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Rich Besser’s Journey of Service

May 11, 2017, 11:00 AM, Posted by Najaf Ahmad

From his Princeton roots to his experiences as a pediatrician, public health practitioner and journalist, Rich Besser shares stories and lessons from a career dedicated to service in this Q&A.

Rich Besser was a fourth-year medical student when he found himself performing his first (and last!) solo emergency Cesarean section at a hospital tucked within a rural Himalayan village in Manali, India.

He had come to Lady Willingdon Hospital eager to learn about health problems facing people within the developing world, and worked under a gifted local surgeon, Dr. George “Laji” Varghese. Providing care for the underserved population there was no small feat. For instance, the power would often go out during surgeries, requiring someone to hold a flashlight over the operating table.

Dr. Laji one day left Rich in charge as he departed for a week-long meeting. Before leaving, as a precaution, he walked Rich through how to perform an emergency Cesarean section since they were high up in the mountains and hours away from the next health care facility.

Sure enough, a few days later a woman who’d struggled through labor for over a day arrived. A senior nurse noted that the baby’s heart didn’t sound good.

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How a Swedish Model of Care is Making an Impact in the U.S.

Oct 5, 2016, 9:35 AM, Posted by Laura Leviton, Susan Mende

Disease registries designed to support clinical research can be reimagined to create a new and more effective kind of patient-centered care. Just take a look at Sweden.

The Karolinska Institutet building in Sweden. The Karolinksa Institutet in Solna, Sweden. Photo by Pelle Sten via Flickr.

Large-scale collection of patient data into disease-specific databases, or registries, is vital to research. These registries house standardized information on patients’ diagnoses, care, and outcomes, supporting large-scale comparison and analysis which can lead to better population health management and interventions. But can disease registries also help to move us closer to patient-centered care?

We’re learning from examples overseas that, with the help of new interactive technologies, they can.

Sweden created a disease registry for rheumatology that is much more than a data storage house. The Swedish Rheumatology Quality Registry (SRQ) is an interactive tool that helps patients and doctors prepare for and make better use of their office visits. It helps them to work like a team—to “co-produce” care together.

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What I Learned from Scaling Playworks into a National Movement

Aug 30, 2016, 9:28 AM, Posted by Jill Vialet

Jill Vialet’s idea to transform the school day through the power of play started with just two schools and now serves more than 1,300 nationwide. The CEO and founder of Playworks shares the tough lessons she learned about scale during her journey.

I was visiting an elementary school back in 1996 when the frazzled principal desperately turned to me and asked if I could “do something” about what was happening at recess. Just moments before I arrived she had reprimanded three fifth grade boys in her office for fighting on the playground. It clearly wasn’t the first time they had been there for the same offense.

I was originally there to discuss an artist residency program for a children’s art museum I was running in Oakland, California. Instead, I listened to the principal lament how recess had become the most dreaded part of the school day. Kids were getting into trouble, getting hurt, and feeling left out. As far as this principal was concerned, the real tragedy was the distraction from teaching and learning, something she just couldn’t accept.

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6 Reasons Why Parks Matter for Health

Aug 22, 2016, 1:45 PM, Posted by Teresa Mozur

As the National Park Service celebrates its 100th anniversary of beauty, recreation, and conservation this summer, we asked six leaders why access to public land is vital to everyone's physical and mental health.

A couple looking at the mountains. Yosemite National Park

The National Park Service celebrates its centennial this week, and our national parks have never been more appreciated; visitors made a record-breaking 307.2 million visits to them in 2015. But what many park goers may not realize is that the access to natural scenery and park activities national parks provide play a role in improving health. In fact, research shows that using public parks—even tiny local ones in your neighborhood—contributes to health in a number of ways, from promoting physical activity to improving mental health and even having the potential to reduce health care costs.

To celebrate this milestone in American history, the Culture of Health blog's editorial team asked six leaders to give us their reasons why parks matter for health.

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How Health Insurers Can Help Kids Reach a Healthy Weight

Jun 1, 2016, 12:30 PM, Posted by Katherine Hempstead, Victoria Brown

Innovative approaches in health insurance can help support youth development and prevent chronic diseases.

While research shows that access to safe neighborhood spaces for physical activity along with affordable healthy foods help families and kids maintain a healthy weight, it’s often not enough.

Health care economist Mike Bertaut illustrated this reality through a deeply personal and passionate post last month. He opened up about his lifelong struggle with obesity and shared some important lessons about how the health care sector can help children maintain a healthy weight. It’s a moving piece worth reading.

As Mike shows us, health care providers—and health insurers—have a critical role to play, especially for children and families at highest risk for obesity and obesity-related disease.

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Why Ashoka is Investing in Children's Wellbeing

May 25, 2016, 2:04 PM, Posted by Tim Scheu

Why is the organization that coined the term “social entrepreneur” putting an emphasis on children's wellbeing? Because it's a critical step in fostering changemakers in our communities.

Did you know that a playground for elephants needs water, plants and rhino playmates? Or that ‘Frogtown,’ the Kermit-friendly analog, needs a rainforest canopy to enable sound sleep and protection for eggs? At least, that was the case during an empathy exercise at Ashoka’s “Bring Your Child to Work Day.”

Even at a young age, children understand the multiple facets of wellbeing: safety and physical fitness, but also emotional attachment. As caregivers for the imaginary animals that populated their cardboard playgrounds, our children wanted a culture of health. As a father to three little girls, I want that same thing.

But in the United States, we don’t often operate from a mindset of wellbeing—or rather, we’re preoccupied with a very limited definition of wellbeing. The individuals, communities, and societies that surround us tend to view wellbeing as only material or physical wellness. Is that playground really safe? How many children are visiting the hospital every year? How many are living outside of homes? This approach to wellbeing creates structures which are reactionary, deficit-oriented and focused on reducing the negative effects of physical harm. We can do better.

Fortunately, leading social entrepreneurs like Dr. Terrie Rose are on the case. Using her venture, Baby’s Space, to transform the norms of childcare in low income neighborhoods, Terrie is ensuring that young children are not only safe, but are also offered emotional stability and opportunities for attachment with their caregivers. Tomas Alvarez is another example. Through Beats Rhymes and Life, Tomas works with mental health workers to offer a hip-hop-based therapy alternative to kids that have felt marginalized by traditional services.

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It's Time to Reframe How We Think About Education and Health

May 17, 2016, 10:03 AM, Posted by Kristin Schubert

Kids spend more time at school than anywhere outside their homes, making schools where we have the greatest chance of improving kids' health trajectory through physical, social and emotional development.

My sister, Katy, and I grew up in a family of teachers. My mother, my father and my aunt all dedicated themselves to educating, inspiring, encouraging and supporting each student who came through their classrooms. While I chose to go into public health, Katy followed in their footsteps and is a fifth-grade teacher. Many of her students experience challenges at home that no child should have to face. So in order for her students to be engaged in learning, not only does she need to know her lesson plans, she also needs to know whether a student has eaten breakfast that day or is suffering from trauma that’s gone untreated. When a student acts out, she needs to understand what underlying issues are causing them to behave that way. She’s seen first-hand how difficult it is for her students to learn when many of their needs go unaddressed. And every day, I can see how the work we’re each doing in our respective fields intersects.

As the research shows, your education has far-reaching implications for your health. The more educated you are, the more likely you are to live a longer, healthier life. Now, more than ever, having a high school diploma can predict your likelihood of having diabetes, heart conditions or other diseases. And across racial and ethnic groups, life expectancy improves with increasing years of education.

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Why School Nurses Are the Ticket to Healthier Communities

May 11, 2016, 9:37 AM, Posted by Susan Hassmiller

A visit to Mt. Pleasant High School in Wilmington, Delaware, highlights the critical role that school nurses play in fostering healthier kids and communities.

Robin Wallin, DNP, RN, first became concerned about the unmet dental needs of children attending the Alexandria City Public Schools in 2000 when one of the school nurses she supervised participated in a multidisciplinary evaluation for a kindergarten boy named José who could not sit still in class.

Upon examining his mouth, the nurse discovered gaping black holes where teeth should have been. She helped find an oral surgeon willing to treat José—who came from a low-income family without health insurance—free of charge. As it turned out, once José’s teeth were treated he no longer struggled with sitting still in class.

This experience led Wallin—who was then the Health Services Coordinator for the Alexandria City Public Schools in Alexandria, Virginia, and now serves as the director of health services at Parkway Schools in the Greater St. Louis area—to wonder if other kids like José struggled with school due to underlying oral health problems.

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How to Build a More Diverse and Inclusive Nursing Workforce

May 9, 2016, 9:32 AM, Posted by Lucia Alfano

A nurse leader shares how she overcame significant barriers to pursue a successful career and what we can do to help minorities in nursing succeed.

I became a nurse by accident at a time in my life when I had no direction. My family had moved from Ecuador to Queens, New York when I was a child.

As a teen, there were times when I lived in group homes or even the streets and I felt completely lost. I dropped out of junior high.

When an acquaintance suggested in passing that I enroll in the nursing program at Queensborough Community College, I followed her advice without realizing that nursing would become my calling. I had to overcome obstacles that included lack of family support, finances and even basic academic skills.

I wanted so badly to be educated, that I persevered through these struggles. I found that I loved everything that had to do with nursing—from what we learned in class, to what we learned in the clinic, to volunteer work in the community.

I believe there are many young people who, like me, would thrive in nursing. But because of their background or existing challenges, they may believe that a career in nursing is not an option. In particular, young students may think that they cannot afford nursing school.  

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Reversing Childhood Obesity with a Novel Approach

Mar 8, 2016, 10:45 AM, Posted by Christina Economos

ChildObesity180 is bringing the best elements of private sector thinking and scientific research in order to improve the health of kids in America. Here's how.

In 2009 it became clear to me that if our nation were truly serious about reversing the childhood obesity epidemic, a novel approach was required. The numbers remain just too unacceptably high in all groups and troubling disparities persist.

Enter Peter Dolan, Chairman of Tufts University Board of Trustees and former Chief Executive Officer of Bristol-Myers Squibb with a long-time commitment to health.  His background made him a complement to our work at Tufts University Friedman School of Nutrition Science and Policy.  Along with Dr. Miriam Nelson, a professor of nutrition, we set out to develop a new method of addressing this complex problem, and co-founded ChildObesity180.

We created a collaborative model: bringing together nationally-renowned leaders from academia, nonprofits, business, and government (whom we refer to as Charter Members) to drive change on a national scale and substantially effect 5-to-12-year-olds across the country. We blend scientific rigor with insights from the private sector to develop, implement, evaluate and scale high-impact obesity prevention initiatives. 

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