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Field Notes: What Cuba Can Teach Us about Building a Culture of Health

Jan 29, 2015, 9:54 AM, Posted by Maryjoan Ladden, Susan Mende

MaryJoan Ladden and Susan Mende Trip to Cuba

Ever since President Obama announced the restoration of diplomatic ties between the United States and Cuba, there’s been growing excitement over the potential for new opportunities for tourism, as well as technology and business exchanges. Most people assume that the flow will be one-sided, with the United States providing expertise and investment to help Cuba’s struggling economy and decaying infrastructure.

That assumption would be wrong. America can—and already has—learned a lot from Cuba. At RWJF, we support MEDICC, an organization that strives to use lessons gleaned from Cuba’s health care system to improve outcomes in four medically underserved communities in the United States—South Los Angeles; Oakland, Calif.; Albuquerque, N.M.; and the Bronx, N.Y. Even with very limited resources, Cuba has universal medical and dental care and provides preventive strategies and primary care at the neighborhood level, resulting in enviable health outcomes. Cuba has a low infant mortality rate and the lowest HIV rate in the Americas, for example—with a fraction of the budget spent in the United States.

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Preparing Family Caregivers to Provide High-Quality Care for People with Dementia

Jan 22, 2015, 9:00 AM

Tatiana Sadak, PhD, PMHNP, is an assistant professor at the University of Washington School of Nursing and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2013-2016). She is working to promote “dementia caregiver activation,” a process of preparing caregivers to become ready to manage the multiple needs of loved ones with dementia while caring for themselves.

Tatiana Sadak
Aging in America

The well-documented personal and societal burdens of dementia are the central focus of the National Alzheimer’s Plan, which calls for extensive reforms in the delivery of health care for patients with dementia and their family caregivers. RWJF answered this national call to action by funding several innovative dementia health services research projects and nurturing the careers of junior dementia researchers.

I was fortunate to receive RWJF Nurse Faculty Scholars funding. It will make it possible for me to focus a majority of my time on improving health services for people living with dementia and for their family care partners—or ‘caregivers.’

Dementia patients suffer brain failure that leads to progressive loss of autonomy and the inability to understand and meet personal health care needs. Clinicians conduct health assessments, create care plans, and treat symptoms, but it is dementia family caregivers who deliver the day-to-day care and health management these patients need. There is, however, considerable variation in their capacity to assist care recipients in making health care decisions, for providing daily care, and for navigating health care systems.

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So Much Data! How to Share the Wealth for Healthier Communities

Jan 14, 2015, 5:15 PM, Posted by Alonzo L. Plough

What Counts: Harnessing Data for America's Communities

The world of research and evaluation is experiencing a dramatic increase in the quantity and type of available data for analysis. Estimates are that an astonishing 90 percent of the world’s data has been generated in just the past two years. This flood of facts, figures, and measurements brings with it an urgent need for innovative ways to collect and harness the data to provide relevant information to inform policy and advance social change. “Not long ago, we had a problem of insufficient data,” says Kathryn Pettit, a senior research associate at the Urban Institute. “Today we have more data than ever before, but we still need to build capacity to use it in meaningful ways.”

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What's Next Health: What We Can Achieve By Working Together

Jan 13, 2015, 10:49 AM, Posted by Marjorie Paloma

Nate Garvis Color How can it be charitable to work with a business whose motive is to make more profit? Marjorie Paloma shares thoughts from from Nate Garvis.

As part of our What’s Next Health series, RWJF regularly talks with leading thinkers about the future of health and health care. Recently, we spoke with Nate Garvis, founder and author of Naked Civics, about entrepreneurial thinking and how it can be applied to building a Culture of Health. RWJF Director Marjorie Paloma reflects on Nate's approach.

What would you be willing to do to learn?

This is just one of many provocative questions Nate Garvis of Naked Civics is asking the Foundation as we look to build a Culture of Health.

Many times, we come across people who seem to have all the answers. But Nate doesn’t pretend to. Instead, he uses questions that help us journey through an issue, guiding us toward a new type of discovery process—one that takes us to uncomfortable places and challenges us to work with unlikely bedfellows.

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New Year, New Coverage for Millions

Jan 9, 2015, 2:51 PM, Posted by John R. Lumpkin

Health Care Dot Gov healthcare.gov

The beginning of a new year is a great time to reflect on progress toward longstanding goals. At RWJF, we’ve spent the better part of four decades advancing solutions to help everyone in our nation gain access to affordable, high quality health care—a goal we reaffirmed in 2014 when we announced our vision for a Culture of Health in America.

Happily, our country has made enormous progress toward this goal in 2014. Health coverage rates improved dramatically last year because of robust enrollment through the health insurance marketplaces, Medicaid, and CHIP. As we enter 2015, we continue to see strong coverage gains, with nearly 6.6 million consumers newly enrolled or renewing through HealthCare.gov.

But let’s not forget that more than 40 million people remain uninsured. There is still more work to be done to make sure all those who are eligible can get the coverage they need and deserve.

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Top 10 Signs We are Building a Culture of Health

Dec 17, 2014, 7:18 PM, Posted by Catherine Arnst

Two daycare teachers play with a group of young children outside.

Last January the Robert Wood Johnson Foundation alerted the world to its new strategy: To build a Culture of Health for all, one that would allow every one of us to make healthy choices wherever we live, work, and play. A big reach, we know, but we are nothing if not optimistic. So, 12 months on, we asked ourselves—How’re we doing? Pretty good, as it turns out. Here are the top 10 signs that America is moving towards a Culture of Health (in no particular order).

10. The evidence is in—kids are beginning to slim down.

Research published in February shows continued signs of progress toward reversing the childhood obesity epidemic: Obesity prevalence among 2 to 5 year olds dropped by approximately 40 percent in eight years, a remarkable turnaround. There is still much work to do in this area, but at least our youngest kids can look forward to a healthier future.

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Healthy Community Planning Means Healthier Neighbors

Nov 17, 2014, 3:44 PM, Posted by Helene Combs Dreiling

5716 Wellness is housed in a historic Albert Kahn-designed cigar factory. 5716 Wellness is housed in a historic Albert Kahn-designed cigar factory.

Too often, U.S. public health policy focuses on treating illnesses after they are diagnosed, instead of encouraging healthy lifestyles to prevent illness in the first place. But architects—my profession—are engaged in a wholesale effort to reverse this focus. Throughout the U.S., right in the buildings where we live and work, architects are incorporating design techniques that can help prevent illness and benefit the local communities that live with their designs.

One of the best examples of this effort—even amidst bankruptcy and a historic unraveling of a once-dominant American city—is the Detroit Collaborative Design Center (DCDC), a nonprofit architecture and urban design firm that offers proof that neighborhoods that facilitate holistic wellness and preventative care are as valuable as doctors who make house calls.

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Babies are Dying in Rochester at Twice the National Average. Why?

Nov 7, 2014, 11:13 AM, Posted by Maria Hinojosa

America by the Numbers series on Infant Mortality Photo by: Paul de Lumen.

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.

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Bringing Brain Science to the Front Lines of Care

Nov 4, 2014, 5:34 PM, Posted by Jane Isaacs Lowe, Martha Davis

070702.tt.RWJF.Davis.00685

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?

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New School Year Means New Opportunities to Build Healthy Campuses

Oct 14, 2014, 5:14 PM, Posted by Ginny Ehrlich

RWJF Philadelphia Child Obesity

September always brings the promise of a fresh start, especially for school age kids and their parents. New teachers, new books, new supplies, new shoes. And hopefully, a renewed emphasis on healthy choices. This week is National School Lunch Week, a time to highlight the importance of serving healthy school meals to students throughout the U.S.

Making sure all children have access to healthy food and drinks is a key priority for RWJF. Schools are where kids spend the most amount of time outside of their homes, so it’s an ideal place to instill lessons about the importance of eating healthy and being active. That’s why we are leading a number of initiatives to highlight how healthy school food, as well as recess and physical education (PE), contribute to nationwide efforts to reduce the prevalence of childhood obesity.

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