Category Archives: Health & Society Scholars

Nov 21 2014
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Ebola as an Instrument of Discrimination

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.

Allison Aiello Allison Aiello

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
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Is Louisville, Kentucky, the New Face of Asthma Healthography?

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.

Meredith Barrett

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. 

American Public Health Association Meeting & Expo

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 13 2014
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RWJF Scholars in the News: EpiPens in schools, suicide prevention, financial incentives for wellness, 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:

A study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH, shows that keeping supplies of epinephrine, commonly known as EpiPens, in schools saves lives, Health Day reports. Epinephrine injections are given in response to life-threatening allergic reactions to food or to insect stings. Gupta’s study found that epinephrine was administered to 35 children and three adults in Chicago public schools during the 2012-13 school year. “We were surprised to see that of those who received the epinephrine, more than half of the reactions were first-time incidents,” Gupta said. “Many children are trying foods for the first time at school, and therefore it is critical that schools are prepared for a possible anaphylactic reaction.”  Forty-one states have laws recommending schools stock epinephrine, according to the article.

Matt Wray, PhD, MA, an RWJF Health & Society Scholars program alumnus, writes in Medical Xpress that when it comes to preventing suicides, it’s important to focus some attention on how a person seeks to end his or her life. According to the article, suicide-prevention research has shown that when people who have begun to act on suicidal impulses find that access to their chosen method is blocked, many do not seek out other means. “Most people don’t have a backup plan,” Wray writes. “So when their initial attempt is stalled, the destructive impulse often passes. Moreover, contrary to what many believe, people who attempt suicide more than once are rare. Less than 10 percent of those who survive an attempt ever end up dying by suicide.”

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Nov 10 2014
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To Honor Our Returning Veterans, We Must Address Their Family Needs

Tova Walsh, PhD, MSW, is a Robert Wood Johnson Foundation (RWJF) Health & Society Scholar at the University of Wisconsin in Madison. Her research focuses on the role expectant and new fathers play in the health and well-being of their partners and children, and the influence of parenthood on men's health and well-being. Walsh has used interview, focus group and survey data to examine the experiences of service members returning to family life after deployment.

Tova Walsh (Veterans Day)

On Veterans Day, we honor the service and sacrifice of U.S. military veterans.  Recognizing that it is not just the individual who serves our country, but his or her entire family, we honor, too, our military families, whose support is essential for our servicemen and women to carry out their duties.

When a service member deploys, partners, children and other family members re-organize their lives to accommodate the physical absence of a loved one. They live each day bearing the burden of separation. When their deployed loved one returns home, they share not only in the joy of long-awaited reunion, but also in the joy and challenges of the extended process of the veteran’s reintegration to home, family and community. The youngest members of our military families are least able to understand or express the impact of these experiences, and yet are deeply affected by these transitions and the accompanying shifts in emotions on the part of the adults who they depend upon for care, love and security.

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Nov 7 2014
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Will Menu Calorie Counts Help Whittle America’s Waistline?

By Sheree Crute

Maricelle Ramirez is a foot soldier in America’s battle against obesity. For three years, Ramirez has politely offered Boston area patrons of McDonald’s, Kentucky Fried Chicken, Burger King, Dunkin’ Donuts, Wendy’s and Subway a $2 gift card in exchange for their estimates of the amount of calories in their fast-food feasts.

“I’ve met all types of people,” Ramirez says, recalling the surprise of encountering a nutritionist who was on her way out of McDonald’s after chowing down on a burger and fries. “She explained that she was just enjoying a meal because she had a craving for something indulgent, but she provided a very careful nutritional analysis of what she was eating.”

At the other end of the spectrum was an older woman leaving Kentucky Fried Chicken with a drumsticks-to-mashed potatoes spread for her family who confessed, “I don’t know much about the calorie content of the food, but it would really make a difference for me and my family if I had more information.”

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Nov 4 2014
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In New Book, RWJF Scholar Explores Effects of Genetics on Environmental Science

Sara Shostak, PhD, MPH, is an associate professor of sociology at Brandeis University and author of Exposed Science: Genes, the Environment, and the Politics of Population Health. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2004-2006). 

Sara Shostak Sara Shostak, PhD, MPH

Human Capital Blog: Your book, Exposed Science, won two awards from the American Sociological Association: the Eliot Freidson Outstanding Publication Award from the Medical Sociology Section and the Robert K. Merton Book Award from the section on Science, Knowledge, and Technology (SKAT). Congratulations! What do these awards mean for you and your work?

Sara Shostak: Thank you! I am deeply honored that Exposed Science won those awards. This kind of recognition from one’s colleagues is tremendously meaningful on a personal level, especially as there are many scholars in these sections whose work has inspired me for years.  

More broadly, the dual awards signal something important about the connection between these two domains of inquiry—medical sociology and the sociology of science. That is, science and the politics of science are important foci of analysis for sociologists concerned with population health. The conditions under which scientists do their research—the political economy of knowledge production—is a critical context for what we do and do not know about human health and illness.  

Population health researchers often observe that in the United States, health disparities research tends to focus on differences between racial and ethnic groups, while in the United Kingdom the focus tends to be on variations by social class (or what U.S. researchers more often call socioeconomic status). Scholars of science, knowledge, and technology can help us understand how and why these differences emerged, and with what consequences. My book raises questions also about how any of these determinants get operationalized in laboratory-based research. All of these aspects of how science is done have direct implications for public policy, as well.

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Oct 31 2014
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RWJF Milestones, October 2014

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

Linda Aiken, PhD, FAAN, FRCN, RN, has won the Institute of Medicine’s Leinhard Award in recognition of her “rigorous research demonstrating the importance of nursing care and work environments in achieving safe, effective, patient-centered, and affordable health care.” The director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, Aiken serves on the National Advisory Committee of the RWJF Interdisciplinary Nursing Quality Research Initiative and is a research manager for the Future of Nursing National Research Agenda.

A number of RWJF Scholars and Fellows were recently elected to membership in the Institute of Medicine:

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Oct 30 2014
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RWJF Scholars in the News: Scapegoating EHRs, Ebola fears, children fighting cancer, 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:

In an article published in Healthcare IT News, David Blumenthal, MD, MPP, writes that health care providers may be too quick to blame Electronic Health Records (EHR) for medical errors. Blumenthal notes that EHRs are still imperfect and that improvements will take time, but argues: “There is no going back in the electronic health information revolution. No physician or hospital, however loud their complaints, has ever thrown out their EHR and returned to paper. The dissatisfaction with the technology will recede as EHRs improve, and as a new generation of young clinicians, raised in the electronic world, populates our health care system.”  Blumenthal is president of The Commonwealth Fund, former National Coordinator for Health Information Technology, and an RWJF Investigator Award in Health Policy Research recipient.

In a blog published by the Washington Post’s “Monkey Cage,” Shana Gadarian, PhD, and her co-author write that Ebola anxiety, while potentially misplaced and harmful, is likely to have an impact on whom Americans trust to handle the disease and what kinds of policies they will support to fight it. The authors have studies society’s reactions to small pox and H1N1 flu. “In general we find that anxiety makes people more supportive of government playing an expansive role in protecting them during a health crisis ... we think our study and the current Ebola outbreak both emphasize that people will rally around experts and increase their support for policies that fight the contagion, even if they hurt civil liberties. Let us hope that the U.S. health system is ultimately worthy of the confidence the public has in it.” Gadarian is an RWJF Scholars in Health Policy Research alumna.

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Oct 23 2014
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RWJF Scholars in the News: CPR for Ebola patients, freezing women’s eggs, the inevitability of failure, 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:

The New York Times reports on remarks by medical ethicist Joseph J. Fins, MD, in which he calls for clearer guidance on whether clinicians should administer cardiopulmonary resuscitation (CPR) to Ebola patients whose hearts stop beating. In a commentary published on the Hastings Center Report website, and cited by the Times, Fins argues against administering CPR because of the danger of transmission of the virus to clinicians, the slim likelihood that Ebola patients will recover, and other clinical factors. Fins, an RWJF  Investigator Award in Health Policy Research recipient, urges a dialogue on the question leading to clear guidelines from hospitals and government officials.

In an article for CNN, Rene Almeling, PhD, and co-authors say that while Apple and Facebook made headlines last week for offering to cover costs for their female employees to freeze their eggs, people should be suspicious of egg-freezing as a “solution.” The technology carries risk and has high rates of failure, they write. “But even if the technology were perfect, the proposal to help women put motherhood on ice so they can focus on their jobs is shortsighted,” they add. “[R]ather than making fundamental changes to the structure of work in our society to accommodate women’s reproductive years, technological optimists reach for an engineering solution. ... Instead, the goal should be to build systems of production that allow us to live our lives without constantly watching the clock.” Almeling is an RWJF Scholars in Health Policy Research alumna.

The consumption of sugar-sweetened soda might be promoting disease independent of its role in obesity, according to a study co-authored by RWJF Health & Society Scholars program alumni Belinda Needham, PhD, MA, and David Rehkopf, ScD, MPH. The study shows that telomeres—the protective units of DNA that cap the ends of chromosomes in cells—were shorter in the white blood cells of survey participants who reported drinking more soda, Science Blog reports. Shorter telomeres have been linked to a number of chronic diseases, including heart disease, diabetes and some types of cancer.

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Oct 16 2014
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RWJF Scholars in the News: Ebola safeguards, pay-for-performance, brain development 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:

PBS NewsHour interviews Howard Markel, MD, PhD, FAAP, on whether hospitals, doctors and nurses are sufficiently prepared to handle Ebola cases in the United States, and what measures should be taken to increase safety. “As someone who studies epidemics, there’s always lots of fear, scapegoating and blame,” Markel, an RWJF Investigator Award in Health Policy Research recipient, said. “American tolerance for anything less than perfection has only shortened. The incredible thing to focus on is that so little has happened, so few cases have spread here.” The video is available here and an accompanying article is available here. Markel is also quoted in an Ebola story in the New Republic and wrote a blog for the Huffington Post.

In an article for Forbes magazine, RWJF Investigator Award in Health Policy Research recipient Peter Ubel, MD, discusses whether pay-for-performance health care models can lead to overdiagnosis and overuse of antibiotics. He cites recent journal articles suggesting that sepsis may be over diagnosed in hospitals because the institutions receive higher reimbursements for sepsis patients than for those with milder infections. “In other words, it pays not to miss sepsis diagnoses,” Ubel writes. “Because of the inherent subjectivity of medical diagnoses, those groups that assess health care quality need to remain on the alert for the unintended consequences of their measures. And those insurers and regulators eager to establish clinical care mandates? They need to slow down and make sure their administrative fixes do not create undue side effects.” Ubel also wrote a separate Forbes article on health insurance turnover.

Recent research on children who began life in overcrowded Romanian orphanages shows that early childhood neglect is associated with changes in brain structure, Science Times reports. A study co-authored by RWJF Health & Society Scholars program alumna Margaret Sheridan, PhD, finds that children who spent their early years in Romanian orphanages have thinner brain tissue in cortical areas that correspond to impulse control and attention, providing support for a link between the early environment and Attention Deficit Hyperactivity Disorder (ADHD). Researchers compared brain scans from 58 children who spent at least some time in institutions with scans of 22 non-institutionalized children from nearby communities, all between the ages of 8 and 10. The article notes that the study is among the first to document how social deprivation in early life affects the thickness of the cortex.

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