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Doing More Means Doing Less: Young Innovators Lead the Charge

Jul 23, 2014, 1:28 PM, Posted by Emmy Ganos

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Here at the Robert Wood Johnson Foundation, we often talk about the idea of making the healthy choice the easy choice. To many of us, that means putting the cookies in a high cabinet, and putting the fruit on the counter. But when I think about building a Culture of Health in America, and especially within our health care system, making the healthy choice the easy choice means so much more.

In health care, often the healthy choice actually means doing less—fewer invasive tests and less dependence on medication—and instead watchfully waiting or making healthy lifestyle changes. But it’s not always easy to show a patient that you care when you only have a few minutes to spend together, and ordering a test or prescribing a medication is a simple way to show “I’m doing something to help you.” The trouble is, those tests, procedures and treatments often don't help, and sometimes they can hurt.

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Carrying the Burden of Stress

Jul 7, 2014, 11:36 AM, Posted by Jeff Meade

Forum at Harvard School of Public Health: The Health Burden of Stress, and What We Can Do About It. Presented in collaboration with the Robert Wood Johnson Foundation and NPR. (July 9, 2014)

Nearly half of us suffer through one major stressful event every year, and the weight of that stress can be heavy indeed. Take, for example, trouble at work, problems in a personal relationship, or the death of someone close to you.

At the top of the list: health issues—either yours, or those of a loved one. In fact, a health concern is the leading cause of stress for 43 percent of us. And all of that emotional turmoil can have a ripple effect, extending out into the realm of our overall well-being.

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Bedtime Story

Jul 1, 2014, 10:33 AM, Posted by Jeff Meade

Sarah Meade Reading Pic Sarah, having a read at Granny's house

The globby tears, the quavering voice, the pudgy outstretched hands, the plaintive word “please.” They all come to mind as vividly as if it were yesterday.

Our daughter Sarah was (and still is, at 27) a good soul, but like every small child, she had her moments. And when those “moments” more or less coincided with bedtime, the worst punishment we could mete out was to refuse to read her bedtime stories—or “sturries,” as she called them. We would kiss her good night, and adjourn to the living room, there to sit and look at each other guiltily as our little girl suffered the tortures of the damned.

We listened to that heartbreaking little plea, “But I HAVE to have sturries!” echoing down the hall, and our hearts would break, too. We felt like the worst parents ever

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Supporting Families to Succeed

Jun 30, 2014, 9:31 AM, Posted by Jane Isaacs Lowe, Martha Davis

ACEs Billboard Version 2 Mobile

It has been more than 15 years since the Centers for Disease Control published the Adverse Childhood Experiences (ACES) study. What we learned from that study, and then subsequent research, is that sustained exposure to toxic stress and adverse childhood experiences—including abuse, neglect, neighborhood violence and chronic poverty—without the support of an engaged supportive parent or adult caretaker, can have serious extended effects on children’s subsequent development and success in life. This stress, without intervention, can lead to a lifetime of poorer health, including chronic diseases in adulthood, such as heart disease and diabetes.

In 2012, the American Academy of Pediatrics published a policy statement calling on pediatricians to become leaders in an effort to decrease children’s exposure to toxic stress and to mitigate its negative effects. They acknowledged how much science had taught us about how our environment affects our “learning capacities, adaptive behaviors, lifelong physical and mental health, and adult productivity.” The statement was a significant shift in the conversation. It provided a biological framework and imperative for why we must do something about adverse childhood experiences now.

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Special Olympics Holds Lessons, and Inspiration, for All of Us

Jun 24, 2014, 2:30 AM, Posted by Catherine Arnst

 

Let me win, but if I cannot win, let me be brave in the attempt.”

—Special Olympics motto

The other day I cheered myself hoarse during a swim relay for a team from Maryland that put their all into the race. In fact, the whole viewing crowd cheered on this team. When they finished, the athletes were jubilant, hugging each other and their opponents, thrilled by their performance in this national event. It didn’t seem to bother them much that they finished last.

The 2014 USA Games for the Special Olympics, the world’s largest organization for people with intellectual disabilities, was held in New Jersey June 14-21. Some 3,500 children and adults from all 50 states competed in 16 different sports, and the vast majority took tremendous pleasure in the pure joy of athletics. Sure, plenty were fiercely competitive, but they were also happy and proud to have the opportunity to compete to the best of their ability.

That was pretty inspirational to the 110 staff members from the Robert Wood Johnson Foundation who volunteered at the Special Olympics.

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This Is Your Brain

Jun 20, 2014, 12:30 AM, Posted by Andrew Harrison

In 1990, RWJF refined its grantmaking goals to three strategies:

  • Assure that Americans of all ages have access to basic health care
  • Improve the way services are organized and provided to people with chronic health conditions, and
  • Promote health and prevent disease by reducing harm caused by substance abuse.

The Foundation had studied the issue of substance abuse for several years. In fact, RWJF’s first venture into this field was Fighting Back, a national program aimed at creating community-based solutions to reducing the use of illegal drugs.

RWJF Trustee James E. Burke played a vital role in helping to craft the Foundation’s grantmaking strategies to reduce substance abuse. In 1989, Burke became chairman of the Partnership for a Drug-Free America (PDFA). That same year, the Foundation issued its first grant to the PDFA, and this support continued through 2009. Today, PDFA operates as the Partnership at Drugfree.org.

During the two decades of RWJF funding, PDFA conducted national media campaigns to educate the public about the dangers of substance abuse. Public Service Announcements (PSA) served as one of its primary methods to curb drug use.

Arguably, PDFA’s most effective and memorable PSA was its 1987 ad called “Frying Pan.” The PSA shows an actor named John Roselius holding an egg in his sparsely furnished apartment. He announces that the egg represents a persons’ brain. He picks up a frying pan, and adds: “This is drugs.” He cracks the egg into the pan. Its contents quickly fry. He then delivers the powerful punch line: “This is your brain on drugs.” The ad concludes with the famous tagline: “Any questions?”

This Is Your Brain on Heroin

RWJF did not provide funding for the “Frying Pan” PSA, but Foundation funds did help produce its memorable 1997 sequel. In this version, actress Rachael Leigh Cook also holds an egg in her hand, once again symbolizing a human brain. The frying pan represents heroin. Cook places the egg on a kitchen counter. And then she declares: “This is what happens to your brain after snorting heroin.” The actress violently smashes the egg, wielding the pan like a cast iron cudgel. As she lifts the pan, the egg drips down over her hand and the pan.

It’s not over yet, as Cook makes all too clear. What follows is harrowing, a long string of violent declarations as she smashes everything in the kitchen—wine glasses, the ceiling lamp, the wall clock ... everything.

“This is what your body goes through! And this is what your family goes through! And your friends! And your money! And your job! And your self-respect! And your future!”

“And,” she adds, “your life.”

And once again, at the end, the chilling and memorable catchphrase: “Any questions?”

To this day, we possess an unusual but much appreciated token of appreciation for our two decades of funding for the PDFA. It’s a replica of the frying pan used in the Partnership’s ads. It’s even framed.

It’s hard to imagine a national Culture of Health that does not take into account the toll that drugs take on Americans every day. And not just the lives of vulnerable people dragged down by drug abuse, but the culture of crime and violence that can also short-circuit the lives and futures of so many young people involved in the sale of drugs. And that’s not to mention the deleterious impact on the health of the surrounding community.

And so that frying pan serves as a constant reminder that the work to improve the lives of so many vulnerable people and to improve and enhance the health of whole neighborhoods is still far from over.

Any questions?

Andrew R. Harrison is the Foundation's historian.

When Springtime Turns Ugly: Public Health and Disaster Preparedness

Jun 6, 2014, 11:24 AM, Posted by Beth Toner

MOYER_110506_13128 EMOTIONAL AFTERMATH: A resident of Alabama, overwhelmed by the sight of her ruined home after tornadoes struck at the end of April, 2011.

Ah, springtime: especially welcome for those of us who experienced a particularly harsh winter. Spring often conjures up images of blossoming trees and blue skies, freshly cut grass and picnics.

Yet in May, several anniversaries of devastating natural disasters reminded us that springtime can also bring with it some of nature’s most violent weather phenomena:

  • On May 20, Moore, Okla., marked the first anniversary of the devastating tornado that killed 24, including seven children at an elementary school. It was the second EF-5 tornado to strike the city in 15 years; the May 3, 1999, tornado left 46 dead.
  • In Joplin, Mo., residents remembered the May 22, 2011, EF-5 tornado that killed 161 people.
  • On May 31, Johnstown, Pa,., observed the 125th anniversary of the devastating flood that leveled the entire city and killed 2,209.

While improved warning systems and 21st century technology have certainly played a role in reducing the number of lives Mother Nature’s temper tantrums claim, the fact remains that these events have a substantial impact on our health as a nation.

We recently talked to Paul Kuehnert, director, Bridging Health and Health Care portfolio—as well as a pediatric nurse practitioner and longtime state and local health official—to get his thoughts about the role public health plays in helping us prepare for, cope with, and learn from natural disasters.

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We’re All in This Together: Let’s Bridge the Gap, Not Widen It

May 12, 2014, 4:14 PM, Posted by Beth Toner

Kathleen Hickey

At the end of April, the New York Times published an op-ed by Sandeep Jauhar, a cardiologist who—reacting to a New York bill granting nurse practitioners the right to provide primary care without physician oversight—argued that in primary care, “there will always be subtleties and complexities that demand a doctor’s judgment.”

His conclusion? “If we want more primary care providers, let’s have them be doctors”—and, he added, “let’s find a way to increase their pay.”

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Here's to the Nurses

May 8, 2014, 10:55 AM, Posted by Brent Thompson

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One evening several years ago, as my grandmother suffered through a painful end to her long life, our family gathered around her bedside at a hospital in South Jersey. She had been unconscious most of the day, but various family members, including my grandfather—her husband of six decades—had kept vigil at her bedside because they wanted to be with her in her last moments.

I was the last to arrive.

Shortly after I joined my family in the room, her physician showed up, checked her charts, and pronounced her “pretty much fine under the circumstances.” Then the doctor hurried off to complete his rounds.

My weary family, girding for the possibility of another long night at the hospital, decided to go downstairs for a bite to eat and some coffee. Because I had just arrived, I wanted some time alone with my grandmother, so I stayed behind in the room.

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From Trauma to TED: Boston Marathon Survivor Adrianne Haslet-Davis on Recovery, Care, and Collaboration

Apr 21, 2014, 12:30 AM, Posted by Shaheen Mamawala

Adrianne Haslet-Davis Adrianne Haslet-Davis (photo by James Duncan Davidson)

Last month, I attended my first TED conference in Vancouver, Canada. Though inspiring, it was also overwhelming—in a sea of over 1200 guests, it can often be challenging to make meaningful personal connections. However, when I saw Adrianne Haslet-Davis step onto the stage and dance a beautiful rumba while wearing her prosthetic leg, I knew she was someone I wanted to meet.

While Adrianne and I had just a quick exchange of hellos in person at TED, I was further inspired by the message she wrote when she stopped by our RWJF Culture of Health Café. There she offered her own vision of a Culture of Health, framed within her personal experiences as a victim of the 2013 Boston Marathon bombing. Adrianne graciously offered to expand on her personal Culture of Health vision in a brief interview with me.

Shaheen: You recently returned from TED2014 in Vancouver, where you gave a powerful dance performance. Tell us about that experience.

Adrianne: It was no question at all where I wanted to dance [publicly] again for the first time.  It was important for me to do it at TED because I so strongly believe in TED’s message of getting people to think outside the box about issues that maybe we don’t know we’re interested in. I think it’s really eye-opening in that way.

I went into the project with Hugh Herr, director of the Biomechatronics Group at the MIT Media Lab, who came to me and said “Adrianne, I think we can make this [performance] happen but I’m not going to guarantee it. Are you in?” I said yes because it really helped me have a goal.

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