IDHEAL
International and Domestic Health Equity and Leadership (IDHEAL) - UCLA Emergency Medicine
Mission
Our division mission is to define and promote the role that academic emergency medicine can play in the promotion of health equity and the elimination of health disparities, locally, nationally and globally. To do so, we address the social, economic, environmental, and legal determinants of health by partnering with non-traditional allies, such as community based organizations, in order to understand and treat patients in the context of their communities and their lives. The division is an umbrella for collaboration of faculty and mentorship of trainees on projects within the realms of international emergency medicine, population health, migrant health, and social emergency medicine. We frame this as a division of “Health Equity” rather than a traditional division of International Emergency Medicine to emphasize the similarities between these disciplines and the common goal of health equity on a global scale.
Background
Emergency Departments are the access point for health care and social services for marginalized populations. Emergency Physicians and Emergency Departments have a long track record of involvement in efforts to improve the health of marginalized populations, both at home and abroad. As emergency health care providers in Los Angeles, we have a unique perspective on the fluidity of populations, sharp economic contrasts, and their implications for population health.
We believe that health is a human right, and that a critical component of that right is access to high quality emergency care for all. Currently, access to high quality emergency care is not universally available. Ways in which social forces disrupt the access to and quality of emergency care are dependent on the setting. For example, in Nicaragua, high quality emergency care may not be available because doctors are unable to afford training materials. In Los Angeles, emergency care is universally available, but our patients still face many barriers to quality care. For example, patients delay seeking care until it is too late, because of fear immigration and financial ramifications. Even when they are able to access care, quality may be disrupted by language barriers between patients and practitioners.
Both internationally and domestically, the end result is the same: social forces disrupt the delivery of high quality emergency care with subsequent contribution to health disparities. We believe that the emergency department is the appropriate location to address a variety of barriers to health caused by social forces. Even if the proximate cause of the ED visit seems unrelated to social forces, we should not ignore homelessness, food insecurity and other social barriers to health when present in our ED patients.
Traditionally, humanitarian efforts of emergency physicians were classified under a variety of headings, including “Community Outreach”, “Social Emergency Medicine”, “Migration Health”, and "Global Health”. Recent thinking underscores the similarity between these areas, because at the core is the common theme of health equity & population health. Although Emergency Medicine is an obvious fit for work in these areas, few formal programs relating emergency medicine to questions of health equity and population health exist.

Faculty





















Additional Faculty
- Medell Briggs-Malonson, MD, MPH, MSHS (MLK/UCLA Ronald Reagan)
- Jerome Hoffman, MD (UCLA)
- Carmen Partida, MD (Olive View-UCLA)
- Larry Stock, MD (Antelope Valley)
- Scott Votey, MD (UCLA Ronald Reagan)
Domestic Projects
- Medical-Legal Community Partnerships (MLCPs)
Patients often end up in the emergency department as the result of social and legal forces that precipitate healthcare emergencies. For example, a patient may have lost his/her Medi-Cal, leading to the patient running out of insulin and coming into the emergency department in DKA. MLCPs use attorneys that work with the healthcare team, including social work, to resolve these challenges in order to keep patients healthy. - Language Access
Patients with limited English Proficiency struggle to navigate their ED visits and discharge plans. Despite legislation mandating the use of interpreters in healthcare settings, frequently, language assistance is not used. This project aims to improve the quality of Emergency Department care for limited English proficiency patients in efforts to improve understanding of ED visits and subsequently decrease the contribution of language barriers to health disparities. - Prison Health/Prisoner Re-entry
The LA County prison system often does not properly connect inmates with benefits, including healthcare, follow-up care, and prescriptions on discharge. We are currently exploring how to create a process to ensure proper connection to care, benefits and medications as part of the release process as a way to prevent downstream complications such as emergency department visits. - LA/CA Patient Need Assessment
Based on a survey developed and piloted at Olive View we are currently implementing a needs assessment across the safety net emergency departments in Los Angeles to assessment patients’ social needs. We are also looking to collaborate with safety net emergency departments in the Bay to compare and assess their patients’ social needs. - Asylum Evaluations
Many IDHEAL members participate in the Physicians for Human Rights Asylum Network and perform forensic evaluations of asylum seekers. IDHEAL members have actively supported increasing the capacity in Los Angeles for asylum evaluations and contribute to the three Los Angeles-based Human Rights clinics.
International Projects
- Project SEMILLA
Project SEMILLA is a volunteer organization of Emergency Medical Professionals from Nicaragua and the United States whose mission is to improve emergency healthcare capacity in Latin America through education, system organization, and improved access to technologies. Project SEMILLA currently provides free trainings in cardiac resuscitation, trauma resuscitation, and prehospital care to health professionals throughout Nicaragua.
www.projectsemilla.org - Community Partners International
The mission of Community Partners International is to work with local partners to improve health education, led by and for the people of Myanmar.
www.cpintl.org