Chris Pernell, MD, MPH—or Dr. Chris, as she’s known professionally and in her community—joined the Labor Management Project on August 31 as senior manager of the new 1199SEIU/League Workplace and Community Health Program. Less than two weeks into the new job, she sat down with us to talk about her conviction that good health is “a means and a measure of personal success,” her goals for the program, which she sees as an important way to achieve health equity, and more.
How and why was the Workplace and Community Health Program started?
I’m fortunate to already have a great team to work with. This program grew from previous work led by Dr. Andrew Goodman and the Labor Management Project staff. Their work focused on wellness initiatives at many of our New York City hospitals and nursing homes. It grew out of an understanding that, in order for 1199SEIU members to really be fully productive and involved at work, there needed to be deliberate action to make sure their health and well-being needs were being met.
1199SEIU members are strong in number, they are strong in passion, they are strong in service, but unfortunately they are burdened with high levels of disease, such as diabetes or prediabetes, high blood pressure, overweight and obesity.
This trend of helping people get healthier, rather than just treating them after they become ill or disabled, seems to be growing fast.
Definitely. As a preventive medicine and public health physician, I live in the prevention wheelhouse. I’m always thinking about health and well-being from a community or population standpoint. I’ve said so many times, to so many people, that being well is not the absence of disease. Being well is the realization of a whole person. If we have that understanding, then we can focus on prevention, on health promotion, and on self-actualization, where individuals learn how to be empowered and self-activated. The marriage of two ideas that are near and dear to my heart—how to achieve wholeness and well-being and how to work with vulnerable populations to do that—is what this position affords.
Have you ever been a practicing physician, or were you always more of a public health administrator?
I came into medicine with the understanding that I would do sub-specialty surgical care. But I felt that so much of health happened outside of the clinical setting, that care needed to extend beyond the four walls of medicine. So I switched from a clinical career to a public health career. I trained clinically first, and then I went into public health studies and a private consultancy practice. From there I did post-doctoral work and training at Johns Hopkins. That allowed me to do preventive medicine and public health projects at the federal level, at the state level in New Jersey, and at the community level, both in Newark and Essex County in New Jersey and in Baltimore, Maryland.
I’ve done a gamut of public health and population health projects, and I was looking next for an opportunity to go back to worksite wellness, which I had done as a private consultant. Social justice is important to me. Health equity is important to me. And the workplace provides a captive audience, a great opportunity to say: “While we have you present, how can we inform, educate, activate and empower you so you and ultimately your family and community can be whole?”
What kinds of things have you found work best in workplace wellness programs?
One, there has to be culture of health and wellness in the organization. There has to be buy-in from leadership. Two, there must be occasions for joint work and collaboration—and that’s what we see with the Labor Management Project. Joint initiatives between labor and management create this compelling force by which to empower an organization to either offer programs or, at a higher level, create a strategy that plans for how to improve the health of our workers.
What is the overall goal of your program?
The first and foremost goal is improving workers’ health. Secondly, how can we achieve savings by helping our workers become healthier? We can reduce absenteeism. We can reduce something called presenteeism, meaning our workers are present but they’re not actively or fully engaged in their work, because they have health issues that are somehow lessening their effectiveness or their efficiency. We can decrease disability. Those are ways that we generate savings.
If we’re always thinking about wellness as something that happens before 9AM or after 5PM, it doesn’t really work. It has to be built in throughout the worker’s day, whether it is encouraging walking and taking the stairs, whether it is using the lunch hour to do educational or physical activity programs, whether it is screenings, or whether it is opportunities for workers to empower their families and communities with what they have learned. We need accountability on all sides, and that collective action or force needs to drive change in the larger community as well.
What kinds of initiatives are you working on?
Short-term, we have two initiatives underway. We have a diabetes prevention program—the DPP—that we’re rolling out with one of our partner institutions, Mount Sinai Beth Israel. We have recruited members and employees at the hospital, in addition to staff here with the Labor Management Project, who are being trained as lifestyle coaches to work with people who have prediabetes. The aim of that program is to prevent the onset of diabetes. We’re hoping that its success will lead to a larger campaign with several partner institutions, and ultimately across the whole Labor Management Project—not only with projects such as the DPP.
We also have the worksite assessment survey, which has been released to all of our partner hospitals. This will allow us to see what is already in place and what gaps have been identified. Knowing that, we can then plan how we move forward. How do we offer growth in the area of wellness at this particular organization, and how do we offer growth across all of the organizations?
So these two concurrent efforts will enable this Workplace and Community Health program to move in a strategic, stepwise fashion. There’s a phrase I like to use: “Let’s go well together.” “Go well” implies an action, like “go green.” In going well, there’s action happening around thoughts and processes, there’s action happening around programs, there’s action happening around building joint work collaboratives, there’s action happening around the shared vision of what we must do.
Do you think improving their own health will allow 1199SEIU members to become better healthcare providers by changing the way they communicate with their patients and residents?
While I don’t work specifically on patient care, it is my belief that what we do influences the care continuum by which patients are affected. A lot of 1199SEIU members interact directly with the patient population. But even with those who don’t, we’re all part of the same setting or community. If we empower union members to become healthier and more productive, that feeds into a culture of health, and that culture of health not only affects workers but also affects patients. For example, as health care settings address nutritional guidelines in their cafeterias, concession and vending machines, menus that are offered to patients are also targeted.
You talked about promoting health and well-being as a means to social justice. Can you elaborate on that?
Definitely. That’s one of the things that brought me out of the hospital, this notion of health equity. I have been gifted with amazing opportunities throughout life, and through those opportunities I’ve often sought ways to meet the needs of the most vulnerable among us. When we look at vulnerable groups, groups that bear disproportionate burdens of disease, groups that face issues with access or groups that have faced issues because of historic inequities and say, “How can we ameliorate those inequities?” that’s the social justice component. How can we empower individuals and communities to make more self-efficacious decisions? How can we empower institutions and organizations to be accountable to their workers, accountable to the communities that they serve? That’s where I see this type of work driving health equity. And because it drives health equity, it drives social justice. The realization of justice is to not only to be able to live a whole, well and productive life but to be in a community that incentivizes you to be well, to be in an organization that sees you as an asset.
I really believe this work gets at the nuts and the bolts of what makes people successful. I see health as a means and a measure of personal success. Success is not so much about our academics or our work. It’s about: Do I have the tools and the means to be healthy and to be whole? How can we drive equity in the workplace that will spill over into families and communities?
I was told you tell great stories. Do you have a story for us?
(laughs) Let’s see… Yeah, I do. Like I said, I started out in sub-specialty training for a surgical career. And this particular position is really life come full circle, because I can pay back the people who made my becoming a doctor possible.
When I was training in surgery at UCLA, it wasn’t only the doctors who trained me. It was the nurses and other healthcare workers who trained me. It was the custodial staff, who greeted me in the morning and reminded me why I did what I did. Those are the people who, probably unbeknownst to them, made my day meaningful.
This job is an opportunity to make sure I do right by those who did right by me. I see myself as the community’s physician, as the community’s voice, as the community’s agent. And now it’s like, Dr. Chris is going to look after you, you know? And not only you, but hopefully your family and your community too.