October 2022 Advocacy Champion

Julia Joseph-Di Caprio, MD, MPH

President and Founder, Leap Pediatric and Adolescent Care

Why is being an advocate so important to you?
I advocate for new approaches to improving the health of populations and advancing health equity, because the approaches we have taken have not worked. As I have written and spoken about previously, the business imperatives for new approaches is clear - healthcare costs are reaching unsustainable levels. Nevertheless, I agree with what Don Berwick’s wrote in a 2020 Health Affairs Viewpoint, “The Moral Determinants of Health” that begins with a reference to the 18th century philosopher Immanuel Kant and the “moral law within.” What Dr. Berwick notes is that the greatest reason to change is a moral one and we must advocate for what we know is needed to improve society, even if those things are not in our personal or organizational best interests. He notes that the research is clear on what is needed to improve health, but societies don’t invest in those things. It is my duty as a physician to advocate for what will improve the health of populations, for example increased funding of public health.

What health-care related issue(s) have you advocated for over the past year?
In the past year and for many years before that, I advocated for health system investments in high quality primary care that includes assessing and addressing social drivers of health that include food insecurity, housing instability, and lack of social connections. However, many contend that payment models are inadequate for these investments. In fact, systems that had funded community health workers or social workers to work with patients and families dealing with social risk barriers to health and wellness, will cut these services when dealing with budgetary challenges. These cuts do little to address financial problems, while profoundly limiting the impact of primary care on the health of the populations we serve.

What advice would you offer to others who are interested in advocacy?
First, I thank every advocate for their work and everyone who wants to be an advocate. I advise learning from successful advocates or about various advocacy models. For example, there are frameworks to guide advocacy that improves the health of populations and advances health equity. One I worked on with colleagues at the Alliance of Community Health Plans while I was a Senior Vice President and the Chief Medical Officer for UCare, begins with identifying at least one equity issue to fully address, then use data and analytics to identify root causes and solutions for those root causes that act at the individual, community, and systemic levels. The individual level involves work within your immediate sphere of influence. For a lot of us, that means working on a health issue with our patients. At the community level, we work with others to make a community-wide impact. At the systemic level, healthcare providers advocate for long-term, sustained policy change.