By the time children in New Haven public schools reach high school, 51 percent are overweight or obese, according to Margaret Grey, Dr.PH., R.N., dean of the Yale School of Nursing. It’s a health care crisis brought on by a lack of nutrition education, access to healthy foods, and safe spaces for physical activity in the region. But something as simple as a mobile app could provide a solution.

“Gamification is coming, whether you like it or not,” said Grey, who sat on this year’s alumni reunion panel that discussed “What Will Healthcare in New Haven Look Like in 2024?” Joining Grey were Paul D. Cleary, P.h.D., dean of the Yale School of Public Health and the Anna M.R. Lauder Professor of Public Health, and Marna P. Borgstrom, M.P.H. ’79, CEO of Yale–New Haven Hospital (YNHH). Management expert Richard Foster, Ph.D. ’66, special advisor to President Peter Salovey for health care, moderated.

The panel, which was open to the public, discussed how such trends in health care as a national shift from private to group practice and a deficit of primary care physicians may affect health care in New Haven. Panelists agreed that such innovative use of technology as electronic medical records, telemedicine, and even mobile apps will all shape health care in New Haven in the future.

Grey envisions mobile technologies helping patients to manage or even prevent complex, chronic diseases like type 2 diabetes and cardiovascular disease. Nutrition apps like Awesome Eats aim to get kids eating healthier by interspersing healthy eating tips with puzzle games that feature fruit, while others like MotionMaze require physical movement to play. “The more we embrace that kind of technology in helping people adopt behavior change that will help them manage diseases that require a lot of behavior change, the sooner we’re going to have better outcomes,” said Grey.

Still, one of the greatest barriers to improving outcomes is the environment. “New Haven and Bridgeport are two of the poorest mid–size cities in the United States,” said Borgstrom. “And health is in part a reflection of socioeconomic status.” Fixing the health care crisis in New Haven will require as much focus on social infrastructure as on the delivery of medical and health care. Without a change in that infrastructure and access to healthy foods, said Grey, “The deck is completely stacked against these kids for the rest of their lives,” said Grey.

YNHH supports New Haven Promise, a program launched by Yale University that assists city public school students who attend college in Connecticut, as part of efforts to recognize that education and safe housing are critical to creating a healthier population. “We are talking about ways to integrate health and education, such as the idea of incenting students to pay attention to their health,” Borgstrom said when an audience member asked how to encourage patients to take responsibility for their own health.

On a larger scale, health care in New Haven does reflect many of the national trends occurring within the industry, according to Cleary, including the consolidation of practices and the implementation of electronic medical records. In response to a question about reducing health care costs for patients, Borgstrom noted that the use of electronic medical records in the Yale New Haven Health System has helped to enhance the care of patients that utilize the emergency departments at both YNHH and its new Saint Raphael campus by taking the guesswork out of what labs were done, what radiology may have been done, and what medications were prescribed. “When you don’t duplicate work, you can lower the cost of care,” Borgstrom said.