Working Together to Take on the Opioid Crisis

Mar 29, 2017, 8:00 AM, Posted by Tim Soucy

Drug overdose deaths are fueling a dramatic increase in premature deaths nationally. This community is taking action—here’s how.

I’ve lived in Manchester, New Hampshire, my entire life and led the health department here for more than a decade. So for me, the opioid crisis that has hit the city and surrounding region hard feels like a very personal kick to the gut. Between 2003 and 2015, overdose deaths in Manchester increased 12-fold, and until recently, our emergency responders were seeing 60 to 70 suspected overdoses each month in this city of 110,000 people.

We’ve seen more and more in the news that the drug overdose epidemic has become a national crisis, and the 2017 County Health Rankings released today reveal the extent of its terrible impact. Drug overdose deaths are now the leading cause of death in the United States among 25- to 44-year-olds, cutting short the lives of too many people and underlying a national rise in premature death rates.

Fueled largely by overdose deaths from opioid prescription drugs, heroin, and illegally manufactured fentanyl, the epidemic killed more than half a million people from 2000 to 2015.

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How Can We Design Communities Where Kids and Families Thrive?

Mar 23, 2017, 2:00 PM, Posted by Katie Wehr, Sara Cantor Aye

A new funding opportunity will engage teams in six selected communities to create healthier environments for kids and families.

How can we build healthier communities where children and families thrive?

Every community would likely answer this question differently.

And these unique approaches are exactly what RWJF and Greater Good Studio hope to leverage through a Call for Proposals (CFP) for a new project called Raising Places: Building Child-Centered Communities.

Six selected communities engaged in cross-sector collaboration will be awarded $60,000 each, along with support to take part in a process that identifies priorities, gathers diverse insights from residents and stakeholders, and tests and refines practical solutions for sustainable change. Greater Good Studio, which specializes in addressing social needs through human-centered design, will guide participating communities through this process.

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What You Need to Know About Hospital Roles in Community Investment

Mar 15, 2017, 2:00 PM, Posted by Donald F. Schwarz

Hospitals and health systems are well-positioned to invest resources in creating healthier communities—a few are already leading the way. Their valuable lessons can help others rethink the role hospitals can play in improving health beyond their walls.

Hospitals have a long tradition of serving their communities—not only by providing health care, but by hiring local workers and contractors, buying locally, and building new clinical facilities within their communities.

But you probably wouldn’t think of hospitals as financial investors in their local communities. Nor might you consider them experts in managing community revitalization efforts.

And yet, why not? After all, hospitals and health systems have unique assets that go far beyond their clinical offerings. These include deep community connections and relationships, the ability to make loans, expertise in real estate, finance, and project management, and significant property holdings. All of these can collectively be leveraged to benefit both the community at large and hospitals themselves.

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Four Ways Artists Can Help Heal Communities

Mar 2, 2017, 10:00 AM

Leaders from Louisville—one of seven winners of the 2016 Culture of Health Prize—share how artists can play a role in creating healthier, more equitable communities.

A mural on a brick wall. Smoketown Women's Mural by Steam Exchange and Smoketown community members.

Our Louisville, Kentucky, neighborhood of Smoketown sits across the street from the largest concentration of health care services in our state. Yet people here live 9 years less than the typical Louisville resident. Poverty, racism, unemployment and other social determinants of health have created this gap between residents of Smoketown and those from more affluent parts of the city.

An artist’s creativity has helped make that disparity concrete. Andrew CozzensSmoketown Life Line Project documents the impact of trauma on many aspects of people’s lives and health, as revealed through interviews with more than 20 local residents.

You see the impact in metal rods of different lengths—each representing the length of one community member’s life. Crimps in the rods marked with bands of color represent adverse experiences—violence (red), addiction (white), incarceration (black), trauma (blue)—showing how lives have, in effect, been shortened.

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The 500 Cities Project: New Data for Better Health

Feb 23, 2017, 12:00 PM, Posted by Oktawia Wojcik

For the first time ever, the CDC and CDC Foundation are providing city and neighborhood level data for 500 of the largest U.S. cities, making it possible to identify emerging health problems and effective interventions.

Old Colony YMCA in Brockton, Massachusetts recently discovered something startling: a single neighborhood more burdened by poor health such as asthma, high blood pressure, and elevated cholesterol than surrounding areas. Most surprising, however, was that this particular area had a lower prevalence of unhealthy behaviors like binge drinking than other locations within Brockton.

In the past, public health officials may have expended limited resources on the entire Brockton metropolitan area because they wouldn’t have been able to pinpoint the specific neighborhood facing the spike and determine why it was happening.

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Helping Young People in Crisis, One Text at a Time

Feb 16, 2017, 8:00 AM, Posted by Tracy Costigan

Crisis Text Line uses technology to help adolescents struggling with issues like bullying and anxiety. Now, researchers are using data compiled through this effort to better understand and address patterns of adolescent mental health needs within communities.

It began with a shocking text message that left the staff at DoSomething.org deeply shaken.

The non-profit organization was originally created to promote youth volunteer and social action opportunities. It uses texting—the primary way in which teens communicate—to send thousands of daily messages alerting members to clothing drives, health fairs, park clean-ups, and more. Responses have been common. In addition to the usual sign-up requests, texters have also sought advice on how to handle a bully at school or help a friend struggling with addiction.

But as DoSomething’s CEO Nancy Lublin explained in a memorable TED Talk, one particular message from an anonymous girl changed their world.

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Seeking Evidence for How Policy Can Improve Health

Feb 7, 2017, 9:00 AM, Posted by Kerry Anne McGeary, Mona Shah

$2 million in research funding is available to non-profit or public research institutions that can build an evidence base for how policies, laws, and guidelines can help everyone live a healthier life.

There are countless examples of how policies, laws, and guidelines can help people in our society live better and healthier lives. For example, zoning ordinances can help keep dangerous manufacturing emissions away from homes and schools, ensuring that children aren’t exposed to toxic pollutants. Earned Income Tax Credits have been shown to improve infant mortality and birth outcomes. Healthy food guidelines can help our kids consume less sugar by recommending schools provide whole foods, like apples. These policies shape how we live, learn, work, and play.

But there is still too much we don’t know. If your organization is a non-profit or public research institution, this is where you come in.

Through a new call for proposals from its Policies for Action (P4A) program, the Robert Wood Johnson Foundation (RWJF) seeks to build a stronger evidence base for how policies, laws, and guidelines—in the public or private sectors—can help ensure everyone has the opportunity to live a healthier life.

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About the Culture of Health Blog

Feb 1, 2017, 12:00 PM, Posted by Culture of Health Blog Team

Health and health care occupy a well-deserved place of prominence in the national conversation. Prompted in part by the renewed debate over health reform, we are questioning virtually everything we know, or thought we knew, about our health care system—and our own roles and responsibilities as users of that system.

What we’re seeing is a marked shift away from blithe acquiescence to the status quo, and toward creating a "culture of health."

But what does that mean?

As Risa Lavizzo-Mourey, MD, immediate past president and CEO of the Robert Wood Johnson Foundation, put it:

“What we foresee is a vibrant American culture of health:

  • Where good health flourishes across geographic, demographic, and social sectors.
  • Where being healthy and staying healthy is an esteemed social value.
  • And everyone has access to affordable, quality health care.

“In this national culture of health...

  • Individuals, businesses, government, and organizations will foster healthy communities and lifestyles.
  • The economy will be less burdened by excessive and unwarranted health care spending.
  • Individuals will be proactive in making choices that lead to a healthy lifestyle.
  • And efficient and equitable health care will deliver optimal patient outcomes.

It will be a given that...

  • The health of the population guides public and private decision-making.
  • And, Americans will hold public leaders and policy-makers accountable for the community’s health.

At the Robert Wood Johnson Foundation, we are committed to this vision, and we are in it for the long haul. In this blog, we will regularly share our ideas on how best to realize this vision, and we invite you to take part in the conversation.

Improving Community Health While Reducing Costs: Is it Possible?

Jan 19, 2017, 10:00 AM, Posted by Alexandra Chan, Elise Miller

Community Health Funds (CHFs) are a new way to make communities healthier while reducing costs and supporting collaboration. A new project is asking communities to share and spread lessons from CHF and other health partnership experiences.

Over 80,000 children in Massachusetts suffer from asthma which, when left unmanaged, can dramatically impact overall health, limit school attendance and physical activity. In many cases, uncontrolled asthma symptoms lead to costly emergency room visits. Treating this problem on a large scale will take more than inhalers—it requires coordinated community action. Through the Massachusetts Prevention and Wellness Trust Fund (PWTF), Lynn, Worcester, Holyoke, and other cities have formed community-based partnerships to address several chronic conditions, including childhood asthma. Thanks to these efforts, families receive education, care management and home visits to better manage childhood asthma and ultimately improve their daily lives.

Since underlying social, economic, and environmental factors influence community health issues, the solutions to these issues need a cross-sector approach. But this is sometimes challenging since stakeholders can lack funding and incentives to collaborate.

PWTF was created to address this dilemma. It is a Community Health Fund (CHF)—a financial trust to address local health priorities and promote prevention. CHFs have emerged as an innovative approach for coordinating strategy and shared, flexible funding that supports community stakeholders to work together.

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A Conversation on the Future of Health Equity Research

Jan 12, 2017, 4:43 PM, Posted by Tracy Orleans

In the past decade, the healthy equity research landscape has shifted from building the evidence to identifying solutions. David Williams and Paula Braveman share thoughts on the evolution of research with a look to the future.

The latest National Academies of Science Engineering and Medicine report notes that compared to other fields of health research, health inequities is still a relatively new field that faces significant research and practical application challenges. The consensus report provides specific recommendations including: expanded health disparity indicators, longer-term studies, an examination of structural factors, and new research funding opportunities. RWJF’s Tracy Orleans talks with two of the nation’s leading experts on health equity and health disparities, Dr. David R. Williams and Dr. Paula Braveman, who share their thoughts on some of these issues and the evolution of research with a look to the future. 


Tracy Orleans: Nearly ten years ago you started work together on the RWJF Commission to Build a Healthier America. At the time, gaps in health between groups of people or communities were not news to health experts, but they were surprising to a lot of others. We’ve come a long way since then with a more explicit focus on health equity research. How do you view this shift?

 

David Williams: For a long time, researchers focused on documenting the health differences between populations. Those differences are now well-established and we’re able to point to more scientific evidence about why the gaps exist. For example, there’s a growing body of research around the effects of epigenetic aging, which shows that people who experience discrimination or other trauma are biologically older than people of the same chronological age. Science shows that their telomeres, which protect chromosomes from fraying, are shorter among both children and adults who are black, poor, or from unstable homes. This type of more explicit health equity research is a rapidly growing field.

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