Emerging Trends in Health Care Access


Kim Isett spends her free time suspended high in the air performing precisely controlled movements on a trapeze or wide ribbons of nylon fabric. Think Cirque du Soleil, and you'll have a picture of the modern dance form and theatrical expression that define the aerial arts. It's also an excellent way to stay in shape.

The aerial arts require high levels of physical flexibility, strength and nerve. It's about as far removed from academia as one can imagine — and that's the point.

"I do it for exercise," Isett explains, "but it also helps me to shut off the academic part of my brain and turn on the artistic, creative part of my brain, which helps me to keep some balance in my life."

Isett became an aerialist about four years ago, when she was living in Philadelphia while commuting to her faculty job at Columbia University in New York City. She continues to pursue her avocation since moving to Atlanta two years ago to accept a position as an associate professor in the School of Public Policy at the Ivan Allen College of Liberal Arts.

Her research is decidedly more down to earth: She examines the dynamics affecting the delivery of health and human services to vulnerable populations.

What's an example of a problem that your research addresses?

We're putting together a grant proposal now for a project that grew out of data analysis some students did under my supervision for a local housing agency that provides housing assistance to low-income people living with HIV/AIDS.

As a result of that initial work, we started thinking about who receives this assistance — what the population looks like — and realized that a significant number of clients are going to enter old age in the next few years. So we thought it would be useful to determine what kinds of housing services and supports will be needed for the population of individuals living with AIDS who will be going into geriatric care. The goal is to help them stay out of the hospital or long-term nursing facilities and in stable private housing.

We're talking about a large number: Due to the development of effective medications called highly active anti-retro viral therapy, within the next decade, more than 50 percent of people living with HIV/AIDS will be over the age of 50. The CDC doesn't even consider a diagnosis of HIV/AIDS as terminal anymore; they consider it a chronic illness to be managed, like diabetes.

Isn't a large number of geriatric services already available?

We as a society have done a poor job understanding geriatric illness generally. We're scrambling to do that now on the primary and general health care side, now that we have the aging baby boomers. But we know even less about it in terms of people living with HIV/AIDS. We don't know what their disease progression will look like or what kinds of housing and service supports may be needed.

So we want to be proactive about identifying the services that these folks might need and the barriers they'll face going into their golden years. So this research we're proposing will help us understand what kinds of social service support will allow these people to live independently in their communities. In the long run, this approach will be much more cost effective than sending them to a long-term care facility or nursing home.

How does your research fit with a Georgia Tech Ivan Allen College of Liberal Arts education?

My research feeds directly into the classes that I teach. For example, this past year I taught a health care policy class that covers the "big buckets" of health care such as the pharmaceutical industry, hospitals, public health, and the major health insurance companies. These are important contributors to good health care. But all the literature and research has shown that you get even better health care outcomes when you include housing and the delivery of social services, particularly for those populations that are the sickest or most vulnerable.

I bring that perspective into class and say that we need to understand what these big buckets are, but we also need to understand that they don't operate in a vacuum, and there are other things we need to think about when we think about health care.

Has the interdisciplinary and science and technology emphasis in the Ivan Allen College influenced the way you approach research?

Here at Tech the disciplines are different than any other place where I have done research, so the approaches to problems are quite distinct from the usual health-services research perspectives. Much of my work has been done, consistent with the medical-health services model, in large interdisciplinary teams. Working with colleagues from Industrial and Systems Engineering and from Computing made me realize that while the questions about information and the capacity of a system to respond to events are the same, the kinds of answers we may design have a different flavor. I think being here will help me think about my "important questions" in a new light and hopefully help me push the boundaries of innovation in my field — although I am still working through what those differences are and how to harness them.

What do you like best about teaching?

Every once in a while there's a moment in the classroom when you see that something you're teaching has really clicked with a student. It's like a switch was flipped. The student might start asking question after question, and you can tell it's because he or she just found that spark — they've become passionate about the subject and enjoy thinking about it.

What quality do you most admire in Ivan Allen College students?

They are so smart! They are some of the smartest students I've ever taught.

About Kimberley Isett

Associate Professor, School of Public Policy

Kimberley Isett has concentrated her research on institutional pressures and dynamics in implementing government services, with a particular interest in the delivery of services to vulnerable populations. Her goal is to help government organizations find their optimal system design given their political, policy, regulatory, and financial constraints.