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Research Designed Through the Eyes of Youth

Mar 17, 2015, 12:30 PM, Posted by Alonzo L. Plough, Dwayne Proctor

There's power in giving youth the means to document what they see as the barriers to their community's health. This project from Charlotte, N.C. shows us how this innovative research design can be a step to addressing local disparities.

Last year, we at the Robert Wood Johnson Foundation asked our community a bold question: What was considered the most influential research around identifying and eliminating disparities? In our first-ever Culture of Health reader poll, a winning research paper emerged in Por Nuestros Ojos: Understanding Social Determinants of Health through the Eyes of Youth, published in the Summer 2014 edition of Progress in Community Health Partnerships. The research project equipped young people in Charlotte, N. C., with cameras to identify and document environmental factors that impact health in their Latino immigrant community. What really makes this paper resonate for us—and, it seems, for many of you—is that it provides a clear example of how community-based participatory research (CBPR) is an important approach to understanding the multiple factors underlying health disparities.

We wanted to learn more about this interesting example of participatory research and how the Por Nuestros Ojos project is helping advance health equity in Charlotte. Recently, our blog team had a conversation with three of the study’s authors to find out how employing a participatory research model can help enormously in understanding and eliminating disparities in marginalized communities. Below is an interview with Johanna (Claire) Schuch, research assistant and doctoral candidate at the University of North Carolina at Charlotte (UNCC); Brisa Urquieta de Hernandez, project manager at the Carolinas HealthCare System and doctoral student at UNCC; and Heather Smith PhD, professor, also at UNCC.

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Wellness in a Networked World: Pioneering Ideas Podcast Episode 8

Mar 16, 2015, 10:28 AM, Posted by Lori Melichar

RWJF’s Pioneering Ideas Podcast explores cutting-edge ideas with the potential to build a Culture of Health. Subscribe on iTunes.

I’m speaking at SXSW this week, the annual festival in Austin, Texas, that brings together creative people from a range of fields to share ideas, many of them related to technical innovation. As I mingle with these innovators, it feels appropriate to be sharing the latest episode of our podcast, which explores how technology can promote well-being by connecting us to our essential self, what our knowledge of social relationships—and social media—can mean for how we design our communities, and how institutions can create organizational cultures where health and socially conscious innovation thrive.

I hope you’ll give it a listen, then join the conversation using the comments below or on Twitter at #RWJFPodcast. And if you’re also at SXSW and have ideas to share about building a Culture of Health, I hope you’ll reach out to me at @lorimelichar.

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How Childhood Experiences Shape Our Nation's Health

Mar 12, 2015, 3:36 PM, Posted by Kristin Schubert

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.

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Investing in Systems Changes to Transform Lives

Mar 10, 2015, 10:00 AM, Posted by Catherine Malone, Najaf Ahmad

We know that in order to address health disparities head on, we'll have to implement changes to the systems that influence where we live, learn, work, and play. Oscar and Jose's stories show us that it's possible.   

I was looking at somebody who could be a great person...who could do something great in his future. I also knew that if I sent him to prison, I’d knock him off of that road to success.

In the quote above, Steven Teske, a Juvenile Chief Judge in Clayton County, Georgia is describing the first time he encountered 15-year-old Oscar Mayes as he entered the courtroom in handcuffs. Judge Teske noticed that Oscar was an extremely bright young man and that he had no prior run-ins with the law. Yet Oscar was facing five years in the state’s long term lock up—five years that could have ruined his future.

Fortunately, Oscar literally got a Second Chance. This Clayton County initiative gives youth facing prison an opportunity to redeem themselves through intensive supervision, participation in evidence-based treatment programs, and weekly check-ins with the court. Judge Teske and others in his community had realized that too many of their students were falling out of school and heading into the criminal justice system. To address this, the Juvenile Court partnered with local schools and law enforcement to find ways of disciplining youth while keeping them “in school, out of court, and onto a positive, healthy future.”

Interventions like this have yielded impressive statistics in Clayton County: School arrests have gone down 83% and school attendance has gone up 86%. Clayton County’s approach to juvenile justice reflects the transformational impact that changing a system can have.

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It’s Not Just the Watch: Apple Also Helping Cancer Patients

Mar 9, 2015, 11:21 AM, Posted by Catherine Arnst

Laurie Becklund Laurie Becklund (photo by Bob Barry)

“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.”

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What Will it Take to Help All Kids Grow Up at a Healthy Weight?

Mar 4, 2015, 11:16 AM, Posted by Susan Dentzer

We can all play a role in helping children grow up at a healthy weight, including the U.S. Soccer Foundation. Their work is helping make strides in reducing childhood obesity rates. Here's how.

A group of teens playing soccer.

Washington, D.C.’s Shaw neighborhood is named after Colonel Robert Gould Shaw, who commanded the famed 54th Massachusetts Volunteer Infantry, the all-black regiment that fought for the Union during the Civil War. Today, the multi-ethnic neighborhood is home to the U Street Corridor, a revived commercial district known in the early 1900s as “Black Broadway"; Ben’s Chili Bowl, a celebrated city landmark; and Seaton Elementary, a public school whose students are mainly Hispanic, African-American, and Asian.  

It’s also home to the young goalie of Seaton’s soccer team, sixth grader Kevin Alvarez.

Like many kids in his neighborhood, Kevin, age 13, never played sports until recently, and was seriously overweight. Then his school was fortunate to become home to Soccer for Success®, a program managed locally by DC SCORES, a Washington, D.C., nonprofit.

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Poll: People Worry about Far More than Disease When it Comes to Health

Mar 3, 2015, 9:52 AM, Posted by Catherine Arnst

Q&A with Robert Blendon, Harvard T.H. Chan School of Public Health

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This week a public opinion poll was released by NPR, the Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health asking people to list the factors most likely to cause ill health in adults. The top five included lack of access to high-quality medical care (42%), and viruses or bacteria (40%)—not a surprise—but also such socio-economic factors as personal behavior (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%). And a majority (54%) said that being abused or neglected in childhood is an extremely important risk factor for ill health later in life.

Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health, led the poll and recently talked to RWJF Media Director Catherine Arnst about some of the key results. (Both questions and answers were edited for clarity)  

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A Warrior for a Healthier, More Equitable America

Feb 27, 2015, 4:23 PM, Posted by Risa Lavizzo-Mourey

Andy Hyman / RWJF Andrew D. Hyman, JD

Andy Hyman was a warrior for a healthier, more equitable America.

He dedicated his life and career to social justice and progress for the most vulnerable people among us. As a government official, advocate, and philanthropic leader, Andy was tenacious in his pursuit of a singular vision: that everyone in America would have the coverage necessary to access high quality health care—physical, behavioral, or both.

And what incredible success he had.

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The Secret to Successful Health Partnerships

Feb 26, 2015, 10:58 AM, Posted by Lawrence Prybil, Paul Jarris, Rich Umbdenstock, Robert Pestronk

raising hands graphic

Across the country, there is growing awareness that restraining the increase in health costs and improving the health outcomes will require approaches that address the full array of factors that affect health. Greater attention and resources must be devoted to promoting a safer environment, healthy lifestyles, prevention of illnesses and injuries, and early detection and treatment of health problems, as well as dealing with the underlying determinants of health. Improving access to outpatient and inpatient medical services and the quality of those services, while vitally important, are not enough.

To effectively design, implement, and sustain a comprehensive approach to promoting the overall health of communities, we need meaningful collaboration among healthcare delivery organizations, governmental public health departments, and other community stakeholders. Unfortunately, while there is evidence of some increase in recent years, decades of limited communications, lack of mutual understanding, and incongruent goals have inhibited collaboration among these groups across the country. The University of Kentucky College of Public Health recently conducted a study intended to accelerate change, encourage collaboration, and contribute to building a Culture of Health in America. The purpose of the study is to identify successful partnerships involving hospitals, public health departments, and other stakeholders in improving the health of communities they serve and elevate key lessons learned.

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Setting Our Sights on Healthy Media Consumption

Feb 23, 2015, 4:27 PM, Posted by Alonzo L. Plough

Alonzo Plough, PhD, MPH, is vice president, Research-Evaluation-Learning and chief science officer for the Robert Wood Johnson Foundation. Read more from his series.

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Childhood obesity is a tremendous threat to the current and future health of our young people. Compared with their healthy-weight peers, obese children face a higher risk for serious health problems, miss more school, have greater psychological stress, and are more likely to become obese as adults. If we don’t do something to reverse this epidemic, the nation’s current generation could be the first in history to live sicker and die younger than their parents’ generation. This is why RWJF recently pledged $500 million over the next 10 years to support strategies aimed at helping all children in the United States grow up at a healthy weight. This new funding increases our investment in preventing childhood obesity to more than $1 billion—the largest commitment we have ever made on a single issue.

We are in it for the long haul, and we have already seen signs of progress. Research published last year showed obesity prevalence among 2 to 5 years old dropped by approximately 40 percent in eight years. But nearly one-third of children and adolescents in the U.S. are still obese or overweight, and more than 25 million are at risk for high blood pressure or Type 2 diabetes because of their weight.

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