A Note from the Editor
Buy Issue for $25 at JHUP- A Note from the Editor
This month sees the release of two issue of JHCPU, the present one and a supplemental issue on the burgeoning area of TechQuity. This exciting supplement is guest edited by scholars from the sponsoring organizations: Tiffani Bright, PhD, FACMI (IBM); Cheryl Clark, MD, ScD (Brigham and Women's Hospital); and Kevin Johnson, MD, MS, FACMI, FAAP (Vanderbilt University Medical Center). The issue begins with a preface from David Bates, MD, MSc, Chief of the Division of General Internal Medicine and PrimaryCare at Brigham and Women's Hospital. The issue as a whole presents the state of the art on developing and using technology in the service of health equity.
The regular issue for May is large and wide-ranging. Here, I will highlight fewer than 20 of the 40 articles included.
Health Care Workforce
Several notable papers bring to the fore members of the health care workforce whose roles are especially important, and in some cases, whose roles are changing. Under more than one name, community health workers (CHWs) have proven vital members of health care teams, especially teams working in underserved communities not tightly integrated into the existing health care system. As CHW roles have widened and become more widely recognized, states are beginning to create licensing requirements and standards for employment as a CHW. (Certification is presently required in only four states—Texas, Oregon, Minnesota, and South Carolina—but available in more.) Wennerstrom and colleagues studied the experience of certification in seven states where it had been studied or put in place. They interviewed 41 people with stakes in the proceedings (CHWs, employers, and state health officials) to learn how they had proceeded and what they had learned. Interviewees clearly endorsed supporting CHW workforce development: using national models and standardized training, supporting CHW leadership, involving CHW professional groups, convening workgroups, and educating stakeholders. Interviewees also discussed requiring training and whether or not to give credit for life experience. Importantly, the emphasis often fell on just and respectful treatment of CHWs; themes included ensuring that CHWs are members of communities served and avoiding marginalization of some groups of CHWs. Furthermore, participants outlined practical steps for ensuring active CHW leadership in decision-making about certification.
Biomedical researchers are members of the health care team whom we find in the lab and at the bench. In this issue, three colleagues (Ondigo et al.) from the Centre for [End Page viii] Global Health Research, Kenya Medical Research Institute in Kisumu, Kenya reflect on the mentorship of three departed biomedical researchers who laid the groundwork for studying global health in Kenya: Prof. Ayub Opiyo Ofulla, Dr. John F. Kennedy Vulule, and Dr. Peter Odada Sumba. Ondigo et al. present their work as mentors and teachers as a vital to creating the next generation of scholars in a manner "transcending race, color, nationality, ethnicity, culture, faith, gender identities, sexual orientation, age, ability, and background."
Finally, specialty training can contribute vital skills to some of the hardest cases. Heller and colleagues report on a health care intervention to enable adults with mental illness to remain in supportive housing as they age. Trained geriatric health care workers assess the competencies of aging residents and place them in contact with local programs that can meet their changing needs without the much more disruptive solution of transferring people to high-intensity care or institutions.
Unmet Needs
Another set of papers represent the perennial concern of unmet needs. A team from the CDC (Kilmer and Hughes) found that rates of hepatitis B and C were significantly higher among people on probation or parole than among the people not on probation or parole. They make the common-sense argument for treatment and prevention efforts for viral hepatitis with this population for its health and the health of the larger community.
Unmet needs among people from the Marshall Islands living in the U.S. have a particular urgency in view of the history of that country. The Marshall Islands of Micronesia have a long history of colonial occupation and subjugation, culminating in U.S. control of the islands and their use as proving grounds in nuclear bomb testing from 1946–1958...
