Mar 19, 2015, 12:31 AM, Posted by
Everyone in America deserves a chance to live the healthiest life possible. The reality is a bit more complicated: A person’s ZIP code, after all, can be as important as their genetic code when it comes to determining health. A true Culture of Health in the United States won’t be possible unless we address the inequities that allow some full access to a healthier life, while others are left to struggle.
This week, RWJF arrived at the TED conference in Vancouver, British Columbia, with a challenge for attendees: Try to understand what millions of people face in their pursuit of a healthy life. And in the spirit of the conference’s “Truth & Dare” theme, we dared the TED participants to envision a future in which everyone had access and a path to a healthier life. How might that happen? So far we’re hearing incredible ideas: let’s get to a place where we can celebrate justice rather than seek justice. Let’s make smarter choices about where we spend our health care.
We’ve enlisted five talented—brilliant, really—young filmmakers to help us. We asked each of them to tell the stories of their lives and to document the challenges that sometimes seem distant, but that are all too real for the people in their worlds. Check out their remarkable stories:
View full post
Mar 10, 2015, 10:00 AM, Posted by
Catherine Malone, Najaf Ahmad
We know that in order to address health disparities head on, we'll have to implement changes to the systems that influence where we live, learn, work, and play. Oscar and Jose's stories show us that it's possible.
I was looking at somebody who could be a great person...who could do something great in his future. I also knew that if I sent him to prison, I’d knock him off of that road to success.
In the quote above, Steven Teske, a Juvenile Chief Judge in Clayton County, Georgia is describing the first time he encountered 15-year-old Oscar Mayes as he entered the courtroom in handcuffs. Judge Teske noticed that Oscar was an extremely bright young man and that he had no prior run-ins with the law. Yet Oscar was facing five years in the state’s long term lock up—five years that could have ruined his future.
Fortunately, Oscar literally got a Second Chance. This Clayton County initiative gives youth facing prison an opportunity to redeem themselves through intensive supervision, participation in evidence-based treatment programs, and weekly check-ins with the court. Judge Teske and others in his community had realized that too many of their students were falling out of school and heading into the criminal justice system. To address this, the Juvenile Court partnered with local schools and law enforcement to find ways of disciplining youth while keeping them “in school, out of court, and onto a positive, healthy future.”
Interventions like this have yielded impressive statistics in Clayton County: School arrests have gone down 83% and school attendance has gone up 86%. Clayton County’s approach to juvenile justice reflects the transformational impact that changing a system can have.
View full post
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.
View full post
Jan 29, 2015, 7:31 AM, Posted by
Jacquelyn Taylor, PhD, PNP-BC, RN, FAAN, is an associate professor of nursing at Yale University and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program (2008-2012). She recently received a $3.4 million grant from the National Institute of Nursing Research, a department of the National Institutes of Health, to conduct a large-scale study on the influence of genetic and psychological factors on high blood pressure in African-American women and children.
Human Capital Blog: Congratulations on your new grant from the National Institutes of Health to study blood pressure in African-Americans. What will be your focus?
Jacquelyn Taylor: African-Americans have the highest incidence of hypertension of any racial or ethnic group in our country. Studies show that some medications don’t work very well in reducing blood pressure in this population, and we are convinced that some other underlying mechanisms are at play. My co-principal investigator, Cindy Crusto, PhD, an associate professor in the department of psychology at Yale School of Medicine, and our research team and I will be studying two of those—genetic markers and psychological factors, such as perceived feelings of racism, mental health, and parenting behaviors—in our study. We want to know what effects these variables have on increases in blood pressure among African-American women and children over time.
HCB: Does this study build on your earlier work?
Taylor: In a previous study in Detroit, I looked at gene-environment interactions for high blood pressure in three generations of African-American women and identified hypertension risk alleles in grandmothers and in their daughters and granddaughters. Then I replicated the study in West Africa, where people live the same way as they did in the 1400s—in clay huts, with no running water, no sanitation, and no fast food as in the developed areas such as Detroit. The West African Dogon sample were mostly underweight, participated in large amount of physical activity, and had a limited but healthy diet. But they still had the same genetic markers for hypertension that I had identified in the sample in Detroit.
View full post
Jan 27, 2015, 9:00 AM, Posted by
At Virginia Commonwealth University School of Medicine, Briana Mezuk, PhD, is an assistant professor in the Department of Family Medicine and Population Health, Division of Epidemiology; and Tiffany L. Green, PhD, is an assistant professor in the Department of Healthcare Policy and Research. Both are alumnae of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program.
Approximately 30 million U.S. adults currently have diabetes, and an additional 86 million have pre-diabetes. The incidence of diabetes has increased substantially over the past 30 years, including among children. Estimates place the direct and indirect costs of diabetes at a staggering $218 billion annually.1 Like many other diseases, disparities on the basis of race and income are apparent with diabetes. Non-Hispanic blacks, Hispanics, Native Americans, and socioeconomically disadvantaged groups are more likely to develop diabetes than non-Hispanic whites and socioeconomically advantaged groups.
Despite the enormous economic and social costs associated with diabetes, it remains a struggle to apply what we know about diabetes prevention to communities at the highest risk. We have robust evidence from randomized controlled trials that changing health behaviors, including adopting a healthy diet and regular exercise routine and subsequent weight loss, will significantly lower the risk of diabetes. Unfortunately, these promising findings only appear to apply to the short-term. Even worse, results from community-based translation efforts have been much more modest than expected, and show only limited promise of reducing long-term diabetes risk. In response, leaders at the National Institutes of Health have noted that many efforts at translating clinical findings into community settings are “limited in scope and applicability, underemphasizing the value of context.”2
View full post
Jan 16, 2015, 10:11 AM, Posted by
Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action. This piece is cross-posted with Off the Charts, the American Journal of Nursing Blog.
I spent the 2014 holiday season reading a book by Sarah Wildman called Paper Love. She describes how she, as a journalist, examined the fate of her Jewish predecessors, including her grandfather and his long lost love. I selected the book because my father was a Jew of Polish descent.
Wildman describes the horrific atrocities bestowed upon the Jews. Of course I knew of the Holocaust growing up, but as I get older, the connections between past and present seem to be more important. While I don’t know of any relative who was personally affected or killed, someone in my extended family very likely was. I pondered my own existence and how it may have depended on a relative escaping Europe and immigrating to the United States to escape the death camps. It is unspeakable how one man’s view of what is mainstream or normal sent so many others to their death.
I am not naive enough to believe that prejudice is a curse of the past. Stark data on health disparities continue to mount. The Centers for Disease Control and Prevention report on Health Disparities and Inequalities (2013) found that mortality rates from chronic illness, premature births, suicide, auto accidents, and drugs were all higher for certain minority populations.
But I believe passionately that nurses and other health professionals can be part of the solution to addressing these disparities. Nurses are privileged to enter into the lives of others in a very intimate way, and that means lives that are, more often than not, very different than our own.
View full post
Dec 15, 2014, 9:00 AM, Posted by
Roland J. Thorpe, Jr.
Roland J. Thorpe, Jr., PhD, MS, is an assistant professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health and director of the Program for Research on Men’s Health at the Johns Hopkins Center for Health Disparities Solutions. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held December 5th. The conversation continues here on the RWJF Human Capital Blog.
Nearly half a century ago, Dr. Martin Luther King Jr. famously said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Yet decades later, only modest progress has been made to reduce the pervasive race- and sex-based disparities that exist in this country. African-American men who are at the intersection of race and sex have a worse health profile than other race/sex groups. This is dramatically evidenced by the trend in life expectancy.
For example, African-American life expectancy has been the lowest compared to other groups ever since these data have been collected. Today the lifespan of African-American men is about six years shorter than that of white men. Furthermore, a study from the Program for Research on Men’s Health at the Johns Hopkins Center for Health Disparities Solutions provides a financial perspective around this issue.
View full post
Dec 11, 2014, 4:50 PM, Posted by
Dwayne Proctor, Kristin Schubert
Millennials get a lot of attention as today’s trendsetters. What are they buying? What social media are they using? How are they voting? But there is an equally important question that is rarely raised: How healthy are 20-somethings? A new report explores that last question, and the answers are not good. An even better question might be: What’s standing in the way of healthier, more productive lives for millennials?
Adults between the ages of 18 and 26 are "surprisingly unhealthy," according to the report from the Institute of Medicine (IOM) and the National Research Council (NRC). One out of every four young adults is obese, and those numbers are rising. One in 10 has suffered from untreated mental illnesses within the past year. What lies behind these disturbing trends might be a much bigger issue than what young people choose to eat or how they handle stress. The report points to big-picture causes—broken pathways from quality education to solid jobs, and widening disparities that make it harder for marginalized young adults to succeed.
View full post