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The Secret to Successful Health Partnerships

Feb 26, 2015, 10:58 AM, Posted by Lawrence Prybil, Paul Jarris, Rich Umbdenstock, Robert Pestronk

raising hands graphic

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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Go Back to Basics, Go Back to Schools

Jan 23, 2015, 9:00 AM, Posted by Katherine Vickery

Erin Maughan
Health Care in 2015 logo

If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either.  One of the places to begin coordinated cultural change is in schools.

Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.

There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.

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Restoring Dignity to Those with Dementia

Jan 21, 2015, 4:00 PM

Judy Berry is the founder of Dementia Specialist Consulting and the Lakeview Ranch Model of Specialized Dementia Care in Darwin, Minn., and a 2010 recipient of the Robert Wood Johnson Foundation (RWJF) Community Health Leaders award.

Judy Berry
Aging in America

I live in rural Minnesota, and my passion is to make a significant contribution to improving dementia care in our society and to be an advocate for all seniors with dementia in their quest to maintain their basic human right to dignity, choice, and quality of life until their death.

My mother, Evelyn Holly, passed away 16 years ago. She spent the last seven years of her life being bounced from one nursing home or residential dementia facility to another, and in and out of hospital geri-psych units, all because of her so-called “challenging and aggressive behavior.” She spent the last year of her life strapped in a chair and drugged so she would be “compliant.” I imagine many of you have had similar experiences. Click on this link to view a video about my personal struggle with dementia care—a struggle that has fueled my passion to improve it.

After many years of heartache and frustration in my struggle to find appropriate care for my mother, and after being told repeatedly by others in the health care industry that the kind of dignified care that I visualized was impossible because it was too expensive, I discovered that I could not find any financial support for trying something different. I decided to use my own life savings to try to develop a model of specialized dementia care that would focus on the unmet emotional and spiritual needs of persons with dementia, many of whom are unable to communicate those needs, and to meet their physical needs as well.

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‘Glocalizing’ Solutions for the Rising Chronic Disease Epidemic

Jan 13, 2015, 9:00 AM, Posted by Justin List

Justin List, MD, MAR, MSc, is a Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholar at the University of Michigan and primary care general internist at VA Ann Arbor Health System. His research interests include community health worker evaluation, social determinants of health, and improving how health systems address the prevention and management of non-communicable diseases.

Justin List

The emergency sirens sounded loudly for the rising burden of chronic disease in 2014. Chronic diseases, also called non-communicable diseases (NCDs), broadly include cardiovascular disease, chronic respiratory disease, cancer, and diabetes. In 2014, we learned that, overall, 40 percent of Americans born between 2000 and 2011 are projected to develop diabetes in their lifetimes. This is double the lifetime risk from those born just a decade earlier. Rates of obesity, a condition related to many NCDs, remains stubbornly high in the United States. Mortality and morbidity from NCDs, not to mention the social and economic costs of disease, continue to rise.

The United States is not alone in the struggle with a well-entrenched NCD burden. At the end of 2014, a Council on Foreign Relations task force issued a report with a clarion call for the United States to aid in addressing NCDs in low- and middle-income countries (LMICs) where the epidemic of chronic disease poses risks to communities, economies, and security. The task force, which included RWJF President & CEO Risa Lavizzo-Mourey, MD, MPH, among its members, recommended: (1) U.S. global health funding priorities expand from disease-focused objectives to include more outcome-oriented measures for public health; and (2) the United States convene leading partners and stakeholders to address NCDs in LMICs.

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The Imperative to Collaborate Across Disciplines to Make It Easier to be Healthy

Jan 12, 2015, 9:00 AM, Posted by Chevy Williams

Chevy Williams, PhD, MPH, is a fellow at Experience Institute, where she is learning and applying design thinking to social problems. Williams is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Pennsylvania. 

Chevy Williams

Today, we can get access to just about anything in minutes or hours. Smartphones put a world of information literally at our fingertips. Within minutes, most of us can get food we want, entertainment we desire, even travel to another city. But seeing a doctor, an arguably more immediate need, is not so easy. Creating a Culture of Health requires our collective interdisciplinary expertise to make health and health care as accessible and user-friendly as other products and services we use on a regular basis.

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Before I left academia, I heard the word “interdisciplinary” tossed around a lot, but I saw it practiced in very safe ways. Typical research teams of grants I was on or would review comprised researchers from only the social, psychological, and health and medical sciences.  As public health faculty, I’d hear statements like “Public health is inherently interdisciplinary.” This may be true since public health draws from multiple disciplines, but I couldn’t help but feel that such statements were more a reflection of inertia than anything else.

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The Role of the Chief Nursing Officer in Bridging Gaps Among Health Systems and Communities to Improve Population Health

Jan 8, 2015, 9:56 AM

Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

Jerry Mansfield
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Since my doctoral work in public health, I have thought a great deal about the relationship of public health theory and practice and my acute care background. With more than 30 years of progressive leadership experience in a variety of for-profit/non-profit, inpatient and outpatient positions, I am trying to generate dialogue and discern a purposeful plan regarding the role of a Chief Nursing Officer in an academic medical center and the health of the populations we serve in our communities.

Based on earlier work in the 1990s and early 2000s, in 2007 the Health Research and Education Trust (HRET) engaged national experts to address the following question: How can hospitals engage their communities to improve the health of everyone? The report provides a framework and encourages hospital leaders and community members to envision health care in communities beyond the medical services offered by providers; it notes that the production of health is not only medical care, but also our environment, individual behavior, and genetic make-up.

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New Network Unites Community Leaders to Improve Health

Dec 10, 2014, 12:55 PM

The Build Healthy Places Network, a new and innovative resource to improve health outcomes in low-income communities, launched last month during the annual meeting of the American Public Health Association.

This groundbreaking network sits at the intersection of public health and community development. The goal of the network is to expand our collective understanding of the social determinants that impact public health and catalyze action. In so doing, the Build Healthy Places Network hopes to create new models and develop new tools to help leaders of low-income communities and create a Culture of Health where every individual lives the healthiest life possible.

Already, cutting edge work is being done in the public health sphere to begin addressing the many factors that impact health. As Douglas Jutte, MD, MPH, the Network’s executive director, recently described, the Network is designed to aggregate the work being done to help build a knowledge base for every community to use. 

“The concept is derived from a series of conferences that the Federal Reserve System has held focusing on both health and community development,” said Jutte. “There was a growing recognition that there needs to be a support system to build bridges between these two distinct sectors. While the conferences were a good start, we saw the opportunity for a network to help build these cross-sectoral connections and keep this field of collaboration moving forward.”

The Network’s website includes resources such as primers on improving the health of communities and stories about communities that are already uniting community development experts and public health experts to build a Culture of Health.

Jutte says a lot of the successes in the field currently are anecdotal and people working in the field often come up them “accidentally.”

“You hear about this amazing work that someone is doing in some corner of a faraway state and that really should end because we have the ability to share that kind of knowledge,” says Jutte.

He continued, “A key goal is to move health and community development from their siloes to collaboration. The Network will serve as a clearing house to bring together stories and evidence and examples of collaboration in communities.”  

Going forward, the Network plans to “synthesize” what is known and what the good examples are “so that we can help communities and leaders who are not even sure where to start, to really understand what’s going on in terms of new models with a focus on measurement, policy, finance and investment,” Jutte said.  

This commentary originally appeared on the RWJF New Public Health blog.

We Are All Tuskegee

Dec 10, 2014, 9:00 AM, Posted by Collins O. Airhihenbuwa

Collins O. Airhihenbuwa, PhD, MPH, is professor and head of the Department of Biobehavioral Health at Penn State University. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held last week. The conversation continues here on the RWJF Human Capital Blog.

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As we address disparities and inequities, the challenge is to think about solutions and not simply defining the problem. Most would agree that health is the most important part of who we are. It is the first thing we think about in the morning when we greet one another by asking, “How are you this morning?” It is the last thing we think about at night when we wish someone a restful night.

Collins Airhihenbuwa

What may be different is what health means to us and our families. This is why place and context are important. How we think about health and what we choose to do about it is very much influenced by where we reside. Our place and related cultural differences about health are less about right or wrong and more about ways of relating and meeting expectations our families and communities may have of us, whether expressed or perceived. More than that is the way we relate to what our place means in terms of how it is defined and subsequently how that definition shapes how we define it for ourselves. In other words the ‘gate’ through which we talk about our place and ourselves is very important in having a conversation about who we are and what that means for our health.

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Seizing Opportunities to Reinvent Public Health

Dec 2, 2014, 10:57 AM, Posted by Susan Dentzer

A doctor talks in a friendly manner to a disabled patient sitting in a wheelchair

“The only thing we know about the future is that it will be different,” wrote the late management guru Peter Drucker.  To the list of society’s sectors that are struggling with that conclusion, add government-funded public health.

State and local health departments face growing challenges, including infectious disease threats such as Ebola and chikungunya; a rising burden of chronic illness; an increasingly diverse population; even the health impact of global warming. At the same time, fiscal constraints accompanying the 2007–2008 recession and its aftermath hammered local, state, and territorial health agencies, which lost nearly 30,000 jobs—6 percent to 12 percent of their total workforces—from 2008 to 2013.

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Lessons from the Arabbers of Baltimore

Nov 28, 2014, 9:00 AM, Posted by Maya M. Rockeymoore

Maya M. Rockeymoore, PhD, is president of the Center for Global Policy Solutions, a nonprofit dedicated to making policy work for people and their environments, and director of Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation (RWJF). On December 5, RWJF will hold its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.

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When I think of the resilience of disadvantaged communities disproportionately affected by health disparities, I think of the Arabbers of Baltimore, Md. They are not Arabic speaking people from the Middle East or North Africa, but scrappy African American entrepreneurs who started selling fresh foods in Baltimore’s underserved communities in the aftermath of the Civil War.

Maya Rockeymoore

Their relevance continued into the modern era as supermarkets divested from low-income neighborhoods, leaving struggling residents with few options aside from unhealthy fast food and carry-out restaurants. Driving horses with carts laden with colorful fresh fruits and vegetables, Arabbers sold their produce to residents literally starving for nutritious food.

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