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Want a Healthier Workforce? Investing in Community Health Can Pay Off

Aug 18, 2015, 10:40 AM, Posted by Marjorie Paloma

Regardless of what sector they occupy, businesses have a critical role to play in improving the health of their employees and in forging vibrant, healthy communities beyond their own walls.

Beyond Four Walls

Nearly 80% of U.S. employers now offer workplace health promotion programs aimed at improving the health and productivity of their workers. The most comprehensive of these programs—mainly at larger companies—have employees doing yoga poses at lunchtime; 7-minute workouts during breaks, or spinning at the on-site gym. Cafeterias may offer salad bars and heart-healthy entrees while vending machines are stocked with wholesome snacks and water instead of chips and soda. Some companies provide free weight loss counseling or connect employees at risk of heart disease or diabetes with a health coach. The entire workplace may be smoke-free.

But what happens when employees leave the four walls of these healthy workplaces and go home? If they live in neighborhoods with scarce green space, poor access to active transportation, few nutritious food options, or in communities plagued by crime or pollution, it can be very difficult for employees and their families to continue making healthy lifestyle choices. For businesses, the desired impact of their workplace health promotion programs will necessarily be limited.

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How Food Marketing Can Help Kids Want What’s Good For Them

Aug 11, 2015, 2:45 PM, Posted by Victoria Brown

If we want to ensure that all children are able to grow up at a healthy weight, companies can play a role by continuing to reduce marketing of unhealthy foods and beverages and increase promotion of healthy choices.

A student drinking from a carton of milk.

When it comes to helping Americans eat healthier, the conversation often focuses on price and access. But, there’s a third, equally consequential, condition: desire. Preference is shaped by myriad factors and the effects of marketing and advertising are of paramount importance. Food and beverage companies spend hundreds of millions of dollars to market their products, and their investments produce results: adults and kids are swayed by marketing.

A new report from the UConn Rudd Center for Food, Policy & Obesity reveals that a majority of the largest food and beverage companies are spending a disproportionate amount of money advertising their nutritionally poor products to Black and Hispanic consumers, especially youth. While food marketing is not inherently bad—it appears Sesame Street characters could be great “salespuppets” for fruits and veggies—it becomes a problem when it features unhealthy products known to contribute to obesity and other poor health outcomes. And, with rates of overweight/obesity higher among Black and Hispanic kids and teens, this type of business approach is especially harmful.

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Reaping the Rewards of the Culture of Health Prize

Aug 10, 2015, 3:25 PM, Posted by Susan Dentzer

It's been a year since Brownsville, Texas, won the Culture of Health Prize for its engagement of leaders across sectors to improve local health outcomes. Here's what the community has been up to since.

Brownsville, TX 2014 Culture of Health Prize Winner

Brownsville, Texas, had plenty to celebrate when it became one of six communities to win the Robert Wood Johnson Foundation’s Culture of Health Prize in June 2014. This predominantly Hispanic city along the U.S.-Mexico border is one of the poorest in the country. Seven in 10 residents are uninsured, 8 in 10 are overweight or obese, and 1 in 3 has diabetes. Yet the community’s efforts to improve health—including new bike trails, community gardens, and a successful bilingual public health education campaign—have earned it wide respect and national recognition, along with $25,000 that goes with the RWJF Culture of Health Prize.

City officials are still discussing how to use the prize money. One option is commissioning a piece of artwork that could be moved around to highlight various initiatives, such as the periodic CycloBia events that make some of the city’s streets car-free for a day so that residents can bike, run, or engage in other physical activity.

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A New Approach to a Healthier New Jersey

Aug 5, 2015, 4:49 PM, Posted by Bob Atkins

New Jersey Health Initiatives is investing in grassroots solutions to local health challenges in our own backyard, with 10 New Jersey communities serving as laboratories to learn what it will take to build a Culture of Health.

New Jersey Health Initiatives

We’re trying a new approach to building a Culture of Health in communities across New Jersey. It’s a creative, grassroots, on-the-ground approach that could become a model for many other cities and towns across America.

For decades, folks in the health field have been working hard to turn around health inequities that mean some kids have a better chance of growing up healthy than others. They’ve done great work, but sometimes in isolation, and often making decisions based on best practices rather than authentic community engagement. Even more often, health organizations’ hands have been tied because the true causes of poor health sit in other sectors: poverty, unaffordable and poor quality housing, fractured or nonexistent transportation systems, and uneven quality education and access to jobs.

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Getting to the Essence of Value in Health Care

Aug 3, 2015, 1:57 PM, Posted by Susan Dentzer

In this era of value-based payment, we need to consider how different players within health care approach the value equation.

2013 April Cost Test

How would you judge the value of your health care? A longstanding definition of treatment holds that value is the health outcomes achieved for the dollars spent. Yet behind that seemingly simple formula lies much complexity.

Think about it: Calculating outcomes and costs for treating a short-term acute condition, such as a child’s strep throat, may be easy. But it’s far harder to pinpoint value in a long-term serious illness such as advanced cancer, in which both both the outcomes and costs of treating a given individual—let alone a population with a particular cancer—may be unknown for years. And then there’s the complicating issue of our individual preferences, since one person’s definition of a good outcome—say, another few years of life—may differ from another’s, who may be seeking a total cure.

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Harnessing the Power of Shared Data Across Sectors

Jul 24, 2015, 9:47 AM, Posted by Hilary Heishman

Silos of data need to be opened up across sectors to reveal hidden connections with the potential to improve health outcomes. Here's how RWJF is investing in innovative solutions.

Shared data across sectors

A year and a half ago, the Robert Wood Johnson Foundation wrote about the groundswell of interest in connecting health care systems with other organizations and their local communities to build a Culture of Health. Since then, the Data4Health listening tour and the launch of Data Across Sectors for Health (DASH), have given more evidence to the importance of data—or the flow of information—in creating and benefitting from these connections. With work the Foundation and others across the country are doing, the “connections checklist” is increasingly taking shape.

In communities large or small, data can become a bridge between one organization’s need and a very different organization’s solution. In Rochester, New York, the business community took a hard look at a most alarming expense they faced—soaring health care costs. In 2009, the Rochester Business Alliance entered into a strategic partnership with the Finger Lakes Health Systems Agency to build a healthier workforce and lower costs. Analyzing data about community health issues revealed a shared concern about high blood pressure. The Agency developed community-based interventions that the Business Alliance and local businesses could use to help their employees and the wider community understand the importance of controlling their blood pressure. Working together, this collaboration has improved the county’s blood-pressure control rate by over 7%.

Underlying this community connection is a data connection between health care and the business community that brings root-cause analysis and rapid-cycle evaluation together to really focus attention towards groups of people who are at highest risk of uncontrolled hypertension. The Agency created a registry of information from electronic health records (EHRs) to fully understand the situation and monitor any changes brought about by their activities. Careful stewardship of sensitive information, real results, and the tantalizing promise of further benefits are sustaining and expanding this partnership.

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Three Things the United States Can Learn About Public Health From Around the World

Jul 23, 2015, 10:45 AM, Posted by Najaf Ahmad

When it comes to bridging health and health care delivery, the U.S. has an opportunity to learn from global innovations that link the public health, social services, and health care systems.

Globe Image via Joseph Li

It started with three hundred Boy Scouts from across Uganda being trained as “social monitors”. They were tasked with reporting the conditions of their communities to Uganda’s Ministry of Health through their mobile phones. In less than a year, these “U-reporters” grew to over 89,000. The U-report itself is a free SMS-based system that allows young Ugandans to share what’s happening in their communities and work with community leaders and government to affect positive change. The information gathered is disseminated through radio, TV, websites, youth events, community dialogue and other ways.

This system of real time surveillance is a vital new development for the world’s fifth-fastest growing country. Reliable health information in Uganda can mean the difference between life and death. As has been seen recently, epidemics like Ebola or West Nile thrive on information delays. Furthermore, U-reports are empowering Ugandans to share responsibility for creating healthier conditions within their communities.

The U-report is just one of the many exciting global innovations highlighted in a report by the Robert Wood Johnson Foundation (RWJF) and AcademyHealth. Written by Margo Edmunds and Ellen Albritton at AcademyHealth, the report showcases innovations that link public health, social services, and health care systems. These initiatives serve as examples of bridging otherwise disparate elements of health and health care delivery. The authors deliberately selected racially, ethnically and economically diverse regions around the world to ensure that their innovations were applicable to and reflected the diversity of the United States. A Google Hangout also convened several experts to discuss the report’s findings.  

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Success Starts Early: What We Can Learn From a 5-Year-Old's Social Skills

Jul 16, 2015, 4:05 PM, Posted by Kristin Schubert

Groundbreaking research from a 20-year study has found that the social skills a child exhibits in kindergarten are linked to their health outcomes in early adulthood.

RWJF Culture Of Health Prize - Taos, NM

As I was thinking about writing this blog, I did what I typically do when I need some insight—I asked my kids for help. I asked my 7-year-old son what he thought about sharing. He said, “Sharing is the nice thing to do. You should share your things with your little brother or sister.”

“Why?” I asked.

“Because it makes you feel good and they might just share back with you too.”

So simple, right? And so hard to teach at times!

As a busy working mom of two young children, my days are filled with helping my kids learn how to get along in the world. From learning to feed and dress themselves, to learning how to get along with others and how to recognize and deal positively with their emotions. It’s a job I wouldn’t trade for the world! And it is also one that can be daunting at times, requiring the utmost patience and perseverance. Some days I wonder if I am doing all I can to help them grow up healthy and I know many parents feel the same way.

The good news is that today, more than ever, we have incredible insight into what parents, caregivers, and teachers can do to ensure that children grow up healthy. We now know that what was once thought of as “nice” skills to have, like being a good sharer and empathetic, are actually critical to life long health, happiness, and success.

In a newly released study in the American Journal of Public Health, funded by the Robert Wood Johnson Foundation, researchers found that the social skills a child exhibits in kindergarten were linked to their outcomes—both positive and negative—two decades later in early adulthood.

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Using Social Data to Build Our Evidence Base

Jul 16, 2015, 2:22 PM, Posted by Alonzo L. Plough, Lori Melichar

Social media offers an exciting opportunity to innovate in health research—but the social data sandbox could use more players to conduct research, share datasets, and generate ideas about what we should be studying.


What do our tweets reveal about our health? What can we learn from Twitter about the health of those in our community? Can analysis of Twitter activity help predict an epidemic like the flu weeks before a community is inundated with cases?

Nicholas Christakis, director of the Human Nature Lab at Yale University and Thomas Keegan, Deputy Director of the Yale Institute for Network Science are conducting pilot studies in San Francisco and Boston to explore these questions and more. With funding from RWJF, Christakis’s lab uses Twitter posts that include mention of flu symptoms to map how the virus spreads outward from individuals to family, friends, and others in their social networks. This mapping method, which identifies central “influential” individuals, offers the possibility of early detection of the flu and therefore early intervention to prevent its spread. In addition to giving health officials and medical personnel a valuable head-start in responding to and preventing the spread of contagious illness, this kind of insight could also help people make decisions about their own behavior, including getting flu vaccines and being more diligent about hand washing.

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Community Development For and By the Community

Jul 13, 2015, 12:37 PM, Posted by Jasmine Hall Ratliff

Many families face rising rents they can’t afford. One local developer revamped an aging historic hotel into affordable housing to transform: "community development being done TO us.. to development done BY us."

Boyle Hotel before and after renovations. Before: The Boyle Hotel in disrepair. After: The Boyle Hotel-Cummings Block Apartments bring 51 new apartments to the neighborhood, all priced for people making between 30 to 50 percent of the area’s median income.

Ten years ago, Los Angeles’ Boyle Hotel was more than down on its luck. The grand old Victorian dame, built in 1889 by an Austrian immigrant and his Mexican wife, was uninhabitable. Over the years neglect had turned the stunning building with intricate period details into a ramshackle apartment house with shared bathrooms and communal kitchens. The wiring was faulty and the pipes leaked. Mold bloomed up walls. Rats scurried along the hallways. Absentee landlords racked up housing code violations, ignoring the residents’ repeated requests for basic protections of their safety and health.

Most of the tenants were older, single men: many of them mariachi musicians scraping by from gig to gig. They’d spend their weekends across the street in the plaza, as generations had going back to the 1930s, exchanging news and waiting for word of a quinceñeara or wedding where they might play. The musicians were a cultural anchor for the neighborhood, so much so that the residence was nicknamed the Mariachi Hotel.

The hotel sits at the peak of a steep hill, and if you look just beyond it you can see the full glory of downtown LA glinting in the sun. Maria Cabildo, Co-Founder and President Emeritus of the East LA Community Corporation (ELACC) and current Chief of Staff to the LA County Supervisor, saw the writing on the wall: The Boyle Hotel was bound to be snapped up by developers, and replaced by luxury rooms with a view if nobody attempted to save it. With plans for the LA Metro to extend its new light rail into the heart of the plaza, she knew that new development wouldn’t be far behind. What would the influx of business mean for the residents – mariachi musicians and families alike – who’d long called the neighborhood home?

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