Now Viewing: Social Determinants of Health

How to Build a Healthier Millennial

Dec 11, 2014, 4:50 PM, Posted by Dwayne Proctor, Kristin Schubert

Game of Life Photo: Will Folsom

 

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.

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American Public Health Association Meeting: All About Where You Live

Nov 14, 2014, 9:55 AM, Posted by Linda Wright Moore

Commission NOLA built environement 4

The Robert Wood Johnson Foundation (RWJF) has long embraced the idea that advancing America’s health is a community affair. Much of our work—and our current vision for building a Culture of Health—is grounded on the basic premise that where we live, work, learn, and play is inextricably connected to our health and well-being.

Consider that life expectancy can differ by 25 years in neighborhoods just a few miles apart; that a ZIP code can determine rates of preventable disease, violence, and access to healthy food. With this in mind, RWJF supports a wide range of programs designed to foster healthy communities—including efforts to prevent obesity and chronic disease, reduce disparities in health and access to care, and improve early childhood development.

We recognize that the best strategies are driven by local data and address the unique challenges and characteristics of individual communities. We know that what works for Camden, N.J., might not fly in Minneapolis or Baltimore.

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Every Child Counts: Stopping Infant Loss

Nov 13, 2014, 3:08 PM, Posted by Sheree Crute

mother with son on her lap

“Matthew was born big and healthy, just under eight pounds,” Carol Jordan says.

That’s why it was such a shock to her to lose him on an otherwise average Sunday afternoon.

“We had just gotten home from church. My daughter Taylor and my other son Jacob settled in with their video games,” Carol recalls. “I breastfed Matthew and lay him down on his back in his bassinet. He was 3 and ½ months old. About 30 minutes later, I went to check on him. He was on his stomach and he was not breathing.”

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Babies are Dying in Rochester at Twice the National Average. Why?

Nov 7, 2014, 11:13 AM, Posted by Maria Hinojosa

America by the Numbers series on Infant Mortality Photo by: Paul de Lumen.

Rochester, N.Y., is the birthplace of Xerox, Bausch & Lomb, and Kodak, and home to two top-ranked research institutions, the University of Rochester and Rochester Institute of Technology. Nevertheless, babies die in this upstate New York city at a rate two times higher than the national average, and Rochester’s children of color are three times more likely than white infants to die before their first birthday. Why?

To come up with some answers, Futuro visited Rochester as part of its America by the Numbers series, made in partnership with Boston public TV station WGBH (check your local PBS and World Channel listings to see the series). We went knowing that the U.S. as a whole ranks 56th in the world for infant mortality, by far the lowest of any industrialized nation, despite the fact that we spend more on health care per capita than any other country, and the largest portion goes towards pregnancy and childbirth. This makes Rochester’s statistics even more tragic—an outlier in an outlier.

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Let’s Talk About Stress

Oct 2, 2014, 9:52 AM, Posted by Michael Painter

Mike Painter Mike Painter speaking at Health 2.0.

I recently returned from the Health 2.0 conference in California, which drew 2,000 health care innovators. One of the most popular Health 2.0 sessions was called “The Unmentionables”—where speakers discussed those important things that affect our health but we are often afraid to address. I participated in this year’s session where we talked stress—what it is and how it’s making us sick.

I’m an avid cyclist. That means I train a lot. Training on a bike means purposefully and intensely stressing your body—sometimes ridiculously hard—in order to make your body stronger, fitter and faster. In that sense stress can be really good. You can’t get stronger without it.

But here’s the key: as you ratchet up that stress—the miles, the hours on the bike, the intensity—you must work just as hard on the flipside, the buffering. The more you train, the more you have to focus on the rest, the sleep, your social supports, the yoga, the nutrition—whatever it takes.

If you don’t buffer you will burn out, get injured or sick, or all of the above. Without buffers, the stress will crush you.

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Stress: Withstanding the Waves

Sep 23, 2014, 11:42 AM, Posted by Ari Kramer

Infographic: stress_section
Infographic: stress_section

Infographic: How Do We Move From a Culture of Stress to a Culture of Health?

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As a kid, when you went to the beach, did you ever play that game where you’d wade into the ocean and test your strength against the waves? You'd stand your ground or get knocked over, and after a few minutes, you'd head back to shore.

We didn’t realize it at the time, but as we felt those waves roll by, we were getting an early glimpse of the stresses of everyday life. The difference is, as adults we can't choose to stand up to just the small ones. And for the most part, going back to shore is not an option.

In a survey RWJF conducted with the Harvard School of Public Health and NPR, about half of the public reported experiencing a major stressful event in the past year. In more than four in 10 instances, people reported events related specifically to health. Many also reported feeling a lot of stress connected with jobs and finances, family situations, and responsibility in general.

Over time, those waves can take their toll. And when they become overwhelming, they can truly wear us down, seriously affecting our both our physical and emotional health.

So how can we deal with these waves of stress? Certainly, there are proactive things we can all do help manage its effect on our lives—exercise, for example. At the same time, we’ve probably all experienced instances when we’d love nothing more than to get up early for a run or brisk walk—but don’t have the energy because stress kept us up at night. Or we may just be too tapped out from long hours, relationship struggles, caring for loved ones, etc., to spare the energy or the time.

If this sounds familiar, consider yourself human. Right next to you, whether at work, on the train, in your grocery store, is probably someone whose waves are similar to or bigger than your own. So at the same time as you try to manage your stress, ask yourself: What could be done to help others achieve a solid footing? In this ocean of ours, there’s never a shortage of opportunity to lend a helping hand.

Have an idea to help move from a culture of stress to a Culture of Health in the home, workplace or community? Please share below—we’d love to hear from you.

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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A Prescription for Solutions that Bridge Health and Health Care

Jun 12, 2014, 1:44 PM, Posted by Risa Lavizzo-Mourey

MOYER_101203_06850_RET A former Health Leads volunteer who has since gone into practicing medicine hands Health Leads volunteer, Brittany Ashe, a Health Leads prescription at the Harriet Lane Clinic in Baltimore, Md.

When Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation, was a physician-in-training at a hospital in a disadvantaged area of Boston, she came to know a woman that she recalls now as "Patient Ruth."

Writing in the professional social networking site LinkedIn, Lavizzo-Mourey remembers Ruth vividly:

"Her feet were swollen, she wore flimsy house shoes, and raw leg ulcers made walking painful. She’d been to the hospital many times before, and we gave her the usual treatment—a few hours in a warm bed, some antibiotics, and a decent meal. The next morning she limped back to the same problems: No home, no job, lousy food, cast-off clothing, no family or friends to come to her aid. We were not equipped to protect her from the harshness of life outside the hospital, a life that was literally killing her."

If health care providers want to improve patients' wellbeing, Lavizzo-Mourey adds, "they must find a way to bridge the worlds in and out of the clinic."

Lavizzo-Mourey points to many splendid examples of projects and programs designed to address the social determinants of patient health—including Boston-based and RWJF-supported Health Leads, which prescribes basic resources for low-income patients—everything from food to job training.

Bridges between health and health care are "spreading across the nation," Lavizzo-Mourey writes, and she invites readers to suggest other examples, "so there will be no more Patient Ruths."

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Two New Mexico Counties: One’s Healthy, One’s Not. Why?

Jun 4, 2014, 10:48 AM, Posted by Barbara Basler

NewMexicoRWJF_0540_RET

The healthiest county in New Mexico—indeed one of the healthiest  counties anywhere in the country—is Los Alamos, ironically the birthplace of the world’s first atomic bomb.

According to the Robert Wood Johnson Foundation’s 2014 County Health Rankings and Roadmaps, Los Alamos, with one of the highest concentrations of PhDs and one of the highest median incomes in the nation, is not only wealthy and wise, but very healthy. In fact, it is a shining example of how education, income, and community—or the lack of—can shape our health, says Julie Willems Van Dijk, deputy director of the Rankings project.

New Mexico is a poor, rural state with a few small pockets of wealth. A 2012 analysis of state income disparities by the Center on Budget and Policy Priorities in Washington found that the gap between New Mexico’s rich and poor is, proportionately the widest in the nation. The County Health Rankings reflect the health consequences of that gap.

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Building a Culture of Health in Every Community

May 28, 2014, 10:19 AM, Posted by Risa Lavizzo-Mourey

DC metro map

Where you live can make a big difference in how long you live.

With an introduction by American Heart Association CEO Nancy Brown, RWJF President and CEO Risa Lavizzo-Mourey, MD, lends strength to that argument in a new entry in The Huffington Post.

Brown notes that people near the Friendship Heights station of Washington, D.C.'s Metro system live seven years longer than residents of the area surrounding the Tenleytown-AU station—just two stops away. Friendship Heights is in Maryland; Tenleytown-AU is in the District of Columbia. (View maps for Washington, D.C., and several other major cities and areas of the country.)

Lavizzo-Mourey picks up on that theme, elaborating on the findings and recommendations of the Foundation's recently issued County Health Rankings.

"Such socio-economic factors may seem like insurmountable obstacles to good health, but I believe we can use the County Health Rankings to help build a Culture of Health in every community," Lavizzo-Mourey writes. A report by the Robert Wood Johnson Foundation Commission to Build a Healthier America, she adds, also offers practical solutions to the problem, with 10 recommendations "for improving factors that lie far outside the clinic's door, such as early childhood education, adequate shelter, access to fresh produce, and the high levels of stress produced by living in poverty."

Read Lavizzo-Mourey's views in the Huffington Post