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So Much Data! How to Share the Wealth for Healthier Communities

Jan 14, 2015, 5:15 PM, Posted by Alonzo L. Plough

What Counts: Harnessing Data for America's Communities

The world of research and evaluation is experiencing a dramatic increase in the quantity and type of available data for analysis. Estimates are that an astonishing 90 percent of the world’s data has been generated in just the past two years. This flood of facts, figures, and measurements brings with it an urgent need for innovative ways to collect and harness the data to provide relevant information to inform policy and advance social change. “Not long ago, we had a problem of insufficient data,” says Kathryn Pettit, a senior research associate at the Urban Institute. “Today we have more data than ever before, but we still need to build capacity to use it in meaningful ways.”

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RWJF Executive Nurse Fellow Brings Nursing Perspective to Bioethics

Jan 14, 2015, 9:00 AM

Cynda Rushton, PhD, RN, FAAN, is the Anne and George L. Bunting Professor of Clinical Ethics and a professor of nursing and pediatrics at Johns Hopkins University. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2006-2009). In 2014, she was named a Hastings Center Fellow for her work in bioethics.

Cynda Rushton

Human Capital Blog: Congratulations on being named a 2014 Hastings Center Fellow. What does this fellowship mean for you and your career?

Cynda Rushton: It’s a wonderful honor to be included in this interprofessional group of scholars of bioethics. It’s a terrific opportunity to cross-pollinate with great thinkers and leaders and to think about some of the most vexing ethical issues in health care. It’s going to be a rich container for dialogue, learning, and leadership.

HCB: How will the fellowship work?

Rushton: Fellows have the opportunity to help guide the direction of the Hastings Center, which is an independent, non-partisan and nonprofit bioethics research institute in New York. The center’s mission is to address fundamental ethical issues in the areas of health, medicine, and the environment, and we’ll be bringing up issues that we think deserve more in-depth scholarship and research. This summer, we’re having a retreat where we will be able to work together around issues of common concern, particularly in the area of bioethics.

HCB: What will you focus on as a fellow?

Rushton: My focus has been on how to create a culture of ethical practice in health care. I’m interested in what is required to create that culture and what kind of individual competencies need to be in place to support people to practice ethically and reduce moral distress.

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What's Next Health: What We Can Achieve By Working Together

Jan 13, 2015, 10:49 AM, Posted by Marjorie Paloma

Nate Garvis Color How can it be charitable to work with a business whose motive is to make more profit? Marjorie Paloma shares thoughts from from Nate Garvis.

As part of our What’s Next Health series, RWJF regularly talks with leading thinkers about the future of health and health care. Recently, we spoke with Nate Garvis, founder and author of Naked Civics, about entrepreneurial thinking and how it can be applied to building a Culture of Health. RWJF Director Marjorie Paloma reflects on Nate's approach.

What would you be willing to do to learn?

This is just one of many provocative questions Nate Garvis of Naked Civics is asking the Foundation as we look to build a Culture of Health.

Many times, we come across people who seem to have all the answers. But Nate doesn’t pretend to. Instead, he uses questions that help us journey through an issue, guiding us toward a new type of discovery process—one that takes us to uncomfortable places and challenges us to work with unlikely bedfellows.

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‘Glocalizing’ Solutions for the Rising Chronic Disease Epidemic

Jan 13, 2015, 9:00 AM, Posted by Justin List

Justin List, MD, MAR, MSc, is a Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholar at the University of Michigan and primary care general internist at VA Ann Arbor Health System. His research interests include community health worker evaluation, social determinants of health, and improving how health systems address the prevention and management of non-communicable diseases.

Justin List

The emergency sirens sounded loudly for the rising burden of chronic disease in 2014. Chronic diseases, also called non-communicable diseases (NCDs), broadly include cardiovascular disease, chronic respiratory disease, cancer, and diabetes. In 2014, we learned that, overall, 40 percent of Americans born between 2000 and 2011 are projected to develop diabetes in their lifetimes. This is double the lifetime risk from those born just a decade earlier. Rates of obesity, a condition related to many NCDs, remains stubbornly high in the United States. Mortality and morbidity from NCDs, not to mention the social and economic costs of disease, continue to rise.

The United States is not alone in the struggle with a well-entrenched NCD burden. At the end of 2014, a Council on Foreign Relations task force issued a report with a clarion call for the United States to aid in addressing NCDs in low- and middle-income countries (LMICs) where the epidemic of chronic disease poses risks to communities, economies, and security. The task force, which included RWJF President & CEO Risa Lavizzo-Mourey, MD, MPH, among its members, recommended: (1) U.S. global health funding priorities expand from disease-focused objectives to include more outcome-oriented measures for public health; and (2) the United States convene leading partners and stakeholders to address NCDs in LMICs.

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One Blog, Many Voices

Jan 12, 2015, 11:00 AM, Posted by Culture of Health Blog Team

We’re changing how we’re doing things here at the Robert Wood Johnson Foundation. We’re striving to work better together to serve one big, bold goal: to build a Culture of Health in America. One way to get there? Shine a light on the stories across the country that bring this unified vision to life. It’s with this in mind that we will be ceasing publication of the Human Capital, NewPublicHealth and Pioneering Ideas blogs at the end of the month. From that point on, we’ll begin to tell our stories in one place: right here on our Culture of Health blog.

In the meantime, we want to hear from you. We invite you to tell us what kinds of posts you’re looking for in a brief online survey.

Your thoughts and ideas will help make sure we're offering more of the stories you want, and delivering them to you in the ways that meet your needs. We look forward to hearing from you—and thank you for your continued readership!

The Imperative to Collaborate Across Disciplines to Make It Easier to be Healthy

Jan 12, 2015, 9:00 AM, Posted by Chevy Williams

Chevy Williams, PhD, MPH, is a fellow at Experience Institute, where she is learning and applying design thinking to social problems. Williams is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Pennsylvania. 

Chevy Williams

Today, we can get access to just about anything in minutes or hours. Smartphones put a world of information literally at our fingertips. Within minutes, most of us can get food we want, entertainment we desire, even travel to another city. But seeing a doctor, an arguably more immediate need, is not so easy. Creating a Culture of Health requires our collective interdisciplinary expertise to make health and health care as accessible and user-friendly as other products and services we use on a regular basis.

Health Care in 2015 logo

Before I left academia, I heard the word “interdisciplinary” tossed around a lot, but I saw it practiced in very safe ways. Typical research teams of grants I was on or would review comprised researchers from only the social, psychological, and health and medical sciences.  As public health faculty, I’d hear statements like “Public health is inherently interdisciplinary.” This may be true since public health draws from multiple disciplines, but I couldn’t help but feel that such statements were more a reflection of inertia than anything else.

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Changing the Conversation about Obesity

Jan 9, 2015, 4:02 PM, Posted by Darrin Anderson

Children play tether ball on a playground. "Our goal is to help children and communities achieve a healthy weight through prevention strategies that support access to affordable, healthy foods and increase opportunities for safe physical activity."

Nearly one in four children ages 10-17 in New Jersey is overweight or obese, leading to a plethora of adult-style health issues in kids,  such as high blood pressure, diabetes, and high cholesterol. Even more concerning: If the prevalence of obesity continues to rise, New Jersey’s obesity-related health care spending could quadruple to $9.3 billion by 2018. In order to truly have an impact on those costs, both human and monetary, we need to change the way we talk about obesity.

The New Jersey Partnership for Healthy Kids (NJPHK) recently hosted a conference to do just that. More than 300 community leaders, dietitians, teachers, school nurses, and social workers gathered at our Building Healthy, Equitable Communities conference on December 3 to talk about what works, and doesn’t work, in the fight against obesity. Ultimately, we all need to work together to build a Culture of Health in communities where everyone can reach optimal health, regardless of the color of their skin or where they live.

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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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Being Willing to Really Listen Can Help Those Facing Extreme Disparities and Challenges

Jan 9, 2015, 9:00 AM, Posted by Malia Davis

Malia Davis, MSN, RN, is a nurse practitioner and the director of nursing and clinical team development at Clinica Family Health Services in Lafayette, Colorado. She has cared for patients in the community, including those who are homeless, for more than a decade. She is a 2014 Robert Wood Johnson Foundation Executive Nurse Fellow.

Scholars Forum 2014 Logo

Social and economic disparities define my work each day, and have provided powerful motivation for me to commit my professional life to attempts to minimize these disparities in the health care setting. Community health centers, which provide health care for the homeless, are where some of the sickest and poorest people in our communities seek medical and behavioral health care from people like me, a nurse practitioner who is honored to serve each of these individuals and families. 

I believe one common misperception is that some of my patients fail to contribute to society. Working in community health care for 12 years—10 of them serving homeless people—I have found that most people are very hardworking. Many work at day labor and other low-wage, temporary jobs that are physically demanding and fraught with challenges of all kinds. I often hear of workers experiencing abuse, failing to get paid, and experiencing unsafe working conditions.

They have, of course, none of the benefits we usually associate with jobs. Instead, they face the stress of not knowing day to day if they will find work and be able to support their families—or not. This stress is often compounded by the personal experience of witnessing, surviving, and overcoming trauma or violence, often while in poverty and with very limited resources for healing physically or emotionally. 

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The Role of the Chief Nursing Officer in Bridging Gaps Among Health Systems and Communities to Improve Population Health

Jan 8, 2015, 9:56 AM

Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

Jerry Mansfield
Health Care in 2015 logo

Since my doctoral work in public health, I have thought a great deal about the relationship of public health theory and practice and my acute care background. With more than 30 years of progressive leadership experience in a variety of for-profit/non-profit, inpatient and outpatient positions, I am trying to generate dialogue and discern a purposeful plan regarding the role of a Chief Nursing Officer in an academic medical center and the health of the populations we serve in our communities.

Based on earlier work in the 1990s and early 2000s, in 2007 the Health Research and Education Trust (HRET) engaged national experts to address the following question: How can hospitals engage their communities to improve the health of everyone? The report provides a framework and encourages hospital leaders and community members to envision health care in communities beyond the medical services offered by providers; it notes that the production of health is not only medical care, but also our environment, individual behavior, and genetic make-up.

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