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Doing More Means Doing Less: Young Innovators Lead the Charge

Jul 23, 2014, 1:28 PM, Posted by Emmy Ganos

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Here at the Robert Wood Johnson Foundation, we often talk about the idea of making the healthy choice the easy choice. To many of us, that means putting the cookies in a high cabinet, and putting the fruit on the counter. But when I think about building a Culture of Health in America, and especially within our health care system, making the healthy choice the easy choice means so much more.

In health care, often the healthy choice actually means doing less—fewer invasive tests and less dependence on medication—and instead watchfully waiting or making healthy lifestyle changes. But it’s not always easy to show a patient that you care when you only have a few minutes to spend together, and ordering a test or prescribing a medication is a simple way to show “I’m doing something to help you.” The trouble is, those tests, procedures and treatments often don't help, and sometimes they can hurt.

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Help or Hype: The True Costs of Robotic Surgery

Jul 14, 2014, 10:29 AM, Posted by Sheree Crute

Robotic Surgery

Joe Meyer is the model of a well-educated, engaged patient. A self-described “typical Midwestern guy” who settled in Chapel Hill, N.C., to raise a family and build a career, Meyer did everything in his power to make the best decisions when his 2013 physical produced unexpected and frightening results.

“I live a pretty healthy lifestyle. I exercise. I eat well,” says the 62-year-old chief operating officer of a large manufacturing company. “I was very surprised when my PSA test came back at 5.1 [3 to 4 is normal]. Further testing showed that I had prostate cancer.”

One of more than 200,000 men who are diagnosed each year, Meyer put his faith in his physician and the health care system when gathering information about treatment.

“After the biopsy, they told me my Gleason score was 7. [The higher the score on a scale of 1 to 10, the more likely a cancer will spread.] I realized I was high risk, so I started reading as much as I could about the choices I was offered—hormone therapy, radiation, or prostate removal.” He chose robotic prostatectomy over open or laparoscopic prostatectomy. Surgery, as opposed to hormone therapy or radiation, was widely considered a good decision for someone with Meyer’s prognosis.

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Let’s Help Each Other Cope With Stress

Jul 11, 2014, 12:04 PM, Posted by Risa Lavizzo-Mourey

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Just about everybody experiences stress, to a greater or lesser degree. The bad news: Too many of us fall into the "greater" category.

All of that stress has consequences not just for our mental health, but for our overall wellbeing, says Risa Lavizzo-Mourey, MD, Writing in the professional social networking site LinkedIn.

Lavizzo-Mourey cites the results of a recent NPR/RWJF/Harvard School of Public Health poll, which shows:

  • One in four said they experienced a great deal of stress in the previous month.
  • Almost half reported a major stressful event or experience within the past year.
  • Seventy-four percent said stress affected their health.
  • Forty-three percent said that a health concern is a leading cause of their stress.
  • Eighty percent of people in poor health reported that their health problems raised their level of stress.

If we are to make progress in building a Culture of Health, we need to acknowledge the deleterious role of stress in Americans' lives and health—and everybody needs to be at the table.

"This is clearly an area where health care providers, communities, and employers can help," Lavizzo-Mourey writes.

Read Lavizzo-Mourey's blog post on LinkedIn

Carrying the Burden of Stress

Jul 7, 2014, 11:36 AM, Posted by Jeff Meade

Forum at Harvard School of Public Health: The Health Burden of Stress, and What We Can Do About It. Presented in collaboration with the Robert Wood Johnson Foundation and NPR. (July 9, 2014)

Nearly half of us suffer through one major stressful event every year, and the weight of that stress can be heavy indeed. Take, for example, trouble at work, problems in a personal relationship, or the death of someone close to you.

At the top of the list: health issues—either yours, or those of a loved one. In fact, a health concern is the leading cause of stress for 43 percent of us. And all of that emotional turmoil can have a ripple effect, extending out into the realm of our overall well-being.

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How Do We Empower Communities to Get Healthy?

Jul 6, 2014, 9:03 PM, Posted by Martin Scaglione

Shoppers at an outside food market in Philadelphia

I’ve been privileged to live in many communities across the nation—16, to be exact. My wife Lisa and I recently moved from Iowa City, a "college town" of 80,000 people, to New York City, a bustling urban region of 23 million. Life from city to city and region to region is different in some ways, yet concerns related to community wellness remain the same.

On any given Saturday throughout the year, one can find dozens of farmers markets in New York City with fresh local produce and other offerings that encourage healthful choices. This is something we expected while living in Iowa, but were pleased to also find in the city. However, despite the fact that both communities benefit from farmers markets, health awareness campaigns and arguably the finest health care providers, both also struggle with obesity and chronic illness. Even within cities well equipped to promote health and provide care, certain individuals and neighborhoods thrive, while others struggle; is this merely a reflection of wealth disparity, or could it have to do with something more?

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GirlTrek: Black Women Walking for Body, Mind and Soul

Jul 3, 2014, 10:21 AM, Posted by Keecha Harris

Keecha Harris GirlTrek

I first met my friend Leah in September 2013, when she started walking with GirlTrek in Birmingham, Ala. GirlTrek is a movement of thousands of Black women across the country mobilized in response to the problem of staggering rates of obesity and its co-morbidities. Leah read a local NPR article about Black women walking for wellness under the banner of GirlTrek, and she decided to check it out.

As a GirlTrek volunteer, it is always a pleasure to connect with women new to our local organizing efforts. Leah joined us on a Full Moon Trek. Under celestial brilliance, Leah and I walked into the woods of the Hillsboro Trail as strangers. By the end of the trek, I had a new and humorous sister who fearlessly faced the possibility of running into snakes and other wildlife.

And when there is the promise of a storm, if you want change in your life, walk into it.
If you get on the other side, you will be different.
And if you want change in your life and you’re avoiding the trouble, you can forget it.
—Bernice Johnson Reagon

Friends were exactly what Leah needed. She and her husband had moved to Birmingham in 2007 to escape Michigan winters, and to establish a vibrant community of people with common interests. The winters are warmer here, true—but friends aren’t always easy to come by when you’re a stranger in a new city.

And that was the beginning of Leah’s relationship with a warm, welcoming organization of women passionate about improving their health—and fostering change. In short: she found the new friends she had been seeking. But these friendships gave her much more than she anticipated. Her doctor had delivered the grim news the month before that she was pre-diabetic. So walking with others was very timely.

Leah found herself in good company. GirlTrek has a goal of engaging 1 million Black women and girls in its walking-related programming by 2015. The program is sparking a health revolution, and it does so by building upon the rich cultural legacy and assets of the African American community.

Take, for example, Harriet Tubman. She’s a patron saint to GirlTrek supporters. Tubman was known to walk as many as 15 miles per day in uncut forests, through mossy swamps and across the Appalachian Ridge. Within the course of a decade, Tubman walked north toward freedom with hundreds escaping slavery. If Harriet Tubman could walk her way into new realities, the thinking goes, then so can we.

Leah was intrigued by the Full Moon Trek—and why would she not want to be part of a group of Black women who trekked to the light of the moon?  We connected through Facebook, excited to learn more about each other during a night walk in nature.

Walking to bring about change was a familiar theme for Leah. In fact, she was born to trek.

“Thinking back, walking has always held importance in my life—even before I took my first steps or took my first breath of air. My mother was weeks past her due date. Upon her third trip to the hospital, she was put in a hospital gown and instructed to walk up and down the halls.”

Thereafter, Leah and her mother racked up quite a few miles on foot. On weekends and evenings, her mom walked to relish joy or to ease pains, with little Leah in tow: “She’d walk, and walk, and walk, and walk. My little legs would go as fast as they could to keep up. When we returned home, I’d nearly collapse. But of course the next time she put on her shoes, I’d be ready to go again!“

That began to change in October. Leah has stepped up to lead other walkers to wellness. For the past eight months, she has led daily treks at the University of Alabama at Birmingham. These “smokeless breaks” are about 30 minutes each, with two to six women walking together.  Sometimes they walk to Railroad Park. During inclement weather, they trek inside along the long corridors connecting area hospitals.  

All of that walking has paid off for Leah—in a way that the everyone should applaud her for. In 2003, Leah did her first half-marathon. Over the last eight months, she has lost 30 pounds ... and shaved 17 minutes off her half-marathon time. She is no longer taking Metformin to treat her pre-diabetes. She feels more confident and peaceful. Moreover, Leah has found the warm, vibrant community of friends that she desired when she moved here.

For Leah, there is now no challenge too great. In May, Leah and other GirlTrekkers committed to walk at least 52.4 miles to honor their mothers. She walked at work and on weekends with her 5-year-old daughter, Neah Imani, in tow. Neah’s name means "moving faith."

Movement has been transformational for these three generations of trekkers. Leah’s mom continues to inspire her walking journey. In fact, Leah’s mom lost over 40 pounds in 2013, by walking the hallways at the University during her breaks.  

These days, though, mom can’t keep up with Leah any longer. She says Leah walks too fast. But even though they can’t walk together, they’re still walking in common cause: to heal their bodies, soothe their souls and form community with other black women.

About the Author
Keecha Harris, DrPH, RD is a walking enthusiast who has trekked every day since October 2012.  Her consulting company has provided support to the Robert Wood Johnson Foundation Childhood Obesity Team and the Research, Evaluation and Learning unit.   

What’s Keeping the Cardiac Polypill off the Market?

Jul 3, 2014, 10:05 AM, Posted by Sheree Crute

Lisa Ranson Lisa Ranson

No matter how busy Lisa Ranson’s morning gets, somewhere between preparing breakfast and suiting up for work or play, she takes the first cluster of eight pills that protect her from a family legacy of heart disease so powerful she had bypass surgery at 34.

Even at that young age, she was no stranger to daily prescription regimens. Growing up, she watched her dad struggle. These days they compare notes. “He’s survived two heart attacks, had bypass surgery, and he has a pacemaker,” Ranson says.

An avid walker who treks three and a half miles most days near her home in the small town of Dunbar, W.Va., Ranson is now 51 and in great shape. But her healthy lifestyle is no match for her genetic inheritance—she is one of 34 million people living with hypercholesterolemia.

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Bedtime Story

Jul 1, 2014, 10:33 AM, Posted by Jeff Meade

Sarah Meade Reading Pic Sarah, having a read at Granny's house

The globby tears, the quavering voice, the pudgy outstretched hands, the plaintive word “please.” They all come to mind as vividly as if it were yesterday.

Our daughter Sarah was (and still is, at 27) a good soul, but like every small child, she had her moments. And when those “moments” more or less coincided with bedtime, the worst punishment we could mete out was to refuse to read her bedtime stories—or “sturries,” as she called them. We would kiss her good night, and adjourn to the living room, there to sit and look at each other guiltily as our little girl suffered the tortures of the damned.

We listened to that heartbreaking little plea, “But I HAVE to have sturries!” echoing down the hall, and our hearts would break, too. We felt like the worst parents ever

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Supporting Families to Succeed

Jun 30, 2014, 9:31 AM, Posted by Jane Isaacs Lowe, Martha Davis

ACEs Billboard Version 2 Mobile

It has been more than 15 years since the Centers for Disease Control published the Adverse Childhood Experiences (ACES) study. What we learned from that study, and then subsequent research, is that sustained exposure to toxic stress and adverse childhood experiences—including abuse, neglect, neighborhood violence and chronic poverty—without the support of an engaged supportive parent or adult caretaker, can have serious extended effects on children’s subsequent development and success in life. This stress, without intervention, can lead to a lifetime of poorer health, including chronic diseases in adulthood, such as heart disease and diabetes.

In 2012, the American Academy of Pediatrics published a policy statement calling on pediatricians to become leaders in an effort to decrease children’s exposure to toxic stress and to mitigate its negative effects. They acknowledged how much science had taught us about how our environment affects our “learning capacities, adaptive behaviors, lifelong physical and mental health, and adult productivity.” The statement was a significant shift in the conversation. It provided a biological framework and imperative for why we must do something about adverse childhood experiences now.

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I'm Happy I Dropped my iPhone in the Pool ...

Jun 29, 2014, 11:23 AM, Posted by Najaf Ahmad

Bye Bye, iPhone

But I wasn't happy at first. While on vacation, I was mortified when I saw “him” lying at the bottom of the pool. “He” was my constant companion through boredom-and caffeine-fueled late-night working sessions.

Snap back to reality. Moments later my other companion—my husband—frantically rescued my iPhone from the depths of crystal clear waters. First aid involved promptly powering off the phone and depositing “him” into a bag of rice where “he” would remain for a week (or two!), drying out

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