Nov 11, 2015, 11:30 AM, Posted by
Alonzo L. Plough
It's time to change our culture into one that values health everywhere, for everyone. Introducing a new Action Framework and Measures to help us get there.
Our nation is at a critical moment. There is plenty of data that reveals discouraging health trends: We are living shorter, sicker lives. One in five of us live in neighborhoods with high rates of crime, pollution, inadequate housing, lack of jobs, and limited access to nutritious food.
But there is other data that gives us glimpses of an optimistic future. There’s increasing evidence that demonstrates how we can become a healthier, more equitable society. It requires a shared vision, hard work, and the tenacity of many, but we know it is possible.
Starting with a Vision
Last year, the Robert Wood Johnson Foundation (RWJF) shared our vision of a country where we strive together to build a Culture of Health and, every person has an equal opportunity to live the healthiest life they can—regardless of where they may live, how much they earn, or the color of their skin.
As my colleagues and I traveled throughout the country, we met many of you and heard your views on an integrated, comprehensive approach to health. You told us that in order to achieve lasting change, the nation cannot continue doing more of the same. Realizing a new vision for a healthy population will require different sectors to come together in innovative ways to solve interconnected problems.
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Aug 18, 2015, 10:40 AM, Posted by
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.
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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Jan 30, 2015, 5:47 PM, Posted by
“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.
And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.
One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.
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Jan 27, 2015, 9:00 AM, Posted by
At Virginia Commonwealth University School of Medicine, Briana Mezuk, PhD, is an assistant professor in the Department of Family Medicine and Population Health, Division of Epidemiology; and Tiffany L. Green, PhD, is an assistant professor in the Department of Healthcare Policy and Research. Both are alumnae of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program.
Approximately 30 million U.S. adults currently have diabetes, and an additional 86 million have pre-diabetes. The incidence of diabetes has increased substantially over the past 30 years, including among children. Estimates place the direct and indirect costs of diabetes at a staggering $218 billion annually.1 Like many other diseases, disparities on the basis of race and income are apparent with diabetes. Non-Hispanic blacks, Hispanics, Native Americans, and socioeconomically disadvantaged groups are more likely to develop diabetes than non-Hispanic whites and socioeconomically advantaged groups.
Despite the enormous economic and social costs associated with diabetes, it remains a struggle to apply what we know about diabetes prevention to communities at the highest risk. We have robust evidence from randomized controlled trials that changing health behaviors, including adopting a healthy diet and regular exercise routine and subsequent weight loss, will significantly lower the risk of diabetes. Unfortunately, these promising findings only appear to apply to the short-term. Even worse, results from community-based translation efforts have been much more modest than expected, and show only limited promise of reducing long-term diabetes risk. In response, leaders at the National Institutes of Health have noted that many efforts at translating clinical findings into community settings are “limited in scope and applicability, underemphasizing the value of context.”2
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Jan 12, 2015, 9:00 AM, Posted by
Chevy Williams, PhD, MPH, is a fellow at Experience Institute, where she is learning and applying design thinking to social problems. Williams is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Pennsylvania.
Today, we can get access to just about anything in minutes or hours. Smartphones put a world of information literally at our fingertips. Within minutes, most of us can get food we want, entertainment we desire, even travel to another city. But seeing a doctor, an arguably more immediate need, is not so easy. Creating a Culture of Health requires our collective interdisciplinary expertise to make health and health care as accessible and user-friendly as other products and services we use on a regular basis.
Before I left academia, I heard the word “interdisciplinary” tossed around a lot, but I saw it practiced in very safe ways. Typical research teams of grants I was on or would review comprised researchers from only the social, psychological, and health and medical sciences. As public health faculty, I’d hear statements like “Public health is inherently interdisciplinary.” This may be true since public health draws from multiple disciplines, but I couldn’t help but feel that such statements were more a reflection of inertia than anything else.
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Dec 22, 2014, 5:08 PM, Posted by
In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.
The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.
On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.
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Dec 2, 2014, 11:00 AM, Posted by
Rosa Gonzalez-Guarda, Rosa M. Gonzalez-Guarda
Rosa M. Gonzalez-Guarda, PhD, RN, CPH, FAAN, is an assistant professor at the University of Miami, School of Nursing & Health Studies and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. On Friday, December 5, she will be a panelist at the RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.
My research has focused on understanding and addressing behavioral and mental health disparities experienced by Hispanic/Latino communities. Although I initiated my research looking at substance abuse, violence, HIV and mental health as separate conditions that often co-occurred in marginalized communities, I soon realized that these conditions were just symptoms of an underlying phenomena— something my colleagues and I refer to as the Syndemic factor.
We have been studying the social determinants of the Syndemic factor in hopes of developing culturally tailored interventions that can potentially address multiple behavioral and mental health outcomes for the Hispanic/Latino community. From this research we have learned that interventions that address stress and family support offer promise for this community.
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Nov 26, 2014, 8:59 AM, Posted by
Here at the Robert Wood Johnson Foundation, the name of the game is collaboration. Our goal—to build a Culture of Health in which getting and staying healthy is a fundamental societal priority—is an ambitious one, requiring coordinated efforts among everyone in a community, from local businesses to schools to hospitals and government. It also calls for those of us at the Foundation to collaborate with other like-minded groups to address the complex challenges that stand in the way of better health.
That is why we are so pleased to be a partner in the BUILD Health Challenge, a $7.5 million program designed to increase the number and effectiveness of community collaborations to improve health.
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Nov 21, 2014, 1:00 PM, Posted by
Jennifer Schroeder, Stephanie M. DeLong, Shannon Heintz, Maya Nadimpalli, Jennifer Yourkavitch, and Allison Aiello, PhD, MS, professor at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This blog was developed under the guidance of Aiello’s social epidemiology seminar course.
Ebola is an infectious disease that the world has seen before in more moderate outbreaks in Africa. As the devastating Ebola outbreak in West Africa has taken a global turn, fear, misinformation and long-standing stigma and discrimination have acted as major contributors to the epidemic and response. Stigma is a mark upon someone, whether visible or invisible, that society judgmentally acts upon. Ebola has become a significant source of stigma among West Africans and the Western world.
In many ways, the source of this discrimination can be traced back to the legacy of colonialism and the western approach to infectious disease response in Africa. The history of foreign humanitarian aid has sometimes dismissed cultural traditions and beliefs. As a consequence, trust in westerners has eroded and has been compounded by a disconnect between western humanitarian aid approaches and a lack of overall infrastructure investment on the part of African national health systems. This is apparent in the Ebola epidemic in West Africa. Some don’t actually think that Ebola exists; instead they believe that it is a hoax carried out by the Western world. All of these factors are facilitating the rapid spread of the disease.
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