Now Viewing: Built Environment and Health

Healthy Community Planning Means Healthier Neighbors

Nov 17, 2014, 3:44 PM, Posted by Helene Combs Dreiling

5716 Wellness is housed in a historic Albert Kahn-designed cigar factory. 5716 Wellness is housed in a historic Albert Kahn-designed cigar factory.

Too often, U.S. public health policy focuses on treating illnesses after they are diagnosed, instead of encouraging healthy lifestyles to prevent illness in the first place. But architects—my profession—are engaged in a wholesale effort to reverse this focus. Throughout the U.S., right in the buildings where we live and work, architects are incorporating design techniques that can help prevent illness and benefit the local communities that live with their designs.

One of the best examples of this effort—even amidst bankruptcy and a historic unraveling of a once-dominant American city—is the Detroit Collaborative Design Center (DCDC), a nonprofit architecture and urban design firm that offers proof that neighborhoods that facilitate holistic wellness and preventative care are as valuable as doctors who make house calls.

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RWJF Pioneering Ideas Podcast: Episode 6 | What if? Shifting Perspectives to Change the World

Oct 20, 2014, 9:00 AM, Posted by Pioneer Blog Team

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RWJF's Pioneering Ideas Podcast is on iTunes! Don’t miss an episode—click to subscribe.

Welcome to the sixth episode of RWJF’s Pioneering Ideas podcast, where we explore cutting edge ideas and emerging trends that can help build a Culture of Health. Your host is Lori Melichar, director at the foundation.

Ideas Explored in This Episode

Sharing Health Care Providers’ Notes (3:08) OpenNotesTom Delbanco and Jan Walker talk with RWJF’s Emmy Ganos about why they decided getting health care providers to share their notes with patients was an essential innovation–and where their work is headed next. Here’s a hint: what if the  3 million patients who now have easy access to their clinician’s notes could co-write notes with their providers?

Rethinking How We Solve Poverty (18:46) Kirsten Lodal, founder and CEO of LIFT, talks with RWJF’s Susan Mende and shares some simple ideas with the potential to revolutionize our approach to helping people achieve economic stability and well being. In a thought-provoking conversation, Lodal connects the dots between improving the well being of those living in poverty and building a Culture of Health.

A Historian’s Take on Building a Culture of Health (27:58) – Princeton historian Keith Wailoo and RWJF’s Steve Downs discuss how deeply held cultural narratives influence our perceptions of health, and how today’s “wild ideas” are often tomorrow’s cutting edge innovations.

Sound bites

...On opening up health care providers’ notes and what’s next:

“What I would like to do is spread the responsibility for health beyond the health care system. The health care system is good; I hope that it gets better, but there are so many other parts of our lives that contribute to our well being.” – Jan Walker, OpenNotes 

“It will be a very different world in the future. And we do think that OpenNotes is kind of giving people a peek into it. It's a first glimmer that this kind of transparency, this kind of approach to things, while it's passive now, it just opens up an enormous amount of possibilities for the future. And that's what really excites us.” – Tom Delbanco, OpenNotes

...On rethinking how we solve poverty:

“People's lives are like rivers... they flowed before coming into contact with us, and they will flow after having contact with us. And so the opportunity that we have, the privilege that we have is of most positively affecting the trajectory and the velocity of that flow. But if we forget that–if we get too swept up in having to own everything that happens in a person's life–then we won't build the best solutions, because we won't build solutions that provide people with the support they need to navigate the flow of that river over the long term.” – Kirsten Lodal, LIFT

...A historian’s take on building a Culture of Health: 

“Our concern with aggregate trends is an important one in tracing the shifting demographics of health in our country, but to understand what health actually means involves actually putting the data aside and thinking about lives and thinking about individuals and thinking about what these trends mean on an individual level.”– Keith Wailoo, Princeton University

Your Turn

Now that you’ve listened – talk about it! Did anything you heard today get you thinking in new ways about how you can help build a Culture of Health? Do you have a cutting-edge idea you’d like to discuss? Comment below or tweet at me at @lorimelichar, or consider submitting a proposal. Be sure to keep the conversation and explorations going at #RWJFpodcast.

Join the Conversation

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Healthy Communities: The Building Blocks of a Culture of Health

Aug 25, 2014, 9:15 AM, Posted by Jamie Bussel

Baldwin Park California

What do Corvallis, Ore.; Baldwin Park, Calif.; and Buffalo, N.Y. have in common? It certainly isn’t their weather.

Hint—the commonality is something much more relevant to RWJF’s newly refined mission. These three cities are building a Culture of Health for all their citizens. They are tapping into the skills and resources of a diverse group of partners to ensure everyone has access to healthy choices. It’s their collective efforts, along with dozens of other communities supported by the Foundation’s Healthy Kids, Healthy Communities (HKHC) program, that make me so optimistic about our organizational goal.

My strong belief that environments—physical, social and educational—play a prominent role in our individual health and well-being is what initially drew me to RWJF. So, in 2008, I excitedly embraced the opportunity to be the national program officer for HKHC, which addressed the root causes of childhood obesity by transforming the physical activity and food environments in which children and their families live, learn and play.

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New Microbiome Health Research Puts the ‘Cell’ Back in Cell Phone

Jun 24, 2014, 12:13 PM, Posted by Deborah Bae

WNH Jessica Green infographic

What’s Next Health guest Jessica Green, founding director of the BioBE (Biology and the Built Environment Center), visited RWJF last year to discuss the health implications of the microbiome—the invisible collection of bacteria, viruses, fungi, and archaea that live on, in and all around us. Watch Jessica’s What's Next Health interview to learn more about microbiomes in the built environment and how that knowledge can be used to design spaces and buildings to create a healthier, more sustainable world.

During her visit, Jessica led an educational workshop where staff swabbed their fingers and mobile phones to learn about the relationship between the microscopic communities living on both. The findings from that educational workshop turned out to be quite interesting, and ultimately led to a study published today in the journal PeerJ. Senior Program Officer Deborah Bae caught up with Jessica to learn more about her research.

Deborah: When we hear the term microbe, many of us think about germs that cause disease. So what is the microbiome, and why is it important in promoting health?

Jessica: Twenty years ago, when I was an environmental engineering student, I learned that microbes were pollutants or contaminants, and were something that you wanted to eliminate, particularly in the indoor environment. And we know from history that being in a very unclean, unsanitary environment kills people. What we’ve learned more recently is that for every human cell, we have up to ten bacterial cells and even more viruses living on the human body. There's a rising consensus that aspects of this microbiome can be beneficial to human health. Some of these microorganisms help our immune system function, ward off pathogens and infections, and microbes in our gut may be even linked to the way that we think and feel.

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A Behind the Scenes Look at a Documentary Series on Climate Change

Apr 16, 2014, 9:00 AM, Posted by Sabrina McCormick

file

The first episode of Years of Living Dangerously, a new documentary series exploring the human impact of climate change, aired last Sunday on Showtime. I worked on the series as associate producer and producer, but I am also a scientist who has been studying the impact of climate change on human health for almost a decade. In all that time, I’d developed a good grasp of what climate change looks like from a scientific point of view. But working on the series made me learn a lot more about what climate change looks like, not just here in the United States but worldwide.

This documentary television series consists of nine episodes featuring star correspondents as they meet experts and visit ordinary people who have lived through extreme weather events triggered by climate change. James Cameron, Jerry Weintraub, and Arnold Schwarzenegger served as executive producers of the series, along with former 60 Minutes producers Joel Bach and David Gelber. I worked with Matt Damon on an upcoming segment about heat waves and with Michael C. Hall on another story focusing on Bangladesh, a nation already vulnerable to extreme weather.

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What’s Next Health: The Motivation Bias

Nov 27, 2013, 7:00 AM, Posted by Pioneer Blog Team

Debra Joy Pérez, vice president for Knowledge Support at the Annie E. Casey Foundation Debra Joy Pérez, vice president for Knowledge Support at the Annie E. Casey Foundation

Each month, What’s Next Health talks with leading thinkers about the future of health and health care. Recently, we talked with BJ Fogg, director of the Stanford Persuasive Tech Lab, to discuss motivation versus ability, and to better understand which matters more in creating long-term change. In this post, Debra Joy Pérez, former assistant vice president for Research and Evaluation at the Robert Wood Johnson Foundation, who is now working with the Annie E. Casey Foundation, shares her impressions of BJ’s model and how it might impact the work of organizations like ours.

By Debra Joy Pérez

There is something magically simple in how BJ Fogg’s Behavioral Model addresses behavior change. When just three elements coincide—motivation, ability and a trigger—behavior change happens.

From my own experience, I can tell you that BJ’s model can work in developing new and healthy habits. I heard from BJ that immediately after he pees, he does push-ups. He is attaching a new habit he wants to create to an old habit he already has. Every time he relieves himself, he is triggered to perform a simple action that has him looking and feeling healthier. Like BJ, I wanted to improve my health (motivation)—specifically, I wanted to drink more water. My trigger was green tea. I drink a lot of it, so after each cup, I remember to fill the empty cup with water. I’m pleasantly surprised when I see that I’m nearing half a gallon by the middle of the day. It's working.

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Childhood Lead Exposure: Piling Disadvantage onto Some of the Country’s Most Vulnerable Kids

Nov 19, 2013, 9:00 AM

Sheryl Magzamen, PhD, MPH, is an assistant professor in the College of Veterinary Medicine and Biomedical Sciences at Colorado State University and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2007-2009). She recently published two studies exploring the link between early childhood lead exposure and behavioral and academic outcomes in Environmental Research and the Annals of Epidemiology. She discusses both below.

file

Human Capital Blog: What are the main findings of your study on childhood lead exposure and discipline?

Sheryl Magzamen: We found that children who had moderate but elevated exposure lead in early childhood were more than two times as likely as unexposed children to be suspended from school, and that’s controlling for race, socioeconomic status, and other covariates. We’re particularly concerned about this because of what it means for barriers to school success and achievement due to behavioral issues.

We are also concerned about the fact that there‘s a strong possibility, based on animal models, that neurological effects of lead exposure predispose children to an array of disruptive or anti-social behavior in schools. The environmental exposures that children have prior to going to school have been largely ignored in debates about quality public education.

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Shutdown

Oct 9, 2013, 12:05 PM, Posted by Michael Painter

Mike Painter

There are still places left where the prehistoric wisdom of our planet stands sentinel. I just returned from such a spot, a high elevation Sierra Nevada fortress of wildness and ancient Earth. Ironically, our own federal government has designated the region a wilderness. It's almost comical to me that right as we hiked into this area, bickering, partisan factions back east shut down the very government that presumes to preside here. In fact, until those folks sort out their problems, you can visit these wilderness areas without a federal permit. Heads up, however, if something happens to you during your permit-less visit; you are on your own. I like the sound of that, actually.

These places are vast and impervious to current events. Trust me; they do not care about human welfare, cultures, health, poverty, wealth, communities, cities, or governments. They just silently stand testament throughout the millennia to the true nature of our home.

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Leveraging the Power of Design and Design Thinking for Public Health

Oct 8, 2013, 10:00 AM, Posted by Matthew Trowbridge

AIGA UVA Design

It is increasingly clear that solutions for our most pressing and challenging public health issues will ultimately hinge on designing environments that encourage healthy behavior choices by making them more available, economical, and enjoyable.

Traditional public health approaches are not perfectly suited to this task. For example, epidemiological studies allow us to measure the association between environmental design features such as parks or sidewalks and walking behavior, but these experimental data are generally insufficient to be either actionable by decision-makers or effective in prompting behavior change. As Jeff Speck, urban planner and theorist, observes in his recent book Walkable City: How Downtown Can Save America, One Step at a Time:

The pedestrian is an extremely fragile species, the canary in the coal mine of urban livability. Under the right conditions, this creature thrives and multiplies. But creating those conditions requires attention to a broad range of criteria, some more easily satisfied than others.”

Public health must improve its ability to develop multi-dimensional interventions to more successfully provide environments and experiences that encourage positive health outcomes.  Put another way, public health must develop its capacity for design thinking.

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Introducing the Pitch Day Finalists: The Human Genome + the Human Exposome = Your Health

Oct 7, 2013, 8:00 AM, Posted by Pioneer Blog Team

Elise Miller Elise Miller, director of the Collaborative on Health and the Environment

What if we could map the environmental exposures that affected someone’s health, starting from the moment of conception? And what if we could use that information to radically transform our ability to prevent disease? That’s the highly simplified version of the idea that a team helmed by Elise Miller. She was invited to present her idea live and in person at the first-ever Pioneer Pitch Day, along with seven other finalists. Read Miller’s 1,000-character proposal below, and join the discussion on Twitter at #pioneerpitch.

Elise Miller is the director of the Collaborative on Health and the Environment, which you can connect with on Twitter at @che_for_science and on Facebook. The other members of her pitch team include Frederica Perera, PhD, and Maida Galvez, MD, MPH.

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