In 2014, for the first time in Staten Island history, Borough President James Oddo announced the appointment of a health and wellness director.
Fulfilling a campaign promise, Oddo expressed his concern for a myriad of the borough’s health issues and cited a need to “equip, educate and encourage Islanders to make healthier choices.” And in the past five years, Dr. Ginny Mantello has spearheaded a variety of initiatives to meet that goal.
“In this role I’ve been given an infinite amount of resources to create a population level impact on the health of Staten Islanders,” noted Dr. Mantello. “The Borough President has so much passion for the health and wellbeing of his constituents and he shares that passion with Staten Island’s public health partners. And that kind of synergy, leadership and alignment makes it possible for us to bring so many healthcare initiatives to the table.”
Dr. Mantello, an attending neuroradiologist at Montefiore Medical Center and part of Main Line Health Systems in Pennsylvania and Northwell Health in New York, works closely with over 75 healthcare providers and community based organizations to complete her work for the Borough President’s office.
She has taught meditation at Staten Island Technical High School for the past 12 years and works closely with schools in implementing Wellness Councils and Healthy Lifestyle programs. She co-chaired the Wellness Committee at Staten Island University Hospital for over five years and has been instrumental in starting employee wellness programs at both SIUH and Richmond University Medical Center.
She co-chairs multiple large initiatives and coalitions for the borough and works closely with public health focused agencies like SIPCW (Staten Island Partnership for Community Wellness) and the Staten Island Performing Provider System (SI PPS) to advance Medicaid Health reform.
Her main focus for the past five years has been to provide primary prevention and early intervention to Staten Island youth, all while emphasizing the borough’s battle with substance abuse. Here’s a look at four different wellness programs she is currently developing for our borough:
Launched in November 2016, the Staten Island Asthma Coalition is dedicated to improving the health of all children with asthma on Staten Island with a goal of reducing asthma-related ER visits, hospitalizations and school absences by 25 percent in the year 2020.
“Asthma is the number one cause of school absences and the number one reason children are hospitalized,” Dr. Mantello reported. “Over 200,000 children suffer from asthma citywide and approximately 4,000 school-aged children in Staten Island are affected by it – in 2014 alone over 700 ER visits occurred in the borough due to asthma. But no child should have to be hospitalized for this condition. It’s something that can be treated and controlled in a community setting – and that’s why we are spearheading this effort.”
The cross sector program, which is currently lead by the Borough President’s Office along with the Staten Island Performing Provider System (PPS) and Richmond University Medical Center, coordinates care in the child’s home, in a clinical setting and in the child’s school.
“We look at where each child lives, learns, plays and receives their healthcare,” Dr. Mantello said. “Is there mold or pests in their home? Are there any pollutants or allergens in their school? And do the doctors in their pediatric practice have evidence-based tool kits to share? We are taking a comprehensive approach, making sure that everyone in the child’s life has an asthma action plan: The proper forms are filled out, parents and schools have inhalers on hand – all measures which reduce calls to 911 and enable the family and the child themselves to manage their condition.”
Asthma education is also being expanded in an afterschool setting and Department of Education school nurses are being trained to properly treat asthmatic students. And the drop in Staten Island’s asthma statistics are already noticeable.
“Medicaid invested $7 billion to come up with an asthma prevention plan and 25 Performing Provider Systems (PPS) were formed by big hospital systems across New York State for that purpose,” Dr. Mantello said. “On Staten Island, both hospitals came together to form one PPS and it is currently ranked number one in the state for asthma prevention.”
That PPS checks hospital data nightly and weekly, watching in real time how many children check into Staten Island ERs for asthma-related symptoms.
“Because of this effort we now have funding for specific measures and have been able to hire contractors to perform home visits for children with recurring hospital admissions,” Dr. Mantello said. “That remediation has had very positive results.”
After reading an article about a soda-free program that schools had adopted in Ohio, Borough President Oddo decided to implement similar measures at several Staten Island schools.
“We started our own study on Staten Island about four or five years ago and challenged schools to cut out sugar-sweetened beverages, replacing them with healthier options,” Dr. Mantello said. “Four schools participated in that pilot program and the following year 10 schools joined the initiative. We even went into each school and did a program on the harms of these drinks, highlighting the damage they do to the body and the organs affected.”
This year, the program expanded to include a “Fizz Free February” social media campaign designed at educating the public about the realities of sugar. Each Friday, the BP’s office listed statistics on its Facebook and Instagram accounts showing that in this country, sugar sweetened beverages are the largest source of added sugar to a person’s diet and increased sugar consumption has been shown to lead to obesity, which dramatically increases the risk of diabetes and heart disease.
“The idea of the program is to remind youth that a large portion of their diet – about 10 to 15 percent – consists of sugar sweetened beverages,” Dr. Mantello said. “There is hidden sugar in everything you pick up and some sodas even contain hidden carcinogens. We wanted to create awareness that drinking soda not only affects your weight – it affects every single organ system in the body.”
Food As Medicine
Recognizing that food and nutrition have a huge impact on our health and wellbeing, the Borough President’s office is currently investigating the idea of food as medicine. If a doctor provides a prescription for healthy food, would patients follow it?
“There are multiple pilot programs across the country – California has the oldest – that use food as medicine, treating diabetic patients with healthful meals instead of or in addition to medication,” Dr. Mantello said. “Patients in these programs were given a full comprehensive wellness plan designed by personal dieticians, care coordinators and social workers plus 10 meals a week. Not only did their diabetes improve dramatically but so did their cholesterol and weight, resulting in an almost 80 percent hospital cost savings because they did not have to return to the hospital for treatment.”
Dr. Mantello said the BP’s office is in the process of working out the details of a similar trial with its hospital partners, possibly using the “Food as Medicine” initiative as an extension of the cardiac rehab programs that have been recently launched in the borough.
“The idea is the foundation and building blocks of healthcare: ‘Let food be thy medicine,’” Dr. Mantello said. “I think this will be a very exciting program for the borough.”
In order to battle the borough’s drug epidemic, Dr. Mantello says the Borough President’s office is taking a comprehensive approach.
“When you have a complex health issue such as substance use you cannot approach it in a cookie cutter manner; there is never going to be one solution or organization that will solve the problem,” Dr. Mantello noted.
That’s why multiple agencies across different sectors are aligning to take on the common cause of stemming the crisis.
“We’re looking at the entire continuum because someone doesn’t just wake up one morning and decide to shoot heroine,” Dr. Mantello said. “That’s why we’re starting prevention early on, looking at factors in the life of children and trying to reduce the risk factors at an early age.”
The “Too Good for Drugs” program, now in its fifth year, brings the message of prevention into elementary school classrooms, teaching children how to have the confidence to say no. In the high school setting, students are introduced to more in-depth concepts about alcohol, tobacco and substance abuse.
“Research has shown that at any time in a child’s life if they perceive a disapproval rate to be high for an action, then the usage rate is low,” Dr. Mantello said. “Because alcohol and marijuana is so socially accepted, use amongst teenagers is remarkably high. So we talk openly and honestly about the usage of those substances and the ill effects they have.”
The BP is also working with the Island’s PPS system to maximize and make more treatment options available in the borough – all measures that have already proved successful.
“In 2016 there was a steady increase in the number of drug-related deaths in Staten Island – in fact we had the highest rate out of all the boroughs,” Dr. Mantello concluded. “But in 2017 those numbers plateaued and in 2018 the rate dropped. I personally believe those stats are improving because there has been such a concerted effort at attacking this problem from all angles. And that effort will only continue to get stronger in the future.”