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Crafting Win-Win Solutions with Health Impact Assessments

Jun 22, 2015, 3:01 PM, Posted by Pamela Russo

Health impact assessments are a powerful way to help communities think broadly about the health implications and equity aspects of policies and projects, so that a comprehensive approach to health becomes routine.

Prison Alternatives Boosted by Health Impact Assessment

Last week, almost 500 attendees arrived in the nation’s capital for the 2015 National Health Impact Meeting. The impressive turnout is a testament to the growing importance of health impact assessments (HIA) as a tool to improve community health outcomes.

As this year’s meeting attendees know, an HIA is a process that helps evaluate the potential health effects of a plan, project or policy outside of the traditional health arena. The findings from a completed HIA can provide valuable recommendations to help communities more effectively foster better and more equitable health among their citizens.

The use of HIAs has grown rapidly from just a few dozen in 2000 to more than 350 completed HIAs today. Dozens more are in the works. The earliest HIAs were mostly applied to the built environment, such as zoning, land use and transportation decisions. However, today the field has expanded to include such areas as energy policies, criminal justice and living wages.

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We Went to Oxford and Got Schooled in Primary Care

Apr 23, 2015, 9:00 AM, Posted by Maryjoan Ladden, Susan Mende

As other countries continue to spend far less on health care but perform better on measurable health outcomes, there's opportunity to learn what works abroad and apply those lessons stateside.

Oxford University

It’s a hard notion for many Americans to accept—although we spend more money on health care than any other country in the world, we are far from having the best health outcomes. When you look at measures that include life expectancy, infant mortality rates and preventable illness, other countries that spend far less than the U.S. perform better. But in many of these countries people of all ages and socio-economic status are able to easily access primary care that is comprehensive, patient-centered and rooted in local communities.

One of our goals as program officers at RWJF is to look beyond our borders to identify promising practices that might be incorporated into America’s health care system. Last fall we traveled to Oxford, England, to learn first-hand about promising primary care practices in Chile, England, the Netherlands and Canada—all high and middle income countries that spend less on health care yet have better outcomes than the U.S. We attended a conference organized by the Training and Research Support Centre (TARSC), an organization supported by Charities Aid Foundation of America through a grant from the RWJF Donor-Advised Fund. TARSC provides support and training to government and civic health organizations, and the conference was the next step after its report, “Strengthening primary care in the USA to improve health: Learning from high and middle income countries.” We came away with a lot of insights from both, but were struck by several themes that were constant throughout.

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Q&A with Pau Gasol: The NBA All-Star's Health Advocacy Off-the-Court

Apr 20, 2015, 9:29 AM, Posted by Merlin Chowkwanyun

It may be NBA playoffs season, but the Gasol brothers are committed to promoting child health year round. RWJF Health & Society Scholar Merlin Chowkwanyun recently sat down with the Chicago Bulls' center to learn about his passion for health advocacy and how he's working to build a Culture of Health in the U.S. and abroad.

Gasol brothers Image credit: Joe Murphy (NBAE/Getty)

Since moving to the Chicago Bulls last summer, NBA star Pau Gasol has been having one of the most sensational seasons of his basketball career. A two-time champion with the Los Angeles Lakers, the new Bulls starting center is entering the playoffs as the league leader in double doubles, averaging about 18 points and 12 rebounds per game. In February, he and his younger brother Marc Gasol (of the Memphis Grizzlies) made NBA history as the first siblings to start in the annual All-Star Game: Pau for the East team, Marc for the West.

The two have been equally active off the court. In 2013, after years of work with various philanthropic associations, Pau and Marc formed the Gasol Foundation. It focuses on child health and works towards "a world where all children will enter adulthood physically and mentally equipped to live successful, healthy and productive lives." The Foundation recently launched outreach projects in two areas with severe socioeconomic disadvantage. Vida! Health & Wellness in Boyle Heights (Los Angeles) provides parents and children with instruction in physical activity, physiology, and fitness; healthy cooking and eating; and psychological wellness. L'Esport Suma in South Badalona (Catalonia, Spain) uses sports to promote human development and social cohesion among participants. It is run in conjunction with Casal dels Infants, a long-standing NGO in the region.

Pau has always been a very visible 7-foot presence—literally and figuratively—in Memphis, Los Angeles, and now Chicago, the three cities where he has played. Among other things, that included visiting patients and working with the Children's Hospital Los Angeles and St. Jude Children's Research Hospital, and around the world, raising awareness of refugees' plight as a UNICEF ambassador. In 2012, the NBA recognized these and many other efforts with its J. Walter Kennedy Citizenship Award, given to only one player a season. He recently was named one of ten finalists for the NBA's Community Assist Award, and fans can vote for him on Facebook, Twitter, or Instagram by typing #NBACommunityAssist and #PauGasol. 

Each year, Robert Wood Johnson Foundation Health & Society Scholars at the University of Wisconsin-Madison's site complete a "'knowledge exchange" project designed to foster communication among the general public, academic researchers, and population health practitioners. As someone who grew up in Los Angeles, I cheered for Pau during his seven seasons with the Lakers but admired him just as much for what he did beyond the game. For my project this year, I wanted to interview Pau about his and Marc's plans because it seemed the Gasol Foundation's goals dovetailed with those of RWJF's Culture of Health initiative in many respects.

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U.S. Army Moves Closer to Achieving Public Health Accreditation

Apr 10, 2015, 12:55 PM, Posted by Pamela Russo

The U.S. Army is gearing up for public health accreditation for the first time, a development that opens the door for collaboration between military and civilian public health departments—leading to better health for all.

military soldier soluting

A decade ago, there was a common maxim heard about governmental public health departments that declared “if you’ve seen one health department; you’ve seen one health department.”

This tongue-in-cheek expression arose in part from the federalist administration of public health, which has resulted in public health codes that vary by state, and department-specific financing and structure. Additionally, this maxim reflected a fragmented and dysfunctional national system that lacked consistency across public health settings.

Today, the Robert Wood Johnson Foundation is working to realize a new era of public health defined by the application of strong and universal public health standards. That’s why the Foundation is a proud supporter of the Public Health Accreditation Board (PHAB) and their efforts to establish national performance standards for public health agencies across the United States.

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From High Schooler to Activist: How I Came to Build a Culture of Health in East LA

Apr 7, 2015, 2:12 PM, Posted by Jennifer Maldonado

A young activist tells the story of her journey empowering students to influence the health in their local community. This article was originally published in Equal Voice for Families on January 26, 2015.

I was a student at Woodrow Wilson High School in Los Angeles from 2005 to 2009. The school sits on top of a hill, overlooking the city. We had a great view, but our predominantly Latino student body did not have the resources to aspire. Books were dated, classes were crowded, there were few counselors and there weren’t enough teachers. My working-class community struggled with jobs and survival. I did not know how to interpret and change what I, and many of my friends, were experiencing—peer-on-peer violence, racial tensions, gang violence, broken families, and poor health, all the outcomes of an impoverished community.

My school friend Cindy fell into gang life at an early age. I saw her investment in the gang increase until she eventually stopped attending school and I lost contact. I began to wonder if any of the adults at our school tried to support her. Looking back, I believe that Cindy’s path was partially the result of the lack of student support in our education system.

One day, I found an opportunity to create change, or should I say, it found me.

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How Can We Use a Wealth of Data to Improve the Health of Communities Across the Nation?

Apr 6, 2015, 11:15 AM, Posted by Alonzo L. Plough

There's a wealth of data that paints a picture of the health challenges and successes of communities across the country. It's critical to use that data to measure progress in order to raise the grade of our nation's health.

Signs of Progress - Philadelphia

For local health officials across the nation, the release of the 2015 County Health Rankings gives communities an important opportunity to reflect on how they are doing when it comes to the health of their residents. The Rankings are a snapshot capturing the healthiest or least healthy counties in a given state.

But the Rankings also give communities a chance to delve deeper and explore beyond the headlines and the misrepresentative “best and worst” lists. Through the Rankings, we can really dive into data that can help us understand how to build a Culture of Health for citizens in all counties across the nation.

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Data, Meet Curiosity: Finding Bright Spots in Appalachia

Apr 1, 2015, 9:20 AM, Posted by David Krol

There are so many opportunities to connect the wealth of data we have at our fingertips and to start asking new questions. David Krol tells his story about how he took this approach to find bright spots in Appalachia.


If you close your eyes and picture Appalachia, what do you see? The images that often arose first in my mind were those from LIFE Magazine’s 1964 photo essay on the war on poverty. Photojournalist John Dominis gave the nation a face to the plight of Appalachian communities in Eastern Kentucky, and poverty and economic hardship have long been central to an outsider’s understanding of the region ever since. But through my work at the Foundation, I knew this narrative was only one part of the region’s rich and diverse story. I knew there was a different story to be told, and so I wanted to shine a light on these bright spots that demonstrate how health can flourish across Appalachia.

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The 2015 Rankings and Philadelphia’s Power of ‘Brotherly Love’

Mar 25, 2015, 12:15 AM, Posted by Donald F. Schwarz

Rather than taking poverty and its ravaging effects on health as a given, Philly leaders and citizens came together to usher in change that would make the city a healthier and better place to live for everyone.

The Philadelphia skyline on a sunny day.

If you want to understand the texture of a large city, drive from its downtown and make your way out to the suburbs. With few exceptions, you’ll encounter pockets of poverty transitioning into mixed income neighborhoods and, finally, wealth and privilege in the suburbs.

I have lived in Philadelphia—the nation’s 5th most-populous city and 21st most populous county—for most of my adult life, and that is her reality. As a former public health official, I can tell you that such income gradients have a profound impact on the health of our populations.

The 2015 County Health Rankings released today are unique in their ability to arm government agencies, health care providers, community organizations, business leaders, policymakers, and the public with local data that can be applied to strengthen communities and build a true Culture of Health.

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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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Go Back to Basics, Go Back to Schools

Jan 23, 2015, 9:00 AM, Posted by Katherine Vickery

Erin Maughan
Health Care in 2015 logo

If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either.  One of the places to begin coordinated cultural change is in schools.

Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.

There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.

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