Category Archives: Healthy Food Access

Aug 28 2014
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RWJF Scholars in the News: Medical marijuana’s unanticipated benefits, infant sleep pods, 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:

States that have legalized medical marijuana have seen nearly 25 percent fewer deaths from overdoses involving prescription painkillers than states that have not, according to a study led by Marcus Bachhuber, MD. ABC News reports on it, noting that 23 states and the District of Columbia have such laws. Researchers found that while opioid overdose rates continued to climb, the increase was much slower in states with medical marijuana laws, resulting in 25 percent fewer deaths from opioid overdose. “This study raises the possibility that there is an unintended public health benefit of medical marijuana laws, but we still need to collect more information to confirm or refute what we’ve found,” says Bachhuber, an RWJF/Veterans Administration Clinical Scholar at the Philadelphia Veterans Affairs Medical Center. Outlets covering Bachhuber’s study include CNN, Washington Post, Business Insider, Health Day and Vox.

An infant “sleep pod” designed by Jennifer Doering, PhD, RN, is one of 11 projects funded through new grants from the University of Wisconsin Extension and the Wisconsin Economic Development Corporation, the Milwaukee Journal Sentinel reports. The $25,000 Ideadvance grants are intended to move good ideas more quickly to the marketplace. Doering’s I-SleepPod, developed as a result of her work in the RWJF Nurse Faculty Scholars program, would allow an infant to sleep next to an adult while remaining safe, thanks in part to an alarm that wakes the adult in the event of an unsafe sleeping position. “We designed the sleep pod to minimize hazards because, if we don’t move in that direction of reducing sleep-related infant deaths, then [society] is essentially saying it’s acceptable to have 600 babies die every year that way,” Doering said.

Nutrition rating systems in supermarkets may encourage shoppers to purchase less junk food, according to a study led by John Cawley, PhD, an RWJF Scholars in Health Policy Research alumnus and Investigator Award in Health Policy Research recipient. The study coupled sales data from Hannaford Supermarkets in the northeastern United States from January 2005 to December 2007 with the Guiding Stars nutritional rating system. The ratings system assigns zero to three stars to food items, based on their nutritional value. Researchers found that sales of less healthy foods—such as highly processed snack foods—fell by 8.31 percent when branded with a low nutrition rating, while healthy food purchases rose by 1.39 percent, Medical Xpress reports.

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Jul 9 2014
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Is Comfort Eating Actually Comforting?

A. Janet Tomiyama, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2009-2011), is assistant professor of psychology and director of the Dieting, Stress, and Health (DiSH) Lab at the University of California, Los Angeles. She was recently named the 2013 recipient of the Early Career Investigator Award from the Society of Behavioral Medicine. Her favorite comfort food: potato chips.

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What’s your favorite comfort food? Ice cream, pizza, chocolate—everyone’s got a preference, whether they’re from Los Angeles, London, Sao Paolo, or Tokyo. Stress eating is as universal as eating itself; indeed, even Cervantes in his 1605 classic Don Quixote addressed the practice with the line, “All sorrows are less with bread.” Humans seem to reach for food as a way to soothe negative emotions, and that food is often high-fat, high-sugar, and high-calorie. That’s why comfort eating is often blamed as one reason stress is bad for health—because stress causes us to find comfort in a dozen cookies.

A. Janet Tomiyama

If you’re like me, you’ll be surprised but delighted to know it’s not just humans that engage in comfort eating! Eating high-fat, sugary foods in response to stress is a behavior that we see in non-human species like rodents and primates. Under chronic stress conditions, for example, rats will shift their food intake away from standard food pellets to the rodent version of “comfort food” (researchers often use Crisco mixed with sugar).

Even more amazing: it works. These comfort-eating rats showed dampened biological stress reactivity in a stress system called the Hypothalamic-Pituitary-Adrenal (HPA) axis. Sustained over-activity of the HPA axis is associated with poor health, and these studies suggest that comfort eating is playing an important role in managing an organism’s stress levels.

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May 15 2014
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RWJF Scholars in the News: Budget cuts and babies’ health, nurse engineers, 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:

New research led by RWJF Clinical Scholar Nicole Brown, MD, MPH, suggests that children with attention deficit hyperactivity disorder (ADHD) are more likely to be from families affected by such stressors as poverty, divorce, neighborhood violence, or substance abuse, HealthDay reports. Researchers analyzed survey responses from parents of more than 65,000 children. Approximately 12 percent of the children had been diagnosed with ADHD, and their parents reported higher rates of those stressors than other respondents. “Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," Brown said. The HealthDay article was republished in Philly.com, U.S. News & World Report, and WebMD.

RWJF Nurse Faculty Scholar Betty Bekemeier, PhD, MPH, RN, examined 11 years of data on budget cuts at 100 county health departments in Washington state and Florida in order to understand and quantify how the cuts affected children’s health, My Northwest (Washington) reports. She focused on the impact of funding reductions to such services as the Women, Infants and Children program and nutrition advice for mothers. Bekemeier found a direct correlation between budget cuts for such programs and the number of low birthweight babies. Children born with low birthweight, she notes, often have greater health care needs that may end up costing counties as much or more than the money saved by the original budget cuts.

Duquesne University is pioneering the nation’s first dual degree in nursing and biomedical engineering this fall, according to the Tribune-Review (Pittsburgh). Mary Ellen Glasgow, PhD, RN, ACNS-BC, dean and professor of the Duquesne University School of Nursing, said the dual major will provide engineers with hands-on clinical experience in patient care that will give them a better perspective on the practical applications of solutions to health care problems. “We aren’t going to be putting out millions of nurse engineers,” Glasgow, an RWJF Executive Nurse Fellow, said, predicting that nurse engineers will help pioneer advances and efficiencies in health care through their direct experience with patient care.

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Nov 1 2013
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A Closer, More Dispassionate Look at Obesity

Abigail Saguy, PhD, is an alumna of the Robert Wood Johnson Foundation Scholars in Health Policy Research program (2000–2002). In January, she published the book, “What's Wrong with Fat?”

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Human Capital Blog: You argue in your book that the focus on the “obesity epidemic” obscures a deeper, more important question: How has fatness come to be understood as a public health crisis at all? How do you answer that question?

Abigail Saguy: It’s multilayered. On the deepest level, the fact that we perceive obesity as a public health crisis is related to the fact that fatness, or corpulence, has become an undesirable social characteristic. It has not always been that way, and it is not that way everywhere even today. In many places and times in history, being heavier has been considered a positive social characteristic, particularly in times and places where food is scarce. This is why, in certain contexts, women or girls are fattened up for marriage; there, the woman’s fatness symbolizes the wealth or status of their families.

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Sep 24 2013
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What’s Cooking? Med Students Learn ‘Culinary Medicine’

There have been some unusual cooks in the kitchen at the Johnson & Wales University culinary institute in Providence, R.I., lately: medical students.

Doctors-in-training from Tulane University have been cooking alongside Johnson & Wales students for several weeks, NPR reports, to learn about nutrition. This unique program, which debuted this year and was organized by Tulane’s Goldring Center for Culinary Medicine, aims to change the way medical students think about food and, ultimately, how they will talk to future patients about nutrition and healthy eating.

Many health problems and diseases—like obesity and diabetes—could be prevented by lifestyle changes such as better eating habits.

"We basically learn how to take care of patients when things go wrong,” Neha Solanki, a fourth-year Tulane medical student, told NPR. “I think that we need to learn how to be able to make nutritious meals and to discuss diet in an educated manner."

In addition to the collaboration with Johnson & Wales, Tulane’s Goldring Center for Culinary Medicine has built relationships in its own community. Medical students help with an “edible schoolyard” program at local schools, and host hands-on cooking and nutrition education classes for community members at the nation’s first teaching kitchen affiliated with a medical school.

Read the story from NPR.
Learn more about the Goldring Center for Culinary Medicine here and here.

May 16 2013
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Human Capital News Roundup: Oregon’s Medicaid system, ‘healthy’ fast food restaurants, primary care workforce innovation, 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 Alan Teo, MD, MS, is the lead author of a study that finds the quality of a person’s social relationships influences the person's risk of major depression, regardless of how frequently their social interactions take place. “The magnitude of these results is similar to the well-established relationship between biological risk factors and cardiovascular disease,” Teo told Health Canal. “What that means is that if we can teach people how to improve the quality of their relationships, we may be able to prevent or reduce the devastating effects of clinical depression.”

RWJF recently announced the selection of 30 primary care practices as exemplary models of workforce innovation. The practices will serve as the basis for a new project: The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP). Among them is CareSouth Carolina, the Hartsville Messenger reports. Learn more about the LEAP project and the practices selected for the program.

Low-income Oregonians who received access to Medicaid over the past two years used more health care services, and had higher rates of diabetes detection and management, lower rates of depression, and reduced financial strain than those without access to Medicaid, according to a study co-authored by RWJF Investigator Award in Health Policy Research recipient Amy N. Finkelstein, PhD, MPhil. The study found no significant effect, however, on the diagnosis or treatment rates of hypertension or high cholesterol levels.  Among the outlets to report on the findings: Forbes, the New York Times, the Washington Post Wonk blog, Health Day, and the Boston Globe Health Stew blog. Read more about Finkelstein’s research on the Oregon Medicaid system.

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Feb 15 2013
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Researching the Triggers for Obesity and Diabetes

Gary A. Taubes, MSE, MS, is recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research, and co-founder of the Nutrition Science Initiative. He is an award-winning science and health journalist, and author of Why We Get Fat and Good Calories, Bad Calories.

Gary Taubes

Human Capital Blog: Why did you and Dr. Attia start the Nutrition Science Initiative (NuSI)? What was the problem you saw that needed to be addressed?

Gary Taubes: I spent the better part of a decade, from the late 90s through 2007, doing an extensive journalistic investigation of the research that led us to our established beliefs about the environmental triggers of obesity, type 2 diabetes and their associated chronic diseases, which include heart disease and cancer. During these years it also became clear that the economic burden of these diseases was becoming unsustainable and were driving health care costs in this country. Obesity alone is estimated to cost the health care system $150 billion a year, and add type 2 diabetes and that number might double.

My research led me to two major conclusions. One is that our understanding of what fundamentally causes obesity may be incorrect: that it may not be what researchers refer to as an "energy balance" disorder— that we merely consume more calories than we expend—but rather a hormonal/regulatory defect, just like any other growth disorder. This was the hypothesis embraced by European clinicians prior to the Second World War. What I learned in my research was that this hypothesis vanished with the war and the evaporation of the relevant medical research community. Instead we all came to believe that obesity is simple–caused by eating too much or being too sedentary or some combination of the two—and this is what our national guidelines have communicated to the public and to individuals. While this has happened, the nation has waxed fatter and fatter.

The second conclusion of my work and my books was that the research in nutrition and obesity has simply never been rigorous enough to establish reliable knowledge in this field, one way or the other. There are a lot of good reasons for this, in particular that doing rigorous experimental trials with humans is difficult and exceedingly expensive. But without these experiments, we're just guessing when we say we know why humans get fat. It's quite likely that one reason we've seen an obesity epidemic is because our fundamental understanding of the disorder itself and how to cure and prevent it is incorrect. And if this is true about obesity, it's true about diabetes and heart disease as well.

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Dec 27 2012
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Creating a System that Encourages Healthy Behaviors

Mitesh Patel, MD, MBA, is a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the Leonard Davis Institute for Health Economics at the University of Pennsylvania.  He is a practicing physician at the Philadelphia Veteran Affairs Medical Center; and author of Clinical Wards Secrets, a guide for medical students transitioning from the classroom to the hospital wards. This post is part of the "Health Care in 2013" series.

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While most people spend a few hours a year visiting the doctor, they spend another 5,000 waking hours without any direct contact from the U.S. health care system.  There has been an increasing amount of attention on how to design systems that encourage healthy behaviors among the population during their everyday activities.  Insights from behavioral economics provide opportunities to design systems that monitor, incentivize and provide feedback to encourage these changes. 

One proposal to change behavior is to increase price transparency in the U.S, with initiatives at the state and federal levels.  Lessons from other industries and concepts from behavioral economics demonstrate that this must be designed carefully to increase the likelihood that price transparency changes behavior. 

One example is the use of calorie-labeling in fast food restaurants.  While its intended outcome is to reduce consumer consumption, there are several reasons why it has thus far not been very successful. Consumers may not understand the caloric information or the problem may be self-control and not related to information at all. 

Using concepts from behavioral economics such as framing the information or making it more salient could improve its impact on reducing calorie consumption.

As the New Year approaches, millions of Americans will make resolutions to improve their diet, increase their exercise, or to quit smoking.  Let’s do our part to design systems that help our population meet their goals and increase healthy behavior. 

Aug 23 2012
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Human Capital News Roundup: Healthy food "prescriptions," student debt, the tax system, 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 and grantees. Some recent examples:

Women who had attention-deficit hyperactivity disorder (ADHD) as girls are more likely to hurt themselves or attempt suicide, compared to those who did not have ADHD, according to a longitudinal study led by RWJF Investigator Award in Health Policy Research recipient Stephen P. Hinshaw, PhD. More than half of the girls, ages 6 to 12, who were tracked by the study were reported to have engaged in self-injurious behavior, and more than one-fifth had attempted suicide, United Press International reports. Among the other outlets to report on the findings: Health Day, MediLexicon, Health Canal, and Science Daily.

The New York Times interviewed RWJF Clinical Scholars alumna Comilla Sasson, MD, MS, and others who were working at the University of Colorado Hospital the night of the shootings at an Aurora movie theater. Sasson’s team treated 23 patients, and every patient who arrived at the hospital with a pulse survived. “We went into emergency medicine because we know it’s crazy—you never know what’s going to come through the door,” she said. “But the thing none of us have gotten over is, we made it through. We really, truly shined [that night].” Read a post Sasson wrote for the RWJF Human Capital Blog about the experience.

RWJF/U.S. Department of Veterans Affairs Physician Faculty Scholar Rebecca Sudore, MD, continues to receive media coverage for a study she led that finds almost half of adults with type 2 diabetes experience acute and chronic pain. “Palliative care has already begun to be woven into the care provided to patients with cancer, heart failure and kidney failure,” Sudore told Health Day. “Our results highlight the need to expand diabetes management to also include the palliative care model.”

RWJF Executive Nurse Fellows alumna Cynda Hylton Rushton, PhD, RN, FAAN, spoke to NBC News about a study conducted by researchers in England that finds “some terminally ill children experience unnecessary treatment and prolonged suffering because their parents believe they will experience a ‘miracle cure.’” These situations occur rarely, Rushton says, and “it takes time to evolve and fully understand every perspective and rationale. The process should take seriously the implications of overruling parents’ deeply held religious viewpoints, and include sufficient safeguards that are fair and balanced.”

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Jul 19 2012
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Human Capital News Roundup: Paying patients for tissue donation, intermittent explosive disorder, effect of diet on menopause, 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 and grantees. Some recent examples:

Sandro Galea, MD, MPH, DrPH, recipient of an RWJF Investigator Award in Health Policy Research, chaired an Institute of Medicine panel that last week recommended soldiers returning from Iraq and Afghanistan undergo annual screenings for post-traumatic stress disorder. The Associated Press and Health Day News are among the outlets to report on the recommendations.

Reuters reports that RWJF Clinical Scholar Katherine Neuhausen, MD, co-authored an editorial in the Archives of Internal Medicine to accompany a study examining the effects of upcoming changes in Medicare and Medicaid payment policies on safety-net hospitals. Instead of penalizing struggling safety net hospitals, the Centers for Medicare and Medicaid Services and state Medicaid agencies should design incentive programs that reward safety-net hospitals for improving patient experience and quality, they write.

Dominick L. Frosch, PhD, an alumnus of the RWJF Health & Society Scholars program and recipient of an Investigator Award, continues to receive media coverage for his study that finds most patients are unwilling to speak up when they disagree with their care providers. Reuters reports on the findings. Read an RWJF Human Capital Blog Q&A with Frosch on his study.

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