Mar 3, 2015, 9:52 AM, Posted by
Q&A with Robert Blendon, Harvard T.H. Chan School of Public Health
This week a public opinion poll was released by NPR, the Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health asking people to list the factors most likely to cause ill health in adults. The top five included lack of access to high-quality medical care (42%), and viruses or bacteria (40%)—not a surprise—but also such socio-economic factors as personal behavior (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%). And a majority (54%) said that being abused or neglected in childhood is an extremely important risk factor for ill health later in life.
Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health, led the poll and recently talked to RWJF Media Director Catherine Arnst about some of the key results. (Both questions and answers were edited for clarity)
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Jan 28, 2015, 3:00 PM, Posted by
Every few weeks, Dana Todd, MD, does something rare for an American physician: She makes a house call. The visits are her way of making life easier for a bedridden stroke survivor and her caregiver daughter.
“One afternoon, I looked out into the clinic waiting room and there they were,” Todd recalls. “My patient was laying on a stretcher. Her daughter was by her side. Her family was adamantly against putting her in a nursing home because she is only in her 50s, so coming in was the only way she could get care. I just hated seeing her that way so I said, ‘Next time, I’ll come to you.’”
Todd is one of four primary care physicians who, along with a small group of nurse practitioners, provide care for residents of Greensboro, Ala., population 2,440, in rural Hale County. The little town, though, is a lot more to Todd than a place to work.
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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
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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.
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Jan 15, 2015, 12:00 PM, Posted by
Amani M. Nuru-Jeter
Amani M. Nuru-Jeter, PhD, is an associate professor of community health and human development, and epidemiology at the University of California, Berkeley School of Public Health, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. Her research focuses on racial health disparities.
Eric Garner’s death and the failure to indict NYPD Officer Daniel Pantaleo have had a profound effect on communities throughout the United States. But it’s not just Eric Garner. This, and similar cases including Michael Brown, Tamir Rice, Trayvon Martin, and Oscar Grant, have put race relations front and center in the national debate.
I’m tired of it, this stops today...every time you see me you want to harass me, you want to stop me...please just leave me alone” –Eric Garner
These last words from Eric Garner are not that different from what we hear in our work with African American women in the San Francisco Bay area:
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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.
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Dec 12, 2014, 9:00 AM, Posted by
Lainie Ross, MD, PhD, is a 2013 recipient of the Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and a 2014 Guggenheim Fellow. During her fellowship year, she will work on a book tentatively titled, From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World.
Human Capital Blog: What are some of the incidental findings and unintended consequences you will discuss in your book?
Lainie Ross: First, let me explain what I mean by “incidental findings.” Incidental findings refer to unanticipated information discovered in the course of medical care or research that may or may not have clinical significance. They are not unique to genetics. In some studies, up to one in four diagnostic imaging tests have incidental findings, although most do not have immediate clinical consequences.
One example of an incidental finding that I discuss in the book involves incidental findings uncovered while screening candidates for research participation. This can range from discovering high blood pressure (known as the “silent killer”) to extra sex chromosomes in people who volunteer as “healthy controls.” This raises the question of what is a clinically significant or “actionable” finding, and what information should be returned to the research participant. These types of questions are critical, especially because many research consent forms have historically stated that “no results will be returned.”
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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.
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