In 1995, Tom Stoner and his wife Kitty discovered a tiny urban park in the middle of a busy London neighborhood that had been used as a refuge during World War II. On the backs of many of the park’s benches, the Stoners found loving thoughts and peacetime memories that had been etched by Londoners during the horrors of war. They realized that if an urban park could be a source of quiet and solace during a time of bombing and destruction, then similar natural environments could certainly offer spaces for reflection, recovery and respite for people dealing with the stress of modern life. With that idea the Stoners created the TKF Foundation to support the creation of urban green spaces.
“The speed, violence and alienation that characterize our current period in human history create an important need for open spaces, sacred places,” says Tom Stoner.
In 2010 Tom and Kitty began the National Nature Sacred Awards Initiative, designed to support the creation of public greenspaces to serve as demonstration and research sites to study the impact of nature on the human spirit. NewPublicHealth recently spoke with Tom Stoner about the intersection of green space and improved health and lives.
We’re changing how we’re doing things here at the Robert Wood Johnson Foundation. We’re striving to work better together to serve one big, bold goal: to build a Culture of Health in America. One way to get there? Shine a light on the stories across the country that bring this unified vision to life. It’s with this in mind that we will be ceasing publication of the Human Capital, NewPublicHealth and Pioneering Ideas blogs at the end of the month. From that point on, we’ll begin to tell our stories in one place: our Culture of Health blog.
We encourage you to tune in. On the Culture of Health blog, you will continue to find stories on cutting-edge ideas, innovation in health, health care and beyond, and insights from the leaders driving change. And don’t worry: You’ll still be able to find previous posts through a new archive.
In the meantime, we want to hear from you. We invite you to tell us what kinds of posts you’re looking for in a brief online survey.
Your thoughts and ideas will help make sure we're offering more of the stories you want, and delivering them to you in the ways that meet your needs. We look forward to hearing from you—and thank you for your continued readership!
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.
Today at the American Public Health Association annual meeting in New Orleans, Shirley Orr, MHS, APRN, a Robert Wood Johnson Foundation Executive Nurse Fellow and public health consultant, and Doris Brown of the Louisiana Department of Health, will be talking about opportunities for nursing leaders to implement the recommendations of a 2010 Institute of Medicine Report entitled “The Future of Nursing.” This report looks at ways that the nursing profession can transform itself in order to better align with population health and more effectively collaborate to create a healthier overall population.
NewPublicHealth recently spoke with Orr about how nurses can help improve community and population health. This interview has been lightly edited for clarity and length.
NewPublicHealth: What does the nursing profession need to do in order to align itself with a focus on population health?
Shirley Orr: A couple of things in particular that stand out are education and diversity. We recently did a public health nursing enumeration that was funded by the Robert Wood Johnson Foundation, and we found two things in particular relating to the recommendations. First, that overall, public health nurses need new skills and they need higher levels of education to be able to function more collaboratively and within collaborations—both within health care and with other community partners.
Second, we found that nationwide, the demographic profile of public health nurses does not look like the population that we serve. Ethnic minorities are very much underrepresented among public health nursing—particularly in leadership roles.
We have a very urgent need to recruit more nurses of color into the ranks of public health nursing leadership.
NPH: Why is that necessary?
Orr: A core component of nursing curriculum today is culture competency. That being said, we also know that having nurses who understand populations very, very deeply by having a frame of reference for that population and being a member of that population really are able to help to get the highest level of engagement from the population. They’re also best prepared to understand the culture, the needs, the motivations about populations, so they’re really best positioned to be able to carry out in partnership strategies that are going to make a difference long-term in the health of populations.
Beverage companies spent $866 million to advertise unhealthy drinks in 2013, and children and teens remained key target audiences for that advertising, according to a new report released today at APHA by the Yale Rudd Center for Food Policy & Obesity. The report “Sugary Drink FACTS 2014” highlights some progress regarding beverage marketing to young people, but also shows that companies still have a long way to go to improve their marketing practices and the nutritional quality of their products to support young people’s health.
“Despite promises by major beverage companies to be part of the solution in addressing childhood obesity, our report shows that companies continue to market their unhealthy products directly to children and teens,” said Jennifer Harris, PhD, Rudd Center’s director of marketing initiatives and lead author of the report. “They have also rapidly expanded marketing in social and mobile media that are popular with young people, but much more difficult for parents to monitor.”
Harris and her team examined changes in the nutritional content of sugar-sweetened drinks including sodas, energy drinks, fruit drinks, and others. They also analyzed marketing tactics for 23 companies that advertised these products, including changes in advertising to children and teens on TV, the internet, and newer media like mobile apps and social media. Researchers also examined changes in the nutrition and marketing of diet beverages, 100% juice, and water. The report was funded by the Robert Wood Johnson Foundation.
Learn more about the key findings of the report in the following exclusive interview with Harris. The interview has been lightly edited for clarity and length.
NPH: You issued the first version of this new report in 2011. What are the changes since then?
Jennifer Harris: The biggest change that we saw was a very significant decline in advertising on television. Preschoolers are seeing 33% fewer TV ads for sugary drinks in 2013 than they saw in 2010. Children are seeing 39% fewer, and teens are seeing 30% fewer. So, that was really some great news to see, but some categories had bigger declines than others. Fruit drinks went down by about 50%, but advertising for energy drinks that kids see actually increased. So, there was some good news and some bad news.
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.
Looking at Health Departments’ Ever-Changing Future: A Discussion of the Recent Findings of the Public Health 2030 Project
From the dramatic impact of extreme weather events such as Hurricanes Katrina and Sandy, to the rapidly changing policy landscape of health care providers, the functions, missions and futures of public health agencies continue to change.
To help health departments plan for an uncertain future, the Institute for Alternative Futures—with support from the Robert Wood Johnson Foundation and the Kresge Foundation—recently worked with state and local health departments, leaders and experts in the field to look forward to the year 2030 and analyze public health scenarios in order to offer pathways to expectable, challenging and visionary futures for public health.
On Tuesday afternoon at APHA, Clement Bezold, PhD, the Founder and Chairman of the Institute for Alternative Futures, and Terry Allan MPH, will discuss theses scenarios and findings and insights gained.
Prior to their presentation, NewPublicHealth sat down with Bezold for an exclusive preview of his presentation.
NewPublicHealth: How did your APHA presentation come about?
Clement Bezold: The presentation is based on the Public Health 2030 project, and that project came about following scenario reports on primary care, on vulnerability, social and economic vulnerability in the United States and on health and health care.
NPH: What are some of the key points about the Public Health 2030 project?
CB: With Public Health 2030, there are a host of challenges and opportunities facing health departments. There are the ongoing fiscal issues at the state and local governmental levels, there’s increased infectious disease, there are climate-change-related changes that communities are facing.
Financial Incentives Double Smoking Quit Rates
Offering small financial incentives doubles smoking cessation rates among low-income smokers, according to research from The University of Texas Health Science Center at Houston. The study was published in the American Journal of Public Health. Participants in the intervention group could earn up to $150 in gift cards over four weeks. Progress was monitored for 12 weeks following the quit date. A control group received only cessation information, no incentives. The researchers found that quit rates were 49 percent for those in the incentive group but only 25 percent in the control group. Read more on tobacco.
Two Thirds of Parents Would Take Kids out of Daycare if Other Children Don’t Have Their Immunizations
A national survey of parents with children ages 0-5 found that three quarters of them would take their children out of daycare if at least one quarter of the children at daycare were not up to date on their vaccines. The researchers say the scenario is realistic since about 25 percent of preschool children in the United States are not fully vaccinated, according to national statistics. Just over 40 percent of survey responders also said that children missing vaccines should be asked to leave daycare until they are up to date. Read more on vaccines.
Three Drugs During Pregnancy Better Than Current Complicated Regimen for Preventing Mother-to-Baby HIV Transmission
For HIV-infected women in good immune health, taking a three-drug regimen during pregnancy prevents mother-to-child HIV transmission more effectively than taking one drug during pregnancy, another during labor and two more after giving birth, according to a new study funded by the National Institutes of Health. Read more on maternal and infant health.
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.