Newsletter

Milken Institute Public Health — Spring 2022

Public Health

We are excited to launch our first Milken Institute Center for Public Health (CPH) newsletter to our community and look forward to keeping you updated on the programs, projects, and events taking place at CPH quarterly moving forward. The Milken Institute is proud to bring together stakeholders from across sectors and industries to help catalyze and accelerate change. Our passion for public health, coupled with the Milken Institute’s approach of uncovering intersections between finance and health, enables us to connect decision makers and subject matter experts to tackle the most pressing public health issues we face today in innovative and meaningful ways.

Watching the effects of the pandemic unfold over the past two years has brought public health to the forefront of our daily lives in a way most of us have never experienced, and we continue to see the cascading impact of COVID-19 on people’s well-being, both physical and mental.

The COVID-19 pandemic has brought long-standing social, health, and racial inequities into stark relief. After adjusting data for age, Hispanic, Black, and Indigenous Americans are about twice as likely to die from COVID-19 as White Americans. This further reinforces our commitment to address social determinants of health as a root cause of health disparities, in addition to the work we are doing to achieve racial and ethnic representation in clinical studies of vaccines and treatments.

The pandemic also reinforced our sense of urgency as it pertains to preventing chronic disease through early detection and whole-person-centered care, as we witnessed the significant additional strain and complications of the pandemic on Americans with existing chronic conditions. Per the National Institutes of Health, globally, approximately one in three of all adults suffer from multiple chronic conditions, while six in ten Americans live with at least one chronic disease, like heart disease and stroke, cancer, or diabetes, according to the Centers for Disease Control and Prevention (CDC). Even before being exacerbated by COVID, these and other chronic illnesses, including chronic kidney disease, have been the leading causes of death and disability in America and are a leading driver of health-care costs.

Often referred to as the “Shadow Crisis” because of its having been pushed out of the spotlight by the pandemic, the addiction crisis has not only continued to take American lives, it has been intensified by the social isolation, anxiety, and depression resulting from COVID mitigation measures. CDC reported a record-breaking 100,000 overdose deaths in the 12 months leading up to April 2021. According to the Kaiser Family Foundation, during the pandemic, about 4 in 10 adults in the US have reported symptoms of anxiety or depressive disorder. We must address the public health crises of mental health and addiction.

Through our employer-focused work, we see organizational leaders stepping forward with a desire to work collaboratively to address addiction and promote better mental health—not only in their own workforces but also in their surrounding communities. While we know there is much work to be done, we have a renewed sense of hope as we see employers not just responding to the current addiction and mental health crises, but changing the way they view health—prioritizing mental well-being to the same extent as physical—and anticipating the needs of a diverse and multigenerational workforce for years to come.

The evident racial health disparities, the additional risk of severe illness in those with existing chronic diseases, and the alarming increase in drug overdoses and other mental health conditions have led us to approach our work in three interconnected focus areas: health equity, prevention (including chronic disease), and mental health. We are grateful to our esteemed CPH Advisory Board members, whose knowledge and expertise guide our work.

For more information on our Advisory Board, current projects, and recent reports, please continue reading. We also invite you to connect with us on LinkedIn. We look forward to seeing many of you at our annual 2022 Global Conference in May and our 2022 Future of Health Summit/Partnering for Patients Forum in December.

Regards,

Esther Krofah
Executive Director
FasterCures and Center for Public Health
Milken Institute

Program Descriptions

Health Equity

Building thriving communities and advancing health equity require improving the interrelated social and economic conditions at the root causes of health outcomes. This includes ensuring that health communication, access, and delivery reflect the needs, experiences, and unique characteristics of historically excluded people.

Prevention

This all-encompassing priority addresses how chronic diseases are understood and managed, how populations are impacted, and how issues related to infrastructure and financing can affect health and well-being.

Mental Health

To attain total health, we must normalize a “whole person” approach that prioritizes mental and physical health equally. We are working strategically with employers, as they are uniquely positioned to reach employees, their families, and the surrounding communities, and can help them access evidence-based, innovative, inclusive prevention, treatment, and recovery resources to address mental health issues and addiction.

Programs at a Glance

Mental Health

CPH began its work in mental health in 2017, specifically addressing the opioid crisis, which had just been declared a public health emergency. The mental health and addiction portfolio has since expanded to include broader mental health, including addiction/substance use disorder, and focuses on collaboration with employers as critical community stakeholders who reach millions of Americans. CPH’s mental health work can be categorized into three workstreams: access to mental health services and resources, innovation in scalable technologies, and investment in policy change. Projects and events include workplace pilots and policy action briefs, a health tech innovation and investment series, listening and discussion forums, employer action groups, executive resources, and thought leadership acceleration. Please see below for more information about our current projects.

Employers Prioritizing Mental Health: Collaboration with Leidos

In May 2021, we announced an exciting project taking place through December 2022 in partnership with Leidos, a global defense, aviation, IT, and biomedical research company. This work leverages the reach of employers, recognizing that they provide health benefits for nearly 50 percent of the US population, and are uniquely positioned to influence and shift attitudes towards substance use disorder and mental health. Employers can help address stigma and normalize an approach of “total health” that looks at the whole person, prioritizing mental health as much as physical.

Building off the momentum of Leidos’ 2017 CEO Pledge, the Center for Public Health has partnered with Leidos to create an Action Group of over 70 employers from across industries and sectors, committed to taking actionable steps to improve mental health and address the addiction crisis by examining internal programs, cultures, and internal policies. The efforts are aimed at focus areas including racial equity, stigma, raising awareness about the science of the disease of addiction, recovery-ready workplaces, and creating psychologically safe environments. Leveraging the Milken Institute’s power of identifying intersections and connecting organizations and resources, since the October kickoff we have already seen progress. Read more about this project. If you are interested in learning more, please contact us directly.

Raising Awareness among Employers about Local Drug Threats with DEA

The Center for Public Health has worked with the Drug Enforcement Administration (DEA) to address the demand for illicit drugs, understand the supply, and prevent addiction since 2017, hosting various curated private sessions of cross-sector stakeholders. The Milken Institute has focused on understanding the intersection of public health and public safety, and where the overlap accelerates meaningful collaboration. The work has had both a national and local focus, from working with employers across the country in 11 distinct regions to conducting pilots with individual employers within a city to create a community stakeholder collaborative action forum that led to relationships that continue to evolve.

Growing out of this long-standing relationship, in 2021, CPH was asked to collaborate with DEA as part of its larger Operation Engage initiative, focused on the employer component of a community-wide strategy to raise awareness about local drug threats. CPH held 11 virtual convenings, each focused on a particular region, during which employers had the opportunity to hear directly from their local DEA offices about the drug threats impacting their employees, their families, and by extension, their surrounding communities. In addition to raising awareness, these virtual events provided employers with free, evidence-informed drug prevention resources offered by organizations that specialize in evidence-based prevention. These resources could be shared with their employees to help reach the broader community and even led, among other things, to the American Medical Association’s creation of an issue brief for employers on ways to prevent and address the addiction crisis.

Closing the Gap to Provide Addiction and Mental Health Resources

As part of our employer programmatic portfolio, we formed a listening and discussion series focused on “Closing the Gap” between what addiction and mental health resources employers think they are providing to employees and what employees use in practice. These sessions have focused on themes of psychological safety, stigma in the workplace, and performance and engagement at work. More information on this exciting project, including an action brief, will follow in a future newsletter.

Fostering Innovation with NIDA

Having begun in 2019, we continue to work with National Institute on Drug Abuse (NIDA). In 2019, CPH held an Investment and Innovation Accelerator Forum to bring together the NIDA community of innovators, including startups, small businesses, winners of NIDA challenges and prize competitions, and the Milken Institute’s community of investors, companies, and philanthropists interested in investing in innovative addiction prevention interventions. At the height of the COVID-19 pandemic, CPH worked with CEOs from several of these startups and small businesses to create a written thought leadership series that highlighted how these health tech innovators had pivoted to meet the needs of patients with substance use disorder during the pandemic. We look forward to continuing our work with our NIDA colleagues this year and will share more information in a future newsletter.

Prevention

Pandemic Lessons Learned

Last fall, CPH leveraged our network of thought leaders to uncover lessons from the COVID-19 pandemic with a focus on examining the private sector’s role and responsibility in supporting public health. Drawing on a comprehensive landscape analysis and discussions with 32 experts, CPH found that public-private partnerships (PPPs) strengthened or newly formed during pandemic response are a bright spot in imagining a better future. In February, CPH released a commentary paper on this work, 'Learning from COVID-19: Reimagining Public-Private Partnerships in Public Health', which presents lessons from three case studies that support an evolution from traditional PPPs towards a concept of Partnerships for Public Purpose, which emphasizes sustainable, systemic public impact over the collaborators’ sectors. The report includes 10 CPH recommendations to assist policymakers, private-sector leaders, and all those looking to craft sustainable, impactful partnerships. To celebrate the report release, we held a private coffee chat with 30 thought leaders on how to further actualize and advance Partnerships for Public Purpose.

Chronic Disease Prevention

With more than half of US adults living with at least one chronic disease, there is a pressing need to catalyze policy, system, and environmental changes that examine the value and benefit of implementing innovative whole-person-centered care at earlier stages. These approaches can improve care coordination, well-being, and health outcomes to better prevent and manage chronic disease in a post-COVID era, especially now that public health infrastructure is over-leveraged and stretched thin. Last fall, CPH embarked on a US-focused initiative to uncover and explore early detection barriers and prevention gaps in chronic kidney disease (CKD) and identify opportunities for addressing them. We’ve convened a series of workshops that will inform a detailed report and roadmap that will outline actionable steps and policies to make scalable upstream improvements to CKD care. More information on this initiative will follow in next quarter’s newsletter.

Health Equity

CPH recognizes that building thriving communities and advancing health equity require improving the interrelated social and economic conditions at the root causes of health outcomes. Sessions at our recent and upcoming signature events drive this theme, including at Global Conference in May 2022: 'Advancing Social Policies for Public Health Equity and Well-being' and 'The Economics of Health Equity: Implications for Policy, Research, and Practice'. We look forward to announcing a health equity director starting this spring to evolve the Center for Public Health’s upstream strategic work in this pillar.

CPH is also lending a public health lens to support FasterCures’ work to advance system change within biomedical research to focus on and value diversity and representation within clinical trials. We are proud to share the 'Achieving Health Equity: A Multi-Stakeholder Action Plan to Address Diversity across the Clinical Trials Enterprise and the Biomedical Research Ecosystem' report, as well as the mention of both FasterCures and the Center for Public Health in this announcement regarding the DEPICT Act. We will be publishing a joint policy brief in the coming weeks on Recently Proposed Policies on Clinical Trial Diversity in the 117th Congress. Our recommendations focus on reporting and progress evaluation, investments in structural barriers to clinical trial research, and the role of digital health technologies.