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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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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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BUILDing Bridges To Better Health Through Partnerships

Dec 1, 2015, 3:30 PM, Posted by Amy Slonim

A new collaboration is helping communities forge partnerships that address the social determinants of health integral to the well-being of individuals and communities.

BUILD Health panel at Colorado Health Symposium BUILD funding partners (from left to right): Chris Denby, The Advisory Board Company; Christopher Smith, Colorado Health Foundation; Chris Kabel, The Kresge Foundation; Amy Slonim, Robert Wood Johnson Foundation; Brian Castrucci, de Beaumont Foundation; Rachel Keller Eisman, The Advisory Board Company. [Photo credit: Chris Schneider for the Colorado Health Foundation]

“This is about communities owning the solutions to improving health ... this is where the rubber meets the road." That’s how my colleague Brian Castrucci, chief program and strategy officer at the de Beaumont Foundation, described the goals of the BUILD Health Challenge during the fifteenth annual Colorado Health Symposium. Brian and I shared the symposium stage with senior officers from the four foundations and one for-profit firm that, together with the Robert Wood Johnson Foundation (RWJF), launched the BUILD Health Challenge earlier this year.

Why do communities need to BUILD bridges to improve health? For RWJF, the BUILD Health Challenge embodies the essence of our Foundation’s focus on bridging. As my colleague Paul Kuehnert notes, health care, public health and social services have traditionally operated in siloes. By breaking down these siloes and “bridging” health care with systems that are not traditionally thought of as health-related—such as education, housing and transportation—we can help people get the services they need, when they need them.

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A New Nutrition Research Center Set on Making New Jersey a Healthier State

Nov 23, 2015, 11:39 AM, Posted by Peter Gillies

The New Jersey Institute for Food, Nutrition, and Health is impressive both in size as well as in its plans to help transform New Jersey into a national model for promoting healthier lifestyles for children and families.

Last month, Rutgers University opened the doors to the New Jersey Institute for Food, Nutrition, and Health (IFNH), a new interdisciplinary research hub for scholars, policymakers, students, and parents to advance, educate and promote issues of nutrition and wellness. At the dedication ceremony, I couldn’t help but think of something the great Chicago architect Daniel Burnham once said:

“Make no little plans.”

It’s no surprise that an architect would come to mind as I sat proudly marveling in the atrium of our magnificent new home. The modern, open-concept building is a beautiful addition to the Rutgers campus, designed with nearly 70,000 square feet of research and community space dedicated to making New Jersey a healthier and happier state. It’s also a heartening testament to the support we enjoy from organizations like the Robert Wood Johnson Foundation (RWJF), which calls on all of us to work together to build a Culture of Health, where getting healthy and staying healthy are guiding values.

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Measuring What Matters: Introducing a New Action Framework

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.

A Culture of Health is where communities can flourish and individuals thrive.

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. 

A First Friday Google+Hangout discussion on "Measuring What Matters in Building a Culture of Health" took place on Friday, November 6

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How Public Health Sharing Arrangements Fit Into the Value Equation

Oct 6, 2015, 11:05 AM, Posted by Meshie Knight

In recent years, cross-jurisdictional sharing has been a focus for policymakers and public health officials wishing to increase effectiveness and efficiency in the delivery of public health services. Measuring its impact is next.

public health nursing banner

Well-functioning, high-value public health departments are critically important to ensuring the conditions for good health in communities. In recent years, however, health departments have been faced with exceptional financial challenges mostly in the form of repeated reductions in state and local funding for public health budgets. At the same time, expectations for their roles and responsibilities—as monitors and chief health strategists for communities and as partners within and beyond the health sector—are growing.

In 2012, RWJF launched a program to investigate a potential strategy for strengthening health departments that could be especially effective in times of financial or administrative hardship, and importantly, could also help to augment the capabilities of health departments serving particularly small or rural jurisdictions: cross-jurisdictional sharing (or more simply, publicly authorized sharing of public health services across jurisdictions). The Center for Sharing Public Health Services (CSPHS) was designed to help build the evidence for how cross-jurisdictional sharing (CJS) arrangements can be planned for and implemented in different environments.

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Redesigning the Hospital as a Community Health Network

Sep 10, 2015, 3:35 PM, Posted by Shannon Kraus

Cleveland's MetroHealth Medical Center has reimagined itself to embrace community and build in thoughtful improvements to its programs and design that focus on everyday wellness and well-being.

Graphic of the MetroHealth Medical Center Image via HKS Architects

In a room filled with architects, acting Surgeon General Rear Admiral Boris D. Lushniak shook up the common definition of our profession by saying that “if you are an architect, you are a public health worker.

And many architects were already with him. We have been expanding our thinking beyond typical individual buildings to create healthy blocks, corridors and neighborhoods by shaping what they do within the property line so it’s responsive to what’s happening outside the property line. This in itself is not new, but doing so to improve health and wellness, while leveraging the resources of large civic-minded institutions, is a new approach to a traditional problem.

MetroHealth Medical Center in Cleveland, Ohio has taken on this mindful, responsive approach while morphing from an isolated hospital into an inclusive community health center. This process flips the paradigm of health delivery; instead of focusing on the hospital as the first line of defense in the care and wellbeing of a population, it is now the last stop.

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What Hurricane Katrina Taught Us About Community Resilience

Aug 27, 2015, 8:59 AM, Posted by Alonzo L. Plough, Anita Chandra

Hurricane Katrina left a path of destruction, death, and suffering in its wake. Its uneven recovery has taught us valuable lessons about community resiliency that will help us prepare for the next storm and beyond.

New Oreleans St. Bernard Housing project. Girl on scooter.

Ten years ago Risa Lavizzo-Mourey visited Gulfport, Mississippi, and witnessed firsthand the devastation and ruin wrought by Hurricane Katrina. “We may not be able to fix the broken levees, restore ruined cities, house the homeless, or feed the hungry,” she wrote soon after. “That’s not our job. But we most certainly can apply Katrina’s lessons to the wide range of good work that we support...”

On the 10th anniversary of Hurricane Katrina, we must reflect on valuable lessons learned from this cataclysmic event, the complexity of recovery, and the disastrous health outcomes that can result from a fundamental distrust between residents and government agencies. Katrina’s devastation and the Gulf’s uneven recovery also have served as an opportunity for studying resiliency—the capacity of communities to prepare for, respond to, and recover from adversity whether in the form of a natural disaster, economic downturn, or a pandemic.

This emphasis on community resilience represents a paradigm shift in emergency preparedness, which has traditionally focused on shoring up infrastructure (reinforcing buildings, roads, and levees), improving detection of new hazards to human health, and being able to mount an immediate response to disasters. Katrina and subsequent threats such as Hurricane Sandy, the Florida panhandle oil spill and the H1N1 epidemic have taught us that to be truly prepared for the long-term impact of adversity communities must also develop a different set of assets: those that build strength through promoting well-being and community engagement.

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