Archive for: March 2014

County Health Rankings: Five Key Elements of The Picture of Health

Mar 28, 2014, 10:16 AM, Posted by Susan Dentzer

Behind the County Health Rankings: What makes a county healthy or unhealthy?
Skip Rope

Paint a portrait of a healthy county, and you’d show the features that contribute to good health: high incomes and levels of education; access to health care; plentiful healthy food, and ample places to exercise.   

Paint a portrait of an unhealthy county, and the palette becomes darker: higher rates of joblessness; more children in poverty; high rates of smoking, obesity and physical inactivity; and more people living in sub-par housing that they may struggle to afford. 

Those, in fact, are the real portraits emerging from the 2014 County Health Rankings, newly released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

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Partnering with Business to Create a Healthier Future

Mar 27, 2014, 6:10 PM, Posted by John Lumpkin

Joh Lumpkin at Partnership for a Healthier America

“I want you to join together with the band.”
—Join Together, The Who

I’ve been thinking about this lyric after attending an important health conference in Washington, D.C., earlier this month, focused on strategies and collaborations that can reverse the childhood obesity epidemic in the U.S. The attendees weren’t just your usual health conference suspects—researchers, medical professionals, public health officers, etc. The Building a Healthier Future summit, convened by the Partnership for a Healthier America (PHA), also offered leaders from the nonprofit, academic, and public sectors the all-too-rare opportunity to swap ideas and strategies with corporate executives.

Now that’s a band.

If you’re thinking that a healthier future and the likes of Pepsico and Del Monte Foods have nothing in common, it is time to revise your thinking. PHA was formed in 2010, at the same time as Michelle Obama’s Let’s Move initiative, to work with the private sector to develop strategies for addressing childhood obesity (RWJF was one of the founding partners).

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Big East Leads Going into March Madness

Mar 26, 2014, 8:57 AM, Posted by Katherine Hempstead

Because every state has approached health reform differently, the Affordable Care Act (ACA) provides us with a unique opportunity to observe federalism in action. We now have 51 unique environments in which to assess the implementation of health reform.

Given the magnitude of the policy intervention, this variation provokes great interest in understanding the state’s role in health reform, and in disentangling policy and governance factors from other state characteristics.

A new report from the University of Pennsylvania’s Leonard Davis Institute looks at Marketplace enrollment and state exchange characteristics, and shows that states that created their own exchange have enrolled a higher percent of their eligible population in Marketplace plans than states that had the federal government partly or completely manage their exchange.

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The World’s Biggest Expert In Me

Mar 24, 2014, 2:03 PM, Posted by Anne Weiss

Flip the Clinic Graphic for Advances

I've worked at the Robert Wood Johnson Foundation for almost 15 years, and it’s still thrilling (and a little intimidating), working with some of the world's leading experts, thinkers, and innovators, not to mention colleagues who are brilliant, passionate, and kind. While I’ve never admitted this before, as a long-time fan of television medical dramas the people from clinical backgrounds, the “white coats,” especially fascinate me. The doctors, nurses and other health professionals I work with seem part of some mysterious club, survivors of years of arduous training who have the ability to improve peoples' lives in a way I simply can't.

But it turns out that I am an expert, something I learned from a new Robert Wood Johnson Foundation initiative called Flip the Clinic. Flip the Clinic aims, quite simply, to help patients and their doctors (or other providers) get more out of the medical encounter: that all-too-short office visit that leaves both parties wishing for more time, more information, more of a relationship. You can learn more about the history of Flip the Clinic, including its intriguing name, here.

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A Culture of Health Vision at TED 2014

Mar 20, 2014, 6:00 PM, Posted by Culture of Health Blog Team

TED 2014 culture of health building blocks Leigh Rowan adds his culture of health building block at TED 2014. Photo by Bret Hartman.

This week we’re thrilled to bring the conversation about a culture of health to TED, the annual conference dedicated to spreading innovative ideas from all sectors of society. At RWJF we believe that our health involves far more than health care; it also extends to how we work, how we live, our families and our communities. We are passionate about collaborating with others to cultivate a culture of health, where being healthy and staying healthy is valued by our entire society. (Read more about RWJF’s vision for a culture of health.)

To that end, we are bringing our vision to TED. RWJF staffers led a master class at TED earlier in the week about designing and building a culture of health, and we are hosting the RWJF Café, where an interactive display invites people to answer the question, “What does a culture of health mean to you?” We’ve been sharing highlights on Twitter using the #cultureofhealth hashtag, and would love for you to join the conversation, either on Twitter or in the comments on this post.

Here are some of the responses we’ve gotten at TED so far:

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Head Start Program Uses Brain Science to Help Kids Heal

Mar 20, 2014, 3:40 PM, Posted by Jane Isaacs Lowe

In the late 1990s, a major study of adverse childhood experiences by Kaiser Permanente in California found that people who had been exposed to traumatic events such as violence or abuse during childhood were much more likely to have serious health problems as adults. Over the next decade, advances in neuroscience explained how childhood trauma can harm brain development and change the way kids feel and act in response to even normal events in their lives.

So, what to do? How do you protect or heal vulnerable children? An article on an innovative pre-school program in the Fixes column of yesterday's New York Times is an example of some solutions that are starting to emerge.

In 2010, the Robert Wood Johnson Foundation (RWJF) partnered with local funders and Crittenton Children's Center in Kansas City, Mo. to pilot a new kind of Head Start program that would provide caring support to pre-schoolers exposed to traumatic events—homelessness, abuse, the loss of a parent, for example. The idea was to create a web of support among all of the adults who would interact with kids throughout their day, including parents, teachers, administrators, even the school bus driver. The school would also give kids specific tools to help them deal with their emotions in a healthy way and build resilience.

Head Start Trauma Smart wanted to ensure that the children would master the skills they need by the time they start kindergarten, because kids who are already falling behind in kindergarten have a much harder time succeeding in school and living a healthy life. The results of the pilot were so promising that in 2013 RWJF gave Crittenton Children's Center a $2.3 million grant to expand the Head Start Trauma Smart model throughout the state of Missouri. 

Watch a new video documenting how Head Start Trauma Smart works. Hear some of the stories of kids who have been exposed to traumatic events that are almost unimaginable and of the caring adults who are helping them heal. 

The parents and school staff are trailblazers, doing inspired and inspiring work to help bring out the best in each and every child. And while there is nothing that they are doing in Missouri’s Head Start programs that couldn’t be done in every community, it’s not easy to get systems of care to adopt this kind of change.

New York Times columnist David Bornstein explains why this program is so significant. “Trauma interventions can be highly effective but the challenge today is extending them from therapeutic settings—which are limited and expensive—into the broad systems that serve larger numbers of children.”

Here at RWJF we think a lot about what it takes to build a culture of health in America. There are few better examples than the Head Start Trauma Smart pre-school, where every child has the chance to thrive, and every adult who crosses their path has an opportunity to be a positive influence. And where great ideas that improve health spread to more communities where they can help more families in need.

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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If Patients Are Flipped Out by Today's Physician Encounters, Why Not "Flip" The Clinic?

Mar 3, 2014, 5:34 PM, Posted by Susan Dentzer

“I am stressed.”

“I am feeling pressured.”

“I have been through all this before.”

“Why is it taking so long?”

If you’ve ever had any of these feelings while biding your time in a doctor’s office, you’re not alone.  There are a myriad ways in which the classic physician visit can often be sub-optimal: Spending a long time in a waiting room before a too-short doctor’s visit; barely understanding or absorbing what the physician says before he or she rushes off to see the next patient.

The experience could try the patience of the most self-confident of patients—and positively overwhelm the more nervous among us.  Small wonder that some patients experience “white coat syndrome,” or elevated blood pressure during a clinical encounter.  It’s believed to be brought on by some combination of apprehension about a potential disease or diagnosis, or even intimidation at the sight of the doctor in a white coat.

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