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Shifting Academic Health Centers From a Culture of Community Service to Community Engagement and Integration

Wilkins, Consuelo H., MD, MSci; Alberti, Philip M., PhD

doi: 10.1097/ACM.0000000000002711
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There is an increasing need for academic health centers (AHCs) to engage communities across their clinical, research, and educational missions. Although AHCs have a long-standing history of community service, a more comprehensive approach to working with communities is required to respond to shifts toward a population health paradigm, funder requirements for community engagement in research, and demands that medical education focus more on social and environmental determinants of health. Community engagement has been employed at many AHCs, though often in limited ways or relying heavily on students and faculty interested in serving communities. This limited involvement has been due, in part, to lack of infrastructure to support engagement, resource constraints, and the lack of a clear value proposition for long-term investments in community partnerships. However, there are compelling reasons for AHCs to take an enterprise-wide approach to working with communities. An enterprise-wide approach to community engagement will require reconsideration of communities, moving from viewing them as people or groups in need of service to seeing them as assets who can help AHCs better understand and address social determinants of health, enhance students’ and trainees’ ability to provide care, and increase the relevance and potential impact of research discoveries. To accomplish this, AHCs will need to establish the necessary infrastructure to support long-term community partnerships, adapt policies to support and reward engaged scholarship and teaching, and consider new ways of integrating community members in roles as advisors and collaborators across the AHC.

C.H. Wilkins is vice president for health equity, Vanderbilt University Medical Center, and executive director, Meharry-Vanderbilt Alliance, Nashville, Tennessee; ORCID: https://orcid.org/0000-0002-8043-513X.

P.M. Alberti is senior director of health equity research and policy, Association of American Medical Colleges, Washington, DC; ORCID: https://orcid.org/0000-0002-3381-4882.

Acknowledgments: The authors thank Ms. Rohini Chakravarthy for her critical review of the manuscript.

Funding/Support: No research results are reported in this manuscript; however, Dr. Wilkins is the principal investigator of awards from the National Institutes of Health (award numbers U24TR001579 and U54MD010722) and the Patient-Centered Outcomes Research Institute (award number ME 1306-03342).

Other disclosures: Dr. Alberti is employed by the Association of American Medical Colleges.

Ethical approval: Reported as not applicable.

Disclaimers: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Patient Centered Outcomes Research Institute, or the Association of American Medical Colleges.

Previous presentations: Dr. Wilkins presented on this topic during the Association of American Medical Colleges Leadership Forum, Washington, DC, June 12, 2018.

Correspondence should be addressed to Consuelo H. Wilkins, Meharry-Vanderbilt Alliance, 1005 Dr. D.B. Todd Jr. Blvd., BioMedical Building, Nashville, TN 37208; telephone: (615) 963-2820; e-mail: consuelo.h.wilkins@vumc.org; Twitter: @DrCHWilkins.

© 2019 by the Association of American Medical Colleges