Jul 8, 2015, 4:59 PM, Posted by
Ellen Lawton, Megan Sandel
Civil legal aid agencies are a proven resource for clinics to support patient needs and achieve health equity by addressing the social barriers to health.
A lawyer as part of the health care team? It's not as strange as it sounds. Many of the social conditions that impede health, such as housing, education, employment, food and insurance, can be traced to laws unfairly applied or under-enforced, often leading to the improper denial of services and benefits designed to help vulnerable people.
There are eight thousand civil legal aid lawyers in the U.S., and much of their work is directly related to improving health. They ensure access to food, health benefits and insurance for their clients. By fighting for better housing conditions and preventing evictions, they help create healthier physical environments. They help keep families safe and stable by establishing guardianships.
There is evidence that lawyers are more critical than ever to the health of vulnerable people. Each year the Department of Veterans Affairs surveys homeless veterans; the most recent CHALENG survey found that six of the top 10 barriers to housing were legal in nature. And a recent study at Lancaster General Hospital found that each of the hospital's highest-need, highest-cost patients had two to three health-harming civil legal problems.
View full post
Jun 22, 2015, 3:01 PM, Posted by
Health impact assessments are a powerful way to help communities think broadly about the health implications and equity aspects of policies and projects, so that a comprehensive approach to health becomes routine.
Last week, almost 500 attendees arrived in the nation’s capital for the 2015 National Health Impact Meeting. The impressive turnout is a testament to the growing importance of health impact assessments (HIA) as a tool to improve community health outcomes.
As this year’s meeting attendees know, an HIA is a process that helps evaluate the potential health effects of a plan, project or policy outside of the traditional health arena. The findings from a completed HIA can provide valuable recommendations to help communities more effectively foster better and more equitable health among their citizens.
The use of HIAs has grown rapidly from just a few dozen in 2000 to more than 350 completed HIAs today. Dozens more are in the works. The earliest HIAs were mostly applied to the built environment, such as zoning, land use and transportation decisions. However, today the field has expanded to include such areas as energy policies, criminal justice and living wages.
View full post
Jun 9, 2015, 4:58 PM, Posted by
Initiatives like the Future of Nursing and Project ECHO are expanding opportunities for more communities to get quality health care and lead healthier lives regardless of ZIP code.
I read recently in The New York Times about Murlene Osburn, a cattle rancher and psychiatric nurse, who will finally be able to start seeing patients now that Nebraska has passed legislation enabling advanced practice nurses to practice without a doctor’s oversight.
Osburn earned her graduate degree to become a psychiatric nurse after becoming convinced of the need in her rural community, but she found it impossible to practice. That’s because a state law requiring advanced practice nurses to have a doctor’s approval before they performed tasks—tasks they were certified to do. The closest psychiatrist was seven hours away by car (thus the need for a psychiatric nurse), and he wanted to charge her $500 a month. She got discouraged and set aside her dream of helping her community.
I lived in Nebraska for seven years, and I know firsthand that many rural communities lack adequate health services. As a public health nurse supervisor responsible for the entire state, I regularly traveled to small, isolated communities. Some of these communities did not have a physician or dentist, let alone a psychiatric nurse. People are forced to drive long distances to attain care, and they often delay necessary medical treatment as a result—putting them at risk of becoming even sicker, with more complex medical conditions.
View full post
May 19, 2015, 9:00 AM, Posted by
Change leadership means thinking big about impact, responding to urgent needs, and actively tolerating risk. This is the kind of big, bold way of working—together—that will get us to a Culture of Health.
Just over a year ago, I started in a new role at the Robert Wood Johnson Foundation. Not long after, my colleagues and I began the exciting, challenging, and collaborative process of co-designing four new programs that will develop, train, and network change leaders who will help build a Culture of Health.
You may be wondering – What is change leadership? How do we know it when we see it? And, why is it essential for achieving RWJF’s vision?
>>Could your organization serve as a National Leadership Program Center? View the call for proposals.
Here's the type of challenge our nation's leaders often face:
For a half-century, charities, nonprofits and local and federal governments have poured billions of dollars into addressing the problems plaguing [many] Americans. But each issue tends to be treated separately – as if there is no connection between a safe environment and a child’s ability to learn, or high school dropout rates and crime. –The Wall Street Journal, September 2013
Now here's an example of what change leadership looks like:
View full post
Apr 23, 2015, 9:00 AM, Posted by
Maryjoan Ladden, Susan Mende
As other countries continue to spend far less on health care but perform better on measurable health outcomes, there's opportunity to learn what works abroad and apply those lessons stateside.
It’s a hard notion for many Americans to accept—although we spend more money on health care than any other country in the world, we are far from having the best health outcomes. When you look at measures that include life expectancy, infant mortality rates and preventable illness, other countries that spend far less than the U.S. perform better. But in many of these countries people of all ages and socio-economic status are able to easily access primary care that is comprehensive, patient-centered and rooted in local communities.
One of our goals as program officers at RWJF is to look beyond our borders to identify promising practices that might be incorporated into America’s health care system. Last fall we traveled to Oxford, England, to learn first-hand about promising primary care practices in Chile, England, the Netherlands and Canada—all high and middle income countries that spend less on health care yet have better outcomes than the U.S. We attended a conference organized by the Training and Research Support Centre (TARSC), an organization supported by Charities Aid Foundation of America through a grant from the RWJF Donor-Advised Fund. TARSC provides support and training to government and civic health organizations, and the conference was the next step after its report, “Strengthening primary care in the USA to improve health: Learning from high and middle income countries.” We came away with a lot of insights from both, but were struck by several themes that were constant throughout.
View full post
Apr 20, 2015, 9:29 AM, Posted by
It may be NBA playoffs season, but the Gasol brothers are committed to promoting child health year round. RWJF Health & Society Scholar Merlin Chowkwanyun recently sat down with the Chicago Bulls' center to learn about his passion for health advocacy and how he's working to build a Culture of Health in the U.S. and abroad.
Since moving to the Chicago Bulls last summer, NBA star Pau Gasol has been having one of the most sensational seasons of his basketball career. A two-time champion with the Los Angeles Lakers, the new Bulls starting center is entering the playoffs as the league leader in double doubles, averaging about 18 points and 12 rebounds per game. In February, he and his younger brother Marc Gasol (of the Memphis Grizzlies) made NBA history as the first siblings to start in the annual All-Star Game: Pau for the East team, Marc for the West.
The two have been equally active off the court. In 2013, after years of work with various philanthropic associations, Pau and Marc formed the Gasol Foundation. It focuses on child health and works towards "a world where all children will enter adulthood physically and mentally equipped to live successful, healthy and productive lives." The Foundation recently launched outreach projects in two areas with severe socioeconomic disadvantage. Vida! Health & Wellness in Boyle Heights (Los Angeles) provides parents and children with instruction in physical activity, physiology, and fitness; healthy cooking and eating; and psychological wellness. L'Esport Suma in South Badalona (Catalonia, Spain) uses sports to promote human development and social cohesion among participants. It is run in conjunction with Casal dels Infants, a long-standing NGO in the region.
Pau has always been a very visible 7-foot presence—literally and figuratively—in Memphis, Los Angeles, and now Chicago, the three cities where he has played. Among other things, that included visiting patients and working with the Children's Hospital Los Angeles and St. Jude Children's Research Hospital, and around the world, raising awareness of refugees' plight as a UNICEF ambassador. In 2012, the NBA recognized these and many other efforts with its J. Walter Kennedy Citizenship Award, given to only one player a season. He recently was named one of ten finalists for the NBA's Community Assist Award, and fans can vote for him on Facebook, Twitter, or Instagram by typing #NBACommunityAssist and #PauGasol.
Each year, Robert Wood Johnson Foundation Health & Society Scholars at the University of Wisconsin-Madison's site complete a "'knowledge exchange" project designed to foster communication among the general public, academic researchers, and population health practitioners. As someone who grew up in Los Angeles, I cheered for Pau during his seven seasons with the Lakers but admired him just as much for what he did beyond the game. For my project this year, I wanted to interview Pau about his and Marc's plans because it seemed the Gasol Foundation's goals dovetailed with those of RWJF's Culture of Health initiative in many respects.
View full post
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.
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.
View full post
Apr 2, 2015, 10:10 AM, Posted by
Using data for health is most powerful when you know what problems you're trying to solve. The latest Data for Health report looks at how we can harness that data to source community solutions.
A few months ago, community members and leaders from an array of local organizations came together in Philadelphia, Des Moines, San Francisco, Phoenix, and Charleston, to talk about ways they and others around them use data to improve health—as well as the hopes, concerns, and challenges they face in collecting and sharing data.
After listening to and reading about these conversations that were part of the Data for Health listening series, this piece of practical wisdom captured in a new report on what we learned from those meetings jumped out at me:
The real question is not 'What data do you want to collect?' but rather, 'What problem do you want to solve?'
View full post
Mar 12, 2015, 3:36 PM, Posted by
New findings strongly suggest that Americans are ready for new approaches to address early childhood trauma and stress. To do that in a big way, we need more than science—we need a movement.
I remember when I first learned about research showing that what happens to a person as a child impacts their health later in life. It was 2007, and I was pregnant with my first child. My boss and mentor, Jim Marks, brought the Adverse Childhood Experience’s (ACE) study to my attention. The Centers for Disease Control and Kaiser Permanente had surveyed 17,000 Kaiser members about their childhood experiences and compared the answers to those members’ medical records.
The ACE researchers found that the more trauma and stress you experienced as a child, the more likely you were to have cancer, heart disease, and diabetes as an adult. The more likely you were to suffer from chronic depression, be addicted to drugs and alcohol, or attempt suicide. And the more likely you were to drop out of school, be incarcerated, or chronically unemployed.
View full post
Mar 9, 2015, 11:21 AM, Posted by
“I am dying literally, at my home in Hollywood, of metastatic breast cancer ... For six years I’ve known I was going to die, I just don’t know when.”
That was written by renowned journalist Laurie Becklund, a former Los Angeles Times correspondent, shortly before she died on Feb. 8 at age 66. Her powerful Los Angeles Times essay was not a lament, however, but a fierce call to action for better cancer research; informed by much, much better data.
As she noted, each cancer patient’s disease is unique, yet there is no system in place to gather data on these tens of thousands of individual diseases. If there were, the data would enable both lab research and clinical trials to be far more efficient, and effective. “The knowledge generated from our disease will die with us because there is no comprehensive database of metastatic breast cancer patients, their characteristics, and what treatments did and didn’t help them,” Becklund wrote. “In the big data era, this void is criminal.”
View full post