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A Prescription for Solutions that Bridge Health and Health Care

Jun 12, 2014, 1:44 PM, Posted by Risa Lavizzo-Mourey

MOYER_101203_06850_RET A former Health Leads volunteer who has since gone into practicing medicine hands Health Leads volunteer, Brittany Ashe, a Health Leads prescription at the Harriet Lane Clinic in Baltimore, Md.

When Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation, was a physician-in-training at a hospital in a disadvantaged area of Boston, she came to know a woman that she recalls now as "Patient Ruth."

Writing in the professional social networking site LinkedIn, Lavizzo-Mourey remembers Ruth vividly:

"Her feet were swollen, she wore flimsy house shoes, and raw leg ulcers made walking painful. She’d been to the hospital many times before, and we gave her the usual treatment—a few hours in a warm bed, some antibiotics, and a decent meal. The next morning she limped back to the same problems: No home, no job, lousy food, cast-off clothing, no family or friends to come to her aid. We were not equipped to protect her from the harshness of life outside the hospital, a life that was literally killing her."

If health care providers want to improve patients' wellbeing, Lavizzo-Mourey adds, "they must find a way to bridge the worlds in and out of the clinic."

Lavizzo-Mourey points to many splendid examples of projects and programs designed to address the social determinants of patient health—including Boston-based and RWJF-supported Health Leads, which prescribes basic resources for low-income patients—everything from food to job training.

Bridges between health and health care are "spreading across the nation," Lavizzo-Mourey writes, and she invites readers to suggest other examples, "so there will be no more Patient Ruths."

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Filling in the Cracks: The Fight for Mental Health

Jun 11, 2014, 3:11 PM, Posted by Beth Toner

In December 2009, I found myself in a narrow, cramped waiting room that looked, via one small window, into the locked psychiatric unit of a suburban Pennsylvania community hospital. On the other side was my oldest son, just a week shy of his 17th birthday. He was clad only in a thin hospital gown, perched in a wheelchair that was outfitted for restraints—although he wasn’t restrained. He looked tired, frightened, and overwhelmed. My husband, his stepfather, sat next to me as we waited for answers. Tears sprang to my eyes. Could my son—and our family—find our way back?

That moment was the culmination of six months of escalating anxiety and mood swings in my son’s life. He had always been, from a very young age, an intense child: bright, intensely focused, and articulate—which occasionally manifested itself in stubbornness and a reluctance to back down from an argument. But the fall of his junior year of high school had proved to be something very different. Suddenly, his occasional anxiety multiplied exponentially, completely out of proportion to the stressors in his life. Ten-point assignments in an advanced placement bio class turned into all-night crying and screaming sessions that ended with him sitting in a corner sobbing—and us all exhausted and at wit’s end. We tried therapy, with minimal effect. His school guidance counselor, not really understanding the depth of Wesley’s despair, encouraged him to “tough it out.”

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When Springtime Turns Ugly: Public Health and Disaster Preparedness

Jun 6, 2014, 11:24 AM, Posted by Beth Toner

MOYER_110506_13128 EMOTIONAL AFTERMATH: A resident of Alabama, overwhelmed by the sight of her ruined home after tornadoes struck at the end of April, 2011.

Ah, springtime: especially welcome for those of us who experienced a particularly harsh winter. Spring often conjures up images of blossoming trees and blue skies, freshly cut grass and picnics.

Yet in May, several anniversaries of devastating natural disasters reminded us that springtime can also bring with it some of nature’s most violent weather phenomena:

  • On May 20, Moore, Okla., marked the first anniversary of the devastating tornado that killed 24, including seven children at an elementary school. It was the second EF-5 tornado to strike the city in 15 years; the May 3, 1999, tornado left 46 dead.
  • In Joplin, Mo., residents remembered the May 22, 2011, EF-5 tornado that killed 161 people.
  • On May 31, Johnstown, Pa,., observed the 125th anniversary of the devastating flood that leveled the entire city and killed 2,209.

While improved warning systems and 21st century technology have certainly played a role in reducing the number of lives Mother Nature’s temper tantrums claim, the fact remains that these events have a substantial impact on our health as a nation.

We recently talked to Paul Kuehnert, director, Bridging Health and Health Care portfolio—as well as a pediatric nurse practitioner and longtime state and local health official—to get his thoughts about the role public health plays in helping us prepare for, cope with, and learn from natural disasters.

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How RWJF Looks to Businesses as Partners to Create Scalable Solutions

Jun 5, 2014, 5:35 PM, Posted by Risa Lavizzo-Mourey

Health is a "multifaceted and interdependent issue," observes RWJF President and CEO Risa Lavizzo-Mourey, MD, in a June 5, 2014, post in the Stanford Social Innovation Review blog. To build a Culture of Health in America, she writes, we must "connect our actions to those of others, forming partnerships with a variety of organizations in all sectors—particularly in the corporate sector."

Lavizzo-Mourey outlines the rationale behind that transformative approach, and suggests that it is "time for new ways of thinking and acting that will encourage organizations of every kind to join the transformative scale movement."

Read the SSIR blog post

A Stronger Future for Young Men of Color

Jun 4, 2014, 11:12 AM, Posted by Maisha Simmons

New Orleans - Forward Promise - Tyrone Turner - 04/2013

 “All hands on deck” is the best way to describe the last three months. Over the last 90 days, many of my colleagues and I have had endless conversations with the 11 foundations working in parallel to the White House’s launch of My Brother’s Keeper. These conversations have enabled us to develop a comprehensive strategy to catalyze broader investments to improve opportunities and outcomes for boys and young men of color. Now, RWJF and our partners are excited to release the executive summary of our new report, A Time for Action: Mobilizing Philanthropic Support for Boys and Young Men of Color.

Read the news release

Together we’ve looked at some of the most promising models for unlocking opportunity for young men despite the multitude of challenges they face. We’ve asked ourselves, “What strategies will move the needle farthest? How can we move beyond adopting programs to fundamentally changing those systems that help shape the experiences and trajectory of our young men?” We’ve shared our foundations’ unique approaches to the work and long-term goals. I’ve been most struck by the underlying passion that each of our foundations has for this work. While we each take a different approach in the grants we make and priorities we’re advancing, at root there is a true and touching shared commitment to improving the lives of our country’s young men of color.

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Two New Mexico Counties: One’s Healthy, One’s Not. Why?

Jun 4, 2014, 10:48 AM, Posted by Barbara Basler

NewMexicoRWJF_0540_RET

The healthiest county in New Mexico—indeed one of the healthiest  counties anywhere in the country—is Los Alamos, ironically the birthplace of the world’s first atomic bomb.

According to the Robert Wood Johnson Foundation’s 2014 County Health Rankings and Roadmaps, Los Alamos, with one of the highest concentrations of PhDs and one of the highest median incomes in the nation, is not only wealthy and wise, but very healthy. In fact, it is a shining example of how education, income, and community—or the lack of—can shape our health, says Julie Willems Van Dijk, deputy director of the Rankings project.

New Mexico is a poor, rural state with a few small pockets of wealth. A 2012 analysis of state income disparities by the Center on Budget and Policy Priorities in Washington found that the gap between New Mexico’s rich and poor is, proportionately the widest in the nation. The County Health Rankings reflect the health consequences of that gap.

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Building a Culture of Health in Every Community

May 28, 2014, 10:19 AM, Posted by Risa Lavizzo-Mourey

DC metro map

Where you live can make a big difference in how long you live.

With an introduction by American Heart Association CEO Nancy Brown, RWJF President and CEO Risa Lavizzo-Mourey, MD, lends strength to that argument in a new entry in The Huffington Post.

Brown notes that people near the Friendship Heights station of Washington, D.C.'s Metro system live seven years longer than residents of the area surrounding the Tenleytown-AU station—just two stops away. Friendship Heights is in Maryland; Tenleytown-AU is in the District of Columbia. (View maps for Washington, D.C., and several other major cities and areas of the country.)

Lavizzo-Mourey picks up on that theme, elaborating on the findings and recommendations of the Foundation's recently issued County Health Rankings.

"Such socio-economic factors may seem like insurmountable obstacles to good health, but I believe we can use the County Health Rankings to help build a Culture of Health in every community," Lavizzo-Mourey writes. A report by the Robert Wood Johnson Foundation Commission to Build a Healthier America, she adds, also offers practical solutions to the problem, with 10 recommendations "for improving factors that lie far outside the clinic's door, such as early childhood education, adequate shelter, access to fresh produce, and the high levels of stress produced by living in poverty."

Read Lavizzo-Mourey's views in the Huffington Post

Closing the Gap on Child Obesity

May 22, 2014, 9:56 AM, Posted by Susan Dentzer

An elementary school student takes plastic cutlery for the meal he is holding.

Imagine a splashy, big bucks television commercial selling kids on the tantalizing deliciousness of eating ... carrots.          

Or a new course sandwiched into already packed middle-school and high school curricula: “Food Shopping and Cooking for a Healthy Life.”

Sound implausible? Maybe—but then again, such innovations could be a part of what is needed to make more progress in the war on child obesity.

These were some of the suggestions that emerged from a recent conference in Newark, where the Clinton Health Matters Initiative, the Robert Wood Johnson Foundation, and Grantmakers in Health sponsored a day-long summit entitled Closing the Gap: Childhood Obesity (and in which I was a participant). You can watch a video of the meeting here.

As RWJF CEO, Risa Lavizzo-Mourey reminded the audience, the Foundation has set a goal of reversing the U.S. child obesity epidemic by 2015—and as that date approaches, she confessed, “I’m getting a little nervous.” (View Risa's remarks.)

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We’re All in This Together: Let’s Bridge the Gap, Not Widen It

May 12, 2014, 4:14 PM, Posted by Beth Toner

Kathleen Hickey

At the end of April, the New York Times published an op-ed by Sandeep Jauhar, a cardiologist who—reacting to a New York bill granting nurse practitioners the right to provide primary care without physician oversight—argued that in primary care, “there will always be subtleties and complexities that demand a doctor’s judgment.”

His conclusion? “If we want more primary care providers, let’s have them be doctors”—and, he added, “let’s find a way to increase their pay.”

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Here's to the Nurses

May 8, 2014, 10:55 AM, Posted by Brent Thompson

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One evening several years ago, as my grandmother suffered through a painful end to her long life, our family gathered around her bedside at a hospital in South Jersey. She had been unconscious most of the day, but various family members, including my grandfather—her husband of six decades—had kept vigil at her bedside because they wanted to be with her in her last moments.

I was the last to arrive.

Shortly after I joined my family in the room, her physician showed up, checked her charts, and pronounced her “pretty much fine under the circumstances.” Then the doctor hurried off to complete his rounds.

My weary family, girding for the possibility of another long night at the hospital, decided to go downstairs for a bite to eat and some coffee. Because I had just arrived, I wanted some time alone with my grandmother, so I stayed behind in the room.

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