I was introduced to April Merrill through a connection at Code for America to provide insight for an environmental health project in Tulsa. I immediately recognized April’s passion while talking to her, and wanted to shine a light on the work that she is doing to improve the way patients receive care.
April is the founder of Project REVIVE. She started her career as an educator but after seeing the connection between home life and performance in the classroom, April knew that she couldn’t help her students in the way she knew she needed to. She had to do something to help children and families become healthy and safe. This motivated her to make a career transition and obtain a degree in law with the mission of doing just that.
April started Project REVIVE, Restoring Equality and Vitality in Vulnerable Environments, to address how poor housing and unsafe neighborhoods relate to poor physical, mental, and behavioral health outcomes in the families and children who live in these conditions. Project REVIVE, with the help of GIS mapping, visualizes and analyzes the relationship between a child’s environment and their medical record to present a more accurate picture of a patient’s condition.
“Environmental health gives context to the clinical,” says April.
For example, if a physician learns that a child is having trouble sleeping, they could access their housing and neighborhood information to identify a potential cause of anxiety, such as a rodent infestation, neighborhood fire, crime, etc. rather than prescribing medication. April is truly exemplifying the power of informatics by showing how data can be turned into meaningful information to inform innovative and effective public health programs and policies. There is a real role for EH to play in informatics, as this profession collects so much data on so many things.
In her work, April has run into obstacles, specifically with attaining datasets from their respective sources that are essential to the development of the project.
Four datasets are used to identify how a patient’s poor health could be attributed to poor housing:
- Confirmed housing violations from the health department
- Crime data from the police department
- Fire and non-fire data from the fire department
- Clinical patient records that tie to EH-related diagnoses from a clinic
Aside from patient records, this data is categorized as public, but in most cases, it is not easily available and comes with a fee. April has become an advocate for open data and believes that data should be easily available and shareable between entities, “health problems aren’t being resolved because environmental health, clinical, and public health don’t talk,” she says.
Long-term, April hopes that health departments and EH professionals that perform housing inspections will share inspection results in real-time. For example, collected data would feed into a central database, which would then feed into electronic medical records, and pediatricians could see in almost real time what issues are happening in their patient’s neighborhoods. She believes that this would benefit clinicians and communities, who could use the information to bring housing properties up to code or more quickly condemn them, which would ultimately lead to community change and better health.
At this point, April continues to focus on the pediatric population in Tulsa, but plans to expand her initiative to other cities that are interested in adopting a similar program. Her goal is to create a model that can be replicated in any area that is interested and willing to work to get the data.