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Building the Information-Rich Culture of Health

Aug 20, 2014, 10:36 AM, Posted by Mike Painter, Susan Dentzer

Reform by the Numbers Visual

What if your mother wanted to take some ibuprofen for her arthritis, but didn’t know if it would interact adversely with her other medications?

No problem, right?

She could whip out her smartphone and launch an app that connected to her local health information exchange. Within fractions of a second, the exchange would verify her identity, locate the computer storing her electronic health record (EHR), and shoot an answer back to her.

This scenario is just one example of the many ways that having timely access to health information could contribute to health. It could, that is, if the nation had an agreed-upon way to organize data about health and health care in ways that made it easily accessible and usable while still secure and protected.

But for now, we don’t.

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Preventing Suicide: If You See Something, Say Something

Aug 13, 2014, 9:16 AM, Posted by Brent Thompson

Dave and Brent Dave and Brent

The second week of August is one of the worst weeks of the year for me. At least it has been since 2008.

Six years ago this week, my friend Dave decided he had enough of the daily struggles of this world and took his own life on a trailhead in the desert near Tucson, Ariz.

He was 31 years old and left behind a fiancé, family, and scores of friends who loved him deeply.

Dave was one of the most incredible people I’ve ever known: a generous soul, full of humor, creativity, compassion, and love. He had more friends than anyone I know. Dave elevated everyone who knew him, inspiring them to find joy, open their minds, chase dreams, and see beauty in the world. It is impossible to count the lives Dave changed for the better, including my own.

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To Build a Culture of Health, There Is No Place Like Home

Aug 11, 2014, 3:36 PM, Posted by Kristin Schubert

Child First

A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete.

The case for bringing health care back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns.

Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.

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An Ounce of Prevention, Even for Serious Mental Illness

Aug 7, 2014, 1:30 AM, Posted by Jane Isaacs Lowe

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As we work to build a Culture of Health for all Americans, it is time to end the stigmatizing distinctions between mental and physical health. After all, the brain and the body are in constant contact, and affect the well-being of each other in too many ways to count. A true Culture of Health recognizes the interdependence of mental and physical health, and places a premium on prevention and early detection of illness, regardless of type.

We commonly provide preemptive treatment or suggest early lifestyle changes for people at risk for diabetes before the condition evolves into full-blown disease. Yet, we typically don’t approach care for serious mental illness in the same way. It’s time for that to change.

The results from a recently released national study of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP), a project RWJF funded between 2006 and 2013, demonstrate that early intervention to prevent the onset or progression of psychosis in teenagers and young adults improves health and well-being. By helping family members, pediatricians, teachers, young people, and other community members identify young people experiencing early symptoms of serious mental health problems, EDIPPP was able to engage and treat these young people early. That early intervention in turn helped them stay in school, remain employed, and maintain vital connections to family and friends. These benefits mitigated the effects of mental illness, and allowed these teens and young adults to lead healthier and more productive lives.

This study should shift our thinking about how we best treat young people at high risk of serious mental illness. It should also remind us to look at good health and good health practices through a much broader lens, because building a Culture of Health means finding and sharing solutions, and celebrating signs of progress.

Read a Washington Post article on the program

Read a first-person post about depression and the best way to support those who are suffering with it

Read a post by Brent Thompson on bipolar disorder and the death of a friend

If It’s Broken, They Fix It

Jul 30, 2014, 3:25 PM, Posted by Risa Lavizzo-Mourey

 A nurse fills a syringe, while another nurse watches

By “broken,” we mean medical equipment or processes that could use a little improvement—and sometimes a lot of improvement. And by “they,” we mean nurses who harness the power of their own creativity, often using whatever material they have on hand—and sometimes taking inventiveness to a whole new level.

They call them MakerNurses, eager participants in the emerging “maker” movement. One MakerNurse, Roxana Reyna, RN, of Corpus Christi, was honored at the recent White House Maker Faire for her innovative wound-care techniques in caring for infants born with their organs outside of their bellies, sparing them immediate surgery.

RWJF supports such nurse-inventors through the Little Devices @ MIT initiative’s MakerNurse program, because they hold the potential to make health care more effective and affordable.

It’s a sound investment with even larger possibilities, said RWJF President and CEO Risa Lavizzo-Mourey, MD, writing in the professional social networking site LinkedIn.

“The “maker” movement has the potential to empower all kinds of people to devise the solutions that make possible a Culture of Health—not just nurses, but caregivers, patients, and family members, all creating and sharing devices and ideas that improve health.”

Read Lavizzo-Mourey’s blog post on LinkedIn

Advanced Practice Nursing: Providing Care and Promoting Health

Jul 29, 2014, 10:50 AM, Posted by Susan Dentzer

Check out an August 1 Google+ Hangout with the Campaign for Action and RWJF.

The U.S. population is growing, getting older and suffering from more chronic disease. Thanks to the Affordable Care Act (ACA), more people are gaining health coverage and the means to obtain care. And there’s a widespread view that the country faces a drastic shortage of doctors—and primary care providers in particular.

So why are so many states seemingly determined not to let advanced practice registered nurses deliver the primary care they specifically trained to provide—and help millions of patients in the process?

Across the country, 31 states impose varying limits on the ability of nurse practitioners (one of the four types of advanced practice registered nurses) to evaluate patients; diagnose, order and interpret diagnostic tests; and to initiate and manage many treatments, including prescribing medications.

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Putting a Female Face on the Need for a Culture of Health

Jul 25, 2014, 11:29 AM, Posted by Susan Dentzer

A doctor examines a patient.  An image appears on a computer monitor.

Statistics are “human beings with the tears washed away,” an old saying goes. Sadly, the tears behind one set of statistics, showing that women’s life expectancy has been falling in just under half of U.S. counties, have rarely garnered much notice.

How to put a face on this story, to help mobilize corrective action?

Progress toward that end was made last week, when the Robert Wood Johnson Foundation teamed up with Women’s Policy, Inc, a nonprofit, nonpartisan organization that seeks to inform policy-making on women’s issues, to sponsor a briefing on that subject on Capitol Hill. About 75 people, including several female members of Congress, gathered in the Rayburn House Office Building to learn what is driving the widespread trend of poorer female health. (Watch the webcast by clicking here).

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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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Let’s Help Each Other Cope With Stress

Jul 11, 2014, 12:04 PM, Posted by Risa Lavizzo-Mourey

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Just about everybody experiences stress, to a greater or lesser degree. The bad news: Too many of us fall into the "greater" category.

All of that stress has consequences not just for our mental health, but for our overall wellbeing, says Risa Lavizzo-Mourey, MD, Writing in the professional social networking site LinkedIn.

Lavizzo-Mourey cites the results of a recent NPR/RWJF/Harvard School of Public Health poll, which shows:

  • One in four said they experienced a great deal of stress in the previous month.
  • Almost half reported a major stressful event or experience within the past year.
  • Seventy-four percent said stress affected their health.
  • Forty-three percent said that a health concern is a leading cause of their stress.
  • Eighty percent of people in poor health reported that their health problems raised their level of stress.

If we are to make progress in building a Culture of Health, we need to acknowledge the deleterious role of stress in Americans' lives and health—and everybody needs to be at the table.

"This is clearly an area where health care providers, communities, and employers can help," Lavizzo-Mourey writes.

Read Lavizzo-Mourey's blog post on LinkedIn

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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