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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue About the Workforce for Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25545.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Dialogue about the Workforce for Population Health Improvement PROCEEDINGS OF A WORKSHOP Melissa Maitin-Shepard and Carla Alvarado Roundtable on Population Health Improvement Board on Population Health and Public Health Practice Health and Medicine Division PREPUBLICATION COPY: UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and Association of American Medical Colleges, Blue Cross Blue Shield, The California Endowment, Dartmouth-Hitchcock Medical Center, Fannie Rippel Foundation, Geisinger, Kaiser Permanente, The Kresge Foundation, Nemours, Robert Wood Johnson Foundation, Samueli Foundation, U.S. Department of Health and Human Services Program Support Center, and Wake Forest Baptist Medical Center. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/25545 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2019 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Dialogue about the workforce for population health improvement: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25545. PREPUBLICATION COPY: UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS

PLANNING COMMITTEE ON DIALOGUE ABOUT THE WORKFORCE FOR POPULATION HEALTH IMPROVEMENT1 KEVIN BARNETT, Senior Investigator, Public Health Institute NISHA BOTCHWEY, Associate Professor, School of City and Regional Planning, Georgia Institute of Technology GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University PHYLLIS D. MEADOWS, Senior Fellow, Health Program, Kresge Foundation JEREMY MOSELEY, Director of Community Engagement, FaithHealth Division at The Wake Forest Baptist Health KAREN MURPHY, Executive Vice President and Chief Innovation Officer, Founding Director, Steele Institute for Healthcare Innovation, Geisinger JOSHUA M. SHARFSTEIN, Associate Dean for Public Health Practice and Training, Johns Hopkins Bloomberg School of Public Health 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for this published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. PREPUBLICATION COPY: UNCORRECTED PROOFS v

ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1 SANNE MAGNAN, Co Chair, Adjunct Assistant Professor, Division of Medicine, University of Minnesota JOSHUA M. SHARFSTEIN, Co Chair, Associate Dean for Public Health Practice and Training, Johns Hopkins Bloomberg School of Public Health PHILIP M. ALBERTI, Senior Director, Health Equity Research and Policy, Association of American Medical Colleges TERRY ALLAN, Health Commissioner, Cuyahoga County Board of Health JOHN AUERBACH, Executive Director, Trust for America's Health CATHY BAASE, Chair, Board of Directors, Michigan Health Improvement Alliance DEBBIE I. CHANG, Senior Vice President, Policy and Prevention, Nemours KATHY GERWIG, Vice President, Employee Safety, Health and Wellness and Environmental Stewardship Officer, Kaiser Permanente MARTHE GOLD, Senior Scholar in Residence, The New York Academy of Medicine MARC N. GOUREVITCH, Professor and Chair, Department of Population Health, New York University School of Medicine GARTH GRAHAM, President, Aetna Foundation GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University WAYNE JONAS, Executive Director, Integrative Health Programs, H&S Ventures ROBERT M. KAPLAN, Professor, Center for Advanced Study in the Behavioral Sciences, Stanford University DAVID A. KINDIG, Professor Emeritus of Population Health Sciences, Emeritus Vice Chancellor for Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison SALLY A. KRAFT, Vice President, Population Health, Dartmouth-Hitchcock PAULA M. LANTZ, Associate Dean for Academic Affairs and Professor of Public Policy, Gerald R. Ford School of Public Policy, University of Michigan MICHELLE LARKIN, Associate Vice President, Associate Chief of Staff, Robert Wood Johnson Foundation THOMAS A. LAVEIST, Dean, School of Public Health and Tropical Medicine, Tulane University JEFFREY LEVI, Professor, Department of Health Policy & Management, Milken Institute School of Public Health, The George Washington University SHARRIE MCINTOSH, Vice President for Programs, New York State Health Foundation PHYLLIS D. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation BOBBY MILSTEIN, Director, ReThink Health JOSÉ T. MONTERO, Director, Office for State, Tribal, Local, and Territorial Support, Deputy Director, Centers for Disease Control and Prevention KAREN MURPHY, Executive Vice President and Chief Innovation Officer, Founding Director, Steele Institute for Healthcare Innovation, Geisinger MARY PITTMAN, President and Chief Executive Officer, Public Health Institute 1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for this published Proceedings of a Workshop series rests with the workshop rapporteurs and the institution. PREPUBLICATION COPY: UNCORRECTED PROOFS vii

RAHUL RAJKUMAR, Senior Vice President and Chief Medical Officer, Blue Cross Blue Shield of North Carolina LOURDES J. RODRIGUEZ, Director, Community-driven Initiatives at Dell Medical School, Associate Professor, Department of Population Health, University of Texas at Austin PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation MYLYNN TUFTE, State Health Officer, North Dakota Department of Health HANH CAO YU, Chief Learning Officer, California Endowment Health and Medicine Division Staff ALINA BACIU, Roundtable Director CARLA ALVARADO, Program Officer KIMANI HAMILTON-WRAY, Senior Program Assistant (through May 2019) BRITTANY DAVENPORT, Senior Program Assistant (beginning July 2019) ROSE M. MARTINEZ, Senior Board Director Consultant MELISSA MAITIN-SHEPARD, Rapporteur PREPUBLICATION COPY: UNCORRECTED PROOFS viii

REVIEWERS This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: LOURDES J. RODRIGUEZ, Center for Place-based Initiatives, Dell Medical School, University of Texas at Austin KAREY M. SUTTON, Association of American Medical Colleges PHILLIP M. ALBERTI, Association of American Medical Colleges Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by ANTONIA M. VILLARRUEL, University of Pennsylvania School of Nursing. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. PREPUBLICATION COPY: UNCORRECTED PROOFS ix

CONTENTS Acronyms and Abbreviations xiii 1 Introduction 1 Workshop Objectives, 1 Context, 2 Organization of the Workshop and Proceedings, 4 2 Building a Health Workforce for the Future: Lessons from a Multi-Stakeholder Statewide Initiative 5 Discussion, 10 3 Perspectives from Professional and Accrediting Organizations 13 Public Health Workforce Interest and Needs Survey, 13 Role of Essential Hospitals in Assessing Population Health Needs, 15 Local Public Health Workforce Considerations, 20 Physician Education and Health Equity, 21 Discussion, 22 4 The Community Health Workforce 25 Community Health Worker Panel, 25 CHW Workforce Development and the Oregon Community Health Workers Association, 28 CHW Training and the Future of the Profession, 30 Discussion, 33 5 Cross-Sector Workforce: National and Local Examples 37 TRAIN Learning Network and Competencies for Population Health Professionals, 37 Be a Change Leader, Build a Culture of Health, 40 Nontraditional Student Training Through the Bloomberg American Health Initiative, 42 Planning and Public Health, 45 Health in All Policies in Fairfax County, Virginia, 47 Discussion, 48 6 Breakout Session: Moving Toward a Population Health Workforce Exercise 51 Instructions, 51 Discussion, 52 7 Reflections on the Day and Closing Remarks 55 Appendixes A References 59 B Workshop Agenda 61 C Biosketches of Speakers, Moderators, and Planning Committee Members 63 D Small Group Exercise Instructions and Worksheet 75 PREPUBLICATION COPY: UNCORRECTED PROOFS xi

Abbreviations and Acronyms AAMC Association of American Medical Colleges ACE Adverse childhood experience ACO accountable care organization APA American Planning Association ASTHO Association of State and Territorial Health Officials AEH America’s Essential Hospitals ASTHO Association of State and Territorial Health Officials CDC U.S. Centers for Disease Control and Prevention CHW community health worker CCO coordinated care organization CMS Centers for Medicare & Medicaid Services DSH disproportionate share FQHC federally qualified health center GME graduate medical education HUD U.S. Department of Housing and Urban Development IPHI Institute for Public Health Innovation MCH Maternal and Child Health MPH Master of Public Health degree NACCHO National Association of City and County Health Officials NCQA National Committee for Quality Assurance ORCHWA Oregon Community Health Worker Association PH WINS Public Health Workforce Interests and Needs Survey ROI return on investment RWJF Robert Wood Johnson Foundation VA U.S. Department of Veterans Affairs WHO World Health Organization WIC Special Supplemental Nutrition Program for Women, Infants and Children PREPUBLICATION COPY: UNCORRECTED PROOFS xiii

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On March 21, 2019, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a 1-day workshop to explore the broad and multidisciplinary nature of the population health workforce. Workshop participants explored methods for facilitating a population health orientation/perspective among public health and health care leaders and professionals; framing the work of personnel such as community health workers (CHWs), health navigators, and peer-to-peer chronic disease management educators within the context of population health; and leveraging the competencies of public and private sector workforces, such as education, transportation, and planning, that are working to include a “health in all policies,” community livability, or well-being orientation in their activities. This publication summarizes the presentations and discussions from the workshop.

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