Special Message from the Director
The Flint Water Crisis

Over the last several months, the country's attention has turned to an unprecedented public health emergency that has unfolded over the past year in Michigan. The long-term health ramifications of the Flint water crisis are still unclear, particularly for the city's children. But what is certain is that an effective response will require addressing needs across multiple domains including healthcare, education and child development, infrastructure and technology, and economic and public health policy.

A number of our IHPI members, such as Cleo Caldwell, Ph.D., Rebecca Cunningham, M.D., and Marc Zimmerman, Ph.D., have long been engaged in Flint through established relationships with community partners. Matt Davis, M.D. is serving as a member of the Governor's advisory task force charged with reviewing actions around the crisis and offering recommendations for future policies to protect public health and safety, while Eden Wells, M.D. has been involved in communicating about health risks and working with local, state, and federal officials in her role as Michigan's Chief Medical Executive.

Our UM-Flint colleagues have helped lead response efforts in coordination with community partners to help protect the health of Flint citizens and ensure safe drinking water on its campus. UM-Flint is maintaining information and local resources on its website, and its Department of Public Health and Health Sciences is offering a free on-campus, open-to-the-public course on understanding the issues surrounding the water crisis. Our School of Public Health has also assembled valuable resources and information related to the crisis and its own response efforts.

Last month, more than 140 faculty members from U-M's Flint, Dearborn, and Ann Arbor campuses met in Flint to begin a conversation about the ways we might collaborate with Flint community partners on issues related to health, water infrastructure, and policy, and how our research expertise might align with and support community-identified priorities. These events remind us that water quality is one of many systemic issues contributing to health disparities not just in Flint, but in many other communities across the country, and I am hopeful that we as a society will develop new ways to help ensure communities have healthier environments and more effective healthcare to prevent such crises from happening in the future.

John Z. Ayanian, M.D., M.P.P.
Alice Hamilton Professor of Medicine
Director, Institute for Healthcare Policy and Innovation
University of Michigan
The dose makes the poison: Opioid overdose study supports call for caution in prescription levels

When it comes to prescription painkillers, the difference between controlling pain and dying from an overdose may come down to the strength of the prescription the doctor wrote, according to a new study. And the threshold for safe prescribing may be lower than most people think ---- or than most guidelines recommend.

The researchers, led by opioid overdose expert Amy Bohnert, Ph.D., M.H.S., U-M assistant professor of psychiatry and research investigator at the VA Ann Arbor Healthcare System, made the findings through a careful examination of records from 221 veterans who died from accidental opioid painkiller overdoses, and an equal number of veterans who were matched to be exactly alike in many ways, and took opioids for chronic pain, but did not overdose.

High opioid doses could be marker for suicide risk

In a recent study of nearly 124,000 Veterans, those receiving the highest doses of opioid painkillers were more than twice as likely to die by suicide, compared with those receiving the lowest doses. But it's unclear from the study whether there's a direct causal link between the pain medications and suicide risk. Rather, the high doses may be a marker for other factors that drive suicide ---- including unresolved severe chronic pain.

"This relationship is likely more complicated than an increase in access to opioids leading to an increase in intentional overdoses," wrote the authors, led by Mark Ilgen, Ph.D., U-M associate professor of psychiatry and research investigator with the VA Serious Mental Illness Treatment Resource and Evaluation Center, and the VA Center for Clinical Management Research.

One in seven colorectal cancer patients diagnosed before recommended screening age

Nearly 15 percent of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin.

A new studyfound that younger patients were more likely to have advanced disease. Study authors and IHPI members Samantha Hendren, M.D., M.P.H., associate professor of surgery and Scott Regenbogen, M.D., M.P.H., assistant professor of surgery, suggest this is in part because they are diagnosed only after their cancers have grown large enough to cause symptoms.

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The Institute brings great minds together to address healthcare's biggest challenges. More than 460 investigators come to IHPI from U-M's top-ranked schools of medicine, nursing, public health, engineering, social work, law, business, and public policy, among others, as well as members of affiliated local research organizations. 
Fendrick testifies before Michigan Senate Committee

Mark Fendrick, M.D., professor of internal medicine, U-M Medical School, testified before the Michigan Senate Appropriations Subcommittee on Health and Human Services in Lansing, Michigan, on February 9, 2016. He was asked to discuss opportunities to improve the health of Michigan residents through the utilization of value-based services and performance metrics, as well as how clinically nuanced cost-sharing has been an effective way to improve value and creates an opportunity for broad innovation in the Medicaid space.

Is the Dementia Risk Falling?

Ken Langa, M.D., Ph.D., professor of medicine, U-M Medical School, was interviewed by Scientific American amid gloomy reports of an impending epidemic of Alzheimer's and other dementias. According to the World Alzheimer Report 2015, 46.8 million people around the globe were living with dementia last year, and that number is expected to double every 20 years. But new epidemiological studies reveal a hopeful trend: Analyses conducted over the last decade in the U.S., Canada, England, the Netherlands, Sweden and Denmark suggest that a 75- to 85-year-old has a lower risk of having Alzheimer's today than 15 or 20 years ago.

Join the movement where medicine and technology intersect!

HealthDesignBy.Us Design Bootcamp

Date: February 22, 2016
Time: 1:00 p.m. --- 4:00 p.m.
Location: University of Michigan School of Information, North Quad,
105 S State St, Ann Arbor, MI 48109, Room 2435

HealthDesignBy.Us is a collaborative of patients and caregivers, healthcare providers and researchers, designers and artists, engineers and technologists, public health professionals and community members who are passionate about patient-centered participatory design and infusing the maker movement into healthcare.

This workshop is for anyone interested in learning more about using human-centered design thinking to develop healthcare solutions for the future.

This workshop is open to the public.

PICTURED RIGHT: Two young patients designed these emojis to help children and teens with Type 1 diabetes better communicate with their parents and caregivers.

The University of Michigan Injury Center is a comprehensive CDC-funded Injury Control Research Center that works to prevent injury through research, education, and outreach. The center has special expertise in the population of teens and young adults (although not exclusively), and in geo-spatial analysis. It focuses on transportation safety, violence interventions, prescription drug misuse, concussion, campus sexual violence, and other injury topics. Working closely with faculty across many disciplines, with regional education and public health partners, and in close coordination with the CDC, it generates and shares new findings about injury prevention that can impact both policy and individual behavior.

The center began in 1997 as the Injury Research Center (founded within the U-M
Department of Emergency Medicine), which in 2010 merged with the Center for Injury Prevention among Youth. The Injury Center was designated a CDC-funded
Injury Control Research Center in 2012.

The Institute for Healthcare Policy and Innovation is committed to improving the quality, safety, equity, and affordability of healthcare services

To carry out our ambitious mission, our efforts are focused in four areas:
  • Evaluating the impact of healthcare reforms
  • Improving the health of communities
  • Promoting greater value in healthcare
  • Innovating in IT and healthcare delivery

If you are interested in supporting health services and health policy research at the University of Michigan, click here

IHPI Informs is published monthly by the University of Michigan Institute for Healthcare Policy & Innovation.
U-M Institute for Healthcare Policy & Innovation
North Campus Research Complex (NCRC)
2800 Plymouth Road, Building 16
Ann Arbor, MI 48109

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