Now Viewing: Social determinants of health

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

A Healthier Denver

Apr 29, 2014, 8:55 AM, Posted by Shale Wong

Bldg a Healthier Denver Members of the Collective - GlaxoSmithKline

I live in Denver. I work in Denver. And as a pediatrician, I’ve dedicated my life to the health of Denver’s kids. It is remarkable to me how connected our health is to our community. In Denver, we have some of the finest health care in the state, yet more and more of our kids are struggling to maintain a healthy weight. It takes much more than having great hospitals in our community for our kids to live a healthy life.

If we want all our kids to grow up healthy in Denver and throughout the United States, we must recognize all of the elements that affect their well-being. That means ensuring our communities are safe, with strong education and ample access to healthy foods and recreational spaces. And it means addressing poverty whether it is tucked into pockets or widespread in our communities.

This connection between our health and our community was affirmed by the release of the latest County Health Rankings and Roadmaps—an initiative of the University of Wisconsin Population Health Institute and sponsored by the Robert Wood Johnson Foundation. The latest installment showed that those of us who live in the least healthy communities in America are twice as likely to live shorter lives as those who live in healthy communities. And these least healthy communities have twice as many kids living in poverty.

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Why Empathy is Essential to a Culture of Health

Apr 11, 2014, 11:34 AM, Posted by Tara Oakman

Peace activist Zak Ebrahim speaks at TED 2014

Everyone knows it is hard to get 2-year-olds to do anything on a schedule. They want to do everything their way, on their own time. As you can imagine, trying to get my twins out the door each morning—let alone take a bath or eat a meal, can be quite a challenge. After trying a number of different parenting methods, I have discovered that the one way I can usually motivate them is to talk about feelings, and get them to recognize how their actions affect their sibling. Just yesterday, the only way I could get my son out of the bath was by telling him that his sister was sad and lonely waiting for him. And then, and only then, did he move.

Building empathy has been a critical strategy in my household of late—not only because it helps motivate them, but also because it is an important part of their social development. Lately I have been thinking about empathy on a larger scale, beyond my household, and how critical it is to building a Culture of Health.

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Making a Collective Impact in the Lives of Young Men of Color

Apr 2, 2014, 9:15 AM, Posted by Maisha Simmons

Hispanic, Iraqi and African American male students

On a bone-chilling cold day in Chicago last fall, I went on a site visit for a pending grantee. The grantee's office was warm and cozy, tucked away in a neighborhood with a bustling corridor of small businesses that sold a variety of ethnic foods and baked goods. The office walls told the stories of the neighborhood through brightly colored murals depicting loving families and happy children, on a backdrop of a beautiful Chicago landscape.

During this site visit I met a young man named Jose who captivated the room with his story. Jose loved art, even though his school had no art program. Art was the one way that he could express his love, fear, joy and pain. The art poured out of him—on his notebooks and books, and eventually on the walls and fences of his community. Luckily, a relative recognized Jose’s talent and found a community art program where he could learn his craft and express himself on canvases and murals instead of on buildings and public property.

A few months later, Jose was called into his principal’s office and threatened with suspension. Teachers and staff suspected that Jose was to blame for recent vandalism on school property. Shocked and nervous, Jose tried to explain that his art program had given him an outlet and that he no longer drew on desks or walls. But he had no proof and was suspended.

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Bridging Health and Health Care: Confessions of an "Upstreamist"

Mar 20, 2014, 8:40 AM, Posted by Susan Dentzer

The Upstream Doctors

A key aspect of the Robert Wood Johnson Foundation’s new “culture of health” focus is “bridging” the two worlds of population health and health care. One component of that bridge—arguably, its abutment—rests in the nation’s more than 100 academic health centers (AHC’s).

These schools of health and medical professional education, linked with owned or affiliated teaching hospitals and health systems, have long concentrated on the invention and provision of intensive, costly, and high-tech medicine. But now some of these centers are also building bridges upstream—focusing on incomes, housing, transportation, and other social forces that are the primary drivers of health.

Leaders in this movement recently convened at Georgetown University in Washington, D.C., for the third national conference of Academic Health Centers and the Social Determinants of Health.

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We Are All in This Together

Feb 11, 2014, 4:41 PM, Posted by Risa Lavizzo-Mourey

RWJF NEBRASKA

Building a culture of health means recognizing that while Americans’ economic, geographic, or social circumstances may differ, we all aspire to lead the best lives that we can.

For the Foundation, it also means working hand-in-hand with all Americans to inform the dialogue and build demand for health by pursuing new partnerships, create new networks to build momentum, and stand on the shoulders of others striving to make America a healthier nation.

Learn more in our President’s Message
Risa Lavizzo-Mourey, MD, MBA, is president and CEO of the Robert Wood Johnson Foundation

 

 

Investing in Children to Improve the Nation's Health

Jan 27, 2014, 6:28 PM, Posted by Susan Dentzer

RWJF recently convened a panel of distinguished guests for a Google+ Hangout to examine targeted interventions that could help America’s youngest children live healthier, happier, and safer lives. Here's an archived version of the Hangout.

"It is easier to build strong children than to repair broken men," wrote Frederick Douglass, the 19th century African-American social reformer, writer and orator. A century and a half later, to improve the health of Americans, it's essential to start with kids.

That’s a preeminent conclusion of the new report of the RWJF Commission to Build a Healthier America called Time to Act: Investing in the Health of Our Children and Communities. The report focuses on ways to influence the upstream determinants of Americans' generally poor health, including low levels of education and incomes, unsafe environments, and non-nutritious food. Of the panel's three top recommendations, the first is distinctly child-centric: "Invest in the foundations of lifelong physical and mental well-being of our youngest children." Were he alive today, Douglass would surely agree.

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