In 2016 the National Academy of Medicine (NAM) and the Roundtable on Population Health Improvement, of the National Academies of Sciences, Engineering, and Medicine (the National Academies) held the fourth annual District of Columbia (DC) Public Health Case Challenge, which had its inaugural year in 2013 and was both inspired by and modeled on the Emory University Global Health Case Competition.
The DC Case Challenge aims to promote interdisciplinary, problem-based learning in public health and to foster engagement with local universities and the local community. The Case Challenge engages graduate and undergraduate students from multiple disciplines and universities to come together to promote awareness of and develop innovative solutions for 21st-century public health issues that are grounded in a challenge faced by the local DC community.
Each year the organizers and a student case-writing team develop a case based on a topic that is relevant to the DC area and has broader domestic and, in some cases, global resonance. Content experts are then recruited as volunteer reviewers of the case. Universities located in the Washington, DC, area are invited to form teams of three to six students, who must be enrolled in undergraduate or graduate degree programs. In an effort to promote public health dialogue among a variety of disciplines, each team is required to include representation from at least three different schools, programs, or majors.
Two weeks before the Case Challenge event, the case is released, and teams are charged to employ critical analysis, thoughtful action, and interdisciplinary collaboration to develop a solution to the problem presented in the case. On the day of the competition, teams present their proposed solutions to a panel of judges composed of representatives from local DC organizations as well as other subject matter experts from disciplines relevant to the case.
2016 Case: The Changing American City and Implications for the Health and Well-Being of Vulnerable Populations
The 2016 case focused on the changing American city and implications for the health and well-being of vulnerable populations. The case asked the student teams to develop a program, with a grant of $2 million over five years, that would mitigate the negative effects of urban change on the city’s most vulnerable populations, including residents of low-income minority communities, those who are displaced or at risk of displacement, and those who are homeless. Each proposed solution was expected to offer a rationale, a proposed intervention, an implementation plan, a budget, and an evaluation plan.
The case framed the issue through three scenarios portraying a range of issues faced by vulnerable groups and the conditions created by recent and ongoing policies that put certain groups at risk in changing urban areas. Though the three illustrative scenarios were fictional, they drew from actual circumstances faced by DC residents. The first scenario described a young, Salvadoran mother without insurance working three part-time jobs to support her parents and young son, struggling to afford medication for her type 2 diabetes, and living in a neighborhood (Adams Morgan) that had until recently been a food desert. In the second scenario, a young boy with asthma lives in a non–smoke-free apartment complex in southwest DC with his family, who is increasingly unable to afford rent and groceries and considering moving to the suburbs, despite the strong social support of their neighborhood. The third scenario described an elderly widow with limited mobility and failing eyesight who lives alone in the Bloomingdale area. Eligible for Medicaid, receiving Social Security benefits, but struggling to afford medication and groceries, she must rely on public transportation and is in need of a home health aide.
The teams were provided with background information on urban renewal, the history of chronic disease in DC, health equity in DC, and issues affecting low-income populations in gentrifying areas (including race, discrimination, and oppression; economic and social mobility; affordable housing and homelessness; accessibility and the built environment; health and education; food and nutrition; and health care and social services in changing neighborhoods).