Jan 30, 2015, 5:47 PM, Posted by
“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.
And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.
One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.
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Jan 29, 2015, 9:54 AM, Posted by
Maryjoan Ladden, Susan Mende
Ever since President Obama announced the restoration of diplomatic ties between the United States and Cuba, there’s been growing excitement over the potential for new opportunities for tourism, as well as technology and business exchanges. Most people assume that the flow will be one-sided, with the United States providing expertise and investment to help Cuba’s struggling economy and decaying infrastructure.
That assumption would be wrong. America can—and already has—learned a lot from Cuba. At RWJF, we support MEDICC, an organization that strives to use lessons gleaned from Cuba’s health care system to improve outcomes in four medically underserved communities in the United States—South Los Angeles; Oakland, Calif.; Albuquerque, N.M.; and the Bronx, N.Y. Even with very limited resources, Cuba has universal medical and dental care and provides preventive strategies and primary care at the neighborhood level, resulting in enviable health outcomes. Cuba has a low infant mortality rate and the lowest HIV rate in the Americas, for example—with a fraction of the budget spent in the United States.
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Dec 22, 2014, 5:08 PM, Posted by
In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.
The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.
On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.
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Dec 2, 2014, 11:00 AM, Posted by
Rosa Gonzalez-Guarda, Rosa M. Gonzalez-Guarda
Rosa M. Gonzalez-Guarda, PhD, RN, CPH, FAAN, is an assistant professor at the University of Miami, School of Nursing & Health Studies and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. On Friday, December 5, she will be a panelist at the RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.
My research has focused on understanding and addressing behavioral and mental health disparities experienced by Hispanic/Latino communities. Although I initiated my research looking at substance abuse, violence, HIV and mental health as separate conditions that often co-occurred in marginalized communities, I soon realized that these conditions were just symptoms of an underlying phenomena— something my colleagues and I refer to as the Syndemic factor.
We have been studying the social determinants of the Syndemic factor in hopes of developing culturally tailored interventions that can potentially address multiple behavioral and mental health outcomes for the Hispanic/Latino community. From this research we have learned that interventions that address stress and family support offer promise for this community.
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Nov 26, 2014, 8:59 AM, Posted by
Here at the Robert Wood Johnson Foundation, the name of the game is collaboration. Our goal—to build a Culture of Health in which getting and staying healthy is a fundamental societal priority—is an ambitious one, requiring coordinated efforts among everyone in a community, from local businesses to schools to hospitals and government. It also calls for those of us at the Foundation to collaborate with other like-minded groups to address the complex challenges that stand in the way of better health.
That is why we are so pleased to be a partner in the BUILD Health Challenge, a $7.5 million program designed to increase the number and effectiveness of community collaborations to improve health.
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Nov 21, 2014, 1:00 PM, Posted by
Jennifer Schroeder, Stephanie M. DeLong, Shannon Heintz, Maya Nadimpalli, Jennifer Yourkavitch, and Allison Aiello, PhD, MS, professor at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This blog was developed under the guidance of Aiello’s social epidemiology seminar course.
Ebola is an infectious disease that the world has seen before in more moderate outbreaks in Africa. As the devastating Ebola outbreak in West Africa has taken a global turn, fear, misinformation and long-standing stigma and discrimination have acted as major contributors to the epidemic and response. Stigma is a mark upon someone, whether visible or invisible, that society judgmentally acts upon. Ebola has become a significant source of stigma among West Africans and the Western world.
In many ways, the source of this discrimination can be traced back to the legacy of colonialism and the western approach to infectious disease response in Africa. The history of foreign humanitarian aid has sometimes dismissed cultural traditions and beliefs. As a consequence, trust in westerners has eroded and has been compounded by a disconnect between western humanitarian aid approaches and a lack of overall infrastructure investment on the part of African national health systems. This is apparent in the Ebola epidemic in West Africa. Some don’t actually think that Ebola exists; instead they believe that it is a hoax carried out by the Western world. All of these factors are facilitating the rapid spread of the disease.
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Nov 17, 2014, 11:00 AM, Posted by
Meredith Barrett, PhD, is vice president of science and research at Propeller Health, a health technology company working to reduce the burden of asthma and chronic obstructive pulmonary disease (COPD). She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of California (UC), Berkeley and UC, San Francisco. Learn about the RWJF Briefings @ the Booth at the APHA Annual Meeting on Monday, November 17 and Tuesday, November 18.
Leaders in Louisville, Kentucky, know first-hand that where you live and work affects your health and well-being. During a special session at the American Public Health Association’s meeting this week in New Orleans, we explore how the air quality in Louisville neighborhoods impacts the health, economy and overall vibrancy of the community. And we’ll highlight how Louisville is the poster child for tackling tough issues like asthma head-on, top-down and bottom-up, through data and collaboration among individual residents, corporate execs, community organizers and public leaders.
Asthma attacks are sneaky, expensive and debilitating, yet almost entirely preventable.
Asthma is one of the most common and costly chronic diseases in the United States, affecting more than 8 percent of the U.S. population. Despite decades of research and the development of effective treatments, rates of morbidity have not declined and health care costs reach more than $50 billion a year. Asthma also leads to more than 13 million missed days of school and 10 million missed days of work, negatively affecting educational achievement, employee productivity and regional business growth. But the most frustrating part is that a large proportion of these hefty impacts could be avoided with improvements in self-management, community policy and advances in digital health care.
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Nov 12, 2014, 1:00 PM, Posted by
Mitesh S. Patel, MD, MBA, MS, is an assistant professor of medicine and health care management at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania. He is a staff physician and core investigator at the Center for Health Equity Research and Promotion at the Philadelphia Veterans Administration (VA) Medical Center. Patel is an alumnus of the VA/Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program at the University of Pennsylvania (2012-2014).
Cardiovascular disease is the number one cause of hospitalizations, morbidity and mortality among the veteran population. Building a Culture of Health could address this issue by focusing on individual health behaviors that contribute to risk factors associated with cardiovascular disease such as physical inactivity, diet, obesity, smoking, hyperlipidemia and hypertension.
The current health system is reactive and visit-based. However, veterans spend most of their lives outside of the doctor’s office. They make everyday choices that affect their health such as how often to exercise, what types of food to eat, and whether or not to take their medications.
Connected health is a model for using technology to coordinate care and monitor outcomes remotely. By leveraging connected health approaches, care providers have the opportunity to improve the health of veterans at broader scale and within the setting in which veterans spend most of their time (outside of the health care system). The Veteran’s Health Administration (VHA) is a leader in launching connected health technologies. VHA efforts began in 2003 and included technologies such as My HealtheVet (serving approximately 2 million veterans) and telemedicine (serving about 600,000 veterans).
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