Communities Are Using a Powerful Tool to Journey Toward Better Health

Jun 27, 2016, 2:00 PM, Posted by Kate Konkle

Communities across the United States are using data to help set goals, measure progress and provide better services that will ultimately improve residents' health.

Graphic showing how data can inform health

“Where have we been? Where are we going? How can we get there?” These are the questions facing communities who want to make health a right, not a privilege, for all of their residents. And they can’t answer these questions without one critical tool: data.

As a former community coach with the Roadmaps to Health Action Center, I was a sounding board, devil’s advocate and cheerleader all in one. I was also a data guru, helping communities use numbers to guide decisions and come together around priorities.

Data is a powerful tool in any community’s work to build a Culture of Health. A good place to start looking for data is the County Health Rankings, a collaboration of the Robert Wood Johnson Foundation and the University of Wisconsin, because it compiles health stats on nearly every county in the nation. Other sources, such as federal, state and local departments of health, education, labor, and parks and recreation also provide useful statistics. In some cases, I advise communities to consider collecting their own data, either because the information they want isn’t already collected, or because existing sources don’t provide the rich level of detail they need about particular populations or issues.

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The Impact of Climate Change on Health and Equity

Jun 22, 2016, 9:00 AM, Posted by Alonzo L. Plough

Tackling the daunting health effects of climate change requires community leaders from all sectors to work together to meet the needs of everyone, especially the most vulnerable.

A flooded town after a big storm.

It’s been nearly 10 years, but I still remember the deadly heatwave that hit California back in July 2006 and claimed hundreds of lives.

The blistering heat lasted for 10 days, with temperatures soaring as high as 119 degrees—the highest ever recorded in Los Angeles County. The number of heat-related deaths was estimated to be as high as 450 across nine counties, including Los Angeles County.

During the five years that I worked as director of emergency preparedness and response for the Los Angeles County Department of Health, we constantly battled the health effects of really hot days, wildfires and droughts.

These weather phenomena directly impact health—and they are all linked with global climate change. Just this past weekend, during a trip to Yosemite National Park, President Obama noted, “Climate change is no longer a threat—it’s a reality.”

The people at greatest risk of serious harm from these climate change-related events include children, the elderly, people with chronic health conditions, the economically marginalized and communities of color.

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Costs of Care: Getting the Patient-Provider Conversation Right

Jun 15, 2016, 9:00 AM, Posted by Emmy Ganos

Doctors and patients want to talk transparently about the costs and value of health care, but it’s easier said than done. A new funding opportunity from RWJF seeks to address this challenge by surfacing best practices.

A doctor asks a patient how he is feeling in a cartoon illustration.

Health care is too often the most stressful part of the American family's budget. In a 2015 survey from the Kaiser Family Foundation, 42 percent of respondents reported that it is somewhat or very difficult to afford health services. This difficulty ranked higher than monthly utilities, housing, food expenses and transportation costs. In the same survey, more than half of respondents said that making information about the price of medical appointments, procedures and tests more available to patients should be a “top health care priority” for the President and Congress.

Rising out-of-pocket costs helped shape these attitudes, and they are hitting patients in the U.S. at all levels. For people with job-based insurance, the number of individuals with plan deductibles—and the size of those deductibles—has grown rapidly in recent years. In 2015, the rate of covered workers enrolled in a plan with an annual deductible of $1,000 or more for single coverage was 63 percent, a significant jump from 10 percent in 2006. This year, deductibles in marketplace plans are even higher than employer insurance, averaging $3,064 for coverage in the popular "silver" tier. For low-income marketplace enrollees, they might qualify for cost-sharing reductions, but they aren’t completely shielded from out-of-pocket expenses.

How can we lower the burden of health care costs in the U.S.?

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How Can Partnering with the Housing Sector Improve Health?

Jun 8, 2016, 11:00 AM, Posted by Pamela Russo, Rebecca Morley

Collaboration between public health and housing sectors can vastly improve the quality of life within communities across the nation.  

Construction of houses in the area of the Jackson Medical Mall in Jackson, MS.

The house that Robert and Celeste Bridgeford bought in Curry County, Oregon over a decade ago wasn’t just old. It was dangerous. Water damage and thin walls wracked by decades of severe storms unleashed wide swaths of mold. The damaged floors put the whole family at risk of falling, especially Robert, disabled years ago by a work injury. “We had always planned to replace the house, but... then...life happened,” says Celeste.

The Bridgeford family—like a third of Curry County’s residents—lives in a prefab house that is manufactured in a factory and then transported to the site. About 40 percent of the prefab housing in Curry County is substandard. With little industry in the area, many families struggled to find work and couldn’t afford to fix or replace their homes.

This all started changing in 2013 when community groups, non-profits and public agencies joined to propose a pilot project for the state of Oregon. This project would, for the first time, provide low cost loans or other funds to help prefab home-owners repair or replace their homes.

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How Health Insurers Can Help Kids Reach a Healthy Weight

Jun 1, 2016, 12:30 PM, Posted by Katherine Hempstead, Victoria Brown

Innovative approaches in health insurance can help support youth development and prevent chronic diseases.

Attendees visit tables at a health and enrollment fair.

While research shows that access to safe neighborhood spaces for physical activity along with affordable healthy foods help families and kids maintain a healthy weight, it’s often not enough.

Health care economist Mike Bertaut illustrated this reality through a deeply personal and passionate post last month. He opened up about his lifelong struggle with obesity and shared some important lessons about how the health care sector can help children maintain a healthy weight. It’s a moving piece worth reading.

As Mike shows us, health care providers—and health insurers—have a critical role to play, especially for children and families at highest risk for obesity and obesity-related disease.

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Why Ashoka is Investing in Children's Wellbeing

May 25, 2016, 2:04 PM, Posted by Tim Scheu

Why is the organization that coined the term “social entrepreneur” putting an emphasis on children's wellbeing? Because it's a critical step in fostering changemakers in our communities.

What does children's well being mean to you?

Did you know that a playground for elephants needs water, plants and rhino playmates? Or that ‘Frogtown,’ the Kermit-friendly analog, needs a rainforest canopy to enable sound sleep and protection for eggs? At least, that was the case during an empathy exercise at Ashoka’s “Bring Your Child to Work Day.”

Even at a young age, children understand the multiple facets of wellbeing: safety and physical fitness, but also emotional attachment. As caregivers for the imaginary animals that populated their cardboard playgrounds, our children wanted a culture of health. As a father to three little girls, I want that same thing.

But in the United States, we don’t often operate from a mindset of wellbeing—or rather, we’re preoccupied with a very limited definition of wellbeing. The individuals, communities, and societies that surround us tend to view wellbeing as only material or physical wellness. Is that playground really safe? How many children are visiting the hospital every year? How many are living outside of homes? This approach to wellbeing creates structures which are reactionary, deficit-oriented and focused on reducing the negative effects of physical harm. We can do better.

Fortunately, leading social entrepreneurs like Dr. Terrie Rose are on the case. Using her venture, Baby’s Space, to transform the norms of childcare in low income neighborhoods, Terrie is ensuring that young children are not only safe, but are also offered emotional stability and opportunities for attachment with their caregivers. Tomas Alvarez is another example. Through Beats Rhymes and Life, Tomas works with mental health workers to offer a hip-hop-based therapy alternative to kids that have felt marginalized by traditional services.

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5 Reasons to Be Excited for the Changes Coming to Menus and Food Labels

May 20, 2016, 11:07 AM, Posted by Jasmine Hall Ratliff

Menu labeling in food retail establishments can help foster a Culture of Health in communities nationwide—here’s why this is great news for American consumers.

A cook at a fast food restaurant prepares a meal.

Today, First Lady Michelle Obama unveiled big news from the Food and Drug Administration: Consumers will soon begin to see an updated and increasingly useful Nutrition Facts Panel on packaged foods and beverages. This is the first comprehensive overhaul of the label since 1994.

Soon, those little black-and-white charts will inform you of the amount of added sugars in a product, and include a “daily value” to help you understand the maximum amount of added daily sugars recommended by experts. Serving sizes will also be revised to reflect the amounts of products that people typically consume in the real world. And, calorie counts will be listed in a much larger and bolder font to make them easier to spot.

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It's Time to Reframe How We Think About Education and Health

May 17, 2016, 10:03 AM, Posted by Kristin Schubert

Kids spend more time at school than anywhere outside their homes, making schools where we have the greatest chance of improving kids' health trajectory through physical, social and emotional development.

A student and her teacher walk down the hallway of the Cleveland Academy of Leadership elementary school.

My sister, Katy, and I grew up in a family of teachers. My mother, my father and my aunt all dedicated themselves to educating, inspiring, encouraging and supporting each student who came through their classrooms. While I chose to go into public health, Katy followed in their footsteps and is a fifth-grade teacher. Many of her students experience challenges at home that no child should have to face. So in order for her students to be engaged in learning, not only does she need to know her lesson plans, she also needs to know whether a student has eaten breakfast that day or is suffering from trauma that’s gone untreated. When a student acts out, she needs to understand what underlying issues are causing them to behave that way. She’s seen first-hand how difficult it is for her students to learn when many of their needs go unaddressed. And every day, I can see how the work we’re each doing in our respective fields intersects.

As the research shows, your education has far-reaching implications for your health. The more educated you are, the more likely you are to live a longer, healthier life. Now, more than ever, having a high school diploma can predict your likelihood of having diabetes, heart conditions or other diseases. And across racial and ethnic groups, life expectancy improves with increasing years of education.

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Everyone Has a Role in Building the Future of Nursing

May 13, 2016, 11:30 AM, Posted by Beth Toner

Two nurses practice taking a fake patient's vitals.

Six years ago, I graduated from nursing school at the age of 40-something—a feat accomplished while working full time, attending class and doing clinical rotations nights and weekends—with no small amount of support from my husband, my teenage children and my almost-3-year-old.

Frankly, when I graduated, I should have given each of them a gift for their support.

Instead, my then 15-year-old daughter gave me a copy of the book Critical Care by Theresa Brown, who, like me, was a second-career nurse. She’d heard her interviewed on National Public Radio and thought I might enjoy it. What I read in that book got me through some very rough overnight shifts when I was working per diem at my first job in long-term care. Her book reminded me that every new nurse is scared, tentative and not quite sure of her or himself. Yet somehow we muddle through, and we do the very best for our patients.

Fast forward to 2013, and I’d come to work at the Robert Wood Johnson Foundation.

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Why School Nurses Are the Ticket to Healthier Communities

May 11, 2016, 9:37 AM, Posted by Susan Hassmiller

A visit to Mt. Pleasant High School in Wilmington, Delaware, highlights the critical role that school nurses play in fostering healthier kids and communities.

A young girl has her blood pressure tested during health screenings at the ReGenesis Back to School Fair in Spartanburg, SC.

Robin Wallin, DNP, RN, first became concerned about the unmet dental needs of children attending the Alexandria City Public Schools in 2000 when one of the school nurses she supervised participated in a multidisciplinary evaluation for a kindergarten boy named José who could not sit still in class.

Upon examining his mouth, the nurse discovered gaping black holes where teeth should have been. She helped find an oral surgeon willing to treat José—who came from a low-income family without health insurance—free of charge. As it turned out, once José’s teeth were treated he no longer struggled with sitting still in class.

This experience led Wallin—who was then the Health Services Coordinator for the Alexandria City Public Schools in Alexandria, Virginia, and now serves as the director of health services at Parkway Schools in the Greater St. Louis area—to wonder if other kids like José struggled with school due to underlying oral health problems.

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