Author Archives: Alonzo L. Plough

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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Beyond Seat Belts and Bike Helmets: Policies that Improve Lives

Jan 27, 2016, 9:13 AM, Posted by Alonzo L. Plough

RWJF announces up to $1.5 million in new funding to create the evidence base needed for a new generation of policies that improve health, well-being and equity.

Needed: Research to inform laws and policies that elevate community health and equity.

Some of us remember the bad old days when nobody wore seat belts and babies bounced on their mothers’ laps in the front seats of cars. For others, it’s the stuff of legend. Since the advent of seat belt laws in the late 1980’s, the proportion of people buckling up has skyrocketed from fewer than 15 percent to over 90 percent in many states. The laws required people to change their behavior initially and continuously until buckling up was a habit of mind and a social norm. Accordingly, the number of deaths and serious injuries from car accidents has plummeted by more than half.  Other policies—including minimum wage laws, zoning and urban planning, or childcare regulations and guidelines—have had large effects on improving population health.

At the Robert Wood Johnson Foundation (RWJF), we have witnessed firsthand the impact that policies and laws can have in improving health. With this in mind, RWJF is launching Policy for Action (P4A). This new initiative provides up to $1.5 million in funding (or $250K in individual grants up to two years) for research efforts that identify policies, laws and regulations in the public and private sectors that support building a Culture of Health. Our focus is intentionally wide-ranging. We recognize that policies developed both within health and prevention sectors and beyond—in education, economics, transportation, justice, and housing, for example—can ultimately affect the ability of all Americans to lead healthy lives.

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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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Collaborating Across Sectors to Grow Healthy Kids

Sep 30, 2015, 1:21 PM, Posted by Alonzo L. Plough

Schools are usually considered to be part of a system separate from the health care system, but they play an important role in building a Culture of Health. See how cross-sector collaborations can ensure children strong starts to healthy, productive lives.

A child eats his lunch at school.

At Cincinnati's Oyler School, I watched as a third-grader received a free eye exam and then pored over the selection of eyeglasses, trying on several pairs, eventually settling on a pair of funky blue frames. He shared that he was looking forward to receiving his glasses, which he'd be able to take home for free the following week. The student’s teacher had noticed that he was having trouble seeing the board in their classroom and was empowered to do something about it. By forging partnerships with nonprofits and government agencies, Oyler has created a vision center, health clinic and dental clinic—all within the school.

Oyler has undergone a transformation over the last decade—from a school plagued by increasing poverty and declining enrollment to a school that is boosting graduation rates and helping improve the surrounding community. Oyler ensures students and their families have access to healthy meals by providing kids breakfast, lunch and dinner and sending them home with food on the weekends. It is part of a movement to create "community schools" that address kids' health needs and get them access to resources that allow them to succeed in the classroom and for years to come.

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What Hurricane Katrina Taught Us About Community Resilience

Aug 27, 2015, 8:59 AM, Posted by Alonzo L. Plough, Anita Chandra

Hurricane Katrina left a path of destruction, death, and suffering in its wake. Its uneven recovery has taught us valuable lessons about community resiliency that will help us prepare for the next storm and beyond.

New Oreleans St. Bernard Housing project. Girl on scooter.

Ten years ago Risa Lavizzo-Mourey visited Gulfport, Mississippi, and witnessed firsthand the devastation and ruin wrought by Hurricane Katrina. “We may not be able to fix the broken levees, restore ruined cities, house the homeless, or feed the hungry,” she wrote soon after. “That’s not our job. But we most certainly can apply Katrina’s lessons to the wide range of good work that we support...”

On the 10th anniversary of Hurricane Katrina, we must reflect on valuable lessons learned from this cataclysmic event, the complexity of recovery, and the disastrous health outcomes that can result from a fundamental distrust between residents and government agencies. Katrina’s devastation and the Gulf’s uneven recovery also have served as an opportunity for studying resiliency—the capacity of communities to prepare for, respond to, and recover from adversity whether in the form of a natural disaster, economic downturn, or a pandemic.

This emphasis on community resilience represents a paradigm shift in emergency preparedness, which has traditionally focused on shoring up infrastructure (reinforcing buildings, roads, and levees), improving detection of new hazards to human health, and being able to mount an immediate response to disasters. Katrina and subsequent threats such as Hurricane Sandy, the Florida panhandle oil spill and the H1N1 epidemic have taught us that to be truly prepared for the long-term impact of adversity communities must also develop a different set of assets: those that build strength through promoting well-being and community engagement.

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Using Social Data to Build Our Evidence Base

Jul 16, 2015, 2:22 PM, Posted by Alonzo L. Plough, Lori Melichar

Social media offers an exciting opportunity to innovate in health research—but the social data sandbox could use more players to conduct research, share datasets, and generate ideas about what we should be studying.

social-media

What do our tweets reveal about our health? What can we learn from Twitter about the health of those in our community? Can analysis of Twitter activity help predict an epidemic like the flu weeks before a community is inundated with cases?

Nicholas Christakis, director of the Human Nature Lab at Yale University and Thomas Keegan, Deputy Director of the Yale Institute for Network Science are conducting pilot studies in San Francisco and Boston to explore these questions and more. With funding from RWJF, Christakis’s lab uses Twitter posts that include mention of flu symptoms to map how the virus spreads outward from individuals to family, friends, and others in their social networks. This mapping method, which identifies central “influential” individuals, offers the possibility of early detection of the flu and therefore early intervention to prevent its spread. In addition to giving health officials and medical personnel a valuable head-start in responding to and preventing the spread of contagious illness, this kind of insight could also help people make decisions about their own behavior, including getting flu vaccines and being more diligent about hand washing.

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Clearing the Air in Louisville through Data and Design

May 13, 2015, 12:44 PM, Posted by Alonzo L. Plough

Louisville, Kentucky ranks among the poorest in air quality and highest in asthma rates among U.S. cities. A new art installation from Propeller Health shows residents real-time changes in the city's air quality, equipping them with the data to reach their goal of becoming one of the healthiest cities by 2020.

Airbare air quality installation in Louisville, Kentucky

I stand in front of an intriguing art installation on a busy street corner in downtown Louisville, KY, and visualize the invisible. It’s a bright orange steel kiosk outfitted with an interactive touch screen that allows passersby to “see” how air pollution levels change around the city in real time while also learning how these pollutants impact the severity of asthma symptoms. Called AirBare, the installation project was funded by RWJF and represents a unique collaboration between visual artists, big data analysts and local health advocates. By “popping” virtual bubbles on the screen, users find out what causes air pollution and what it will take to reverse it. This is relevant information for residents of Louisville, a city that consistently ranks among the lowest in air quality in the nation and has one of the highest rates of asthma and other respiratory conditions.

My visit to the AirBare installation coincided with a conference held in Louisville in March that brought together economists, health policy folks, food experts and, remarkably, Charles, the Prince of Wales, to examine the issue of air quality and the larger concept of sustainability in this Ohio River Valley city. The Prince, a longtime advocate for environmental issues with connections in Louisville, added star power to the Harmony & Health conference, sponsored by the non-profit Institute of Health Air Water & Soil. But there is plenty else to be excited about in Louisville. Under the leadership of Mayor Greg Fischer, city agencies have collected reams of data on air quality, health outcomes, life expectancy, income inequality, and unemployment, among many other measures. What has emerged is a far better picture of the tough environmental and socioeconomic issues impacting the health and wellbeing of Louisville’s 600,000 residents, and a serious and concerted commitment to build a culture of health.

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How Can We Use a Wealth of Data to Improve the Health of Communities Across the Nation?

Apr 6, 2015, 11:15 AM, Posted by Alonzo L. Plough

There's a wealth of data that paints a picture of the health challenges and successes of communities across the country. It's critical to use that data to measure progress in order to raise the grade of our nation's health.

Signs of Progress - Philadelphia

For local health officials across the nation, the release of the 2015 County Health Rankings gives communities an important opportunity to reflect on how they are doing when it comes to the health of their residents. The Rankings are a snapshot capturing the healthiest or least healthy counties in a given state.

But the Rankings also give communities a chance to delve deeper and explore beyond the headlines and the misrepresentative “best and worst” lists. Through the Rankings, we can really dive into data that can help us understand how to build a Culture of Health for citizens in all counties across the nation.

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Research Designed Through the Eyes of Youth

Mar 17, 2015, 12:30 PM, Posted by Alonzo L. Plough, Dwayne Proctor

There's power in giving youth the means to document what they see as the barriers to their community's health. This project from Charlotte, N.C. shows us how this innovative research design can be a step to addressing local disparities.

Last year, we at the Robert Wood Johnson Foundation asked our community a bold question: What was considered the most influential research around identifying and eliminating disparities? In our first-ever Culture of Health reader poll, a winning research paper emerged in Por Nuestros Ojos: Understanding Social Determinants of Health through the Eyes of Youth, published in the Summer 2014 edition of Progress in Community Health Partnerships. The research project equipped young people in Charlotte, N. C., with cameras to identify and document environmental factors that impact health in their Latino immigrant community. What really makes this paper resonate for us—and, it seems, for many of you—is that it provides a clear example of how community-based participatory research (CBPR) is an important approach to understanding the multiple factors underlying health disparities.

We wanted to learn more about this interesting example of participatory research and how the Por Nuestros Ojos project is helping advance health equity in Charlotte. Recently, our blog team had a conversation with three of the study’s authors to find out how employing a participatory research model can help enormously in understanding and eliminating disparities in marginalized communities. Below is an interview with Johanna (Claire) Schuch, research assistant and doctoral candidate at the University of North Carolina at Charlotte (UNCC); Brisa Urquieta de Hernandez, project manager at the Carolinas HealthCare System and doctoral student at UNCC; and Heather Smith PhD, professor, also at UNCC.

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Setting Our Sights on Healthy Media Consumption

Feb 23, 2015, 4:27 PM, Posted by Alonzo L. Plough

Alonzo Plough, PhD, MPH, is vice president, Research-Evaluation-Learning and chief science officer for the Robert Wood Johnson Foundation. Read more from his series.

kidsfastfoodads_part2

Childhood obesity is a tremendous threat to the current and future health of our young people. Compared with their healthy-weight peers, obese children face a higher risk for serious health problems, miss more school, have greater psychological stress, and are more likely to become obese as adults. If we don’t do something to reverse this epidemic, the nation’s current generation could be the first in history to live sicker and die younger than their parents’ generation. This is why RWJF recently pledged $500 million over the next 10 years to support strategies aimed at helping all children in the United States grow up at a healthy weight. This new funding increases our investment in preventing childhood obesity to more than $1 billion—the largest commitment we have ever made on a single issue.

We are in it for the long haul, and we have already seen signs of progress. Research published last year showed obesity prevalence among 2 to 5 years old dropped by approximately 40 percent in eight years. But nearly one-third of children and adolescents in the U.S. are still obese or overweight, and more than 25 million are at risk for high blood pressure or Type 2 diabetes because of their weight.

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