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New Year, New Coverage for Millions

Jan 9, 2015, 2:51 PM, Posted by John R. Lumpkin

Health Care Dot Gov healthcare.gov

The beginning of a new year is a great time to reflect on progress toward longstanding goals. At RWJF, we’ve spent the better part of four decades advancing solutions to help everyone in our nation gain access to affordable, high quality health care—a goal we reaffirmed in 2014 when we announced our vision for a Culture of Health in America.

Happily, our country has made enormous progress toward this goal in 2014. Health coverage rates improved dramatically last year because of robust enrollment through the health insurance marketplaces, Medicaid, and CHIP. As we enter 2015, we continue to see strong coverage gains, with nearly 6.6 million consumers newly enrolled or renewing through HealthCare.gov.

But let’s not forget that more than 40 million people remain uninsured. There is still more work to be done to make sure all those who are eligible can get the coverage they need and deserve.

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The Patient—and Her Data—Will See You Now

Jan 7, 2015, 1:48 PM, Posted by Susan Dentzer

Smartphone Photo by Viktor Hanacek, Picjumbo.com

It’s 2015, the year that Marty McFly, the fictional character in the 1989 hit movie "Back to the Future II," visits by time traveling into the future in a souped-up DeLorean automobile. Predictably, most of the technologies the film foreshadowed haven’t been invented as of the real 2015—not the “hover board” that Marty glides along on, nor the self-lacing sneakers, nor (of course) the time travel.

But plenty else has been invented or discovered in the last 30 years, revolutionizing much of our lives, including our health and health care. If you want to feel as exhilarated, and maybe even as disoriented, as Marty did after fast-forwarding to 2015, read Dr. Eric Topol’s new book, The Patient Will See You Now: The Future of Medicine Is In Your Hands.

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The Best Defense is a Strong Offense: Strengthening Our Nation’s Outbreak Preparedness

Dec 22, 2014, 5:08 PM, Posted by Paul Kuehnert

Outbreaks 2014

In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.

The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.

On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.

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Disparities, Resilience, and Building a Culture of Health

Dec 19, 2014, 12:15 AM

Scholars Forum 2014 Logo

On December 5, 2014, the Robert Wood Johnson Foundation (RWJF) held its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. It was a dynamic event that drew a standing-room-only audience in Washington, D.C. Following the conversation, the Human Capital Blog asked six participants to answer the question, What do you think is the most important step the country can take now to make progress in reducing disparities?

Gloria Sanchez, MD 
Alumna, RWJF Summer Medical and Dental Education Program

Gloria Sanchez

“The United States has the ability to reduce disparities, but we need a movement that creates neighborhoods that provide sound and affordable nutrition, safe environments to exercise, and supportive communities that are free of pollution. Initiatives should guarantee that those individuals most afflicted by disparities are engaged in re-inventing their communities through assessments and interventions that truly create sustainable, positive change.

“Our nation can overcome the multitude of disparities that afflict so many. With directed resources, research, compassion, and community involvement, there is no doubt we will achieve equality.”

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Violence and the Media in 2014: Q&A with Lori Dorfman

Dec 18, 2014, 5:59 PM, Posted by Eric Antebi

Cease Fire A Chicago bumper sticker.

A culture of violence is the antithesis to a Culture of Health. As Risa Lavizzo-Mourey recently said in a speech to the American Public Health Association, “We will never be a healthy nation, if we continue to be a violent one.”

Violence is always in the news. But 2014 saw several high profile stories about violence dominating news cycles, including major stories about child abuse (Adrian Peterson), intimate partner violence (Ray Rice), sexual assault on college campus, and, of course, the deaths of Michael Brown and Eric Garner.

Because media coverage influences the social and political response to violence in America, I wanted to hear from Lori Dorfman, who directs the Berkeley Media Studies Group. She has spent decades monitoring how the media cover violence and other public health issues, helping public health advocates work with journalists, and helping journalists improve their coverage. The following is an excerpt of my interview with her.

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The Front Line of Medicine

Dec 18, 2014, 9:00 AM

For the 25th anniversary of the Robert Wood Johnson Foundation’s (RWJF) Summer Medical and Dental Education Program (SMDEP), the Human Capital Blog is publishing scholar profiles, some reprinted from the program’s website. SMDEP is a six-week academic enrichment program that has created a pathway for more than 22,000 participants, opening the doors to life-changing opportunities. Following is a profile of Juan Jose Ferreris, MD, a member of the Class of 1989.

It is easier to build strong children than to repair broken men.’

The words of abolitionist Frederick Douglass resonate for Juan Jose Ferreris, a pediatrician and assistant clinical adjunct professor at University of Texas Health Science Center. He sees a straight line between the public funds allocated for children’s care and their well-being as adults.

“Kids receive less than 20 cents of every health care dollar. Meanwhile, 80 percent goes to adult end-of-life care. Why aren’t we spending those funds on people when they’re young, when it could make a genuine difference?”

Ferreris contends that money also shapes health in less obvious ways. Salaries of primary care physicians are well below those of more “glamorous” specialists. Some fledgling MDs, burdened with medical school debt, reason that they can’t afford not to specialize. Consequently, he says, only 3 percent of medical students choose primary care.

For Ferreris, who is both humbled and inspired by his young patients, building a Culture of Health necessitates recalibrating priorities.

“Nobody’s concentrating on the whole; they’re only looking at one part. And they’re not paying attention to the human—the brain, the spirit, the soul.

“We overlook that aspect...but it’s where I believe the primary care doctor has irreplaceable value.”

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Top 10 Signs We are Building a Culture of Health

Dec 17, 2014, 7:18 PM, Posted by Catherine Arnst

Buncombe Children Playing

Last January the Robert Wood Johnson Foundation alerted the world to its new strategy: To build a Culture of Health for all, one that would allow every one of us to make healthy choices wherever we live, work, and play. A big reach, we know, but we are nothing if not optimistic. So, 12 months on, we asked ourselves—How’re we doing? Pretty good, as it turns out. Here are the top 10 signs that America is moving towards a Culture of Health (in no particular order).

10. The evidence is in—kids are beginning to slim down.

Research published in February shows continued signs of progress toward reversing the childhood obesity epidemic: Obesity prevalence among 2 to 5 year olds dropped by approximately 40 percent in eight years, a remarkable turnaround. There is still much work to do in this area, but at least our youngest kids can look forward to a healthier future.

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The Legacy of PIN: A New Level of Collaboration in the Pacific

Dec 17, 2014, 9:00 AM

Partners Investing in Nursing’s Future (PIN), an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF), was represented in the U.S. Affiliated Pacific Islands (USAPI) by two partnerships: Building Nursing Faculty Capacity in the U.S. Affiliated Pacific Islands, which brought together the American Pacific Nurse Leaders Council, the World Health Organization and others to strengthen nursing education in the USAPI; and Step by Step, Hand in Hand: Expanding PIN Synergies in the Pacific, which introduced the Dreyfus Health Foundation’s Problem Solving for Better Health® (PSBH®) model to effect change within nursing education and within communities. 

As part of a series of posts on PIN’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities, a number of the USAPI partners have responded to the question: What do you think has been the major impact of the Pacific PIN?

PIN Logo

“Since the first meeting of the Pacific PIN, we have come to learn more about each other’s nursing programs and the common needs that we shared. Through the years, this knowledge has expanded our friendship to those who have patiently stayed with us and directed us toward sharing resources and seeking new learning experiences, all to increase the number of qualified nurses for the Pacific region. I am most grateful to the foundations that were directly involved and the special people who made this all possible. Fa’afetai tele.”

--Lele Ah Mu, RN, BSN, Chair, Nursing Department, American Samoa Community College, American Samoa

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Home is My Facebook Page: mHealth’s Potential to Help the Vulnerable

Dec 16, 2014, 12:09 PM, Posted by Susan Dentzer

La Clinica del Pueblo LaClinica del Pueblo, a federally qualified health center in Washington, DC, serves many Latino patients — and relies increasingly on social media to communicate with vulnerable patients about sensitive topics, such as using condoms to help prevent HIV and sexually transmitted diseases.

Say the words “smartphone user” and “app,” and what comes most readily to mind is probably some hipster pulling out his iPhone to book a ride from Uber. But at last week’s mHealth Summit in Washington, D.C., those words were also linked to far different images—of highly vulnerable people seeking and obtaining health care.

Consider:

  • At La Clinica del Pueblo, a federally qualified health center (and previous RWJF grantee) based in Washington, D.C., smartphones and Facebook are key communications channels for reaching hundreds of young gay Latino men and transgender women at risk for HIV. The clinic’s executive director, Alicia Wilson, said on one panel at the mHealth conference that La Clinica’s Facebook page now has about 1,000 followers. “It allows us to spread prevention messages and bring people into care who have been marginalized,” alerting them to free counseling, testing and referral services available through the clinic, Wilson said.
  • A company called Healthvana has a Yelp-like feature that allows people to search for places to get tested for HIV or sexually transmitted diseases. They can also register and set up secure accounts to receive the results from partner testing centers quickly and discretely, along with advice about “actionable next steps” to take should the tests be positive, says CEO and founder Ramin Bastana.
  • Based in Britain, but with a growing presence in the United States, a website and social network called Big White Wall offers a “professionally curated community” for people with psychological issues or mental illness—a virtual space where they can stay anonymous and confide in others; take courses on managing depression and other illnesses; and even have secure consultations with therapists via Skype. Endorsed by England’s National Health Service, and now offered in a “soft launch” phase to enrollees of Kaiser Permanente Northwest, the site demonstrates that “the depth of the need for alternative person-centered health care across the globe is really profound,” says founder Jen Hyatt.

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Quotable Quotes About Nursing, December 2014

Dec 16, 2014, 9:07 AM

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

“This holiday season, my one wish is that every nurse knows their worth and that every patient knows theirs.”
--Shelly Lopez Gray, RN, blogger, Adventures of Labor Nurse: The Highs and Lows of Labor and Delivery, A Nurse’s Wish in Labor and Delivery, Huffington Post Parents, Dec. 8, 2014

“Nurses have new and expanding roles. They are case managers, helping patients navigate the maze of health care choices and develop plans of care. They are patient educators who focus on preventative care in a multitude of settings outside hospitals. And they are leaders, always identifying ways for their practice to improve. Because nurses have the most direct patient care, they have much influence on serious treatment decisions. It is a very high stakes job. Everyone wants the best nurse for the job, and that equates to the best educated nurse.”
--Judy Evans, MS, RN, associate professor of nursing, Colorado Mountain College, Patients Benefit When Nurses Have Advanced Education, The Glenwood Springs Post Independent, Dec. 7, 2014

“Nurses are not just doers. Our work is supported by evidence and guided by theory. We integrate evidence and theory with our knowledge of patients and make important decisions with and for patients and families at the point of care. Research and practice are not separate but integrated. Nursing is a practice discipline with our own theories and research base that we both generate, use, and disseminate to others.”
--Antonia Villarruel, PhD, RN, FAAN, professor and Margaret Bond Simon Dean of Nursing, University of Pennsylvania, Q&A with Antonia Villarruel, Penn Current, Nov. 20, 2014

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