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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.

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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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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Bringing the Technology Revolution to Caregiving

Sep 17, 2015, 10:32 AM, Posted by David Adler

The Atlas of Caregiving is using new methods to uncover the unique challenges and rewards that caregiving presents, from economic, emotional, and mental stressors to the moments of compassion, joy, and intimacy.

An elderly couple, the woman in a wheelchair sitting in front of a large window showing a view of mountains.

We are at a moment in history when technology is allowing us to collect information about ourselves more effectively and reliably than ever before, from the cell phone in our pocket to the Fitbit on our wrist. This technology can help us device wearers—and even the health care providers, researchers and designers we share our data with—track behaviors related to health and figure out how to improve them. But how can this technology be used to help all of us understand and shape the work of family caregivers?

It is widely believed that family caregivers frequently underestimate how long they spend caring for loved ones and the level of stress induced. This is why RWJF is supporting the Atlas of Caregiving project, which will work with 12 families to collect data using technology with the goal of getting a more accurate picture of how caregivers spend their time, and the physical and mental impact of those activities.

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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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A Community Food Market Where Dignity is at the Center

Aug 25, 2015, 2:46 PM, Posted by Doug Rauch

The Daily Table’s model simultaneously addresses food insecurity and promotes health in a respectful, dignified manner for all customers who walk through their doors. Here's how.

The Daily Table Image via The Daily Table

When we opened the first Daily Table grocery store in Dorchester, Massachusetts this past June, I was eager for early customer feedback. I’ll never forget one of the responses we got:

I was able to check out your new store today and was very impressed. It was also the first time in a while that I didn't feel like crying at a grocery store.  Money is always tight and with kids I often have to settle for some not so healthy choices just because that's all I can afford right now. I just wanted to thank you and let you know that you are already making a huge difference for families!”

Nobody should face tears at the grocery store. Unfortunately, it happens more often than you might imagine, especially when single moms and low-income shoppers confront the daunting task of buying nutritious food to feed themselves and their families. That’s why I started Daily Table as a nonprofit community food market―to sell delicious, wholesome food at very affordable prices.

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Want a Healthier Workforce? Investing in Community Health Can Pay Off

Aug 18, 2015, 10:40 AM, Posted by Marjorie Paloma

Regardless of what sector they occupy, businesses have a critical role to play in improving the health of their employees and in forging vibrant, healthy communities beyond their own walls.

Beyond Four Walls

Nearly 80% of U.S. employers now offer workplace health promotion programs aimed at improving the health and productivity of their workers. The most comprehensive of these programs—mainly at larger companies—have employees doing yoga poses at lunchtime; 7-minute workouts during breaks, or spinning at the on-site gym. Cafeterias may offer salad bars and heart-healthy entrees while vending machines are stocked with wholesome snacks and water instead of chips and soda. Some companies provide free weight loss counseling or connect employees at risk of heart disease or diabetes with a health coach. The entire workplace may be smoke-free.

But what happens when employees leave the four walls of these healthy workplaces and go home? If they live in neighborhoods with scarce green space, poor access to active transportation, few nutritious food options, or in communities plagued by crime or pollution, it can be very difficult for employees and their families to continue making healthy lifestyle choices. For businesses, the desired impact of their workplace health promotion programs will necessarily be limited.

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How Food Marketing Can Help Kids Want What’s Good For Them

Aug 11, 2015, 2:45 PM, Posted by Victoria Brown

If we want to ensure that all children are able to grow up at a healthy weight, companies can play a role by continuing to reduce marketing of unhealthy foods and beverages and increase promotion of healthy choices.

A student drinking from a carton of milk.

When it comes to helping Americans eat healthier, the conversation often focuses on price and access. But, there’s a third, equally consequential, condition: desire. Preference is shaped by myriad factors and the effects of marketing and advertising are of paramount importance. Food and beverage companies spend hundreds of millions of dollars to market their products, and their investments produce results: adults and kids are swayed by marketing.

A new report from the UConn Rudd Center for Food, Policy & Obesity reveals that a majority of the largest food and beverage companies are spending a disproportionate amount of money advertising their nutritionally poor products to Black and Hispanic consumers, especially youth. While food marketing is not inherently bad—it appears Sesame Street characters could be great “salespuppets” for fruits and veggies—it becomes a problem when it features unhealthy products known to contribute to obesity and other poor health outcomes. And, with rates of overweight/obesity higher among Black and Hispanic kids and teens, this type of business approach is especially harmful.

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Reaping the Rewards of the Culture of Health Prize

Aug 10, 2015, 3:25 PM, Posted by Susan Dentzer

It's been a year since Brownsville, Texas, won the Culture of Health Prize for its engagement of leaders across sectors to improve local health outcomes. Here's what the community has been up to since.

Brownsville, TX 2014 Culture of Health Prize Winner

Brownsville, Texas, had plenty to celebrate when it became one of six communities to win the Robert Wood Johnson Foundation’s Culture of Health Prize in June 2014. This predominantly Hispanic city along the U.S.-Mexico border is one of the poorest in the country. Seven in 10 residents are uninsured, 8 in 10 are overweight or obese, and 1 in 3 has diabetes. Yet the community’s efforts to improve health—including new bike trails, community gardens, and a successful bilingual public health education campaign—have earned it wide respect and national recognition, along with $25,000 that goes with the RWJF Culture of Health Prize.

City officials are still discussing how to use the prize money. One option is commissioning a piece of artwork that could be moved around to highlight various initiatives, such as the periodic CycloBia events that make some of the city’s streets car-free for a day so that residents can bike, run, or engage in other physical activity.

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Success Starts Early: What We Can Learn From a 5-Year-Old's Social Skills

Jul 16, 2015, 4:05 PM, Posted by Kristin Schubert

Groundbreaking research from a 20-year study has found that the social skills a child exhibits in kindergarten are linked to their health outcomes in early adulthood.

RWJF Culture Of Health Prize - Taos, NM

As I was thinking about writing this blog, I did what I typically do when I need some insight—I asked my kids for help. I asked my 7-year-old son what he thought about sharing. He said, “Sharing is the nice thing to do. You should share your things with your little brother or sister.”

“Why?” I asked.

“Because it makes you feel good and they might just share back with you too.”

So simple, right? And so hard to teach at times!

As a busy working mom of two young children, my days are filled with helping my kids learn how to get along in the world. From learning to feed and dress themselves, to learning how to get along with others and how to recognize and deal positively with their emotions. It’s a job I wouldn’t trade for the world! And it is also one that can be daunting at times, requiring the utmost patience and perseverance. Some days I wonder if I am doing all I can to help them grow up healthy and I know many parents feel the same way.

The good news is that today, more than ever, we have incredible insight into what parents, caregivers, and teachers can do to ensure that children grow up healthy. We now know that what was once thought of as “nice” skills to have, like being a good sharer and empathetic, are actually critical to life long health, happiness, and success.

In a newly released study in the American Journal of Public Health, funded by the Robert Wood Johnson Foundation, researchers found that the social skills a child exhibits in kindergarten were linked to their outcomes—both positive and negative—two decades later in early adulthood.

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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.


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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