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Dean Schillinger

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Dean Schillinger MD is a practicing general internist and Chief of the University of California San Francisco (UCSF) Division of General Internal Medicine at San Francisco General Hospital (SFGH), where he founded the UCSF Center for Vulnerable Populations in 2006, a research center committed to addressing the social determinants of health through research, education, policy and practice. In its first decade, the Center generated nearly $100 million in funding[1] to describe, study and mitigate the health effects of a range of social vulnerabilities, including homelessness[2], food insecurity, limited health literacy and language barriers[3].  Schillinger has made significant contributions to the fields of health communication and health literacy, and has also been recognized for his body of work related to improving the health of vulnerable populations and the prevention and control of type 2 diabetes.[4]  

Medical Training

Schillinger attended Brown University, where he studied Russian Language & Literature, and obtained his medical degree in 1991 from the University of Pennsylvania School of Medicine. He performed his residency training in Internal Medicine at UCSF. He served as Chief Medical Resident at SFGH before joining the faculty there.[5]

Early Career and Research

Schillinger directed the ambulatory care clinics at SFGH from 1995-1999, during which time he carried out the first study to demonstrate that comprehensive primary care reduces risk of hospitalization among patients with chronic disease. The subsequent focus of his research career  has been in the areas of public health, health literacy and communication. He has been recognized by the American Public Health Association and the American Association for Communication in Healthcare for his lifetime contributions in advancing the field of health communication science[6]. Schillinger has conducted research in the areas of health literacy and communication[7]. His major research accomplishments include discovering that different levels of health literacy are associated with diabetes control[8], complications and overall mortality, and demonstrating that communication technologies developed in collaboration with lower literacy and non-English speaking diabetes patients can improve quality of life. Schillinger and his research team also were the first to develop and validate a novel measure of health literacy employing computational linguistics that can be applied to an entire population of patients in a rapid, automated fashion.[9] Schillinger has advocated for improving provider-patient communication by demonstrating the effectiveness of tools such as “the teach-back method”[10], and the benefits of visual forms of communication for the quality and safety of medical care[11]. This research has led to significant health policy changes at the national level, including the establishment of policies that encourage health systems to improve the quality of their communication in domains such as medication safety and informed consent.[12]

Schillinger was an author of the Institute of Medicine (IOM) Report on Health Literacy (2004)[13] and was commissioned to write a 2012 IOM publication defining the Attributes of Health Literate Healthcare Organizations[14], as well as contributing to additional IOM (now known as the National Academy of Science, Engineering and Medicine) proceedings on public health literacy, innovations in health literacy, digital health literacy, health literacy and health disparities, and oral health literacy[15]. He has published over 230 peer-reviewed scientific articles,[16] and co-authored and edited the medical textbook, Medical Care of Vulnerable and Underserved Patients, which the New England Journal of Medicine called "...an important reminder that many of the issues it raises are relevant to the broader landscape of American health care.[17]" Schillinger also co-directs a national course on this topic for healthcare providers[18]. He also co-authored a literacy level-appropriate patient self-management book in English, Spanish and Chinese, developed in collaboration with diabetes patients, which has been distributed by the American College of Physicians to over 1 million patients with diabetes.[19]

Public Health Advocacy and Diabetes Prevention

Schillinger has led initiatives aimed at confronting the contemporary epidemic of type 2 diabetes. He served as the Chief Medical Officer for the Diabetes Prevention and Control Program for The California Department of Public Health from 2008-13[20]. In 2018, he was appointed to serve on the congressional National Clinical Care Commission to evaluate and provide recommendations on the coordination and leveraging of federal programs related to diabetes. (cite) Schillinger has advocated for local public health regulation of sugary drinks.[21] In 2016, he served as the scientific expert for the City and County of San Francisco in defense of a lawsuit filed in Federal Court by the American Beverage Association for an injunction against the City’s ordinance to mandate health warning labels on billboards advertising sugary drinks, arguing that there is sufficient evidence that sugary drinks contribute to obesity, diabetes and tooth decay to justify public warnings and that warning notices are especially effective for those with limited health literacy, the populations with the greatest likelihood of consuming sugary drinks[22] As a result, the first sugary drink warning label law in the world was set to go into effect July 25, 2016.[23] However, in 2017, the 9th U.S. Circuit Court of Appeals granted the beverage industry’s request to block the warning labels, rested on an assessment that the warning notice was too large, not absence of disease causation.[24]

Schillinger's "public health war" on type 2 diabetes has been profiled in the Bay Area media[25]. His study demonstrating that industry-related conflicts of interests have heavily influenced research examining whether sugary drinks are causally related to diabetes and obesity garnered national media attention.[26] [27] His work contributed to the passage of sugar-sweetened beverage taxes [citation: annals story doesn't support this (?), which CNN article?] in the cities of Oakland and San Francisco, California [this is an opinion piece from you] The issue of industry conflicts of interest in nutritional science and policy was also the subject of a widely-read editorial he authored that revealed the ways in which scientists funded by the International Life Sciences Institute – a research arm of the fast food and junk food industry – used questionable methods to draw unsupported conclusions that national and international dietary guidelines to limit added sugar intake are not based in sound science.[28] [29]The controversy surrounding this conflict of interest was the subject of an investigative journalism piece in The Atlantic Monthly.[30] Schillinger’s research team demonstrated that the sugary drink tax in Berkeley, California resulted in nearly a 50% reduction in the consumption of sugary drinks over three years, relative to changes in consumption in non-taxed cities[31][32][33] Schillinger has also described how, in the face of such reductions, the beverage industry is borrowing from the tobacco industry playbook by preventing taxation of its unhealthy products through the passage of state preemption laws that make it illegal to pass sugary drink tax laws at the municipal or county level.[34]

Schillinger co-created a public health social media campaign called The Bigger Picture. The campaign encourages youth and young adults of color to use spoken word poetry as a means of combating the social and environmental conditions that contribute to type 2 diabetes. Home Flavored, a film produced by The Bigger Picture, won the Grand Prize award at the 2016 Real Food Media short film competition[35]. The campaign has been adopted by a number of California counties for their initiatives to reduce sugar-sweetened beverage consumption.[36] For his efforts to promote public health literacy in California, Schillinger received the 2016 James L. Irvine California Leadership Award, which also led to a state Senate resolution [clarify what this citation is] to honor his contributions on behalf of the people of California.

Awards & Recognition

2003 Institute for Healthcare Advancement Research Award[37]

2008 Research Award in Safety and Quality from the National Patient Safety Foundation[38]

2009 George Engel Career Award for Communication Research, American Association of Communication in Healthcare[6]

2010 Bay Area Research Mentor of the Year Award[39]

2013 Everett M Rogers Award for Outstanding Contributions to Health Communication Research and Practice, American Public Health Association[40]

2016 Institute for Health Policy Career Mentoring Award [16]

2016 James L. Irvine California Leadership Award for innovative work to improve public health literacy and address the epidemic of Type 2 diabetes.[41]

2017 Heroes & Hearts Award, City of San Francisco and San Francisco General Hospital Foundation[42]

Important Publications

Schillinger D, Jacobson M. Science and Public Health on Trial: Warning Notices on Advertisements for Sugary Drinks. JAMA. 2016 Oct 18;316(15):1545-1546

Schillinger D, Tran J, Mangurian C, Kearns C. Do Sugar-Sweetened Beverages Cause Obesity and Diabetes? Industry and the Manufacture of Scientific Controversy. Ann Intern Med. 2016 Nov 1.

Schillinger D, Bibbins-Domingo K, Vranizan K, Luce J, Bindman A. The Effects of Primary Care Coordination on Public Hospital Patients. J Gen Int Med. 2000;15:329-336. PMID: 10840268 PMCID: PMC1495451

Schillinger D, F Wang, K Grumbach, C Daher, J Palacios, G Diaz-Sullivan, J Piette, AB Bindman. Association of Functional Health Literacy with Glycemic Control Among Diabetes Patients. JAMA. 2002;288:475-482. PMID: 12132978

Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, Leong-Grotz K, Castro C, Bindman A. Closing the Loop: Physician-Patient Communication with Diabetic Patients Who Have Low Health Literacy. Arch Int Med. January 13, 2003;163:83-90.

Schillinger D. Improving Chronic Illness Care for Populations with Limited Health Literacy, in Health Literacy: a Prescription to End Confusion. National Academy of Sciences Press. April 2004;269-86

Schillinger D, Handley M, Wang F, Hammer H. Effects Of Self-Management Support On Structure, Process And Outcomes Among Vulnerable Patients With Diabetes: A 3-Arm Practical Clinical Trial. Diabetes Care. 2009 Apr;32(4):559-66. Epub 2009 Jan 8. PMID: 19131469

Seligman H, Schillinger D. Hunger and Socioeconomic Disparities in Chronic Disease. New Eng J Med. 2010 Jul 1;363(1):6-9.

Schillinger D, Keller D . The Other Side of the Coin: Attributes of a Health Literate Healthcare Organization. Institute of Medicine Roundtable on Health Literacy. November 2011. Available at: http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/HealthLiteracy/2011-NOV-16/Commissioned%20Paper.pdf

Schillinger, D., Huey, N. (2018). Messengers of Truth and Health—Young Artists of Color Raise Their Voices to Prevent Diabetes. JAMA, 319(11), 1076-1078.

References

  1. ↑ Baker, Mitzi (7 February 2017). "In Decade Since Founding, UCSF's Center for Vulnerable Populations Has Innovated Research, Care". UCSF News. Retrieved 30 October 2019.
  2. ↑ Leuty, Ron (24 April 2019). "Aiming to move fast with deep data, Benioffs give $30 million to UCSF to study homelessness". San Francisco Business Times. Retrieved 1 November 2019.
  3. ↑ Seligman H, Schillinger D. (1 July 2010). "Hunger and Socioeconomic Disparities in Chronic Disease". New England Journal of Medicine. 363 (1): 6–9. doi:10.1056/NEJMp1000072. PMID 20592297.
  4. ↑ "UCSF Profiles: Dean Schillinger". UCSF. Retrieved 6 November 2019. Unknown parameter |url-status= ignored (help)
  5. ↑ "UCSF Helen Diller Family Comprehensive Cancer Center Profiles". The UCSF Helen Diller Family Comprehensive Cancer Center.
  6. ↑ 6.0 6.1 "Academy of Communication in Healthcare Awards".
  7. ↑ "UCSF News". Retrieved 10 October 2018.
  8. ↑ Schillinger D, F Wang, K Grumbach, C Daher, J Palacios, G Diaz-Sullivan, J Piette, AB Bindman. (2002). "Association of Functional Health Literacy with Glycemic Control Among Diabetes Patients". JAMA – via JAMA Network.CS1 maint: Multiple names: authors list (link)
  9. ↑ Balyan R, Crossley SA, Brown W, III, Karter AJ, McNamara DS, Liu JY; et al. (02/22/2019). "Using natural language processing and machine learning to classify health literacy from secure messages: The ECLIPPSE study". PLoS ONE. 14 (2): e0212488. Bibcode:2019PLoSO..1412488B. doi:10.1371/journal.pone.0212488. Check date values in: |date= (help)CS1 maint: Multiple names: authors list (link)
  10. ↑ "Teach-Back". Health Literacy Out Loud. Retrieved 10 October 2018.
  11. ↑ Machtinger E, Wang F, Chen L, Rodríguez M, Wu S, Schillinger D (2007). "A visual medication schedule to improve anticoagulation control: a randomized, controlled trial". Joint Commission Journal of Quality and Patient Safety – via PubMed.
  12. ↑ ""What Did the Doctor Say?:" Improving Health Literacy to Protect Patient Safety" (PDF). jointcommission.org. Retrieved 2 November 2019. Unknown parameter |url-status= ignored (help)
  13. ↑ Institute of Medicine (US) Committee on Health Literacy; Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. (2004). Health Literacy: A Prescription to End Confusion. National Academies Press. ISBN 978-0-309-28332-8.CS1 maint: Multiple names: authors list (link) CS1 maint: Extra text: authors list (link) Search this book on
  14. ↑ "Ten Attributes of Health Literate Health Care Organizations" (PDF). World Health Organization.
  15. ↑ Institute of Medicine (2013). Oral Health Literacy: Workshop Summary. Washington, DC: The National Academies Press. ISBN 978-0-309-26289-7. Search this book on
  16. ↑ 16.0 16.1 "UCSF Profiles". Retrieved 1 October 2018.
  17. ↑ Burstin, Helen. "Book Review: Medical Management of Vulnerable and Underserved Patients: Principles, Practice, and Populations". The New England Journal of Medicine. 357: 626–627. doi:10.1056/NEJMbkrev57896.
  18. ↑ "Medical Care of Vulnerable and Underserved Populations (Course Information)". UCSF. Retrieved 10 October 2018.
  19. ↑ "Living with Diabetes: An Everyday Guide for You and Your Family" (PDF). American College of Physicians. Unknown parameter |url-status= ignored (help)
  20. ↑ "Diabetes Center at UCSF". Retrieved 7 October 2018.
  21. ↑ "State slow to fight diabetes amid resistance to prevention". San Francisco Chronicle. 2017-12-25. Retrieved 4 October 2018.
  22. ↑ "AM. BEVERAGE v. CITY AND COUNTY OF SAN FRANCISCO Case No. 15-cv-03415-EMC". leagle.com. Retrieved 5 October 2018.
  23. ↑ "Judge clears way for San Francisco's soda pop warnings". USA Today. Retrieved 5 October 2018.
  24. ↑ Adler, Sabrina. "Bittersweet: When a Loss Is Actually a Win". Change Lab Solutions. Retrieved 12 November 2019. Unknown parameter |url-status= ignored (help)
  25. ↑ Knight, Heather (2 April 2016). "Doctor fighting S.F. diabetes epidemic backs soda tax". San Francisco Chronicle. Retrieved 1 November 2019.
  26. ↑ Sifferlin, Alexandra (1 November 2016). "Big Soda-Funded Studies Don't Often Link Drinks to Obesity". Time Magazine. Retrieved 1 November 2019.
  27. ↑ Healy, Melissa (31 October 2016). "Does the soda industry manipulate research on sugary drinks' health effects?". Los Angeles Times. Retrieved 1 November 2019.
  28. ↑ O’Connor, Anahad (19 December 2016). "Study Tied to Food Industry Tries to Discredit Sugar Guidelines". The NY Times. Retrieved 1 November 2019.
  29. ↑ Seaman, Andrew (31 October 2016). "Industry funded studies don't find sweet drinks linked to obesity, diabetes". Reuters. Retrieved 2 November 2019.
  30. ↑ Teicholz, Nina (17 January 2017). "The Limits of Sugar Guidelines". The Atlantic Monthly.
  31. ↑ Lee MM, Falbe J, Schillinger D, Basu S, McCulloch CE, Madsen KA (April 2019). "Sugar-Sweetened Beverage Consumption 3 Years After the Berkeley, California, Sugar-Sweetened Beverage Tax". Am J Public Health. 109 (4): 637–639. doi:10.2105/AJPH.2019.304971. PMC 6417561. PMID 30789776.CS1 maint: Multiple names: authors list (link)
  32. ↑ "Berkeley's Soda Tax Appears To Cut Consumption Of Sugary Drinks". NPR. 23 August 2016. Retrieved 4 November 2019. Unknown parameter |url-status= ignored (help)
  33. ↑ Allday, Erin (21 February 2019). "Berkeley's sugary soda consumption plummeted after tax, study says". Retrieved 5 November 2019.
  34. ↑ Crosbie E, Schillinger D, Schmidt LA. (March 2019). "State Preemption to Prevent Local Taxation of Sugar-Sweetened Beverages". JAMA Intern Med. 179 (3): 291–292. doi:10.1001/jamainternmed.2018.7770. PMID 30667481.CS1 maint: Multiple names: authors list (link)
  35. ↑ "Announcing the 2016 Real Food Films Winners". Real Food Media. 2016-05-02. Retrieved 10 December 2018.
  36. ↑ O'Connor, Anahad (2018-02-14). "Using Art to Tackle Diabetes in Youth". The New York Times. Retrieved 4 October 2018.
  37. ↑ Speaker Biosketches: Implications of Health Literacy for Public Health: Workshop Summary. The National Center for Biotechnology Information. National Academies Press (US). 2014-09-10. Retrieved 12 December 2018. Search this book on
  38. ↑ "The Pfizer Health Literacy Award in Advancing Patient Safety". The Institute for Healthcare Improvement (IHI) / National Patient Safety Foundation (NPSF). Retrieved 10 December 2018.
  39. ↑ "Champion Provider Fellowship Project Team". UCSF Champion Provider Fellowship. Retrieved 19 December 2018.
  40. ↑ "APHA member groups present health awards at Annual Meeting". The Nation's Health. 43: 30. January 2014 – via apha.org.
  41. ↑ "Leadership Awards". The James Irvine Foundation. Retrieved 7 October 2018.
  42. ↑ "UCSF Physicians, Staff Honored by San Francisco General Hospital Foundation". UCSF News. Retrieved 11 October 2018.


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