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July 6, 2000

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Johns Hopkins Establishes Urban Health Institute To Improve Health Of East Baltimore

--Thomas P. O'Toole, M.D., Named Interim Director

"We have before us a challenging mission. This is an unprecedented undertaking for Johns Hopkins, but working together in a true partnership with a shared vision, we can begin making East Baltimore a healthier, happier place to live." President William R. Brody, M.D., Ph.D.

After more than a year of working closely with the East Baltimore community to identify their health concerns, Johns Hopkins has committed $4.5 million over a period of five years to establish an Urban Health Institute to tackle the vexing health problems that plague that community. The Institute brings together a wide range of Hopkins' health experts, community leaders, business leaders, clergy, and state and local city agencies to forge a partnership that will first identify the most pressing health issues and then develop the best methods, including research, education and community outreach, to address these problems.

At the top of the community's list is substance abuse, particularly among women of child-bearing age. Substance abuse was named by the community as its number one problem and the root cause of many other urban health problems.

"We have before us a challenging mission," said Johns Hopkins University President William R. Brody, M.D., Ph.D. "This is an unprecedented undertaking for Johns Hopkins, but working together in a true partnership with a shared vision, we can begin making East Baltimore a healthier, happier place to live."

"The City of Baltimore is pleased to collaborate with Johns Hopkins in the realization of this project," said Peter Bielenson, M.D., M.P.H. commissioner of the Baltimore City Health Department. "The establishment of this institution will go a long way in bringing to light the social problems of East Baltimore and our commitment to improve the overall health status of the community."

Other health priorities identified by the community that the Institute is expected to address include violence, sexually transmitted disease, HIV/AIDS, cardiovascular disease, pulmonary disease, environmental health, the elderly, and family, maternal and child health services.

Thomas O'Toole, M.D., assistant professor of medicine at Hopkins and a member of the executive committee of the Hopkins Urban Health Council, will be interim director of the Institute until the national search for a permanent director is completed.

O'Toole will direct the new Institute's initiatives, and together with the community, monitor and evaluate the effectiveness of each initiative. To ensure that the community's concerns and needs are addressed, the community will be represented within the Institute at all levels.

"We have a unique opportunity for using faculty research and teaching to bring us into closer harmony with the community we historically serve," O'Toole said. "To make this urban health initiative work and pay dividends, there has to be a close, collaborative partnership between Hopkins professionals and community residents. Each has a great deal to offer the other."

O'Toole joined Hopkins in 1999, where he directs a program for homeless, drug-addicted persons seeking recovery and does community-based research in access to health care. Prior to joining Hopkins in 1999, O'Toole was assistant professor of medicine at the University of Pittsburgh Medical Center, where he founded and directed the Program for Health Care to Underserved Populations. This program, which was recognized in the U.S. Health and Human Services Models That Work initiative, sponsors service-learning partnerships with several community organizations and health professional schools at the University of Pittsburgh. O'Toole was recognized in 1999 with the national Ernest A. Lynton Award for Faculty Professional Service and Academic Outreach and with the Healthcare Foundation Humanism in Medical Faculty award. He is on the national board of directors for Community-Campus Partnerships in Health and chairs their advocacy and policy committee. He is a member of the Association for Clinicians to the Underserved and serves on the Health Care Subcommittee of the Baltimore City Mayor's Task Force on Homelessness.

The Institute grew out of the "President's Council on Urban Health," brought together by Brody to identify and target specific health problems in the East Baltimore community. The Council's report recommended the creation of an Institute for Urban Health that would foster research, education, patient care services and community services on issues related to urban health. Its mission: harness the resources of Hopkins faculty and staff across a wide variety of disciplines to help translate new knowledge into new advances in health care and help promote community health education.

"One of the most pressing needs confronting us is the health status of the East Baltimore community," Brody says. "I am absolutely convinced, however, that a properly focused Johns Hopkins program, with help from our neighbors, can both improve our community's health and provide a national model for using the resources of an academic center to improve urban health."

As a highly organized and central focal point for urban health issues, Brody sees the Institute as able to respond in a much more efficient and structured manner to the serious health needs of East Baltimore.

"There is much that needs to be done in East Baltimore," Brody says. "By joining forces with our community, city and business leaders, we are confident that we will develop real-world, effective programs combining health education, disease prevention and primary care that make a real difference in the lives of our community."

To accomplish this ambitious agenda, in addition to the Hopkins commitment of nearly $1 million each of the initial five years, the Institute is expected to obtain funding from foundation and research grants to establish programs such as an academy for community health workers.

The Institute will operate outside any of the current University divisions, with a strong voice at the highest levels of decision-making within the University and The Johns Hopkins Health System. The three major administrative components withing the Institute will reflect its main missions: research and evaluation, education and training, and community affairs.

"The Urban Health Institute is an exciting chance to address the challenges of urban health because of its new approach," said Ackneil Muldrow II, a member of the President's Council on Urban Health's executive committee and president & CEO of Development Credit Fund Inc. "I believe the Institute will develop a national model for using the resources of an academic health center to make a difference in the health status of its surrounding community."

In announcing the new Institute, Brody thanked Johns Hopkins University School of Nursing Professor Martha Hill, who co-chaired along with Johns Hopkins Health System Vice President Colene Daniel, the President's Council on Urban Health, in addition to their other responsibilities. Daniel will continue to co-chair the Council with O'Toole.

Brody also noted that a search for the permanent director has been launched. Provost Steven Knapp, Ph.D., will chair the search committee, which welcomes nominations and applications.


1. What is the Urban Health Institute?
The Urban Health Institute is a multi-disciplinary institution for research, education and community outreach on issues related to urban health with jointly appointed faculty, a core staff, and connections to relevant community, government and health agencies. It will have a special focus on the health problems of East Baltimore and will work in partnership with the community.

2. What is it not?
The Institute is not a medical clinic, although one of its goals will be to improve access and delivery of health care to East Baltimore residents.

3. How is the Institute being funded?
The divisions of the University, the Health System and the President of Johns Hopkins have allocated $4.5 million to fund the Institute for an initial period of five years. Eventually, additional funds will be obtained through research grants from various government agencies and private foundations, as well as individual and corporate philanthropy.

4. What are some of the things the Institute hopes to accomplish?
First and foremost, the Institute will bring to bear the resources of Hopkins and its partners to improve the health status of East Baltimore residents through the development of research, education and community outreach programs with an early focus on substance abuse, identified by the community as the priority community health concern. Some specific objectives include:

5. Will establishment of the Institute mean the creation of new jobs for residents of East Baltimore?
The Institute is designed to take advantage of the expertise of Hopkins faculty and staff members as well as community members. Initially, it is not envisioned that there will be a significant need for additional personnel. However, since the Institute will seek to obtain grant monies for various community research programs and initiatives, as well as help community groups set up their own community-based programs, it is likely that there will be a need for workers from East Baltimore. At this time, it is impossible to estimate the number of such workers.

6. What kind of research will the Institute do and why is it important?
Community health research is a major component of the Urban Health Institute and one of Hopkins' strengths. It is essential to the long-term success and sustainability of the Institute that its programs and initiatives reflect real world conditions and answer the needs of the community. It also is critical that such programs be monitored against tested benchmarks to ensure that the programs are effective. Only structured research can satisfy these requirements and ensure that the health problems are properly identified, understood and acted on. In addition, such research is expected to lead to program development that will bring in outside funds, further enhancing the Institute's ability to improve the health of East Baltimore.

7. How many people will be employed by the Institute?
After a permanent director is engaged, the initial staff will consist of about six individuals, in addition to a number of faculty having joint appointments. Other staffing will be added as external grants are obtained; the numbers and nature of these positions will depend upon the particular projects.

8. Where will the Institute be located?
A search is underway for a suitable location.

9. How important is community involvement to the Institute?
Close community participation and involvement is central to the Institute's mission. It must have a full partnership with the residents of East Baltimore if it is to be successful. This includes a community consensus in setting priorities, participating in decision making (interviewing and recommending leaders, health workers, Council and working group members), advocating for health, and helping shape the norms for community participation.

-- JHMI --
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