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Babies are Dying in Rochester at Twice the National Average. Why?

Nov 7, 2014, 11:13 AM, Posted by Maria Hinojosa

America by the Numbers series on Infant Mortality Photo by: Paul de Lumen.

Rochester, N.Y., is the birthplace of Xerox, Bausch & Lomb, and Kodak, and home to two top-ranked research institutions, the University of Rochester and Rochester Institute of Technology. Nevertheless, babies die in this upstate New York city at a rate two times higher than the national average, and Rochester’s children of color are three times more likely than white infants to die before their first birthday. Why?

To come up with some answers, Futuro visited Rochester as part of its America by the Numbers series, made in partnership with Boston public TV station WGBH (check your local PBS and World Channel listings to see the series). We went knowing that the U.S. as a whole ranks 56th in the world for infant mortality, by far the lowest of any industrialized nation, despite the fact that we spend more on health care per capita than any other country, and the largest portion goes towards pregnancy and childbirth. This makes Rochester’s statistics even more tragic—an outlier in an outlier.

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Data for Health: Learning What Works for Philadelphia

Nov 5, 2014, 12:37 PM, Posted by Susannah Fox

Philadelphia City Hall

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Teen Take Heart

Nov 5, 2014, 11:00 AM, Posted by Steven Palazzo

Steven J. Palazzo, PhD, MN, RN, CNE, is an assistant professor in the College of Nursing at Seattle University, and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2013 – 2016. ) His research focuses on evaluating the effectiveness of the Teen Take Heart program in mitigating cardiovascular risk factors in at-risk high school students.

Steven Palazzo

Difficult problems demand innovative solutions. Teen Take Heart (TTH) is a program I’ve worked to develop, in partnership with The Hope Heart Institute and with support from the RWJF Nurse Faulty Scholars Program, to address locally a problem we face nationally: an alarming increase in obesity and other modifiable cardiovascular risk factors among teenagers. The problem is substantial and costly in both economic and human terms. We developed TTH as a solution that could, if it proves effective in trials that begin this fall in my native Washington state, be translated to communities across the country.

The State of Obesity: Better Policies for a Healthier America, released recently by the Trust for America’s Health and RWJF, makes it clear that as a nation we are not winning the battle on obesity. The report reveals that a staggering 31.8 percent of children in the United States are overweight or obese and only 25 percent get the recommended 60 minutes of daily physical activity. The report also finds that only 5 percent of school districts nationwide have a wellness program that meets the physical education time requirement.

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New School Year Means New Opportunities to Build Healthy Campuses

Oct 14, 2014, 5:14 PM, Posted by Ginny Ehrlich

RWJF Philadelphia Child Obesity

September always brings the promise of a fresh start, especially for school age kids and their parents. New teachers, new books, new supplies, new shoes. And hopefully, a renewed emphasis on healthy choices. This week is National School Lunch Week, a time to highlight the importance of serving healthy school meals to students throughout the U.S.

Making sure all children have access to healthy food and drinks is a key priority for RWJF. Schools are where kids spend the most amount of time outside of their homes, so it’s an ideal place to instill lessons about the importance of eating healthy and being active. That’s why we are leading a number of initiatives to highlight how healthy school food, as well as recess and physical education (PE), contribute to nationwide efforts to reduce the prevalence of childhood obesity.

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Let’s Talk About Stress

Oct 2, 2014, 9:52 AM, Posted by Michael Painter

Mike Painter Mike Painter speaking at Health 2.0.

I recently returned from the Health 2.0 conference in California, which drew 2,000 health care innovators. One of the most popular Health 2.0 sessions was called “The Unmentionables”—where speakers discussed those important things that affect our health but we are often afraid to address. I participated in this year’s session where we talked stress—what it is and how it’s making us sick.

I’m an avid cyclist. That means I train a lot. Training on a bike means purposefully and intensely stressing your body—sometimes ridiculously hard—in order to make your body stronger, fitter and faster. In that sense stress can be really good. You can’t get stronger without it.

But here’s the key: as you ratchet up that stress—the miles, the hours on the bike, the intensity—you must work just as hard on the flipside, the buffering. The more you train, the more you have to focus on the rest, the sleep, your social supports, the yoga, the nutrition—whatever it takes.

If you don’t buffer you will burn out, get injured or sick, or all of the above. Without buffers, the stress will crush you.

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Changing the Culture of Health to Prevent Suicide

Sep 12, 2014, 9:00 AM, Posted by Alexander Tsai

Alexander Tsai, MD, PhD, is an assistant professor of psychiatry at Harvard Medical School, a staff psychiatrist in the Massachusetts General Chester M. Pierce, MD Division of Global Psychiatry, and an honorary lecturer at the Mbarara University of Science and Technology in Uganda. He is an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2010-2012), and a member of the core faculty in the Health & Society Scholars program at Harvard University.

Alexander Tsai

When Robin Williams ended his life last month, his suicide sparked a raft of online and print commentary about the dangers of depression and the need to inject more resources into our mental health care system. I strongly agree with these sentiments. After all, as a psychiatrist at the Massachusetts General Hospital, I regularly speak with patients who have been diagnosed with depression or who are actively thinking about ending their lives.

But what if suicide prevention isn’t just about better screening, diagnosis and treatment of depression? What if there were a better way to go about preventing suicides?

It is undeniable that people with mental illnesses such as depression and bipolar disorder are at greater risk for suicidal thinking or suicide attempts. But not everyone with depression commits suicide, and not everyone who has committed suicide suffered from depression. In fact, even though depression is a strong predictor of suicidal thinking, it does not necessarily predict suicide attempts among those who have been thinking about suicide. Instead, among people who are actively thinking about suicide, the mental illnesses that most strongly predict suicide attempts are those characterized by anxiety, agitation and poor impulse control.

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Living Out Their Salad Days: Shaping Healthier Environments for Kids in the Nation’s Schools

Sep 2, 2014, 10:59 AM, Posted by Susan Dentzer

A school lunchroom full of hundreds of young children, happily slurping up ... salad.

If you’re someone who’s ever struggled to get kids to eat their vegetables, it sounds like an impossible dream.

But this is reality at Anne Frank Elementary School, the largest in Philadelphia, with 1,200 students from kindergarten through fifth grade. Serving salads was the brainchild of Anne Frank principal Mickey Komins, who had the salads brought in from a local high school cafeteria.

Along with the after-school Zumba and kickboxing classes that the school now sponsors for kids, parents, and staff, healthier food offerings are among the innovations that earned Anne Frank an award from the Alliance for a Healthier Generation. The Alliance, a Robert Wood Johnson Foundation grantee, is a nonprofit founded by the American Heart Association and the Clinton Foundation to help stem the tide of childhood obesity. It’s at the vanguard of a growing national movement to turn schools into healthier environments, and offer kids fundamental lifelong lessons about maintaining their health.

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Pediatricians Need to Take Community-Based Approach to Addressing Chronic Conditions in Children

Aug 29, 2014, 9:00 AM, Posted by James Perrin

James Perrin

Human Capital Blog: Congratulations on your new role as president of the American Academy of Pediatrics! What is your vision for the organization?

James Perrin: We are focused on addressing three main areas, which have really driven a lot of our thinking and, more importantly, our activity and change in the last several years.

First, we are working to help pediatric practices take on more community-based interventions to help young families raise their kids more effectively. There is a tremendous growth in the number of chronic diseases among children in four major areas: asthma, obesity, mental health, and neurodevelopmental disorders. We recognize these are not classic health conditions; they arise from and within communities, and both their prevention and their treatment are really community-based endeavors, as opposed to office-based activities.

Our second, and highly related priority, is an increased focus on early childhood development. We have understood the tremendous importance of early childhood for years, but there is now so much more science behind it. We know a lot more about how negative experiences and toxic stress can affect child development and how it can affect brain growth and neuroendocrine function. On the positive side, we also have more knowledge about the importance of reading to children, increasing language in the home, and other early-childhood interventions.

Thirdly, we have a better understanding of the tremendous impact of poverty on child health. Almost a quarter of American children live in households below the federal poverty line, and almost 45 percent live in households with incomes less than twice the federal poverty line. So a large number of American children are poor or near poor, and we know that poverty affects essentially everything related to child health. It makes those four categories of chronic conditions—asthma, obesity, mental health, and neurodevelopmental disorders—more prevalent and more serious, and it affects children’s responses to treatment. Lower-income kids with leukemia or cystic fibrosis, for example, have higher death rates than kids with the same diseases who are middle class. It’s impossible not to see on a daily basis how poverty affects child health.

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Faces of Public Health: Bill Kohl, PhD

Aug 1, 2014, 1:27 PM

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Harold W. “Bill” Kohl, PhD, a professor of epidemiology at the University of Texas School of Public Health is in the midst of a three-year appointment to the President’s Council on Fitness, Sports & Nutrition (PCFSN) Science Board. Kohl’s role is to provide recommendations in the areas of program development and evaluation, which is critical to the Council’s mission to engage, educate and empower all Americans across to adopt a healthy lifestyle that includes regular physical activity and good nutrition. During his time at the School of Public Health, Kohl has been researching effective uses of social networking to create demand for healthy lifestyles among youth and working with organizations to promote disease prevention, physical activity and exercise as a health priority.

NewPublicHealth recently spoke with Kohl about the work of the President’s Council.

NewPublicHealth: Is the current mission of the President’s Council different than it was in the past?

Bill Kohl: There has been a shift. The President’s Council started in the 1950s as the result of a small study that suggested that American kids are not as fit as kids in Eastern bloc countries—Russia, primarily. The President’s Council started under President Eisenhower and then President Kennedy’s administrating sought to increase kids’ fitness by doing fitness testing in schools and promoting physical activity and physical education.

That wound its way through the ‘60s and ‘70s. Then in the ‘80s there was a much bigger rush to health-related physical fitness rather than skill-related fitness activities—things that you can actually change and that are related to health outcomes compared to fitness skills you might be born with, such as the ability to run a 50-yard dash.

Then, most recently, the Council has included nutrition in his mission and been renamed.

NPH: How does your background inform your new role?

Kohl: As chair of the science board, my job is to make sure that the President’s Council has the most up-to-date science that’s relevant to its mission and advancing initiatives that are evidence-based.

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Faces of Public Health: Lisel Loy, Bipartisan Policy Center

Jul 25, 2014, 11:54 AM

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Late last month, the Bipartisan Policy Center, a think tank based in Washington, D.C., released a new white paper, Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care, that strongly recommends providing greater training in nutrition and physical activity  for medical students and physicians in order to help reduce U.S. obesity rates. The report was jointly published with the American College of Sports Medicine and the Alliance for a Healthier Generation, a nonprofit founded by the American Heart Association and the Clinton Foundation as a response to the growing rate of childhood obesity. The report found that current training for medical professionals and students in nutrition and exercise is inadequate to cope with the nation’s obesity epidemic.

A survey conducted for the new report found that more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels. It also found that while some schools have stepped up their performance, fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.

“The health care marketplace needs to place greater value on preventive care,” said Jim Whitehead, Chief Executive Officer and Executive Vice President of the American College of Sports Medicine. “Doing so will provide medical schools with the incentive to train their students accordingly. And it will give medical professionals the leverage they need to address healthy lifestyles with their patients.”

NewPublicHealth recently spoke with Lisel Loy, director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, about the report and about how to improve training for medical professionals on nutrition and exercise.

NPH: What was the idea that propelled you to look into making changing to medical school education?

Loy: Well, the technical launching pad was our June 2012 policy report called Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future. And in that, my four co-chairs recommended a suite of policy changes that would improve health outcomes and lower costs for families, communities, schools and work sites. Within that community context they called out the need to improve training for health professionals—not just physicians but health professionals much more broadly defined than that—in pursuit of the goal of reducing obesity and chronic disease and cutting costs.

So that’s sort of the technical answer to your question. The more philosophical answer is as we as a country shift toward more preventive care, they really saw a gap in the education and training of health professionals in terms of being able to best support improved health outcomes. So that’s how they determined that that belonged in our report as a policy recommendation, and since we put out that report we prioritized a handful of recommendations, one of which had to do with health professional training.

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