Category Archives: Culture of Health
The Trust for America’s Health and the Robert Wood Johnson Foundation highlighted the need to improve vaccination rates among children and adults last week with the release of the 2014 “Outbreaks” report. The report reveals that more than 2 million preschoolers, 35 percent of seniors and a majority of adults do not receive all recommended vaccinations.
When it comes to vaccinating adults, primers for doctors often say the key to success is more education for medical professionals. However, Litjen Tan, MS, PhD, Chief Strategy Officer of the Immunization Action Coalition says it’s not necessarily more education that doctors need. Instead, Tan believes adult vaccination rates can be improved by training the support staff at doctors’ offices to vaccinate, and authorizing them to do so.
The Build Healthy Places Network, a new and innovative resource to improve health outcomes in low-income communities, launched last month during the annual meeting of the American Public Health Association.
This groundbreaking network sits at the intersection of public health and community development. The goal of the network is to expand our collective understanding of the social determinants that impact public health and catalyze action. In so doing, the Build Healthy Places Network hopes to create new models and develop new tools to help leaders of low-income communities and create a Culture of Health where every individual lives the healthiest life possible.
Already, cutting edge work is being done in the public health sphere to begin addressing the many factors that impact health. As Douglas Jutte, MD, MPH, the Network’s executive director, recently described, the Network is designed to aggregate the work being done to help build a knowledge base for every community to use.
“The concept is derived from a series of conferences that the Federal Reserve System has held focusing on both health and community development,” said Jutte. “There was a growing recognition that there needs to be a support system to build bridges between these two distinct sectors. While the conferences were a good start, we saw the opportunity for a network to help build these cross-sectoral connections and keep this field of collaboration moving forward.”
The Network’s website includes resources such as primers on improving the health of communities and stories about communities that are already uniting community development experts and public health experts to build a Culture of Health.
Jutte says a lot of the successes in the field currently are anecdotal and people working in the field often come up them “accidentally.”
“You hear about this amazing work that someone is doing in some corner of a faraway state and that really should end because we have the ability to share that kind of knowledge,” says Jutte.
He continued, “A key goal is to move health and community development from their siloes to collaboration. The Network will serve as a clearing house to bring together stories and evidence and examples of collaboration in communities.”
Going forward, the Network plans to “synthesize” what is known and what the good examples are “so that we can help communities and leaders who are not even sure where to start, to really understand what’s going on in terms of new models with a focus on measurement, policy, finance and investment,” Jutte said.
If we as a nation are to succeed in building a Culture of Health that benefits every individual, it will require collaboration across sectors, open communication among diverse organizations and a willingness to step out of traditional practices to find effective interventions.
On Monday, Robert Wood Johnson Foundation Vice President Michelle Larkin showcased one example of this innovative collaboration that is occurring on the edge of a low-income neighborhood in New Orleans, just a few miles away from this year’s American Public Health Association (APHA) annual meeting.
At the corner of North Broad Street and Bienville Avenue sits The ReFresh Project—an innovative fresh food hub located in a former warehouse that had been vacant since Hurricane Katrina struck the city nine years ago. Today the site is home to a Whole Foods Market, Liberty’s Kitchen, The Goldring Center for Culinary Medicine and an onsite farm.
The goal of the hub, according to project founder Jeffrey Schwartz, is to create new eating, working, exercise and community living cultures.
Each aspect of the Refresh Project is designed to realize these goals.
- At the Whole Foods market, which anchors the Refresh project development, products are specifically chosen to be both high quailty and affordable. Specifically, the store carries more store-line products and often has more sale items than other stores in the Whole Foods chain. Two healthy eating educators are also located on-site to answer questions, craft recipes, and host tours.
- At Liberty’s Kitchen, a culinary work readiness and leadership program for at-risk youth, New Orleans youth ages 16-24 who are out of work and out of school are given an intensive and hands-on food service training, case management, job placement services and follow-up support. Ninety percent of Liberty’s Kitchen Youth Development Program participants are employed on graduation out of the program and 80 percent are still employed at the six-month benchmark, according to the organization.
Healthography—or the health of the place where you live—is the theme of this year’s American Public Health Association (APHA) annual meeting, which is taking place in New Orleans this week.
During the opening session, Georges Benjamin, MD, Executive Director of APHA, announced that APHA’s goal is to create the healthiest generation in American history within one generation. Benjamin’s announcement was coupled with announcements from local and national public health leaders that collectively took another step forward in that effort.
For example, the Partnership for a Healthier America announced a new Healthier Campus Initiative, which calls on colleges and universities to adopt recommended guidelines on food, nutrition and physical activity.
“We know that going to college is a time of change for many students—we also know that means it’s a time when new habits are formed,” said Peter Soler, the partnership’s CEO. “By creating healthier food and physical activity environments today, campuses and universities are encouraging healthier habits that will carry over into tomorrow.”
Guidelines being adopted by participating campuses include promoting the consumption of water instead of soda on campus, offering a bicycle sharing program for all students and providing certified personal trainers and registered dietitian nutritionists on campus.
In addition, Louisiana’s Secretary of Health and Hospitals, Kathy Kliebert, discussed the state’s “Well-Ahead” initiative, which promotes and recognizes smart choices that are made in the spaces and places where people live and work, and which make it easier to live healthier lives. Kliebert told the audience that Well-Ahead promotes voluntary changes without imposing new taxes or creating new rules.
Within the host city of New Orleans, a couple of initiatives to improve health within the Crescent City were also discussed at APHA’s opening session.
One such initiative to combat obesity—known as Fit Nola—now has 100 miles of bike lanes throughout the city. Also, next week legislation will be introduced to ban smoking in the city’s bars, casinos and public spaces.
APHA’s opening session ended with a talk by Pulitzer Prize winner Isabel Wilkerson, who spoke about her book “The Warmth of Other Suns.” A book 15 years in the making, “The Warm of Other Suns” describes the migration of African Americans in the 20th century from the South to the North for a better life for themselves and their children. For example, the parents of Olympian Jesse Owens worried their son would not have the strength to work in the fields, so they moved north to Cleveland, Ohio, where he started running track—a sport that would take him around the world and across the global stage.
Whether the generation of migrants profiled in Wilkerson’s book realized it, their stories epitomize the power of place, and the influence of geography on health, wellbeing and opportunity of every individual.
>>Bonus Link: Also in attendance at yesterday’s opening session was Peter Salk, son of the world famous Jonas Salk, MD, who was on hand to accept a posthumous award from APHA for his father’s discovery of a vaccine for polio. Watch the trailer above for the film “The Shot Felt Round the World” to learn more about the elder Salk’s successful search for a cure.
Yesterday saw the launch of the BUILD Health Challenge, a national award program to create and improve partnerships among health systems, community-based organizations and local health departments with an aim of addressing upstream problems that impact the health of local residents.
On a webinar to announce the challenge yesterday, representatives of the founding partners of the challenge said they were embracing the challenge because “transforming health outcomes requires a coordinated effort to tackle such contributing factors as socio-economic conditions, transportation, housing, environmental issues and access to healthy food.” The evidence base underpinning the new initiative shows that partnerships among health systems, public health agencies and community organizations are the most effective ways to work toward that transformation.
The BUILD Health Challenge will award up to $7.5 million in both financial awards and low-interest loans over two years to support up to 14 community-driven efforts that take Bold, Upstream, Integrated, Local and Data-driven approaches to improving community health and promoting health equity.
>> Bonus Link: Read an FAQ about the Build Health Challenge.
Earlier this year, Brownsville, Tex., was chosen by the Robert Wood Johnson Foundation as a Culture of Health Prize winner for its efforts to improve community health. As part of a new ongoing series, Health Affairs blog has featured a piece by local Brownsville leader Belinda Reininger on the community’s health successes.
Brownsville is a mostly Spanish-speaking town on the Texas border. The community, which is home to approximately 180,000 people, is also among the poorest metropolitan areas in the country. Approximately 48 percent of its children live in poverty, 80 percent of its population is obese or overweight, 30 percent have diabetes and about 67 percent have no health insurance.
However, over the last decade it has also become a “robust, bike-friendly city” that also promotes health through community gardens and the world’s largest Zumba class, according to Reininger. This is thanks in large part to the University of Texas’ decision to open its School of Public Health in Brownsville and the formation of Community Advisory Board that brings together 200 people and organizations, from private citizens and elected officials to business executives and nonprofits.
The board’s members “carry the message of wellness into their homes and businesses, and they’re able to affect policy and environmental changes by voting and leadership—and that’s how we have been able to include the community, by engaging them every single step of the way,” said Reininger, DrPh, to NewPublicHealth earlier this year.
Brownsville’s efforts include:
- Using data to assess the community’s health issues and then to engage with community members in a way that is both informative and beneficial to their health.
- Creating diverse programs — from Brownsville in Motion to promote physical activity through safe access to trails and bike lanes, to the Brownsville Farmers’ Market and Community Garden—to address the relationships between health, poverty, education and the economy.
To learn more about Brownsville’s prize-winning efforts to improve public health, read the Health Affairs blog post.
>>Bonus Content: Watch a NewPublicHealth video on Brownsville's efforts to build a Culture of Health.
Earlier this year, Taos Pueblo, N.M., was chosen by the Robert Wood Johnson Foundation (RWJF) as a Culture of Health Prize winner for its efforts to improve community health by declaring self-governance. As part of a new ongoing series, Health Affairs blog has featured a piece by local Taos Pueblo leader Ezra Bayles on the community’s health successes.
Taos Pueblo is a National Historic Landmark where Native Americans have continuously lived for more than 1,000 years. Approximately 1,350 people call it the sovereign nation home. Despite its concerted efforts to keep its ancient oral language, culture and traditions alive, the community faces serious public health issues that are rooted in high rates of poverty and unemployment. Approximately 47 percent of pueblo youth under age 20 are overweight or obese and 21 percent of its adults have diabetes.
As a means to address these troubling issues, in 2007 the Taos Pueblo Tribal Council took steps toward self-governance, which allowed them to reorganize and streamline community services.
“We’ve taken on even more responsibility and are taking on the programs, functions and services to serve our people,” said Shawn Duran, Tribal Programs Administrator for Taos Pueblo, to NewPublicHealth earlier this year. “We’re finding solutions that we’re familiar with and turning that into programs that work for our people.”
Taos Pueblo’s efforts include:
- Forming the Red Willow Community Growers Cooperative and the Red Willow Farmers Market in order to revive and celebrate the tribe’s agricultural heritage while also providing healthier food options.
- Serving children ages 1 to 5 with the Taos Pueblo Head Start and My First School, which incorporates healthy eating while also instilling a strong sense of community.
- Creating the Public Health Nursing Department, which sends a Native American nurse and two trained Community Health Workers directly to people’s doors as a way to make accessing care easier.
To learn more about Taos Pueblo’s prize-winning efforts to improve health, read the Health Affairs blog post.
>>Bonus Content: Watch a NewPublicHealth video on Taos Pueblo’s efforts to build a Culture of Health.
Earlier this year, Durham County, N.C., was chosen by the Robert Wood Johnson Foundation (RWJF) as a Culture of Health Prize winner for its efforts to ensure that its most vulnerable residents have access to the county’s repository of world-class health resources, high-skilled jobs and places to exercise. As part of an ongoing series, Health Affairs blog has featured a piece by local Durham leader Erika Samoff on the community’s health successes.
While Durham is home to a wealth of health care resources—so much so that it’s been dubbed “The City of Medicine”—a 2004 health assessment found high rates of cardiovascular disease and other chronic conditions; HIV/AIDS and other sexually transmitted diseases; and infant mortality. In addition, a 2007 evaluation found that nearly one in three of Durham’s adults were obese, with the rate especially high in its African-American population, at 42 percent. Half of the adults surveyed pointed to a lack of opportunities for physical activity as a contributing factor to their condition.
County leaders responded to these findings by creating the Partnership for a Healthy Durham. It is an alliance of more than 150 nonprofits, hospitals, faith-based organizations and businesses. The partnership’s efforts include:
- Turning an empty, run-down junior high school into the Holton Career & Resource Center, which offers mentoring programs, internships and hands-on career training to high school students
- Creating new bike lanes, bike racks and sidewalks to encourage physical activity and help combat chronic obesity
- Creating Project Access of Durham County to provide access to specialty care for uninsured residents
- Passing smoke-free legislation
To learn more about Durham’s prize-winning efforts to improve health, read the Health Affairs blog post.
- Learn more about the 2014 RWJF Culture of Health Prize winners and read NewPublicHealth coverage of the prize announcement.
- Read Everyday Health’s post, “How Healthy Is Your Hometown?: What you can do to create a culture of health in your community – and win a prize for it.”
>>Bonus Content: Watch a NewPublicHealth video on Durham’s efforts to build a Culture of Health.
We’ve written extensively on NewPublicHealth on the importance of building a Culture of Health—an environment where everyone has access to opportunities to make healthy choices. In June, the Washington Post held a live forum—sponsored by the Robert Wood Johnson Foundation—titled “Health Beyond Health Care,” which looked at how creative minds in traditionally non-health fields are working together to build a Culture of Health in the United States. As part of our continuing coverage of this issue we spoke with Catherine M. Baase, MD, Chief Health Officer at The Dow Chemical Company, about workplace wellness programs.
NewPublicHealth: Why do you think workplace wellness is important?
Catherine Baase: I guess it depends on “important” in what way. I’ll tell you two things. One is if you were asking me why it’s important to a business or a corporation, I think it brings critical value to many different corporate priorities—things such as safety, human capital priorities such as attracting and retaining talent, manufacturing reliability, the capacity to positively impact health care costs. So there’s a landscape of corporate priorities where the achievement of healthy people is important, even including job satisfaction and employee engagement.
But on another lens, I would say that I think workplace wellness is important to society for the achievement of public health objectives. The fact that we’re not doing really well on the achievement of health outcomes for our population as a whole, and the achievement of improved health will depend on a variety of sectors of society getting involved, and one of them is workplaces. Others are schools and communities and things like that, but the achievement of public health objectives depends a bit on workplaces being involved, as well.
NPH: Who is it that benefits from workplace wellness?
Baase: Well I think the individuals, the employees and oftentimes their families, because a lot of workplace wellness programs either directly or indirectly impact the family. It’s the community within which folks live because the culture is impacted, and the company certainly.
Earlier this year, Spokane County, Wash.,was chosen by the Robert Wood Johnson Foundation (RWJF) as a Culture of Health Prize winner for its efforts to improve community health by increasing graduation rates. As part of a new ongoing series, Health Affairs blog has featured a piece by local Spokane leader Ben Smith on the community’s health successes.
Just eight years ago, the high school graduation rate for Spokane Public Schools was below 60 percent and 18 percent of the county’s students lived in poverty. In addition, the students who did attend college or technical school often failed to earn their degree, leaving them unprepared to fill available positions in the county’s more technical fields.
To address these issues, Priority Spokane emerged from a collaboration of local businesses, educators, health organizations and community nonprofits—all committed to improving the future of Spokane County residents by improving education. A report linking lack of education to poorer health helped spur a dramatic change. Over the next several years, the county emphasized increased collaboration and a clear vision to improve the high school graduation rate to 79.5 percent overall.
Spokane County’s efforts include:
- Training teachers and childcare workers to mentor children who experience traumatic home events.
- Developing an early warning system for at-risk students.
- Establishing community attendance support teams that reengage truant students in school.
- Starting Spokane Valley Tech, a high school designed to help students build careers in science, technology, engineering and math.
To learn more about Spokane’s prize-winning efforts to improve health, read the Health Affairs blog post.
>>Bonus Content: Watch a NewPublicHealth video on Spokane's efforts to build a Culture of Health.