Going Upstream to Address Health Inequities: A Q&A with Kamillah Wood, M.D., M.P.H.
Since 1996, the Commonwealth Fund has offered a yearlong fellowship for physicians committed to transforming health care delivery systems for vulnerable populations, including people of color and economically disadvantaged groups. Under the Commonwealth Fund Fellowship in Minority Health Policy at Harvard University (formerly the Mongan Commonwealth Fund Fellowship in Minority Health Policy), fellows complete academic work leading to a master of public health degree at the Harvard School of Public Health, or a master of public administration degree at the Harvard Kennedy School of Government. Fellows also participate in forums and seminars with nationally recognized leaders in health care delivery systems, minority health, and public policy. This year, the Commonwealth Fund has added a second fellowship, the Commonwealth Fund Fellowship in Minority Health Leadership at Yale University, which is open to clinicians applying to the university’s MBA for Executives (EMBA) program.
We spoke with Kamillah Wood, M.D., M.P.H., a 2010–11 fellow, about how the fellowship has shaped her career.
You attended George Washington University School of Medicine, then completed your residency in pediatrics at the Children’s Hospital of Philadelphia. What got you interested in public health?
I always envisioned myself as being a community pediatrician. I chose Children’s Hospital of Philadelphia for residency because it is one of the best pediatric training programs in the country, and I knew it would give me the skills to bring my vision to life. I absolutely loved my residency experience, but I quickly realized that I was limited in terms of the impacts I could make through clinical medicine alone. For example, I saw a lot of kids with asthma from West Philadelphia, and many were getting sick because of issues like poor housing conditions.
I began to ask questions about how we could do things differently. I had great mentors who helped me navigate my questions, but there were limited opportunities to address upstream factors that impact health in a way that got to the core of addressing health inequities. What attracted me to the Mongan fellowship was its focus on systems-level solutions to address health disparities. It was an opportunity to get the answers to the questions I had been longing to address.
After completing the fellowship, you came back to Washington, D.C., and began working for Children’s National Health System’s mobile health program. Can you tell us about these services?
Children’s mobile health program brings pediatric dental and medical services to schools, affordable housing developments, and other locations in D.C.’s seventh and eighth wards. Folks could walk out their door and visit our mobile units for routine medical care, including well-child visits and vaccinations.
As Associate Medical Director, I was able to bring my public health and policy experience to bear. For example, during the 2012 election, I created the Legislative Education Advocacy Program (LEAP) to help my patients understand the Affordable Care Act, how health policy affected them, and the importance of civic engagement. There was so much at stake during that election, and many of the conversations health policy folks were having revolved around the needs of patients we served, but those patients weren’t part of the conversation.
The Children’s Health Clinic is housed at THEARC (Town Hall Education Arts Recreation Campus), a cultural and social services campus in D.C.’s Anacostia neighborhood that includes a theater, gym, playground, library, mentoring programs, arts organizations, legal aid, job training, and other services. What was it like to deliver care there?
We were able to leverage these community partnerships to provide more than just medical care. For example, we partnered with the Levine School of Music to provide music therapy while patients waited for a visit and referred many families to LIFT DC [a nonprofit dedicated to breaking the cycle of poverty] to help them find employment. Many patients took classes at the Washington School for Ballet there. We created more than just access to health care; we also created access to resources that promoted opportunity. It was an amazing place to work.
Tell us about your current role, as senior vice president of health and housing at Stewards of Affordable Housing for the Future.
Stewards of Affordable Housing for the Future (SAHF) are a national collaborative of nonprofit affordable housing developers that together own more than 130,000 affordable housing units across the country. Our members come together to advance policies and programs that improve the lives of vulnerable populations by preserving, protecting, and creating affordable housing with services. My portfolio of work is focused on ways to leverage housing as a platform to promote better health.
At Stewards of Affordable Housing for the Future, I orchestrate partnerships between our members and the public health and health care fields. For example, our members have partnered with Medicaid managed care organizations to address the health needs of their residents.
In addition, SAHF plays a major role in guiding the health and housing conversation through our thought leadership. We’ve recently hosted a number of roundtables to discuss collaborations across the health and housing sectors focused on issues such as oral health, toxic stress and trauma, food insecurity, and behavioral health. Finally, we advocate to increase the availability of affordable housing options for vulnerable populations.
How far has the health care field come in terms of recognizing the link between stable housing and good health?
A lot of work has focused on ensuring that high-cost populations are stably housed through supportive housing, which combines affordable housing assistance with wraparound support services. This is important work that continues to gain momentum as health systems are incentivized to reduce unnecessary utilization.
However, there are not enough affordable housing options in general. We are pushing to think about how we can get more diverse sources of capital — including health care dollars — into the development of affordable housing to ensure we are providing housing and supports for other vulnerable populations, including low-income families.
What policies might encourage health care providers to invest in housing?
There is no policy stopping hospitals from investing in affordable housing. But we need to continue to develop business models that demonstrate it’s worth the investment. And we need policies to support innovative financing models that promote investment not just in housing, but also more broadly into underresourced communities to foster opportunity and economic mobility.
Looking back, what has been most valuable about your fellowship experience?
Over the years, I have really leaned on my network of Mongan alumni fellows for professional advice and friendship. We really are a family, and I am incredibly grateful to be a part of such an amazing group of leaders and game-changers.
Our fellowship director, Joan Reede, created an environment where I felt empowered. That became a critical part of my career choices after the fellowship, looking at challenging and unique ways to create health equity. It has allowed me to have this weird and interesting career from clinical medicine, to a White House Fellow working on transportation policy and equity, to housing and health policy. Without my experience as a Mongan Fellow, I would not have had the courage to step outside of my comfort zone to pursue these opportunities.