Category Archives: Health & Society Scholars

Aug 25 2014
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RWJF Milestones, August 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

James S. Jackson, PhD, a 2009 recipient of an RWJF Investigator Award in Health Policy Research, has been appointed by President Obama to serve on the National Science Foundation’s National Science Board. Jackson is a professor at the University of Michigan School of Public Health, and director of its Institute for Social Research.

Geraldine “Polly” Bednash, PhD, RN, FAAN, will receive the National League for Nursing’s (NLN) highest honor, the President’s Award, at the 2014 NLN Education Summit in mid-September. Bednash is the recently retired chief executive officer of the American Association of Colleges of Nursing (AACN) and director of New Careers in Nursing, a joint initiative of RWJF and AACN focused on increasing diversity in the nursing workforce.

Sally Cohen, PhD, RN, FAAN, has been selected as the 2014-2015 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine of the National Academies. The program provides a yearlong leadership opportunity to participate in shaping health policy. Cohen was also named editor-in-chief of the journal, Policy, Politics & Nursing Practice.  She is director of the Nursing and Health Policy Collaborative at the University of New Mexico.

Lainie Ross, MD, PhD, a 2013 recipient of an RWJF Investigator Award in Health Policy Research, has been named a 2014 Guggenheim Fellow. Ross will use her fellowship year to research the relationship between ethics and genetics for a book, currently titled, From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World. The fellowship is awarded by the John Simon Guggenheim Memorial Foundation to recipients with “demonstrated exceptional capacity for productive scholarship or exceptional creative ability in the arts.”

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Aug 18 2014
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Combating Suicide in the Population Most At Risk: Older, White Men

Briana Mezuk, PhD, is an assistant professor at Virginia Commonwealth University Medical Center and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2007-2009). She recently earned the Best Early Investigator Award for the top research study from the American Association for Geriatric Psychiatry. 

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Human Capital Blog: Congratulations on your award! What led to your interest in suicide risk in long-term care facilities?

Briana Mezuk: Older adults, particularly non-Hispanic white men, have the highest risk of suicide. This risk increases exponentially after age 75, and recent data suggest that men in the Baby Boomer generation have a higher suicide risk than previous cohorts. There are many risk factors for this group, including social isolation, feelings of disconnection to society, and lack of social supports and close confidantes. Older men are often unwilling to talk about mental health problems with their physicians; they think they are supposed to ‘grin and bear it.’

HCB: What was the goal of your study?

Mezuk: We were trying to understand the epidemiology of suicide in long-term care facilities, and in nursing homes and assisted-living facilities in particular. Suicide risk in these settings may be higher, or lower, than in the general community. For example, suicide risk may be lower in supervised settings because residents would have less access to a means to self-harm. But suicide risk might be higher because residents often have health problems and, frequently, depressive symptoms that are risk factors for suicide. We used data from the Virginia Violent Death Reporting System to identify suicides that occurred among residents of, and among individuals anticipating moving into, these types of facilities.

HCB: What did you find?

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Aug 14 2014
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RWJF Scholars in the News: Ebola fears, ER closures and mortality, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Bringing two American medical volunteers infected with the Ebola virus back to the United States for treatment triggered some criticism, particularly on social media. But Susan Mitchell Grant, MS, RN, CNAA-BC, who is treating the two patients at Emory Healthcare in Atlanta, writes that the criticism is “unfounded and reflect[s] a lack of knowledge about Ebola and our ability to safely manage and contain it.... We are caring for these patients because it is the right thing to do,” she says in a Washington Post op-ed. “Ebola won’t become a threat to the general public from their presence in our facility.” Grant, an RWJF Executive Nurse Fellows alumna, goes on to explain that “the insight we gain by caring for them will prepare us to better treat emergent diseases that may confront the United States in the future.”

Some hospice providers may not be serving patients in the way the end-of-life care should, according to research covered by the Washington Post. Joan Teno, MD, MS, recipient of an RWJF Investigator Award in Health Policy Research, is lead author of a study that analyzed more than 1 million records of Medicare patients across the country. Her research team found that some hospices, particularly those that are new and for-profit, have discharge rates of 30 percent or higher. That is double the standard discharge rate. Historically, some patients are discharged from hospice because their health unexpectedly improves. But Teno and colleagues say the higher discharge rates suggest two types of improper hospice practices: admitting patients who are not dying; and releasing patients when their care becomes expensive. She suggests that both practices may be driven more by “profit margins than compassionate care.”   

Chronic stress during adolescence can lead to adverse health outcomes later in life, says Keely Muscatell, PhD, an RWJF Health & Society Scholar, in an interview with NPR member station KALW (San Francisco). Based on her study, “How Stress Makes Us Sick,” Muscatell suggests that ongoing psychological stress during childhood triggers physiological inflammation throughout the body and could be a primary link to such conditions as major depression, cardiovascular disease, and rheumatoid arthritis. Muscatell explains that chronic stress can even change patterns of gene expression that lead to poor health later in life.

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Aug 13 2014
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Debt Takes Toll on Health, Study Finds

Elizabeth Sweet, PhD, is a biocultural anthropologist researching economic and racial disparities in health and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2008-2010). She was the lead author of a recent study exploring the impact of financial debt on health. 

Elizabeth Sweet

Human Capital Blog: You have published more than one study that looks at the impact of debt on health. What led to your interest in this topic?

Elizabeth Sweet: My interest is driven by both intellectual and personal reasons. As someone who studies the impact of social inequalities on health, I am interested in personal debt as a dimension of socioeconomic status, a site of racial and economic disparity, and a reflection of broader social, cultural, and political-economic forces. Also, as someone who completed education with a fair amount of debt, I am personally familiar with the profound stress that debt can cause.

HCB: College tuition is rising and more people are defaulting on student loan debt. How does student loan debt affect young people’s mental and physical health?

Sweet: This is such an important question. Our study suggests that financial debt indeed impacts the health and well-being of young people—leading to higher stress and depressive symptoms, worse general health, and higher blood pressure. The specific impact of student loan debt, vs. other kinds of debt, is an open question though; the Add Health data that we used did not have that level of detail regarding the types of debt that respondents had. 

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Aug 7 2014
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RWJF Scholars in the News: The ACA and mental health treatment, HIV training for nurses, the rise of superbugs, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

An Affordable Care Act (ACA) provision that allows parents to keep adult children on their health insurance plans under they reach age 26 has resulted in millions more young people with mental-health and substance-abuse problems getting treatment, according to a study led by Brendan Saloner, PhD. Time reports that over two years, young adults ages 18 to 25 who had screened positive for mental health or substance abuse disorders increased their use of mental-health treatment by 5.3 percent compared to a similar group who were not eligible for their parents’ coverage. Vox and HealthDay were among the outlets to report on the study. Saloner is an RWJF Health & Society Scholar.

Infection Control Today quotes Jason Farley, PhD, MPH, CRNP, on the growing need to train nurses to provide HIV care. An RWJF Nurse Faculty Scholar, Farley developed new HIV curriculum for the John Hopkins School of Nursing, where he is an associate professor. “For many years these specialty training programs in HIV have been available for physicians,” he says. “This is the first time we’re offering them to non-physician providers. It’s quite an important development. When you look at data comparing patient outcomes with physician care and with nurse practitioner care in HIV, whether in the United States or in sub-Saharan Africa, those outcomes are the same.”

Magda Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna, explores the stressors that lead to high numbers of returning National Guard soldiers abusing alcohol, reports Science Codex. Cerda is the lead investigator of the study, which examined 1,095 Ohio National Guard soldiers who served primarily in Iraq or Afghanistan in 2008 and 2009, and found that having just one civilian stressor such as job loss, or legal or financial problems, raised the odds of alcohol use disorders. Medical Daily and Medical Xpress also cover Cerda’s work.

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Jul 31 2014
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RWJF Scholars in the News: Cesarean sections, hospital readmissions, nurse practitioners, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

RWJF Clinical Scholar Chileshe Nkonde-Price, MD, shared her experiences with the medical system  during the last week of her recent pregnancy in a video featured on Nasdaq.com. Despite have given birth via Cesarean section earlier, Nkonde-Price wished to deliver vaginally with this pregnancy if she could do so safely. C-section has become the nation’s most common major surgery, the piece says. It examines some of the factors behind the sharp increase in the number of women delivering via C-section in the United States.

In a Health Affairs Blog, José Pagán, PhD, analyzes Medicare’s Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with excessive 30-day readmissions for conditions such as pneumonia and heart failure. While Pagán says that not all readmissions can be avoided, hospitals can improve their performance through effective discharge planning and care coordination. With more incentive programs on the horizon, Pagán suggests that health care organizations “seek and monitor collaborative partnerships and, more importantly, strategically invest in sustaining these partnerships” so they can survive and thrive. He is an RWJF Health & Society Scholars program alumnus and recipient of an RWJF Investigator Award in Health Policy Research.

A study led by RWJF Nurse Faculty Scholar Lusine Poghosyan, PhD, RN, looks at how Nurse Practitioners (NPs) rate their work environments. It finds that those working in Massachusetts fared better that those working in New York on every topic in the survey: support and resources, relations with physicians, relations with administration, visibility and comprehension of their role, and independence of practice. The survey also found that NPs working in community health clinics and physicians’ offices rated their work experiences better than NPs working in hospital-affiliated clinics. Poghosyan told Science Codex the findings suggest “the practice environment for NPs in New York can improve once the state’s NP Modernization Act,” which will expand NPs’ scope of practice, takes effect.

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Jul 24 2014
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RWJF Scholars in the News: Stereotype threat, hand hygiene, misbehaving science, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Anxiety caused by “stereotype threat” could help explain health disparities that persist across race, suggests research co-authored by Cleopatra Abdou, PhD, an RWJF Health & Society Scholars program alumna. News Medical covers the study, describing it as the first of its kind to empirically test, in the context of health sciences, the impact of the “threat of being judged by or confirming a negative stereotype about a group you belong to.” Abdou’s research offers a possible explanation for ethnic and socioeconomic differences in morbidity and mortality between Black and White women because, as Abdou says, the research goes beyond nature vs. nurture, “bringing situation and identity into the equation.” For example, in the study, Black women with a strong connection to their race had the highest anxiety levels when in waiting rooms filled with posters that displayed negative health-related racial stereotypes dealing with such topics as unplanned pregnancy and AIDS.

Having health insurance improves access to medical care for pregnant, low-income women, and results in long-term health benefits for their babies, according to a study by RWJF Scholar in Health Policy Research Sarah Miller, PhD, and RWJF Health & Society Scholar Laura Wherry, PhD, that was reported by Vox. Miller and Wherry found the expansion of Medicaid in the 1980s made prenatal care much more accessible to low-income women, many of whom would otherwise have been without insurance. The result was improvements in obesity, preventable hospitalizations, and preventable, chronic disease-related hospitalizations among children. 

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Jul 18 2014
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Building a Culture of Health at AcademyHealth Annual Research Meeting

RWJF Leadership Reception at the AcademyHealth RWJF Leadership Reception at the AcademyHealth annual meeting in San Diego in June 2014

At this year’s AcademyHealth Annual Research Meeting, held in San Diego, California June 8–10, the Robert Wood Johnson Foundation (RWJF) hosted “Building a Culture of Health: An RWJF Leadership Reception.” More than 100 RWJF scholars, fellows, and alumni representing 14 RWJF Human Capital programs joined with colleagues and friends of the Foundation for the gathering at the Hilton San Diego Bayfront. There, health providers, clinicians, researchers, and graduate students made and renewed the important professional connections that RWJF facilitates.

Among those attending the reception were RWJF Health & Society Scholars alumnus and RWJF Clinical Scholars Associate Program Director (University of Pennsylvania program site) David Grande, MA, MPA, who presented his paper, “How Do Health Policy Researchers Perceive and Use Social Media to Disseminate Science to Policymakers?,” at the meeting; RWJF Nurse Faculty Scholars Lusine Poghosyan, PhD, MPH, RN, and J. Margo Brooks Carthon, PhD, APRN, who chaired and served as a panelist, respectively, at a health care workforce session; and Clinical Scholars Tammy Chang, MD, MPH, MS, and Katherine A. Auger, MD, M.Sc., who were both chosen as recipients of the AcademyHealth Presidential Scholarship for New Health Services Researchers. This scholarship provides financial support to attend the meeting, and recognizes early-career researchers who demonstrate leadership ability and potential to contribute to the field of health services research.

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Jul 17 2014
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RWJF Scholars in the News: Gun violence, suicide, ‘structural’ versus ‘cultural’ competency, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

An NPR story quotes RWJF Health & Society Scholars program alumnus Andrew Papachristos, PhD, citing his extensive research on gun violence. Papachristos criticizes the lack of context in media coverage of violence, noting that incidents such as the series of shootings over the Fourth of July weekend in Chicago tend to be treated simply as a long stretch of violent incidents. “Treating Chicagoland violence as merely a tally necessarily dehumanizes its victims, but it also obscures so much of the larger story about that violence. It's data without context.” Not only is the murder rate steadily declining in Chicago, but there is a massive disparity in victims of these crimes: “Eighty-five percent of violence—any shootings—happens among 5 percent of people,” Papachristos says.

In an article about libertarianism and state laws related to guns and other topics, the Economist cites a study about the social costs of gun ownership by RWJF Investigator Award in Health Policy Research recipients Philip Cook, PhD, and Jens Ludwig, PhD. It finds that “more guns empirically lead to more gun-related violence, largely because legally purchased guns somehow end up in the hands of criminals via theft,” gun shows, and online sales, which are largely unregulated. To address these issues, Cook and Ludwig suggest making it costlier to buy guns in high-crime areas, and improving the records used to screen gun buyers by including more information on possible mental-health problems, among other proposals. (Free registration required to view article.)

A study co-authored by RWJF Health & Society Scholars program alumnus Alexander Tsai, PhD, MD, finds that men who are more socially connected are half as likely to commit suicide as men considered loners, NBC News reports. The study looks at data on nearly 35,000 men, ages 40 to 75, and finds that those who are more isolated are at greater risk, even if they are not mentally ill. “Public health practitioners think about things like cardiovascular disease as warranting public health attention,” says Tsai, suggesting that suicide may also need attention.

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Jul 15 2014
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The Impact of Seasonal Birth-Rate Fluctuations on Measles, Other Vaccine-Preventable Diseases

Audrey Dorélien, PhD, is a 2012-2014 Robert Wood Johnson Foundation (RWJF) Health & Society Scholar studying demography, infectious diseases, and maternal and child health.

Audrey Dorélien

Reoccurring outbreaks of measles and other vaccine-preventable diseases are a major killer of children, particularly in sub-Saharan Africa. In 2012, more than 226,000 cases of measles were reported worldwide, with a little less than half of those in Africa.[1] For the World Health Organization to meet its global measles eradication goal and implement more effective supplemental vaccination programs, public health officials will need a better understanding of the mechanism driving seasonal and episodic outbreaks.

Infectious disease ecologists have demonstrated the importance of human demography, and in particular the influence of the birth rate on the dynamics of acute childhood immunizing (ACI) diseases. For instance in London, in the few years prior to 1950, the city experienced annual measles epidemics, but the dynamics changed to biennial epidemics as a result of a decline in the birth rate between 1950 and 1968.[2] How can the birth rate influence disease outbreaks? An outbreak can only occur when the fraction of the susceptible population exceeds a critical threshold. In the case of ACI disease, the majority of the susceptible population are young children; therefore the birth rate influences the rate at which the pool of susceptibles is replenished.

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