Feb 26, 2015, 10:58 AM, Posted by
Lawrence Prybil, Paul Jarris, Rich Umbdenstock, Robert Pestronk
Across the country, there is growing awareness that restraining the increase in health costs and improving the health outcomes will require approaches that address the full array of factors that affect health. Greater attention and resources must be devoted to promoting a safer environment, healthy lifestyles, prevention of illnesses and injuries, and early detection and treatment of health problems, as well as dealing with the underlying determinants of health. Improving access to outpatient and inpatient medical services and the quality of those services, while vitally important, are not enough.
To effectively design, implement, and sustain a comprehensive approach to promoting the overall health of communities, we need meaningful collaboration among healthcare delivery organizations, governmental public health departments, and other community stakeholders. Unfortunately, while there is evidence of some increase in recent years, decades of limited communications, lack of mutual understanding, and incongruent goals have inhibited collaboration among these groups across the country. The University of Kentucky College of Public Health recently conducted a study intended to accelerate change, encourage collaboration, and contribute to building a Culture of Health in America. The purpose of the study is to identify successful partnerships involving hospitals, public health departments, and other stakeholders in improving the health of communities they serve and elevate key lessons learned.
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Feb 23, 2015, 4:27 PM, Posted by
Alonzo L. Plough
Alonzo Plough, PhD, MPH, is vice president, Research-Evaluation-Learning and chief science officer for the Robert Wood Johnson Foundation. Read more from his series.
Childhood obesity is a tremendous threat to the current and future health of our young people. Compared with their healthy-weight peers, obese children face a higher risk for serious health problems, miss more school, have greater psychological stress, and are more likely to become obese as adults. If we don’t do something to reverse this epidemic, the nation’s current generation could be the first in history to live sicker and die younger than their parents’ generation. This is why RWJF recently pledged $500 million over the next 10 years to support strategies aimed at helping all children in the United States grow up at a healthy weight. This new funding increases our investment in preventing childhood obesity to more than $1 billion—the largest commitment we have ever made on a single issue.
We are in it for the long haul, and we have already seen signs of progress. Research published last year showed obesity prevalence among 2 to 5 years old dropped by approximately 40 percent in eight years. But nearly one-third of children and adolescents in the U.S. are still obese or overweight, and more than 25 million are at risk for high blood pressure or Type 2 diabetes because of their weight.
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Feb 19, 2015, 2:21 PM, Posted by
For the second year running, more women than men have signed up for coverage in health insurance marketplaces during open enrollment under the Affordable Care Act. According to the Department of Health and Human Services, enrollment ran 56 percent female, 44 percent male, during last year’s open enrollment season; preliminary data from this year shows enrollment at 55 percent female, 45 percent male—a 10 percentage point difference.
What gives? An HHS spokeswoman says the department can’t explain most of the differential. Females make up about 51 percent of the U.S. population, but there is no real evidence that, prior to ACA implementation, they were disproportionately more likely to be uninsured than men—and in fact, some evidence indicates that they were less likely to be uninsured than males.
What is clear that many women were highly motivated to obtain coverage under the health reform law—most likely because they want it, and need it.
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Feb 13, 2015, 5:06 PM, Posted by
Sometimes it feels like we take one step forward, two steps back when it comes to making sure that we are getting the best quality health care for the tremendous amount our society invests in it. Maybe sometimes it’s one step forward, three steps back.
But then I think about Aligning Forces for Quality—RWJF’s signature initiative to lift the quality and equality of care in 16 regions around the country—and my hope returns. While progress is slow, it is still progress.
More than 10 years ago, RWJF’s leadership suggested to me that we change course in our health care quality improvement strategy. Instead of testing single interventions in widely scattered sites, they asked, why not focus on a limited number of target communities where we could go deep with multiple approaches? We knew health care is essentially local, though shaped by state and federal policy.
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Feb 10, 2015, 2:13 PM, Posted by
I, like many others, have made a commitment to living healthier this year. I am resolved to find and eat a new fruit and vegetable each month, decrease my consumption of meat to a few times a week, and drink at least a half-gallon of water each day. I also plan to laugh more and spend more time outdoors. My personal goals aside, I also find myself more hopeful than at the start of many past years about the state of health in our nation as a whole.
- More Americans than ever before have access to the health care they need because of the Affordable Care Act;
- States throughout the nation are making significant progress in helping kids achieve a healthy weight;
- The disparities gap between black and white Americans’ life expectancies is narrowing.
These bright spots indicate that America is heading down the road to better health—but they only begin to address the challenges many Americans continue to face in accessing good health. As highlighted in a recent article in the New England Journal of Medicine, significant gaps and unmet needs remain.
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Feb 5, 2015, 1:00 PM, Posted by
Sen. Bill Frist, MD
We all want our kids and grandkids to grow up happier and healthier than we did. Instead, today’s children are the first generation of young Americans to face the prospect of living their entire lives in poorer health and dying younger than previous generations.
The reason is no mystery. Too many of our children – one in three, according to studies – are overweight. We are allowing, and in some ways encouraging, our kids to consume more calories, more sugar, more fat, more sodium. At the same time we’re enabling a more sedentary lifestyle. Running, jumping, skipping, dancing, biking – today’s children simply don’t move as much as they once did, making it that much harder to keep off the pounds.
The childhood obesity epidemic is having a devastating affect on too many families. Obese and overweight children are sick more often. They too often endure prejudice and bullying at school, leaving them embarrassed and depressed. They miss more school. When they grow up, they have more difficulty leading productive work lives. And they are more likely to suffer from chronic illnesses directly linked to obesity, such as diabetes and heart disease.
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Feb 5, 2015, 9:00 AM, Posted by
My husband and I recently bought our first house in Princeton, N.J. We had looked at several houses, all within a similar price range. But price wasn’t the only factor, and simply having a roof over our heads wasn’t our only goal. We wanted a place that allowed us to walk to town and had a yard for the kids to play in, as well as a garage and storage space. We didn’t care so much about some things that might be important to other people, such as the size of the bedrooms or any particular architectural style. Figuring out what was most important to us, what would be a high-value house for us—the people who would be living in the house—was just part of the process.
Just as people have widely varying preferences when it comes to a home purchase, they also have very different preferences and priorities when it comes to their health care. For example, I might prefer a primary care doctor who has weekend and evening hours, whereas my mom might prefer one who has a reputation for spending more time with patients. At least right now, Mom and I just care about different things.
What does “value” in health care mean to consumers generally—and not just consumers overall, but consumers of many different backgrounds and perspectives? What matters to people when they are choosing their health plan, which doctor to go to, or whether to go to a retail clinic, and what might make for a high-value experience in different health care settings? It’s hard to know, because today value is typically measured more from the perspective of payers and providers.
So that is why, this week, the Robert Wood Johnson Foundation and AcademyHealth, released a call for proposals to better understand what factors are most important to consumers when they make health care decisions.
In building a Culture of Health, we realize “value” won’t mean the same thing for everyone, any more than it does when you’re buying a house. But unlike in home buying, we don’t have many tools and supports in place to help people make their own high value decisions. In health care, we don’t have enough information about what people care most about. This is what we want to find out.
Feb 3, 2015, 6:15 PM, Posted by
As we head into the final weeks of this year’s open enrollment season, we can all be proud of the progress that’s been made. New numbers released last week show 9.5 million Americans signed up for health coverage through marketplaces across the country. Behind each number is someone who now has quality, affordable health coverage with access to health care when they need it and protection from financial ruin if they get sick.
But there are still millions more who are eligible for coverage this open enrollment period. RWJF and our partners are doing all we can to get as many people enrolled as possible before the February 15 deadline. These collective efforts focus on breaking down the biggest enrollment barriers for people to get covered. Our research shows that consumers are more motivated to enroll when they understand the benefits of coverage, believe they can afford the cost, and know they can find enrollment support to complete the process.
Enroll America, an RWJF grantee, is addressing the need for in-person help head on—operating grassroots efforts in 11 states and connecting consumers to enrollment tools and help nationwide. Their connector tool, allows consumers to schedule appointments for in-person help right away. Drawing from lessons learned from the first open enrollment period we know this one-on-one support will be critical for many consumers during these final weeks.
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Feb 2, 2015, 11:35 AM, Posted by
Teri Pipe, PhD, RN
In our fast-paced, overcommitted world, our typical automatic first response—to be better multitaskers and problem solvers—often leads to increased stress and reduced satisfaction. As leaders—especially in the high-stakes, quickly changing health care sector, we focus our attention outwardly on the well-being of others. We’re faced with a number of competing priorities, interruptions, and distractions that too often get the best of us. It seems that, for many, the noisy world has taken up residence within us.
As a nurse focusing on gerontology and oncology, I learned to help others find what was most important during times of bittersweet transition, prioritizing where and how their energy was spent. Through my clinical research experiences, I learned that the perception of stress, rather than a specific circumstance, could just as easily lead to physiologic consequences. I also observed how some people used their challenges to become more resilient, while others weakened.
Because of these experiences, the ideas of resiliency, mindfulness, and caring began shaping my research questions and investigations. My research and my work with my nursing colleagues showed me that teaching self-awareness, compassion and attention-focusing practices can reduce stress, build resilience and extend the positive impact of nurses and other leaders, including their ability to care for patients, strengthen communication, mentor others and lead successful organizations.
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Jan 30, 2015, 5:47 PM, Posted by
“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.
And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.
One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.
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