Connecting on Maternal Health in South Jersey

Inspira's President & CEO Amy Mansue sits down with Kathleen Noonan, President & CEO of the Camden Coalition, to discuss maternal health in South Jersey and a new initiative that works to improve the health and well-being of pregnant women and their families throughout the region. 

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Transcript

AMY: 

- Today I am thrilled to be here with Kathleen Noonan. Kathleen is the president and CEO of the Camden Coalition. Kathleen, thank you so much for making yourself available to us. 

KATHLEEN: 

- Thanks for having me. 

AMY: 

- I'm so grateful. Let's just start by talking about you a little. I know you don't like to do that, so I'm going to push you a little bit. But tell us about, you know, where you grew up, where you went to school ... 

 KATHLEEN: 

- Sure. So, I grew up in Long Island and I landed in Philadelphia because of my husband's job. He teaches law at Temple. And I spent 10 years at the Children's Hospital of Philadelphia, and then had the opportunity to come to South Jersey and work in an incredible local organization. 

AMY:  

- CHOP obviously is the Children's Hospital Philadelphia. I mean, you didn't just work there. You guys set up the policy shop, which really then, when you were doing the work at Camden Coalition, was actually the lead for the nation talking about the COVID work in reference to all of the data. So just spend a minute talking about that. 

KATHLEEN: 

- Sure, sure. In 2008, well 2007, I met a pediatrician at the Children's Hospital of Philadelphia, Dave Rubin. And he was very frustrated that the research that he was doing mostly on low-income families, he was finding great things and he couldn't implement. And I was an implementer out working with state and local government agencies, really in very big turnaround situations. And when we were there, we did amazing work. We said if we're getting these research dollars to do a community-based intervention, then we shouldn't do it within the walls of CHOP. We should go out and find community partners and do it with them. And so, we just did all these different things that were amazing and that resulted in more resources and not just research findings. 

 AMY: 

- And that then led you-

KATHLEEN: 

- That led me to the Camden Coalition.  

- Which is where it seems like there's the nexus of all of those things. 

KATHLEEN: 

- Yeah, well the Camden Coalition was interesting to me because they were a small organization that was involved in a big study, a randomized control trial. Really hard for a small organization to be involved in something like that. And I knew from being at CHOP that we had extensive research in cancer care and heart disease and all sorts of different things, but we did not have a lot of research in how you actually engage very, very complex families and kids. And so, to me, I kept saying it doesn't matter what the research says. This is an amazing contribution to the field. You know, right now we're working in five counties. It's a million and a half people. One in five of them are on Medicaid, which means they're getting their health insurance from a public system and that they do not have a high income. And I really have found in New Jersey, in South Jersey, a real interest in working together. And I think the Camden Coalition also, you know, started our work very much in care management with patients, but expanded it into how we build the systems around these patients. And, you know, that's what we've been doing with, you know, hospitals like yours for now, you know, well, it's our 20-year anniversary this year. 

AMY: 

- It's amazing. 

KATHLEEN: 

- Yeah, we've been around for a while. 

AMY: 

- You know, those lessons learned from the early work have really been helpful. And then of course you've continued to evolve. I mean, the data that you have and more importantly the expertise that the Coalition brings has the ability to really refine the data in ways that we can't see across our own organization often, just because we're too busy doing the work. And maybe you'd spend a little bit of time on how you've helped us see some of those things. 

KATHLEEN: 

- Sure, yeah. I come to this always with the knowledge of what the health systems can do and then where the community-based organization can sort of leverage, if you will, it's sort of unique role to be able to pilot something or start something that then the health systems will take on and run with. So, an example is we are working with all the health systems right now on a maternal mortality project. And we are working side by side with your staff in 10 emergency rooms in the five county South Jersey area that we work in. And what we're doing is we're going back to the roots of the coalition, which is to look at who comes to the emergency room for care that maybe you or I wouldn't go to the emergency room for, and is that maybe some signal that they don't have regular care? And so we are actually looking at all of the people who come to the emergency room who test positive for a pregnancy screen, and then working with all your emergency rooms to actually change the way you all do business, which is to not just say to someone, "Okay, this is what you do after the emergency room about what you came to us for," but to say, "Do you have a prenatal care appointment scheduled?" 

AMY:  

- Something that simple. 

KATHLEEN:  

- Something that simple, and it is, I am talking hundreds and hundreds of people across these providers, and it's every provider. And, you know, the truth is, is that when you say out loud, well isn't it standard of care that someone leaves the emergency room and has a prenatal appointment scheduled? The answer is no. So that's what we've been doing with Inspira. We always look to see who your partners are, So we're also working with Complete Care- 

AMY:  

- Which is the federally qualified health center in our region. 

KATHLEEN: 

- Yep. And looking to see that you both are leveraging each other's strengths. And we've seen, you know, sort of amazing things. And let me just give you two examples of stories right out of Inspira emergency rooms. Woman in an emergency room is new to New Jersey, doesn't have insurance yet, but she tested positive for pregnancy, but she was in the emergency room for something else. Did not have money for her prescription that she needed. And because of this new workflow, between you all and us, she got her prescription, she got the prenatal care she needed, we've set up to make sure she has transportation. Another woman, she was trying to go to prenatal care but walks an hour each way to prenatal care. 

AMY:  

- I mean, that's the difference between being in the inner city of Camden, where the services are right here, and being in the bottom of Cumberland County, when there's no transportation available. 

KATHLEEN: 

- Right. And so again, because we picked up the pregnancy test in the emergency room and we have created some flexible funds that are available for things like transportation, you know, we now have a transportation plan for this person. And when you look at the maternal mortality numbers in New Jersey, which are much worse than many, many states- 

AMY: 

- I know it's hard for people to imagine. I'm going to stop you right there, because they're like, "Wait a second. Women die during childbirth? What are you talking about? I thought nobody does." So, talk just a little bit about what we've seen, and it's a nationwide issue, not just a New Jersey issue, but our numbers are of greater concern, especially here in South Jersey. 

KATHLEEN: 

- Yeah. I would say Cumberland, Salem, and Camden are neck and neck for the lowest rankings. And we know that those rankings are driven by low wages and low employment numbers. 

AMY: 

- Mortality rate that's very high before the sick pass away. 

KATHLEEN:  

- People who are very sick and because of their life circumstances are prone to sickness, right? They're not as healthy just as a matter of, like, where they grew up, environmental situations. And so we are really working to change that. 

  

AMY: 

- And hence that's really the, that was, I think, the foundational elements of what happened in reference to getting this to be taken nationwide. So, talk a little bit about that story, 'cause it's just amazing. I think, you know, those of us who are Jersey centric are like, "Oh no, we created that." What are you talking about, there are other people involved?" So, spend a minute or two there. 

KATHLEEN: 

- Well, the Camden Coalition started its work back in 2002 and although now, you know, at least a lot of people in the health world are talking about social determinants of health, which are other things that drive your health other than health, at the time, you know, not everyone was talking about that. So, the Camden Coalition was talking about that, and we were also talking about going outside the walls of the hospital to help people, really using community health workers, having nurses, social workers, and community health worker teams go and meet people. And so, we were doing that very, very early. And over time as we refined how we did this, Robert Wood Johnson Foundation said, you know what, we really want you to take this national and we want you to develop a national center that will bring people together who are doing this work or trying to do this work. You know, and I'm talking 7, 800 people from around the country to come and talk about how they are meeting the needs of adults, children, and families with complex health and social problems. So, it's fabulous. It's really great. 

AMY: 

- And again, Robert Wood Johnson Foundation, their whole core mission is about improving the health of the communities. And they've spent a lot of time and a lot of research and a lot of money trying to look at that, and the piece of it that's often missing is in the implementation. So it seems like just the perfect solution in reference to really taking this to the next level, not just to do more programming, but to actually make that huge difference that we start to see that progress. 

KATHLEEN: 

- And we do the work by talking about it, but we also go into other communities and do it, because we are not just, you know, we don't just care about the research or the numbers. Like we want something different when we leave. 

AMY: 

- Well, I am so grateful to you for all of the work that Camden Coalition does, but also all the research and work you do to us in South Jersey, and I'm confident about the opportunity that we must improve health for everybody. And it's not going to be one thing. It's going to take a lot of little things to really gather that. Thank you so much for your time today. I'm so very grateful. 

KATHLEEN: 

- Thank you for having me.