Helping Young People in Crisis, One Text at a Time

Feb 16, 2017, 8:00 AM, Posted by Tracy Costigan

Crisis Text Line uses technology to help adolescents struggling with issues like bullying and anxiety. Now, researchers are using data compiled through this effort to better understand and address patterns of adolescent mental health needs within communities.

It began with a shocking text message that left the staff at DoSomething.org deeply shaken.

The non-profit organization was originally created to promote youth volunteer and social action opportunities. It uses texting—the primary way in which teens communicate—to send thousands of daily messages alerting members to clothing drives, health fairs, park clean-ups, and more. Responses have been common. In addition to the usual sign-up requests, texters have also sought advice on how to handle a bully at school or help a friend struggling with addiction.

But as DoSomething’s CEO Nancy Lublin explained in a memorable TED Talk, one particular message from an anonymous girl changed their world.

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Seeking Evidence for How Policy Can Improve Health

Feb 7, 2017, 9:00 AM, Posted by Kerry Anne McGeary, Mona Shah

$2 million in research funding is available to non-profit or public research institutions that can build an evidence base for how policies, laws, and guidelines can help everyone live a healthier life.

There are countless examples of how policies, laws, and guidelines can help people in our society live better and healthier lives. For example, zoning ordinances can help keep dangerous manufacturing emissions away from homes and schools, ensuring that children aren’t exposed to toxic pollutants. Earned Income Tax Credits have been shown to improve infant mortality and birth outcomes. Healthy food guidelines can help our kids consume less sugar by recommending schools provide whole foods, like apples. These policies shape how we live, learn, work, and play.

But there is still too much we don’t know. If your organization is a non-profit or public research institution, this is where you come in.

Through a new call for proposals from its Policies for Action (P4A) program, the Robert Wood Johnson Foundation (RWJF) seeks to build a stronger evidence base for how policies, laws, and guidelines—in the public or private sectors—can help ensure everyone has the opportunity to live a healthier life.

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Improving Community Health While Reducing Costs: Is it Possible?

Jan 19, 2017, 10:00 AM, Posted by Alexandra Chan, Elise Miller

Community Health Funds (CHFs) are a new way to make communities healthier while reducing costs and supporting collaboration. A new project is asking communities to share and spread lessons from CHF and other health partnership experiences.

Over 80,000 children in Massachusetts suffer from asthma which, when left unmanaged, can dramatically impact overall health, limit school attendance and physical activity. In many cases, uncontrolled asthma symptoms lead to costly emergency room visits. Treating this problem on a large scale will take more than inhalers—it requires coordinated community action. Through the Massachusetts Prevention and Wellness Trust Fund (PWTF), Lynn, Worcester, Holyoke, and other cities have formed community-based partnerships to address several chronic conditions, including childhood asthma. Thanks to these efforts, families receive education, care management and home visits to better manage childhood asthma and ultimately improve their daily lives.

Since underlying social, economic, and environmental factors influence community health issues, the solutions to these issues need a cross-sector approach. But this is sometimes challenging since stakeholders can lack funding and incentives to collaborate.

PWTF was created to address this dilemma. It is a Community Health Fund (CHF)—a financial trust to address local health priorities and promote prevention. CHFs have emerged as an innovative approach for coordinating strategy and shared, flexible funding that supports community stakeholders to work together.

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A Conversation on the Future of Health Equity Research

Jan 12, 2017, 4:43 PM, Posted by Tracy Orleans

In the past decade, the healthy equity research landscape has shifted from building the evidence to identifying solutions. David Williams and Paula Braveman share thoughts on the evolution of research with a look to the future.

The latest National Academies of Science Engineering and Medicine report notes that compared to other fields of health research, health inequities is still a relatively new field that faces significant research and practical application challenges. The consensus report provides specific recommendations including: expanded health disparity indicators, longer-term studies, an examination of structural factors, and new research funding opportunities. RWJF’s Tracy Orleans talks with two of the nation’s leading experts on health equity and health disparities, Dr. David R. Williams and Dr. Paula Braveman, who share their thoughts on some of these issues and the evolution of research with a look to the future. 


Tracy Orleans: Nearly ten years ago you started work together on the RWJF Commission to Build a Healthier America. At the time, gaps in health between groups of people or communities were not news to health experts, but they were surprising to a lot of others. We’ve come a long way since then with a more explicit focus on health equity research. How do you view this shift?

 

David Williams: For a long time, researchers focused on documenting the health differences between populations. Those differences are now well-established and we’re able to point to more scientific evidence about why the gaps exist. For example, there’s a growing body of research around the effects of epigenetic aging, which shows that people who experience discrimination or other trauma are biologically older than people of the same chronological age. Science shows that their telomeres, which protect chromosomes from fraying, are shorter among both children and adults who are black, poor, or from unstable homes. This type of more explicit health equity research is a rapidly growing field.

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What If All Children Could Attend Preschool?

Jan 3, 2017, 3:00 PM, Posted by Susan Mende, Tara Oakman

In Europe, rich and poor kids alike are enrolling in early care and preschool programs in large numbers. These accomplishments offer us insights for our collective efforts to strengthen early education in the U.S.

For the past 18 years, every 4-year-old in Oklahoma has been guaranteed a spot in preschool, for free. These kids are learning their letters, numbers, colors and shapes. They’re also developing arguably more important social and emotional tools--how to make friends, feel empathy, solve problems, manage conflict. These are the kind of building blocks children need to become thriving adults.

Nearly 75 percent of 4-year-olds are enrolled in Oklahoma’s pre-K program. That's one of the highest participation rates in the country. But if we look across the United States, we see that just 61 percent of kids between the ages of 3 and 6 are enrolled in pre-K, daycare or other formal early childhood education program. 

Why? Of course, many parents stay home or have a friend, neighbor or relative take care of their kid. But a recent Harvard poll of parents with children under the age of five highlights the struggles families face in finding quality, affordable child care. Many parents reported having limited options and said that the cost of child care had caused financial problems. Low-income families were especially likely to report difficulty accessing care.

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How a Healthy Food System Can Transform Your Community

Nov 28, 2016, 9:00 AM, Posted by Dana Harvey

Mandela MarketPlace understands that community members hold the key to positive change. By lifting up a culture of community ownership, Mandela is increasing access to healthy food and sustainable business opportunities.

Sixteen years ago, I embarked on what I thought would be a year-long project to help the residents of West Oakland gain reliable access to affordable, nutritious food.

More than 23.5 million people live in low-income areas that are more than a mile from a supermarket, according to the USDA. That includes West Oakland, one of the city’s poorest areas. The community has a high rate of crime, pollution and unemployment—along with dozens of liquor stores and fast food outlets. Health outcomes are dismal; residents are two times more likely to be born at a low birth weight and 2.5 times more likely to die of stroke than residents in the nearby affluent area of Oakland Hills.

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Encouraging Progress on the State of Obesity in the United States

Nov 17, 2016, 3:00 PM, Posted by Donald F. Schwarz, Richard Hamburg

Teaming up to reverse childhood obesity has yielded promising results—including new data that shows rates among 2-4 year olds enrolled in the federal WIC program have declined in 31 states. But the work is far from over. 

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Home Visits Work: Let’s Make Them Universal

Nov 14, 2016, 1:31 PM, Posted by Martha Davis

Every family deserves an equal opportunity to build a healthy, nurturing environment that helps their kids thrive. That’s where home visits come in.

Some of the most fulfilling and valuable experiences of my early career involved working as a home visitor about twenty years ago. I traveled through Philadelphia’s most underserved neighborhoods with a team from the MomMobile, a community-based organization that provides free support and education to families facing the challenges that pregnancy and parenting bring. I’ve personally witnessed the powerful impact home visits have on families, and that’s why I’m so passionate about the role they can play in building a Culture of Health.

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Tackling Life Expectancy Gaps in New Jersey

Nov 9, 2016, 9:00 AM, Posted by Bob Atkins

New Jersey Health Initiatives is driven by five key principles for building empowered, equitable and healthier communities and narrowing the gaps in life expectancy across the state.

It’s a dismaying fact that we’re all familiar with: where you live has an enormous impact on your life expectancy. Indeed, some researchers now quip that your ZIP code may matter just as much, if not more, than your genetic code when it comes to your health. As one journalistic account put it, it’s “Death by Zip Code.”

New Jersey is no different. This summer, the Robert Wood Johnson Foundation (RWJF), together with Virginia Commonwealth University, published analyses of Mercer County, a prime place to showcase the impact of geography on health. It’s home to both affluent Princeton and economically strapped Trenton. And perhaps not surprisingly, life expectancy reflects the gulf in resources between the two towns. While a person born in Princeton can expect to live 87 years, his or her neighbor in Trenton has a life expectancy of 73 years—a staggering 14 year age gap across only a dozen miles.

These results are sobering. It’s easy to get despondent over them and locked into a narrative of failure and decline. But RWJF’s Culture of Health efforts involve cultivating potential, even in places where we wouldn’t normally think to find it. That’s where New Jersey Health Initiatives’ (NJHI) work comes in.

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A New Innovation Award for Health Care Provider Training and Education

Nov 1, 2016, 9:00 AM, Posted by Jenny Bogard

Providers need to be equipped with the tools to help patients make healthy choices. That’s why the Alliance for Healthier Generation is recognizing innovative training programs providing nutrition, physical activity and obesity counseling education to their students.

Even at the young age of four, Luke was overweight. In fifth grade, he tried out for the baseball team, and although he made it, he struggled that season. He was slower than the other kids as he rounded the bases, and he started having knee pain from the extra weight on his joints. Luke and his family knew they had to do something. But they dreaded going to the doctor, knowing he’d get weighed and then have to confront the escalating numbers on the scale. Year after year, the same thing would happen, and they’d have the same discussion with his doctor when they finally worked up the nerve to go. But the weight never came off.

Apprehension about a visit to the doctor is something we all face, no matter our age or health. Who among us doesn’t get a little nervous before our annual visit, knowing we might face a difficult conversation about losing weight, or flossing more, or stopping smoking? These are things we all know, but have a hard time talking about.

And even worse, if we do have these important conversations, they can lead to feelings of shame and disappointment.

But the reality is that it’s not necessarily your doctor’s fault. Even with the hundreds of thousands of hours of education your doctor gets in classrooms and hospitals, most receive little to no training in how to talk to patients about making healthy choices. In fact, fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise recommended by the National Academy of Sciences, Engineering and Medicine.

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