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All Children Deserve to Grow Up at a Healthy Weight

Feb 8, 2016, 9:15 AM, Posted by Risa Lavizzo-Mourey

A year since RWJF committed $500 million toward reversing childhood obesity, early signs of progress show us that cross-sector partnerships and access to healthier options are key steps to ensure all children have opportunities to grow up at a healthy weight.

A teacher leads students in outdoor physical activity at Cleminson Elementary School in El Monte, California.

One year ago, I traveled to New York City to announce that the Robert Wood Johnson Foundation would commit $500 million toward the goal of helping all children grow up at a healthy weight by 2025, bringing our total investment on this issue to more than $1 billion.

The gym at West Side High was packed and brimming with excitement on announcement day. We cheered early signs of progress in places like Philadelphia, New York City and rural North Carolina, but all of us knew the job wasn’t done. Even in places reporting good news, progress usually wasn’t reaching low income families and communities of color equitably. Everyone agreed we had to push harder, both to accelerate the pace of progress and ensure that its benefits reached all our children.

Now it’s one year later, and I’m pleased to report that the optimism we felt proved justified.

Nationally, research shows that school lunches have improved, and both students and parents support the healthy changes. Physical education is now due for a major upgrade, thanks to new funding sources in the just-passed education law that replaced “No Child Left Behind.”

The latest numbers from the Centers for Disease Control and Prevention’s NHANES study confirm that we are on the right track. Obesity rates are down five percentage points among our youngest children and are holding steady among other age groups. 

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The Next Phase of the OpenNotes Movement

Feb 2, 2016, 10:49 AM, Posted by Susan Mende

What happens when patients gain access to the notes their doctors and nurses take during a visit? A culture shift with empowered and motivated patients at the center.

Medical professions looking at patient records.

In December I was proud to announce an exciting partnership with three other foundations—the Cambia Health Foundation, Gordon and Betty Moore Foundation, and the Peterson Center on Healthcare—to take a bold step to expand access to clinical notes written by doctors, nurses, and other clinicians to 50 million patients nationwide. The $10 million in new funding to OpenNotes will allow the initiative to dramatically step up its efforts to create a new standard of care and set a new bar for patient-centeredness.

We know that physicians can help their patients become more engaged in their own care, and that this kind of patient activation can lead to improved outcomes and lower health care costs. Of course, that is easier said than done—especially when clinicians are already under pressure to adopt new technologies, implement new models for delivering health care, and make data on the quality of their care publicly available.

Health care innovators are unrelenting in their search for simple, scalable solutions to help both clinicians and consumers—and philanthropists can help put these bright ideas to the test to determine what works. OpenNotes is one such solution.

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What Can Communities Do Now for Health Equity?

Jan 28, 2016, 1:21 PM, Posted by Joe Marx

The Culture of Health Prize communities demonstrate that there's no single formula to address health equity locally, but there are key lessons we can all learn from their success.

2015 RWJF Culture of Health Prize video

Our annual RWJF Culture of Health Prize honors and elevates communities across the United States that are making great strides in their journey toward better health. 

A scan of the 2015 winners reveals something we’ve seen in previous years: There is no single blueprint. Even when solving common problems, these Prize communities innovate in their own ways. Each brings fresh ideas to the forefront and offers a unique perspective on how to holistically address our nation’s most complex health issues. So it makes sense to turn to them to answer the question that is at the heart of our work today: How can communities come together to create places where health can happen – for everyone?

We ask that question a lot and sometimes our answers can be pretty lofty: work together across sectors, think about health broadly, and so on. While all true, communities looking to take action sometimes ask us to, well, be a bit more specific. What can we do tomorrow? Where do we start

Here, we dive in to look at how the 2015 Culture of Health communities approached that Prize-winning question. 

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Beyond Seat Belts and Bike Helmets: Policies that Improve Lives

Jan 27, 2016, 9:13 AM, Posted by Alonzo L. Plough

RWJF announces up to $1.5 million in new funding to create the evidence base needed for a new generation of policies that improve health, well-being and equity.

Needed: Research to inform laws and policies that elevate community health and equity.

Some of us remember the bad old days when nobody wore seat belts and babies bounced on their mothers’ laps in the front seats of cars. For others, it’s the stuff of legend. Since the advent of seat belt laws in the late 1980’s, the proportion of people buckling up has skyrocketed from fewer than 15 percent to over 90 percent in many states. The laws required people to change their behavior initially and continuously until buckling up was a habit of mind and a social norm. Accordingly, the number of deaths and serious injuries from car accidents has plummeted by more than half.  Other policies—including minimum wage laws, zoning and urban planning, or childcare regulations and guidelines—have had large effects on improving population health.

At the Robert Wood Johnson Foundation (RWJF), we have witnessed firsthand the impact that policies and laws can have in improving health. With this in mind, RWJF is launching Policy for Action (P4A). This new initiative provides up to $1.5 million in funding (or $250K in individual grants up to two years) for research efforts that identify policies, laws and regulations in the public and private sectors that support building a Culture of Health. Our focus is intentionally wide-ranging. We recognize that policies developed both within health and prevention sectors and beyond—in education, economics, transportation, justice, and housing, for example—can ultimately affect the ability of all Americans to lead healthy lives.

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Helping Mid-Sized Cities Think Big About Health

Jan 13, 2016, 2:00 PM, Posted by Donald Hinkle-Brown

A new initiative will empower mid-sized cities across the U.S. to develop strategies for increasing and leveraging private and public investments to improve neighborhoods facing the biggest barriers to better health.

Runners along a New Orleans city park

Cincinnati, Ohio. Flint, Michigan. New Orleans, Louisiana. Springfield, Massachusetts. The names of many of America’s mid-sized cities are woven into the fabric of our national consciousness.

Others are less well known: Broken Arrow, Arizona. Pasco, Washington. Taylorsville, Utah.

Famed or not, cities boasting populations of 50,000 to 400,000 are where most Americans live. Mid-sized cities can be great places for a healthy, rewarding life. Many have a strong sense of community and history, with less hustle and bustle and traffic and lower cost of living than big cities.

But even in places where quality of life is generally good, not everyone benefits equally. All together, more people live in poverty in America’s mid-sized cities than in large metro areas. Even the most storied of these cities have neighborhoods facing some of the nation’s deepest challenges. And many such cities have suffered economic depression for decades.

My organization, Reinvestment Fund, works closely with cities to use data to better understand the needs of their most at-risk neighborhoods — and then invest in new initiatives that can revitalize housing, health, transportation, education, and other assets that help communities become stronger and healthier. Now, with the Robert Wood Johnson Foundation, we want to help dozens of mid-sized cities think big about ways they can improve health in their most underserved neighborhoods.

To do that, we’ve launched Invest Health, which will give up to 50 mid-sized cities $60,000 each to start to map out the kinds of changes they want to make.

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Removing Barriers and Creating Opportunities for Young Men of Color

Jan 5, 2016, 10:00 AM, Posted by Maisha Simmons

A new toolkit is here to help us understand how to collectively build a path toward a healthy and productive adulthood for young men of color.

Forward Promise - Oakland

Trayvon Martin. Manuel Diaz. Rexdale Henry. Michael Brown. Some names may be more familiar to you than others. But all share a common fate of life lost too soon.

What happens when you hear their names? Do you think about the circumstances that prematurely ended their lives? Or do you regret losing the chance to benefit from the great contributions they could have made?

It's clear that young men of color face daunting barriers to health that directly impact their potential to succeed and thrive. Access to a series of supports and conditions specifically designed to address these barriers can dramatically change their life course trajectory. That is why the Robert Wood Johnson Foundation launched our Forward Promise initiative a few years ago.

As part of this work, the big question we are always asking ourselves is what would it look like for every young man of color to grow up in a Culture of Health? We know for example that there would need to be positive school environments, access to role models, job training, support to understand and heal from trauma in their lives, and pathways to college and career, to start.

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Healthier Cafeterias Thanks to the Healthy, Hunger-Free Kids Act

Jan 4, 2016, 10:25 AM, Posted by Monica Hobbs Vinluan

Five years ago, the U.S. launched an overhaul of nutrition standards for kids. How far have we come?

Signs of Progress: Florida

Last month marked the fifth anniversary of the Healthy, Hunger-Free Kids Act. When the law was passed five years ago, our President and CEO Risa Lavizzo-Mourey called it “a long-awaited victory.”

After five years, a lot truly has been accomplished. Ninety-seven percent of schools nationwide are meeting healthier standards for school meals. Significantly more schools are now offering lunches with fruits, vegetables, and whole grains.

Putting healthier options on kids’ trays is an essential step, but the big challenge is making sure kids are eating and enjoying the meals. The good news is research shows that more students are taking fruit with their lunch, they’re eating more of their vegetables and entrees, and they generally like the new meals.

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The Most Important Thing We Can Do to Give Kids a Healthy Start in 2016

Dec 29, 2015, 9:00 AM, Posted by Giridhar Mallya, Martha Davis

Supporting parents and families is one of the most critical things we can do to safeguard a healthy future for our nation's kids.

Children raise their hands in a classroom.

We talk a big game, as a nation, about how much we value our kids. After all, “the children are our future,” right?

But here’s the thing: our investments and policies don’t yet line up with this value. Spending on children makes up just 10 percent of the federal budget, and that share is likely to fall. The outcomes are clear: Child well-being in the United States ranks 26 on a list of 29 industrialized nations in a UNICEF report. We must do better!

So here’s our recommendation of the absolute best thing we can do to give kids a healthy start in 2016: support parents and families.

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SHOP: Can it Boost Health Coverage for Small Business Employees?

Dec 14, 2015, 6:04 PM, Posted by Katherine Hempstead

A new report shows that small business owners care about the health insurance coverage they offer their employees, yet the Small Business Health Option Program (SHOP) remains an untapped resource with the potential to help employers find affordable plans.

In 1942, Ken Wilson’s grandfather started Bonnie Brae Conoco, a full-service gas station and neighborhood garage in Denver. Today, Ken is the third generation to manage the business. They’ve offered their employees health insurance since 1970, paying 100 percent of the costs for those who work full-time. Although it’s their largest expense, the Wilsons believe offering coverage is essential. They want to take care of their employees and attract and retain the best people.  

Small businesses, like all businesses, have struggled to keep up with the rising cost of health insurance. But unlike larger companies that can leverage their purchasing power to negotiate lower premiums and more comprehensive benefits, small businesses often have a choice of costlier plans with skimpier benefits. A recent study found small firms are far less likely than larger firms to offer health coverage. In 2012 and 2013, the percentage of small employers offering health insurance was 35 percent, while the percentage of large employers offering insurance was 95.8 percent.  

The Affordable Care Act (ACA) has several implications for small businesses. Under the ACA, small business health plans are subject to the marketplace regulations similar to those in the individual market. Depending on the state in which the business is located and the characteristics of the work force, these changes could make premiums change a lot or a little. Many small businesses are still offering pre-ACA plans, and many of them will need to transition to ACA-compliant coverage in 2017.

One new opportunity is the Small Business Health Options Program or SHOP, which is an online marketplace where small business owners with 50 or fewer full-time employees can purchase health insurance for their workers. Features of SHOP attempt to provide flexibility for both employers and employees. Business owners can set their contribution and their employees can choose the plan and benefits they want. Small business owners with 25 or fewer full-time employees can also qualify for a tax credit to put toward the cost of coverage.

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Rebuilding Healthier and More Resilient Communities Together

Dec 7, 2015, 4:01 PM, Posted by Reed Tuckson

Our nation spends billions of dollars to respond to, and rebuild from, disasters, which is why disaster planning must move beyond a narrow focus and create an optimally healthy community.

Trauma and Resilience

It felt like a nightmare to watch the floodwaters rise across New Orleans in August 2005. Yet as the hours turned into days, our nation realized we were watching reality – the reality of a great American city coping with a disaster for which city, state and country had not fully prepared.

The good news is that in the decade since, New Orleans has worked towards a new reality by not just rebuilding what was lost, but by asking how it can rebuild better. In so doing, the city is setting an example for us all.  

Rebuilding better means repairing critical infrastructure (roads, hospitals, businesses, levees), and reforming the organization and interpersonal relationships that are essential to promoting well-being and community engagement. As has been well chronicled, such efforts include fostering neighbor-to-neighbor ties, using data to guide community heath strategic planning, and encouraging multi-sector partnerships between government, business and community organizations. In New Orleans, initiatives such as Fit NOLA and NOLA for Life have united the city’s health department, schools, community-based organizations, and businesses in ways that were unimaginable before the storm.

New Orleans’ efforts align closely with the recommendations of the recently released report, “Healthy, Resilient and Sustainable Communities after Disasters: Strategies, Opportunities, and Planning for Recovery,” intended as a call to action and an action guide. The Institute of Medicine and the National Academy of Science was commissioned to produce this report by the Robert Wood Johnson Foundation. I was honored to serve as chair of the committee, which was composed of disaster planning, and health and human service experts. We were tasked with identifying ways in which local and national leaders can work together to mitigate disaster-related health impacts and optimize the use of disaster resources to create communities that are healthier and more resilient.

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