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Rebuilding Healthier and More Resilient Communities Together

Dec 7, 2015, 4:01 PM, Posted by Reed Tuckson

Our nation spends billions of dollars to respond to, and rebuild from, disasters, which is why disaster planning must move beyond a narrow focus and create an optimally healthy community.

Trauma and Resilience

It felt like a nightmare to watch the floodwaters rise across New Orleans in August 2005. Yet as the hours turned into days, our nation realized we were watching reality – the reality of a great American city coping with a disaster for which city, state and country had not fully prepared.

The good news is that in the decade since, New Orleans has worked towards a new reality by not just rebuilding what was lost, but by asking how it can rebuild better. In so doing, the city is setting an example for us all.  

Rebuilding better means repairing critical infrastructure (roads, hospitals, businesses, levees), and reforming the organization and interpersonal relationships that are essential to promoting well-being and community engagement. As has been well chronicled, such efforts include fostering neighbor-to-neighbor ties, using data to guide community heath strategic planning, and encouraging multi-sector partnerships between government, business and community organizations. In New Orleans, initiatives such as Fit NOLA and NOLA for Life have united the city’s health department, schools, community-based organizations, and businesses in ways that were unimaginable before the storm.

New Orleans’ efforts align closely with the recommendations of the recently released report, “Healthy, Resilient and Sustainable Communities after Disasters: Strategies, Opportunities, and Planning for Recovery,” intended as a call to action and an action guide. The Institute of Medicine and the National Academy of Science was commissioned to produce this report by the Robert Wood Johnson Foundation. I was honored to serve as chair of the committee, which was composed of disaster planning, and health and human service experts. We were tasked with identifying ways in which local and national leaders can work together to mitigate disaster-related health impacts and optimize the use of disaster resources to create communities that are healthier and more resilient.

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Closing Health Gaps: The Oklahoma Example

Dec 7, 2015, 8:00 AM, Posted by Andrea Ducas

With the right data to inform priorities, and a powerful commitment to equity, places like Tulsa, Okla., are making progress to close health gaps.

Adult and child reading a book in the classroom.

What would your ideal future look like? For me and my colleagues at the Foundation, it would be one where everyone has the opportunity to live the healthiest life they can.

An unfortunate reality in this country, however, is that while we continue to realize substantial gains in health, the things that help people become and stay healthy are not evenly distributed across states or even metropolitan areas. Access to healthy foods, opportunities for exercise, good-paying jobs, good schools, and high quality health care services may be readily available in one area, and difficult to come by or nonexistent in another just a few miles away.

Sometimes the differences are particularly stark: In some communities, two children growing up just a short subway or car ride apart could be separated by a 10-year difference in life expectancy.

So how do we square this reality with the Culture of Health we’re working hard with others to build? An important first step is recognizing those disparities and what’s driving them, and ensuring that people in communities across America have strategies – and the data – they can use to proactively close health gaps.

Let’s use Oklahoma, and within it the city of Tulsa, as an example.

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BUILDing Bridges To Better Health Through Partnerships

Dec 1, 2015, 3:30 PM, Posted by Amy Slonim

A new collaboration is helping communities forge partnerships that address the social determinants of health integral to the well-being of individuals and communities.

BUILD Health panel at Colorado Health Symposium BUILD funding partners (from left to right): Chris Denby, The Advisory Board Company; Christopher Smith, Colorado Health Foundation; Chris Kabel, The Kresge Foundation; Amy Slonim, Robert Wood Johnson Foundation; Brian Castrucci, de Beaumont Foundation; Rachel Keller Eisman, The Advisory Board Company. [Photo credit: Chris Schneider for the Colorado Health Foundation]

“This is about communities owning the solutions to improving health ... this is where the rubber meets the road." That’s how my colleague Brian Castrucci, chief program and strategy officer at the de Beaumont Foundation, described the goals of the BUILD Health Challenge during the fifteenth annual Colorado Health Symposium. Brian and I shared the symposium stage with senior officers from the four foundations and one for-profit firm that, together with the Robert Wood Johnson Foundation (RWJF), launched the BUILD Health Challenge earlier this year.

Why do communities need to BUILD bridges to improve health? For RWJF, the BUILD Health Challenge embodies the essence of our Foundation’s focus on bridging. As my colleague Paul Kuehnert notes, health care, public health and social services have traditionally operated in siloes. By breaking down these siloes and “bridging” health care with systems that are not traditionally thought of as health-related—such as education, housing and transportation—we can help people get the services they need, when they need them.

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A New Nutrition Research Center Set on Making New Jersey a Healthier State

Nov 23, 2015, 11:39 AM, Posted by Peter Gillies

The New Jersey Institute for Food, Nutrition, and Health is impressive both in size as well as in its plans to help transform New Jersey into a national model for promoting healthier lifestyles for children and families.

Last month, Rutgers University opened the doors to the New Jersey Institute for Food, Nutrition, and Health (IFNH), a new interdisciplinary research hub for scholars, policymakers, students, and parents to advance, educate and promote issues of nutrition and wellness. At the dedication ceremony, I couldn’t help but think of something the great Chicago architect Daniel Burnham once said:

“Make no little plans.”

It’s no surprise that an architect would come to mind as I sat proudly marveling in the atrium of our magnificent new home. The modern, open-concept building is a beautiful addition to the Rutgers campus, designed with nearly 70,000 square feet of research and community space dedicated to making New Jersey a healthier and happier state. It’s also a heartening testament to the support we enjoy from organizations like the Robert Wood Johnson Foundation (RWJF), which calls on all of us to work together to build a Culture of Health, where getting healthy and staying healthy are guiding values.

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New Partners, New Ways of Thinking: Supporting “Change Leadership” to Build a Healthier Nation

Nov 19, 2015, 1:17 PM, Posted by Herminia Palacio

Building a Culture of Health requires supporting and connecting leaders who can drive change by tolerating risk and seeking inspiration through collaboration.

Audience members listen during a presentation

Building a Culture of Health isn’t easy. It may seem obvious, but think about it: Our nation didn’t develop its current Culture of Unhealth overnight. Reversing it won’t happen quickly, either. As John Lumpkin pointed out recently, paraphrasing Albert Einstein: “You cannot fix problems with the same logic you used in creating them.”

That’s why change leadership is so important.

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Do-It-Yourself Health: How the Maker Movement is Innovating Health Care

Nov 16, 2015, 11:14 AM, Posted by Anna Young

MakerNurse is changing the game for nurses by tapping into their natural problem-solving skills and bringing the spirit of invention, creativity, and innovation into medical settings.

Debra Flynn shows off the prototype of the shower sleeve she designed at the first medical maker space. Debra Flynn shows off the prototype of the shower sleeve she designed at the first medical maker space.

Anyone who has spent time in a hospital knows that—more often than not—nurses are the professionals who catch the little problems with your care: the uncomfortable IV tube, the bandage that doesn’t quite fit, the pill bottle that’s hard to open.

Nurses are natural problem solvers. They cut down bandages to fit preemies. They fashion a plastic cup around an IV site to stop it from snagging clothes. They roll up two hospital blankets and wrap them in tape to make a “cough pillow”—something to clutch against your stomach to ease the pain of laughing or coughing after abdominal surgery. These DIY medical devices are made by nurses every day in hospitals.

Nurses are uniquely positioned to spot such problems. So, why not encourage nurses to continue devising their own solutions, then give them the tools to create them?

With MakerNurse, that’s exactly what we’re doing.

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Measuring What Matters: Introducing a New Action Framework

Nov 11, 2015, 11:30 AM, Posted by Alonzo L. Plough

It's time to change our culture into one that values health everywhere, for everyone. Introducing a new Action Framework and Measures to help us get there.

A Culture of Health is where communities can flourish and individuals thrive.

Our nation is at a critical moment. There is plenty of data that reveals discouraging health trends: We are living shorter, sicker lives. One in five of us live in neighborhoods with high rates of crime, pollution, inadequate housing, lack of jobs, and limited access to nutritious food.

But there is other data that gives us glimpses of an optimistic future. There’s increasing evidence that demonstrates how we can become a healthier, more equitable society. It requires a shared vision, hard work, and the tenacity of many, but we know it is possible.

Starting with a Vision

Last year, the Robert Wood Johnson Foundation (RWJF) shared our vision of a country where we strive together to build a Culture of Health and, every person has an equal opportunity to live the healthiest life they can—regardless of where they may live, how much they earn, or the color of their skin.

As my colleagues and I traveled throughout the country, we met many of you and heard your views on an integrated, comprehensive approach to health. You told us that in order to achieve lasting change, the nation cannot continue doing more of the same. Realizing a new vision for a healthy population will require different sectors to come together in innovative ways to solve interconnected problems. 

A First Friday Google+Hangout discussion on "Measuring What Matters in Building a Culture of Health" took place on Friday, November 6

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Disrupting the Status Quo: Seeking Innovations from Low-Resource Communities

Nov 4, 2015, 3:03 PM, Posted by Catherine Arnst

A call for proposals seeks to support evaluation of disruptive innovations that improve the health of low-resource communities—without increasing costs.

Brownsville Belden Community Garden

Many of the resources that influence whether or not people are healthy vary widely from one community to the next. Income, education and employment levels, access to quality, affordable health care, the availability of social services, and the cultural and physical environment—all have a significant impact on health outcomes. Poorer communities, lacking in resources may struggle to offer all the components that create a healthy environment to live, learn, work and play.

By necessity, however, these low-resource communities often find new and creative ways to do more with less to promote health.  In an effort to uncover such fresh and disruptive approaches to improving health in these communities, the Robert Wood Johnson Foundation (RWJF) is issuing a call for proposals.

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Open Enrollment: One Step Closer to Coverage for All

Nov 2, 2015, 9:00 AM, Posted by John Lumpkin

Let’s build upon the success of the Affordable Care Act with this year’s open enrollment.

A pediatrician makes a house visit to check on an infant patient.

Open enrollment is here again—the annual opportunity for Americans to find and enroll in a health plan through HealthCare.gov or their state-based health insurance marketplace. In three short years, millions of Americans have gained access to health plans that cover important services like doctor’s visits, prescriptions, hospital stays, preventive care, and more. As a doctor, I’ve seen the difference health coverage can make in the lives of families. Quality, affordable health insurance means new access to care—care that can have a huge impact on health, equity, financial security, and a better quality of life. It moves us closer to a Culture of Health, where people can access care when they’re sick and when they’re well, making prevention the priority.

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What Right Care Means to Me: The Physician’s View

Oct 21, 2015, 1:11 PM, Posted by Kathleen Grimm, Vikas Saini

Two physicians describe how they are mobilizing patients, providers and others, to change the culture of overuse in health care, to one that is individualized, compassionate and just.

Two doctors standing in a corridor consult together over some paperwork.

The end of life can be fraught with emotion and excruciating decisions for families. It is a time when overuse of treatments and interventions occurs far too frequently. The culture of medicine teaches physicians to “do everything you can” to keep patients alive, with an underlying message that more is better when it comes to treatments and interventions. For doctors, patients and their families, making the decision to refuse extraordinary measures can feel like giving up.

As physicians who are active in the Lown Institute’s RightCare Alliance, we are dedicated to changing this culture. We know that a range of practices persist as standards that don’t improve the length or quality of life. Overuse and inappropriate care are baked into how we do things to the point that they are almost invisible. From frequent blood draws in the hospital to unneeded imaging for a normal pregnancy and futile chemotherapy in end-stage cancer, our goal is to keep patients safe from unnecessary diagnosis, treatment, and ultimately, harm. We think that it is critical to combine an understanding of the true benefits and risks of procedures and therapies with a respect for a patient’s wishes. Such a thoughtful approach that individualizes care, promotes doing more for the patient and less to the patient.

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