Faith-based responses to homelessness in Greater Seattle: A grounded theory approach

This article reports on the key findings of a 2-year study of faith-based responses to homelessness in Greater Seattle (the United States). Leveraging opportunities and negotiating constraints through experimentation, congregations, and faith-based non-profits, in different ways, are striving to blend local knowledge and professional knowledge, the adaptability of bottom-up civic engagement and the complexities of top-down programming to rethink homelessness interventions. After considering this picture of faith-based organizations (FBOs) as community problem solvers, we sketch three case studies of innovative initiatives: the Network Builders program of Catholic Community Services of Western Washington-King County, the interfaith and cross-sectoral campaign against family homelessness spearheaded by Associated Ministries of Tacoma-Pierce County, and the Para-Navigator partnership between Everett Gospel Mission and the municipal government of Snohomish County.

Managing Cancer Care During the COVID-19 Pandemic: Agility and Collaboration Toward a Common Goal

The first confirmed case of coronavirus disease 2019 (COVID-19) in the United States was reported on January 20, 2020, in Snohomish County, Washington. At the epicenter of COVID-19 in the United States, the Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, and University of Washington are at the forefront of delivering care to patients with cancer during this public health crisis. This Special Feature highlights the unique circumstances and challenges of cancer treatment amidst this global pandemic, and the importance of organizational structure, preparation, agility, and a shared vision for continuing to provide cancer treatment to patients in the face of uncertainty and rapid change.

WHAT CAN COUNTY-LEVEL EMERGENCY MEDICAL SERVICES DATA TEACH PUBLIC HEALTH ABOUT OLDER ADULT FALLS

Fall-related injuries in older adults contribute to an increasing number of deaths, hospitalizations and Emergency Medical Services (EMS) responses. In Snohomish County, the third largest county in Washington State, EMS agencies with electronic health records cover 96% of the county’s population. This EMS data contains unique information on falls, which can estimate costs and clarify intervention priorities. We analyzed 2018 data from EMS in Snohomish County. Fall incidents were summarized by count, frequency, and rate per 1,000 population. Costs for transferring patients to emergency departments (ED) were estimated using 2015 Snohomish Community Paramedic Analysis, and direct medical costs averted by implementing a single intervention were estimated based on prior research by Stevens and Lee (2018). There were total 38,910 incidents in older adults, of those 4,777 incidents were caused by falls (1606 in males and 2906 in females). The mean age (SD) was 81.0 (±8.9). The incidence rate was 45.6 per 1000 (55.8 in females and 30.6 in males). There were 573 repeated falls (12%). Most of the falls happened at home (54.85%), followed by assisted living and nursing homes (27.84%). 85.53% of the falls were transferred to ED, at an estimated cost of 3.15 million dollars. We calculated that one million dollars in medical cost could be averted by implementing home modifications delivered by an occupational therapist (OT). This research demonstrates the utility of EMS data for describing fall injury and determining interventions. Fall prevention programs should focus on preventing repeated falls and addressing home safety risks.