Toyin Ajayi - Health Care Interventions Don’t Always Lead to Better Health for Communities

Search

Loading...

News

Latest News

Dec 09, 2017
by Mirva Villa
Toyin Ajayi - Health Care Interventions Don’t Always Lead to Better Health for Communities

Cityblock Health co-founder describes her interest in building new models of care for all

Toyin Ajayi, pictured above, sitting in Max Reinhardt’s study at Schloss Leopoldskron (Picture: Salzburg Global Seminar/Mirva Villa)

Toyin Ajayi likes people. That is what led her to become a doctor and develop new models of care. She believes health care systems are in need of a new perspective when delivering health. Speaking on the second day of the Salzburg Global session, Building Healthy Communities: The Role of Hospitals, Ajayi says, “I think we are all much more complex as organisms existing within an ecosystem than we are if we focus on just the biology within us.”

In addition to her role as a family physician, Ajayi is the co-founder and chief health officer of Cityblock Health, a recently launched New York-based health and social services company with the goal of offering better integrated health and social services for people with low income and complex care needs. The connection – or even contradiction – between health and health care is at the basis of Cityblock Health’s work. What is this contradiction about, exactly?

“It is a fact of most of our health care systems that we become quite good at doing things to people, and for people: prescribing things to people, doing procedures, and offering interventions that in themselves are health care, but don’t always in aggregate lead to better health,” Ajayi replies, while sitting in Max Reinhardt’s study.

To back up this point, Ajayi gives an example: a person sleeping outside on the streets who develops an obstructive lung disease from smoking and being exposed to lots of other environmental factors. When they access the health care system, Ajayi suggests the focus typically will be on managing their respiratory problems through “aggressive interventions.”

She adds, “We will give them medications, we might put a breathing tube down their throat to breath for them, we might prescribe them additional tests, additional therapies… Those things, in absence of addressing their need for housing, don’t actually make that person healthier in the long term,” says Ajayi. According to her, health care systems have been narrow-minded in their approach. They don’t address the totality of reasons why people have become unhealthy, Ajayi argues. The health sector needs to make a conscious effort to shift their thinking on seeing people holistically.

“Being able to make that transition from more health care to better health requires us to think about things that we’ve never really thought about in health care;” Ajayi says. “Things like transportation, education, access to healthy food, access to housing, social support and community, and love and engagement and trust and empathy – these are all very unfamiliar parts of our armamentarium as health care professionals, but are integral if we actually want to improve the health of communities and populations.”

Ajayi became passionate about the subject while completing her residency training at Boston Medical Center. Some of the patients came to her with problems that far exceeded her ability to treat them.

“I recognized very quickly that if I didn’t understand their ability to take those medicines, their ability to understand the instructions I was giving them, if we didn’t have a trusted relationship, if they didn’t have a fridge to store the medicines, food to eat with their medications, social support and family support to encourage them and keep them engaged, then I could write as many prescriptions as I wanted and it wouldn’t actually improve anyone’s health or well-being.

“I got very interested in thinking how we build models of care to enable doctors like me, frankly, and other professionals who are very passionate about helping people to make better choices for themselves, and live the lives they want to live, to actually gain the skills and experience and the tools to do that and be part of that for them.”

Cityblock Health’s journey has only just started, and the team is working hard to make sure their services and tools will respond to the needs of their future patients.

Commenting on what keeps her moving forward, Ajayi says, “I just fundamentally can’t accept that in 2017, in a country that has such a wealth of resources, some people continue to suffer, continue to face worse outcomes and restricted opportunities based on where they were born and the resources that are available to them. I just cannot accept that we can’t do better than that, and I’m motivated by the idea that we must.”


The session, Building Healthy Communities: The Role of Hospitals is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with the Robert Wood Johnson Foundation. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.