anthropology, his M.S. in Industrial Engineering and Ph.D.in Industrial and Systems Engineering, all from the University of Buffalo.

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