An old joke has it that the doctor’s pen is the costliest technology in medicine, since money typically flows where physicians’ prescriptions and other orders decide that it should go. As a result, influencing these decisions is key to achieving the Triple Aim of better health and health care at lower cost.

But what’s more likely to influence doctors: external factors, such as bonuses for improving the quality of care, or internal factors, such as appealing to their sense of altruism or satisfaction with their work?  In other words, carrots, sticks, or something altogether different—what Daniel H. Pink, author of Drive, calls “our innate human need to direct our own lives, to learn and create new things, and to do better by ourselves and our world”?

Why? Because, aside from the deleterious impact on the health of kids individually, childhood obesity can have an adverse effect on “our economy, our health care system, and our future,” writes RWJF President and CEO Risa Lavizzo-Mourey, MD, in a new blog post on the professional social networking site, LinkedIn.

So what can you do? Quite a bit, Lavizzo-Mourey concludes.

The rate of childhood obesity has been soaring for more than three decades. That has been cause for deep distress, and still is. All the same, she writes, there is new reason for hope, and it is to be found in the findings of an August 6 report by the Centers for Disease Prevention and Control (CDC).

The report suggests that, for the first time, obesity rates dropped in 18 states and one U.S. territory in recent years for low-income children ages 2 to 4.

The report, while not cause for complacency, suggests that—although childhood obesity is still a major health concern—there are steps we can take to arrest and reverse the epidemic.

“The diverse group of states and communities with declines have instituted a wide range of programs to help families make healthy choices where they live, learn, play, and work—programs that can be adapted and scaled up by other regions,” Lavizzo-Mourey asserts. “All of these communities have one important thing in common—they have made childhood obesity prevention a priority.”

In 2007, the Foundation pledged $500 million to meet a goal of reversing the epidemic by 2015. “We know we can do it,” Lavizzo-Mourey writes, “but we can’t do it alone.”

Today, the Centers for Disease Control and Prevention reported that obesity rates among young children from low-income families are falling in 18 states and one U.S. territory—and rising in only three states. 

What an important sign of progress for all of us working to reverse the childhood obesity epidemic! It’s especially terrific because it builds on recent positive news coming from all across the nation.

Childhood obesity rates are falling in states like West Virginia, Mississippi, New Mexico and California. They’re dropping in big cities like New York and rural areas like Vance and Granville Counties, North Carolina.

Today’s news is of falling obesity rates among children participating in federal health and nutrition programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children program, better known as WIC. These are young children in low-income families. Children who have been at the highest risk for obesity and whose families have had the most limited chances to make healthy choices. So this is huge.

As co-founder of ElationEMR, Kyna Fong and her brother Conan hope to revolutionize the way physicians use electronic medical records (EMRs). In this blog post, Fong, a former Robert Wood Johnson Foundation (RWJF) Scholar in Health Policy Research (2008-2010) and assistant professor of economics at Stanford University, explains how her new product helps physicians and nurses embrace the future of medicine. You can read more about how technology is being used in health care settings here.

Caring for patients is becoming increasingly complex. A whopping 68 percent of Medicare beneficiaries have multiple chronic conditions and, of those, 54 percent have four or more.

There is no doubt that innovations in information technology are essential to meeting this challenge and improving the quality and effectiveness of health care. New data streams are creating increasingly rich stories of our individual health—chronicling how we eat, sleep, exercise, and even what our genes predict.

New modes of delivering care are arising as new technologies offer more precise, more accessible vehicles to manage our health, including telemedicine, remote monitoring, connected messaging, and smart devices. What’s blatantly missing in these tools of the future, however, is a full understanding of how to connect with the key individuals who deliver care: physicians and nurses.

Does anybody commute to work anymore without passing by a huge billboard promoting world-class health care at a nearby hospital or surgicenter?  I know I see enough of them to have become pretty calloused to their messages.  But then, I don’t need health care right now.

What if I did?  Could I count on these extravagant advertisements to give me good guidance about where to seek care?

Unfortunately, the answer is probably not.

Scott Simon is a popular radio host on National Public Radio’s Weekend Edition Saturday. His mother, Patricia Lyons Gilband, a former actress, died July 29 at 7:17 p.m., in the intensive care unit (ICU) of a Chicago hospital. But you might already know that, if you are one of Simon’s 1.2 million Twitter followers, because he has been live Tweeting her final days since July 23.  

Judging by the many articles, comments, retweets, and reactions bouncing around the web, Simon’s 140-character dispatches from the frontline of death have been moving and inspirational for most—and gag-inducing for some, who believe death should be a private affair. Having lost a parent and a spouse—and both died in an ICU—I’m with the first group.

Imagine the outrage if an investigation uncovered a decades-old scheme in which hundreds of billions of taxpayer dollars were siphoned off to pay for health care of little to no value. That finding would probably mean that millions of Americans subjected to this unnecessary care could have been harmed as a result.

Guess what? An investigation—actually a new report from the Institute of Medicine—just did "uncover" such a scheme. And much of the original detective work was done by researchers at Dartmouth, supported in part through grants from the Robert Wood Johnson Foundation.

Here at RWJF, we are looking everywhere for good ideas. The other day, I found inspiration in a typo: “Thank you for your health,” a colleague signed her email, when she meant to write help.

I thanked her back: “Thank you for your health, too!”  And, as I hit reply, amused by my little joke, I realized my smile was connected to something deeper than simple wordplay—I felt, for that moment, like a good citizen.

Now admittedly, I’m someone who can get goose bumps when reminded of our basic humanity by a politely held open door. But thanking someone for their health, especially after just being recognized appreciatively for mine, snapped into focus how our health, our own personal health and what we do with it, impacts everyone around us—as clearly as tossing an empty can into the recycling bin.

We each have an active role to play in being good health citizens.

The thin, paper-like hospital gown. Open. Exposing. Awkward. The perfect symbol for what health care in America represents for most of us.

As a bit of context, last week I spent three days with a group of amazing women from across the health care industry at an RWJF-sponsored forum hosted by the Association of American Medical Colleges. At that meeting, a key part of the discussion centered on where the opportunity for meaningful, collective, action might lie to catalyze dramatic system transformation. More than once, the hospital gown metaphor came up.

To me, though, this symbol represents much more than a call for system transformation—I see it as a battle cry for empowerment.

Let me explain.

This is the second in a series. Read the first here.

Promoting a “culture of health” isn’t just a 9-to-5 job for RWJF employees; many of them also use their time out of the office to further their push toward health and well-being. As Risa Lavizzo-Mourey, MD, president and CEO, describes it, creating a culture of health means having “the kind of values where we can say health, and the policies and practices that go into making sure we are a healthy community, are as much a part of us as are the values that say we pursue life, liberty and the pursuit of happiness.” Below, three more members of the RWJF crew talk about how they’re furthering this healthy mindset throughout the summer months.

BRINGING ROLLERBLADING BACK: Christine Nieves (Program Associate, Pioneer Team)

For Nieves, this summer is all about conquering fears. Although she spent her teenage years rollerblading in her native Puerto Rico, her hiatus from the wheels translated into being “terrified” of the activity. Even so, she’s spending her free time getting back into the groove of rollerblading while simultaneously exploring local parks. “It’s more than exercise,” she said. “It’s getting over things that make me nervous and that I’m afraid to do. It’s looking at the things that hold me back and building confidence.”

Nieves and her boyfriend/pseudo-rollerblading coach have already taken to the paved paths of Mercer County Park and Mountain Lakes Nature Preserve (with a goal of rolling around Princeton Stadium “when no one’s looking”).

Lazy patterns of physical activity can lead into lazy patterns of thought, Nieves said, and she reminds herself of this Albert Einstein quote when she’s feeling the urge to slouch on the couch: “Any man who reads too much and uses his own brain too little falls into lazy habits of thinking.”

Added Nieves, “Maintaining a culture of health is something that helps me maintain my mind and set physical, professional, and personal goals for myself. I think of it as a holistic thing.”

OPENING THAT WINDOW: Lori Melichar (Senior Program Officer, Research & Evaluation)

The New York City dweller was struck by a recent RWJF talk about microbes, the trillions of microorganisms invisible to the naked eye that surround us and interact with our bodies and the environment. Biologist, engineer, and ecologist Jessica Green visited the Foundation and said that our secure, built environment – the buildings where we live, work, and play – may not be the healthiest. By holding tight control over our environments and keeping the outdoors out and the indoors in, Green said the microbes around us are less diverse, which studies suggest increases our risk of interacting with potential pathogens.

With this in mind, Melichar is doing what she can to ramp up her microbial variety. “For one of my recent meetings I went on a walking meeting around the Foundation,” she said. “The way I used to think about that was walking for exercise, and now I think about it as getting a little bit of variation in my microbes. I’d never thought before about this, but it seems like there’s the potential for this variation to be health-increasing.”

She said even opening the window a crack can help: “If you have the window open a bit, microbes from the trees and from the birds and from everything else outside can mix with everything inside that hasn’t gotten out…because we have double-doors on everything.”

“GREEN-IFYING” THE HOME: Linda Manning (Program Team Coordinator, Program Service Center)

Along with a 60-year-old house come inevitable renovations, but Manning is choosing to make them green ones. After a faulty lawnmower spit out a rock, breaking a window in her Hamilton home, she and her husband decided to replace their basement windows with those that are more energy efficient.

They’re also re-landscaping to combat the hungry creatures chomping away at the yard. “Rather than spraying all the flowers and plants with a spray – which isn’t always friendly to the environment – we decided to change a lot of the plants to those that will discourage the animals from snacking on them,” Manning said.

Keeping her home tidy and up-to-date helps her stay healthy, too. “I’ve had a lot of health problems that are not controlled by the environment, but I find that, if I do these things, it makes me feel better,” she said. “It makes me feel good that I have a really clean home. I think it just makes everybody healthier.”