Jan 23, 2015, 9:00 AM, Posted by
Erin D. Maughan, PhD, MS, RN, APHN-BC, is director of research at the National Association of School Nurses and a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2013 Cohort).
If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either. One of the places to begin coordinated cultural change is in schools.
Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.
There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.
View full post
Nov 14, 2014, 8:00 AM, Posted by
Eileen Lake, PhD, RN, FAAN, and Jeannette Rogowski, PhD, are co-principal investigators of a study, supported by the Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative, that generated evidence linking nurse staffing and work environments to infant outcomes in a national sample of neonatal intensive care units.* A new documentary, “Surviving Year One,” examines infant mortality in Rochester, N.Y. and nationwide. It is being shown on PBS and World Channel stations (check local listings). Read more about it on the RWJF Culture of Health Blog here and here.
Are some premature babies simply born in the wrong place? Premature babies are fragile at birth and most infant deaths in this country are due to prematurity. It is well established that blacks have poorer health than whites in our country, but the origin of these disparities is still a mystery. It’s possible that the hospital in which a child is born may tell us why certain population groups have poorer health.
A new study by University of Pennsylvania and Rutgers investigators that I led shows that seven out of ten black infants with very low birth weights (less than 3.2 lbs.) in the United States have the simple misfortune of being born in inferior hospitals. What makes these hospitals inferior? A big component is lower nurse staffing ratios and work environments that are less supportive of excellent nursing practice than other hospitals. Our study, which was funded by the RWJF Interdisciplinary Nursing Quality Research Initiative, indicates that the hospitals in which infants are born can affect their health all their lives.
A Brighter Future
What can be done to make these hospitals better? A first step would be to include nurses in decisions at all levels of the hospital, as recommended by the Institute of Medicine to position nursing to lead change and advance health. Laws in seven states require hospitals to have staff nurses participate in developing plans for safe staffing levels on all units.
View full post
Nov 13, 2014, 3:08 PM, Posted by
“Matthew was born big and healthy, just under eight pounds,” Carol Jordan says.
That’s why it was such a shock to her to lose him on an otherwise average Sunday afternoon.
“We had just gotten home from church. My daughter Taylor and my other son Jacob settled in with their video games,” Carol recalls. “I breastfed Matthew and lay him down on his back in his bassinet. He was 3 and ½ months old. About 30 minutes later, I went to check on him. He was on his stomach and he was not breathing.”
View full post
Nov 7, 2014, 11:13 AM, Posted by
Rochester, N.Y., is the birthplace of Xerox, Bausch & Lomb, and Kodak, and home to two top-ranked research institutions, the University of Rochester and Rochester Institute of Technology. Nevertheless, babies die in this upstate New York city at a rate two times higher than the national average, and Rochester’s children of color are three times more likely than white infants to die before their first birthday. Why?
To come up with some answers, Futuro visited Rochester as part of its America by the Numbers series, made in partnership with Boston public TV station WGBH (check your local PBS and World Channel listings to see the series). We went knowing that the U.S. as a whole ranks 56th in the world for infant mortality, by far the lowest of any industrialized nation, despite the fact that we spend more on health care per capita than any other country, and the largest portion goes towards pregnancy and childbirth. This makes Rochester’s statistics even more tragic—an outlier in an outlier.
View full post
Nov 4, 2014, 5:34 PM, Posted by
Jane Isaacs Lowe, Martha Davis
The brain is an exquisitely sensitive organ—so sensitive that, as recent advances in brain science show us, children who are exposed to violence, abuse, or extreme poverty can suffer the aftereffects well into adulthood. They are more likely to develop cancer or heart disease as they age, for example.
But how to translate these findings into practices and policies that can strengthen families and children? How do caregivers help traumatized children and their families cope with adversity? How can the science be applied to what teachers, doctors, social workers, and others on the front lines do every day? And how should the science affect whole systems, so that every person, at every level, can do their part to help children and families thrive?
View full post
Aug 11, 2014, 3:36 PM, Posted by
A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete.
The case for bringing health care back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns.
Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.
View full post
Jul 28, 2014, 9:00 AM, Posted by
Lorraine McKelvey, PhD, is an associate professor of family and preventive medicine and pediatrics at the University of Arkansas for Medical Sciences. She is an alumna of the Robert Wood Johnson Foundation (RWJF) New Connections program (2008-2009) whose work focuses on vulnerable populations.
For children, stress can come from sources inside and outside the family. It was recently documented that nearly two out of every three children in the United States have witnessed or been victims of violence in their homes, schools, or communities. That’s a staggering statistic when we consider the well-established link between children’s exposure to stress and their long-term mental and physical health outcomes.
Indeed, we know that early exposure to adverse experiences can change the way that our brains develop and function. We also know that exposure to adversity increases the likelihood that children will develop psychosocial problems, like depression, aggression, and other antisocial behaviors. There is even evidence that exposure to stressors in childhood increases the likelihood of having heart disease and cancer in adulthood!
View full post
Jul 1, 2014, 10:33 AM, Posted by
The globby tears, the quavering voice, the pudgy outstretched hands, the plaintive word “please.” They all come to mind as vividly as if it were yesterday.
Our daughter Sarah was (and still is, at 27) a good soul, but like every small child, she had her moments. And when those “moments” more or less coincided with bedtime, the worst punishment we could mete out was to refuse to read her bedtime stories—or “sturries,” as she called them. We would kiss her good night, and adjourn to the living room, there to sit and look at each other guiltily as our little girl suffered the tortures of the damned.
We listened to that heartbreaking little plea, “But I HAVE to have sturries!” echoing down the hall, and our hearts would break, too. We felt like the worst parents ever
View full post
May 7, 2014, 4:38 PM, Posted by
We’re seeing signs of promise in the effort to reverse the childhood obesity epidemic in the United States. Overall childhood obesity rates have leveled off—and they’ve even declined in some regions and among some age groups.
But it’s far too early to declare victory, writes RWJF President and CEO Risa Lavizzo-Mourey, MD, in a new post on the professional social networking site LinkedIn. The rate of obesity among U.S. teens, she notes, stands at a “shocking 21 percent, and Hispanic and African-American youth still have higher obesity rates than their white and Asian peers.”
To make more progress, Lavizzo-Mourey says, we need more people and organizations in the fight—particularly the business community.
So what more can be done? On Thursday, May 8, Lavizzo-Mourey and influential leaders from throughout the nation—including many from the business community—met to consider innovative approaches in a forum, “Closing the Gap in Childhood Obesity,” sponsored by RWJF and the Clinton Health Matters Initiative, in collaboration with Grantmakers in Health. The forum focused on developing solutions to the inequities that exist in childhood health and childhood obesity.