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.

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.

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.

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.

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. 

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.

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:

“Preventing diseases before they start is one of the most common sense ways to keep people healthy,” writes Risa Lavizzo-Mourey, MD, MBA, RWJF president and CEO, in a blog post for The Atlantic, “but this nation continues to focus too narrowly on treating medical conditions after they occur.” Lavizzo-Mourey’s essay is part of the “America the Fixable” series, hosted by Atlantic.com in partnership with Common Good. See the full series here.

A study led by RWJF/U.S. Department of Veteran’s Affairs (VA) Clinical Scholar Charles Scales, MD, finds that the number of Americans suffering from kidney stones has nearly doubled since 1994, due in large part to the increase in obesity and diabetes, WTVD (Raleigh-Durham, N.C.) reports. “While we expected the prevalence of kidney stones to increase, the size of the increase was surprising,” Scales said. HealthDay also reported on the findings.

Kavita Patel, MD, MSHS, an alumna of the Clinical Scholars program, was a guest on NPR for a story that asked “Does Race Affect Your Hospital Stay?” The story keyed off findings from Sick in America, a poll commissioned by RWJF, NPR and the Harvard School of Public Health to better understand Americans’ experiences and attitudes related to the cost and quality of their medical care. Nearly half of respondents said that a lack of cultural understanding plays a big role in the problems with U.S. health care quality, the story reports.

Dominick L. Frosch, PhD, an alumnus of the RWJF Health & Society Scholars program, continues to receive media coverage for a study he led that finds some patients are afraid or feel they are unable to speak up and participate in shared decision making with their physicians. American Medical News and Forbes are among the outlets to report on the findings.

Alison Buttenheim, PhD, MBA, an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program and assistant professor at the University of Pennsylvania School of Nursing, is lead author of a study published online this week by the Journal of the Academy of Nutrition and Dietetics. It finds Supplemental Nutrition Assistance Program (SNAP) participants redeem their benefits at higher rates at farmers’ markets when there are more vendor-operated wireless point-of-sale terminals. Read the study and listen to the authors talk about the findings.

Human Capital Blog: Why is it important that SNAP (food stamp) participants are able to get food at farmers’ markets? Why should we want redemption rates to increase?

Alison Buttenheim: There’s been a lot of research into the quality of diets for SNAP participants and it’s pretty clear that there’s room for improvement. They often don’t have access to fresh, affordable fruits and vegetables and other healthy food options. We’ve seen considerable policy interest in how we might change the diets of this population. One approach has been to focus on individual behavior change, but more recently there’s also been a focus on changing the food environment to increase access to healthy food in underserved neighborhoods, in the hopes that this will encourage better diets.

HCB: Why are SNAP redemption rates lower at farmers’ markets?

Buttenheim: Food assistance used to be paper coupons that you literally tore off and handed over to vendors, which made it quite easy. Now SNAP is all electronic, and participants get a card—like a credit card—that they use to redeem their benefits. Brick-and-mortar stores that participate in the SNAP program get a free point-of-sale terminal to process these transactions, and fees associated with the transactions are subsidized. But farmers’ markets rely on third party providers to supply wireless terminals and process transactions, and these providers of course charge wireless service fees and transaction fees. It’s costly. In 2009, only 900 of the 5,200 farmers’ markets in the country participated in SNAP.

By Najaf Ahmad, MPH, Communications Associate, Robert Wood Johnson Foundation Human Capital Portfolio

Walking through Barnes & Noble recently, a book on the “New Arrivals” rack stopped me in my tracks. By now you may know about My Sugar Obsession. So despite being in a rush, I was immediately drawn to Sugar Nation.

Imagine reuniting with a father you haven’t seen in years, finding him in an unrecognizable condition—a “human body in the process of cannibalizing itself”—on death’s door with a missing limb. Author Jeff O’Connell begins with this moving story of how he learned that his estranged father was slowly dying from the ravages of type 2 diabetes.

Despite having learned of his father’s leg amputation weeks earlier, O’Connell—former editor-in-chief at Muscle & Fitness magazine and executive writer at Men’s Health magazine—was certain he had nothing to worry about. He worked out, was lean and appeared healthy. His thin physique didn’t fit the stereotype of someone predisposed to developing type 2 diabetes.

A sobering visit with his doctor shook O’Connell to his core. He was diagnosed with pre-diabetes and headed down the same path as his father. Rather than accepting this fate though, he embarked on a mission to fight back against the enemy lurking within him. In doing so, he unearthed crucial information on how lifestyle factors influence diabetes.

More interestingly, he discovered the troubling manner in which health care providers are (or are not) responding to this burgeoning problem, going so far as to say that many “seem clueless when it comes to diagnosing this disease, let alone treating it.”

Although genes play a prominent role in predisposing someone to type 2 diabetes, lifestyle is a major influence. O’Connell underscores how type 2 diabetes stems from “the sum total of a very long trail of personal choices, made over a lifetime.” We pay a heavy price for our love affair with sugar, as massive quantities from processed foods shock our bodies. It shouldn’t be surprising then that one in three adults in the United States now has a blood sugar abnormality that predisposes them to diabetes-related complications such as heart disease, kidney failure and blindness. Sadly, many do not know they are affected until they develop these complications.

Najaf Ahmad, M.P.H., is a Communications Associate with the Robert Wood Johnson Foundation's Human Capital Portfolio. She has contributed to RWJF’s efforts in the areas of health insurance coverage and nursing since joining the Foundation in 2004, and is currently working on initiatives to build capacity in the health and health care workforce.

I’m obsessed with sugar and so is my husband. It wasn’t always this way; we used to spend many evenings sharing a pint of Ben & Jerry’s curled up in front of the TV.

That was until we became neurotic new parents.

In our quest to become good—and healthy—parents, nutrition became a new-found obsession. Our determination to model healthy behaviors for our child meant, among other things, reassessing our diet. To guide our efforts, we spent many evenings voraciously reading up on diet and nutrition–this time without Ben & Jerry.

It was right around then that I first heard of award-winning science journalist Gary Taubes. He had just published Good Calories, Bad Calories, his magnum opus examining the relationship between carbohydrates and obesity. A Robert Wood Johnson Foundation Investigator in Health Policy Research, Taubes has rediscovered the relationship between excess consumption of sugar, chronic health problems, obesity and food policy. He is one of only a few journalists that the Investigator program has funded.