When more people began to realize how bad tobacco was for your health about a decade ago — and mortality rates fell — leaders in the Centers for Disease Control and Prevention rejoiced.
Altering the collective health of a population certainly took time.
Elizabeth Majestic, who was working in the CDC Office on Smoking and Health back then, knew a mix of marketing, public outreach and data prompted the change in thinking.
It wasn’t easy — even with compelling data — but now “no smoking” signs are commonplace.
After working for 25 years to influence health policy on the national and international level in senior management at the CDC and the U.S. Department of Health and Human Services, Majestic is bringing those strategic talents to Santa Barbara.
She’s settling in this month as Cottage Health’s first-ever vice president of population health, a position created so the regional hospital can expand its community outreach efforts and comply with new requirements under the Affordable Care Act.
The hospital aims to keep people healthy and to prevent any future visits.
“This is a fundamental shift,” Majestic told Noozhawk this week in an interview at her office across the street from Santa Barbara Cottage Hospital.
“We are not just stopping at the walls of the hospital anymore.”
Health care is moving away from a “fee for service” and volume-focused model to “fee for outcomes,” she said.
The new federal law allows hospitals to be reimbursed and judged on their service, namely on 30-day re-admissions and on the follow up and data gathered to identify collective community health issues.
New rules hope to strike a balance between how much the U.S. spends on healthcare — it is No. 1 in the world by far — and the return of keeping people of all ages healthy.
“We’re great at taking care of sick people, but not as good at prevention,” Majestic said.
Majestic has become an expert on chronic disease prevention and health education since leaving her small-town Ohio roots after high school, heading to West Virginia University to play volleyball and earning a couple master’s degrees before landing in Atlanta at the CDC.
She also spent time as an adjunct associate professor at Georgia State University.
“It’s the whole reason I got into it,” she said of preventing illness. “I came here because I think I can make a difference in this community’s population health.”
Most factors impacting a person’s health have less to do with access and quality of care and more to do with socioeconomic determinants like level of education, housing and income inequality, Majestic said.
A healthy child who isn’t tired or hungry likewise tends to do better in school.
In Santa Barbara, where Majestic and her husband have vacationed every year for the past decade after she visited for a conference, she has already identified child poverty and income inequality as determinants.
“Health really begins in these areas,” she said. “Zip code is more important than genetic code.”
That’s why Majestic was brought on — to study admission data and to create countywide and community-specific action plans to address population health issues like heart disease, cancer, obesity and diabetes.
She’ll visit schools, neighborhoods, businesses and community partners that could lend some help, whether via data, joint promotion or more.
Nonprofits round out her formula for success, and there are so many in Santa Barbara that Majestic affectionately refers to the cohort as “nonprofit madness.”
Majestic has also been meeting with fellow healthcare collaborators, including Santa Barbara County Public Health Department Director Dr. Takashi Wada, who this week said he was excited about the possibilities.
“I think it’s great for Cottage to be further developing that aspect of their system,” Wada said, noting he’s familiar with Majestic’s work.
“I think having an executive-level position dedicated to that will certainly add to the capacity.”
Majestic is optimistic she can make an impact and hopes to put particular focus on the link between health and education.
With any luck, the term “population health“ will eventually be commonplace.
“Our hope is that we can use this data, identify problems and come to the table to make plans,” she said. “Partnerships enhance our impact.”
— Noozhawk staff writer Gina Potthoff can be reached at gpotthoff@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.