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If You’re Not at the Table, You’re on the Menu

Nov 25, 2014, 11:03 AM, Posted by David Adler

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I hear the phrase in the title used a lot when people talk about the important role advocacy plays in health policy-making, and it’s very appropriate. But there is one voice often missing in the conversation about how to fix the way we deliver, pay for, and think about health care: Consumers, the very people the system is designed to help. We must make sure that the people at the center of the health care system have a say in how it changes.

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Our Focus Might Change, but We’re Still Guided by Our Research

Nov 19, 2014, 1:47 PM, Posted by Alonzo L. Plough

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There is change afoot at the Robert Wood Johnson Foundation as our entire organization reorients its focus to implementing our Culture of Health strategy. At the heart of this new approach is the belief that everyone—regardless of their ethnic, racial, geographic or socioeconomic circumstances—should have the means and the opportunity to lead the healthiest lives they can. Achieving a Culture of Health requires us to broaden the understanding that good health is far more than the absence of illness; where we work, where we live, what we eat, and where our children play and go to school fundamentally affect our ability to lead healthy lives.

Looking ahead, we see this new focus on building a Culture of Health as catalyzing a larger national movement toward real societal transformation—a chance to eliminate health disparities caused by social, environmental, and economic factors, and a powerful way to improve and advance public health. This is a big challenge for all of us, but there are significant pockets of progress around the country where a diverse range of activities is already driving such transformation.

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What We Learned from the First Open Enrollment Period, and What to Expect from the Second

Nov 18, 2014, 10:32 AM, Posted by David Adler, Lori K. Grubstein

A man fills out an insurance application

It seems like just yesterday we were celebrating the victories from the first open enrollment period under the Affordable Care Act. More than 8 million consumers signed up for coverage through state and federal marketplaces, and millions more enrolled in Medicaid.

As the spring of success gave way to the summer of planning, we are once again in the autumn of enrollment. As work gets rolling for the second open enrollment period, it is an opportune time to reflect on lessons learned from the first open enrollment period, especially since the second one is shorter and there are fewer navigator resources available from the federal government.

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American Public Health Association Meeting: All About Where You Live

Nov 14, 2014, 9:55 AM, Posted by Linda Wright Moore

Commission NOLA built environement 4

The Robert Wood Johnson Foundation (RWJF) has long embraced the idea that advancing America’s health is a community affair. Much of our work—and our current vision for building a Culture of Health—is grounded on the basic premise that where we live, work, learn, and play is inextricably connected to our health and well-being.

Consider that life expectancy can differ by 25 years in neighborhoods just a few miles apart; that a ZIP code can determine rates of preventable disease, violence, and access to healthy food. With this in mind, RWJF supports a wide range of programs designed to foster healthy communities—including efforts to prevent obesity and chronic disease, reduce disparities in health and access to care, and improve early childhood development.

We recognize that the best strategies are driven by local data and address the unique challenges and characteristics of individual communities. We know that what works for Camden, N.J., might not fly in Minneapolis or Baltimore.

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Transparency in Health Care? Sadly, That's Not How We Roll.

Nov 7, 2014, 3:13 PM, Posted by Andrea Ducas

Patrick Toussaint Andrea’s husband, Patrick Toussaint, using his super strength to tighten a lug nut.

What do changing a flat tire and scheduling a surgical procedure have in common? Nothing. And that’s the problem.

Last month, on our way home to New Jersey from Boston, my husband and I got a flat tire. And while this is a dreaded possibility on any road trip, it happened to us at 9 p.m. on a Sunday. No shops were open, and with an early morning flight just a few hours away we didn’t have time to wait for AAA.

At this point it’s important to emphasize that neither my husband nor I know a thing about cars. We didn’t even know we had a jack or spare in the trunk until we called my uncle, who teased us (“You have a new car! Everything you need is in the back!”) and gave us the pep talk we needed. So we pulled out our owner’s manual.

I’m not sure who that manual is written for, but it clearly isn’t for us. After five minutes of thinking I’d need to call the airline and book a later flight, I realized: There is a better way. I pulled out my iPhone, Googled “how to change a flat tire,” and called up a YouTube video and a step-by-step, picture-guided Wikihow article. Within 20 minutes, the tire was changed, our spare was filled with air to 60 psi, and we were on our way.

So what does any of this have to do with health care? Unfortunately, not very much.

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Big (Box) Medicine?

Nov 6, 2014, 4:55 PM, Posted by Mike Painter

Lucy in the chocolate factory

Let’s see a show of hands. Who among us, doctor, nurse, patient, family member, wants to give or get health care inspired by a factory—Cheesecake or any other?

Anyone?

I didn’t think so.

True confession: I have never actually eaten at a Cheesecake Factory (hereinafter referred to as the Factory). My wife, Mary, and I did enter one once. We were returning from a summer driving vacation. Dinnertime arrived, and we found ourselves at a mall walking into a busy Factory.

It seemed popular. The wait was long—really long. We got our light-up-wait-for-your-table device. We perused the menu. There was a lot there. Portions seemed gigantic. We looked at each other and, almost without speaking, walked back to the hostess, returned our waiting device and left.

You got me—I cannot say 100 percent that I wouldn’t love Factory food. We were so close that one time!

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Bringing Brain Science to the Front Lines of Care

Nov 4, 2014, 5:34 PM, Posted by Jane Isaacs Lowe, Martha Davis

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The brain is an exquisitely sensitive organ—so sensitive that, as recent advances in brain science show us, children who are exposed to violence, abuse, or extreme poverty can suffer the aftereffects well into adulthood. They are more likely to develop cancer or heart disease as they age, for example.

But how to translate these findings into practices and policies that can strengthen families and children? How do caregivers help traumatized children and their families cope with adversity? How can the science be applied to what teachers, doctors, social workers, and others on the front lines do every day? And how should the science affect whole systems, so that every person, at every level, can do their part to help children and families thrive?

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What Baltimore Taught Us: On a Journey to Strengthen Families

Oct 31, 2014, 1:12 PM, Posted by Kristin Schubert

young mother with her children

Recently a team from the Foundation went to Baltimore to talk to families and community leaders, gaining their insights into an essential question for us: What can the Foundation do to strengthen the systems—health care, education, community—to create a web of support for families, one in which those at greatest risk can’t easily fall through?

What follows are my colleagues’ reflections on our time in Baltimore.

Martha Davis: I spoke with a Violence Interruptor, a Safe Streets employee who works to stop street violence. He is a 37-year-old man who has spent nearly half his life in jail, and has been shot 14 times. When I asked him how it is that he got to where he is today, he told me he came to the streets to learn how to “be a man,” but the birth of his children inspired him to want to be on the “side of peace." His was a life of violence and suffering, deep poverty, and racism; now he makes people feel safe and hopeful. He and the other Violence Interruptors are living proof that change is possible.

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“Tobacco Just Doesn’t Fit In:” CVS Exec Gives Story Behind the Story

Oct 22, 2014, 4:01 PM, Posted by Catherine Arnst

CVS Ready to Quit sign inside pharmacy store

Along with the start of CVS Health, the sale of cigarettes and tobacco products at CVS/pharmacy ends today. By eliminating cigarettes and tobacco products from sale in our stores, we can make a difference in the health of all Americans.”—CVS Health CEO Larry Merlo

On October 20, The Campaign for Tobacco-Free Kids launched a national campaign calling on America’s retailers to stop selling tobacco products, and a new mobile-friendly website—www.ShopTobaccoFree.org—that has an interactive map that allows consumers to search for the nearest tobacco-free retailers. The website currently features more than 20 retail chains with more than 13,000 separate store locations—chief among them CVS Health.

On September 3, CVS ended sales of tobacco products at all of its 7,700 stores, a month ahead of its previously targeted date of October 1. It is the first, and so far the only, national pharmacy chain to take this step. The company also changed its corporate name to CVS Health in order to reinforce its broader commitment to the health of its customers.

RWJF applauds CVS’s actions wholeheartedly—indeed, we collaborated with CVS on the initial announcement back in February that it would end the sale of tobacco products. So we asked CVS Health executive VP and chief medical officer Troy Brennan MD, to tell us the story behind the story. Just how do you get a publicly traded company to sacrifice some $2 billion in annual sales?

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Global Health in a Time of Ebola

Oct 21, 2014, 2:44 PM, Posted by Paul Kuehnert

Nelson Mandela's cell on Robbens Island Nelson Mandela's cell on Robbens Island (photo by Paul Kuehnert)

I returned from Cape Town, South Africa a week ago and want to share some reflections on my trip and my participation in the Third Global Symposium on Health Systems Research, in Cape Town September 30-October 3, with the theme “Science & Practice of People-Centred Health Systems.”

In the opening session, Professor Thandika Mkandawire from the London School of Economics made two remarks that resonated with me, and that were referred to by other speakers throughout the conference. First, referencing Napoleon’s quote that “War is too important to leave to the generals,” Mkandawire said that “health is too important to leave to health specialists.”  Instead, there is a need for multiple disciplines and sectors to create health and devise health policy. He went on to address the policy issues related to the most vulnerable populations, saying that “policies targeting the poor are poor policies”, arguing for the importance of social solidarity, not charity.

The current Ebola epidemic highlights the gaps in public health in many nations, as well as the erosion of public health emergency preparedness and response at WHO and many other nations, including the US.. This is putting our health at risk from all kinds of infectious and emerging diseases (e.g., MERS, polio) and threatens progress in health in other areas.

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