GW SPHHS awarded three grants to research on critical public health problems

The George Washington (GW) University School of Public Health and Health Services (SPHHS) has been awarded three large grants for projects that will look for innovative solutions to some of the nation's most pressing public health challenges. The awards, the largest of which tops $1.8 million, join a long list of SPHHS initiatives, programs and studies that have been funded by the federal government, private foundations and others, to improve the health care system, look for ways to prevent diseases and facilitate the dramatic transformation of the U.S. health care system.

"SPHHS researchers have a long history of spearheading innovative research on critical public health problems," says Lynn R. Goldman, MD, MS, MPH, dean of SPHHS. "I am particularly excited about the three newest grants, which further cement the school's reputation as a research powerhouse."

In the first, the Health Resources and Services Administration (HRSA) has awarded SPHHS a $1.8 million grant to establish a Health Workforce Research Center (HWRC). This center will conduct studies that focus on the novel and flexible use of health care professionals to improve the health care system-and ease shortages in the workforce, says Patricia (Polly) Pittman, PhD, an associate professor of health policy at SPHHS and principal investigator of the project. She says the Affordable Care Act (ACA) brings up many new questions about the ability of the health care workforce to meet the demands of the future, including a pressing need for primary care delivered in rural or underserved areas of the United States.

"Our research will look at novel ways to ease the shortage of health care professionals in such regions," Pittman says. "We will also investigate other issues that are emerging now under the ACA concerning improvements in the quality of care and efficiency of the health care system." For example, the center will look at whether different skill mix strategies in primary care, and the expanded use of health information technologies, are improving the efficiency and effectiveness of the workforce.

The research conducted by the new center aims to find ways to solve challenges related to the workforce that play a role in access, quality of care and the cost of health care, Pittman says.

In the second, the Centers for Disease Control and Prevention (CDC) has awarded SPHHS a $1.3 million grant to study end-stage kidney disease and kidney cancer among autoworkers exposed to potentially harmful chemicals used on the job. The 4-year study will look at whether exposure to metalworking fluids used in cutting and grinding operations in auto plants could harm kidney cells and lead to end stage renal disease and kidney cancer. There has been very little research on occupational exposures and harm to the kidneys yet these organs constantly filter the blood and thus are vulnerable to damage from chemicals, including those used in the workplace, says Kate Applebaum, ScD, MSPH, an assistant professor in the Department of Environmental and Occupational Health and principal investigator for the project.

The study will look at over 46,000 autoworkers and will include more than 60 years of follow up to find cases of renal disease and kidney cancer, thus making it one of the largest investigations of this issue. "The goal of our project is to advance the knowledge of how these exposures influence multiple adverse outcomes of the kidneys," Applebaum says. "In addition to autoworkers, there are many other occupational groups that use similar fluids. We need to understand the health impact on those exposed and minimize preventable risks." The grant was awarded by The National Institute for Occupational Safety and Health, which is part of the CDC.

In the third, the Robert Wood Johnson Foundation awarded SPHHS approximately $750,000 to develop a user-friendly web tool that would help communities understand how nonprofit hospitals in the area invest in health and health care that is aimed at benefiting the entire community. Users of the tool would be able to see all investments and activities that make the hospital eligible for a tax break and at the same time improve the public health. In order to keep their tax-exempt status nonprofit hospitals must conduct an ACA-mandated community health needs assessment-an analysis that tells them the most pressing health problems in the neighborhoods surrounding the hospital. Hospitals then must develop and execute a plan that tries to come up with solutions for some of the most serious problems, like obesity, smoking or other issues that affect many residents living nearby.

"This web tool would give users a quick way to check on a hospital's health investment and activities that are reported on Schedule H to the Internal Revenue Service," says Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Policy and Law at SPHHS and co-principal investigator. "In addition, the tool will allow users to easily compare how their community hospital's performance in this arena compares to other hospitals locally or nationwide."

The 18-month project will use information and a blueprint developed in an earlier project to build a prototype for a tool that would make the community benefit data collected by the IRS in Schedule H easily accessible and understandable, said Maureen Byrnes, MPA, who is also co-principal investigator of the project and a lead research scientist in the SPHHS Department of Health Policy. The team will also test the prototype and produce an updated economic analysis of the total value of tax exemptions for non-profit hospitals nationwide. Such an analysis has not been done since 2002.