In February, the Robert Wood Johnson Foundation honored six communities with the inaugural RWJF Roadmaps to Health Prize, which recognizes outstanding community partnerships that are helping people live healthier lives.

Recently, NewPublicHealth spoke with Claude-Alix Jacob, chief public health officer at the Cambridge, Mass., department of health, one of the six prize-winning communities to be recognized by the Foundation. Mr. Jacob spoke to NPH about how collaborating around and winning the Prize has impacted the community, including resilience in the face of tragedy.

>>Apply to become a winner of the 2013-2014 RWJF Roadmaps to Health Prize. This year's application deadline is May 23, 2013.

NewPublicHealth: What did winning the RWJF Roadmaps to Health Prize mean to your community?

Claude Jacob: It has been great and exiting news for our community. Over the course of the last few months and through National Public Health Week last month we’ve had a chance to celebrate. We’ve been able to share our public health plans and community partnerships, but also under the aegis of the Robert Wood Johnson Foundation, we now have more credibility for all of our efforts. The Foundation is associated with promoting important health improvement efforts nationwide and just to be linked to the Foundation will open doors, especially now that we’re one of the six inaugural prize winning communities.

During National Public Health Week we invited our community stakeholders to celebrate to thank them for their hard work in helping us to prepare for the site visit that was required of prize finalists. So it’s been a phenomenal few weeks.

NPH: How has winning the prize impacted the health improvements of your community?

Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks. 

NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?

Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.

So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.

NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?

How healthy is your county? Answers are out today in the 2013 County Health Rankings, which examine the health and well-being of people living in nearly every county in the United States and show that how long and well people live depends on multiple factors beyond just their access to medical care. The Rankings allow counties to see what’s making residents sick or healthy and how they compare to other counties in the same state. The County Health Rankings, now in its fourth year, is a joint project of the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute.

“The County Health Rankings can be put to use right away by leaders in government, business, health care, and every citizen motivated to work together to create a culture of health in their community,” said Dr. Risa Lavizzo-Mourey, RWJF president and CEO. “The Rankings are driving innovation, unleashing creativity, and inspiring big changes to improve health in communities large and small throughout the country.”

The Rankings examine 25 factors that influence health, including rates of childhood poverty and smoking, obesity levels, teen birth rates, access to physicians and dentists, rates of high school graduation and college attendance, access to healthy foods, levels of physical inactivity, and percentages of children living in single parent households. 

Although the Rankings only allow for county-to-county comparisons of ranks within a state, this year’s Rankings show significant new national trends:

To mark the launch of the 2013 County Health Rankings, Risa Lavizzo-Mourey, MD, MBA, President and CEO of the Robert Wood Johnson Foundation will be taking questions and leading a group discussion via Twitter on March 20, from 2:00 p.m. to 3:00 p.m.

The Q&A will focusing on what's new in the 2013 County Health Rankings and how individuals and organizations can make use of the Rankings to create change for better health in their communities. Submit your questions to: @RWJF_PubHealth or @CHRankings and make sure to use the hashtag #healthrankings.

You can follow the County Health Rankings & Roadmaps on Facebook and Twitter to learn about the new data, find stories about how the project has improved health in communities like yours and get ideas for taking action where you live. The Facebook page will be posting useful new infographics, videos, quotes and images all week. On Twitter, join the Q&A, share your #healthrankings to fill in the “Race to 50” map, and ask an expert for help by tweeting your county to #myrankings.

The new issue of Frontiers in Public Health Services and Systems Research (PHSSR), an online journal that looks at early research on issues related to public health services and delivery, focuses on quality improvement in practice-based research networks.

This issue’s commentary, from the journal’s editor, Glen Mays, PhD, MPH, is about a series of studies sponsored by the Robert Wood Johnson Foundation that  look at how public health decision-makers are responding to accreditation, quality improvement, and public reporting initiatives during  ongoing fiscal problems. Mays is co-principal Investigator of the National Coordinating Center on PHSSR, Director of the Public Health Practice-Based Research Networks and the F. Douglas Scutchfield Endowed Professor at the University of Kentucky College of Public Health. Mays says that, overall, the current evidence shows that “these initiatives represent promising strategies for strengthening evidence-based decision-making and expanding the delivery of evidence-tested programs and policies in local public health settings.” 

Mays  adds that continued comparative research and evaluation activities are needed to provide more definitive evidence about which combination of strategies work best, for which population groups, in which community and organizational settings, and why.

The Robert Wood Johnson Foundation (RWJF) has announced a second round of grant winners for the Roadmaps to Health Community Grants. The grants support two-year state and local collaborative efforts among policymakers, business, education, health care, public health and community organizations, and are managed by Community Catalyst, a national consumer health advocacy organization. The goal of the grants is to create positive policy or systems changes that address the social and economic factors that impact the health of people in their community.

The grants build on the model of the County Health Rankings & Roadmaps program, which highlights the critical role that factors such as education, jobs, income and the environment play in influencing how healthy people are and how long they live. County Health Rankings & Roadmaps is a collaboration of RWJF and the University of Wisconsin Population Health Institute.

Four of the new grants have been awarded to projects spearheaded by United Way organizations in several states.

The Roadmaps to Health Community Grants are:

• Demonstrating how a range of partners from multiple sectors in a community can work together to take actionable data such as the County Health Rankings and begin addressing the multiple social or economic determinants of health in a community.
• Focusing on collaboration and action at the policy or system-change level.
• Getting grant partners in fields such as education, employment or community safety to think of themselves as part of the work of the public health community.

The County Health Rankings & Roadmaps show how every county in the United States ranks on critical measures that impact health, in comparison to all the counties in a state. The program helps communities create solutions that make it easier for people to be healthy in their own communities, focusing on specific factors that affect health, such as education and income.

Now headed into its fourth year, the Rankings are spurring communities to action. In Scioto County, Ohio, which was ranked last among all 88 Ohio counties last year, the Rankings motivated community leaders to convene two recent meetings. One held last spring gathered stakeholders at the table to set the agenda for helping to improve the county’s health. And a summit held this fall brought engaged county partners together with leaders from counties in both Ohio and Kentucky who shared ideas and initiatives that are already working to help improve health and lives.

NewPublicHealth spoke with two conveners of the summit, Ed Hughes, CEO of Compass Community Health, a local mental health and substance abuse provider, and Ohio State Representative Terry Johnson.

NewPublicHealth: What did the 2012 County Health Rankings reveal for your region?

Ed Hughes: We slipped this year from 87 to 88—last place. So, it became a rallying point for us as a community to be able to actually see those numbers, and to understand what the rates for the measures mean. We probably knew about a lot of it, but didn’t have the information available in a comprehensive way, like the number of people who smoke in our region, the number of folks who are struggling with obesity and the percentage of children who do not have their immunizations. We were surprised that we were one of the most struggling counties in the country.

When it comes to solving problems that affect the health of our communities, knowing what works matters. Using programs, policies and innovations that are based on solid evidence offers a better chance to improve public health.

What Works for Health, the latest release from County Health Rankings & Roadmaps, is an online, searchable menu of policies and programs—each with a rating based on strength of evidence for factors that can help make communities healthier places to live, learn, work and play. Policies, such as sobriety checkpoints, and programs, such as early childhood interventions, included in What Works for Health are rated on their level of evidence to help guide users toward choosing proven strategies. The County Health Rankings & Roadmaps team also hopes this tool will help spur a dialogue, and encourage those in the field to weigh in on other possible evidence-based programs.

NewPublicHealth spoke with Bridget Catlin, PhD, MHSA, director of the County Health Rankings & Roadmaps about the new tool and how she expects it to be used.

NewPublicHealth: Who is the primary audience for What Works for Health?

Bridget Catlin: There are a number of audiences for What Works for Health. Key audiences are people who are leading community health improvement planning processes such as public health officials. Hospitals are also getting involved in this area due to requirements from the ACA and from the IRS. They’re doing community health needs assessments to identify needs in communities and then what they can do to address those needs. Other audiences include employers who want to make their communities healthier for their employees and dependents, as well as grant-makers and policy-makers who are interested in spending their resources in areas that they know will work.

NPH: What’s new about this resource? How is it different from some of the other evidence guides that are out there like The Community Guide?

More than $2.5 trillion is spent on U.S. health care annually. Yet only a small fraction of that goes toward funding public health and prevention programs — programs that could stop people from getting sick in the first place, helping people and communities while saving money in the long run.

In a new op-ed in Roll Call, Hernando Mayor Chip Johnson and Wyandotte Mayor Joe Reardon discuss how their communities have been working to improve public health. Both community prevention efforts were featured as examples of success by County Health Rankings & Roadmaps, a program of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation that measures the health of counties across the country.

Highlights of these efforts include a comprehensive wellness program for municipal workers in Hernando, Miss., and the utilization of tax incentives to bring grocery stores to underserved areas in Wyandotte County, Kan.

“Replicated on a national scale, these kinds of investments in health can yield significant dividends. Spending just $10 per person in programs aimed at smoking cessation, improved nutrition and better physical fitness could save the nation more than $16 billion a year, according to the Trust for America’s Health. That’s a nearly $6 return for every $1 spent. The bottom line is that policies aimed at better health are a smart investment, regardless of where our counties rank.”

>>Read the full op-ed in Roll Call.

>>Watch videos from Hernando Mayor Chip Johnson and Wyandotte Mayor Joe Reardon about improving public health in their communities.

At the Health Data Initiative III: The Health Datapalooza this summer, which looked at the role health data plays in transforming health and health care, the Robert Wood Johnson Foundation (RWJF) announced the three winners of an app challenge calling for developers to create applications that would allow consumers to easily access and make use of comparative information about the quality of care provided in various regions of the country. The data behind the apps came from Aligning Forces for Quality, the Foundation’s initiative to improve the quality of health care in 16 targeted communities.

John Lumpkin, MD, MPH, senior vice president and director of the Health Care Group at RWJF, presented the awards to the top three winners of the challenge. Recently, NewPublicHealth spoke with Dr. Lumpkin about the explosion of health care data, and how to find the strongest data and use it well.

NewPublicHealth:  Quantities of health data are increasing at a speedy clip. What kind of challenge does that pose in order to make sense of the numbers?

Dr. Lumpkin: In a single day there are over 300 million photos that are being posted on Facebook, and 3.2 billion likes and comments. We have 115,000 people participating in web sites such as Patients Like Me and about 9 million tweets each day. So we have all this data, but how do we access it in ways that make it meaningful? Kerr White, MD, the chairman for the U.S. National Committee on Vital and Health Statistics once said: “With the advent of new technology, data can be collected in any format, aggregated by the computer and arrayed in any desired output…untouched by human thought.” And so our challenge is to present it in a way that we actually have it touched by human thought.

Some good examples of this would include the County Health Rankings and the Aligning Forces for Quality Initiative where we have coalitions of consumers, purchasers and providers who, through public reporting of quality and price information and consumer engagement, we encourage to adopt quality improvement methods and use the data in ways that move that process forward.

NPH: Does everyone mean the same thing when they talk about “evidence-based” data?