Explore the Blog Explore Blog

Now Viewing: Public and Community Health

‘Glocalizing’ Solutions for the Rising Chronic Disease Epidemic

Jan 13, 2015, 9:00 AM, Posted by Justin List

Justin List, MD, MAR, MSc, is a Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholar at the University of Michigan and primary care general internist at VA Ann Arbor Health System. His research interests include community health worker evaluation, social determinants of health, and improving how health systems address the prevention and management of non-communicable diseases.

Justin List

The emergency sirens sounded loudly for the rising burden of chronic disease in 2014. Chronic diseases, also called non-communicable diseases (NCDs), broadly include cardiovascular disease, chronic respiratory disease, cancer, and diabetes. In 2014, we learned that, overall, 40 percent of Americans born between 2000 and 2011 are projected to develop diabetes in their lifetimes. This is double the lifetime risk from those born just a decade earlier. Rates of obesity, a condition related to many NCDs, remains stubbornly high in the United States. Mortality and morbidity from NCDs, not to mention the social and economic costs of disease, continue to rise.

The United States is not alone in the struggle with a well-entrenched NCD burden. At the end of 2014, a Council on Foreign Relations task force issued a report with a clarion call for the United States to aid in addressing NCDs in low- and middle-income countries (LMICs) where the epidemic of chronic disease poses risks to communities, economies, and security. The task force, which included RWJF President & CEO Risa Lavizzo-Mourey, MD, MPH, among its members, recommended: (1) U.S. global health funding priorities expand from disease-focused objectives to include more outcome-oriented measures for public health; and (2) the United States convene leading partners and stakeholders to address NCDs in LMICs.

View full post

The Imperative to Collaborate Across Disciplines to Make It Easier to be Healthy

Jan 12, 2015, 9:00 AM, Posted by Chevy Williams

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. 

Chevy Williams

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.

Health Care in 2015 logo

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.

View full post

The Role of the Chief Nursing Officer in Bridging Gaps Among Health Systems and Communities to Improve Population Health

Jan 8, 2015, 9:56 AM

Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

Jerry Mansfield
Health Care in 2015 logo

Since my doctoral work in public health, I have thought a great deal about the relationship of public health theory and practice and my acute care background. With more than 30 years of progressive leadership experience in a variety of for-profit/non-profit, inpatient and outpatient positions, I am trying to generate dialogue and discern a purposeful plan regarding the role of a Chief Nursing Officer in an academic medical center and the health of the populations we serve in our communities.

Based on earlier work in the 1990s and early 2000s, in 2007 the Health Research and Education Trust (HRET) engaged national experts to address the following question: How can hospitals engage their communities to improve the health of everyone? The report provides a framework and encourages hospital leaders and community members to envision health care in communities beyond the medical services offered by providers; it notes that the production of health is not only medical care, but also our environment, individual behavior, and genetic make-up.

View full post

New Network Unites Community Leaders to Improve Health

Dec 10, 2014, 12:55 PM

The Build Healthy Places Network, a new and innovative resource to improve health outcomes in low-income communities, launched last month during the annual meeting of the American Public Health Association.

This groundbreaking network sits at the intersection of public health and community development. The goal of the network is to expand our collective understanding of the social determinants that impact public health and catalyze action. In so doing, the Build Healthy Places Network hopes to create new models and develop new tools to help leaders of low-income communities and create a Culture of Health where every individual lives the healthiest life possible.

Already, cutting edge work is being done in the public health sphere to begin addressing the many factors that impact health. As Douglas Jutte, MD, MPH, the Network’s executive director, recently described, the Network is designed to aggregate the work being done to help build a knowledge base for every community to use. 

“The concept is derived from a series of conferences that the Federal Reserve System has held focusing on both health and community development,” said Jutte. “There was a growing recognition that there needs to be a support system to build bridges between these two distinct sectors. While the conferences were a good start, we saw the opportunity for a network to help build these cross-sectoral connections and keep this field of collaboration moving forward.”

The Network’s website includes resources such as primers on improving the health of communities and stories about communities that are already uniting community development experts and public health experts to build a Culture of Health.

Jutte says a lot of the successes in the field currently are anecdotal and people working in the field often come up them “accidentally.”

“You hear about this amazing work that someone is doing in some corner of a faraway state and that really should end because we have the ability to share that kind of knowledge,” says Jutte.

He continued, “A key goal is to move health and community development from their siloes to collaboration. The Network will serve as a clearing house to bring together stories and evidence and examples of collaboration in communities.”  

Going forward, the Network plans to “synthesize” what is known and what the good examples are “so that we can help communities and leaders who are not even sure where to start, to really understand what’s going on in terms of new models with a focus on measurement, policy, finance and investment,” Jutte said.  

This commentary originally appeared on the RWJF New Public Health blog.

We Are All Tuskegee

Dec 10, 2014, 9:00 AM, Posted by Collins O. Airhihenbuwa

Collins O. Airhihenbuwa, PhD, MPH, is professor and head of the Department of Biobehavioral Health at Penn State University. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held last week. The conversation continues here on the RWJF Human Capital Blog.

Scholars Forum 2014 Logo

As we address disparities and inequities, the challenge is to think about solutions and not simply defining the problem. Most would agree that health is the most important part of who we are. It is the first thing we think about in the morning when we greet one another by asking, “How are you this morning?” It is the last thing we think about at night when we wish someone a restful night.

Collins Airhihenbuwa

What may be different is what health means to us and our families. This is why place and context are important. How we think about health and what we choose to do about it is very much influenced by where we reside. Our place and related cultural differences about health are less about right or wrong and more about ways of relating and meeting expectations our families and communities may have of us, whether expressed or perceived. More than that is the way we relate to what our place means in terms of how it is defined and subsequently how that definition shapes how we define it for ourselves. In other words the ‘gate’ through which we talk about our place and ourselves is very important in having a conversation about who we are and what that means for our health.

View full post

Seizing Opportunities to Reinvent Public Health

Dec 2, 2014, 10:57 AM, Posted by Susan Dentzer

A doctor talks in a friendly manner to a disabled patient sitting in a wheelchair

“The only thing we know about the future is that it will be different,” wrote the late management guru Peter Drucker.  To the list of society’s sectors that are struggling with that conclusion, add government-funded public health.

State and local health departments face growing challenges, including infectious disease threats such as Ebola and chikungunya; a rising burden of chronic illness; an increasingly diverse population; even the health impact of global warming. At the same time, fiscal constraints accompanying the 2007–2008 recession and its aftermath hammered local, state, and territorial health agencies, which lost nearly 30,000 jobs—6 percent to 12 percent of their total workforces—from 2008 to 2013.

View full post

Lessons from the Arabbers of Baltimore

Nov 28, 2014, 9:00 AM, Posted by Maya M. Rockeymoore

Maya M. Rockeymoore, PhD, is president of the Center for Global Policy Solutions, a nonprofit dedicated to making policy work for people and their environments, and director of Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation (RWJF). On December 5, RWJF will hold its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.

Scholars Forum 2014 Logo

When I think of the resilience of disadvantaged communities disproportionately affected by health disparities, I think of the Arabbers of Baltimore, Md. They are not Arabic speaking people from the Middle East or North Africa, but scrappy African American entrepreneurs who started selling fresh foods in Baltimore’s underserved communities in the aftermath of the Civil War.

Maya Rockeymoore

Their relevance continued into the modern era as supermarkets divested from low-income neighborhoods, leaving struggling residents with few options aside from unhealthy fast food and carry-out restaurants. Driving horses with carts laden with colorful fresh fruits and vegetables, Arabbers sold their produce to residents literally starving for nutritious food.

View full post

Improving Health through Collaboration: The BUILD Health Challenge

Nov 26, 2014, 8:59 AM, Posted by Abbey Cofsky

Brownsville Farmers’ Market Enhancing community health: Customers buy produce at the Brownsville Farmers' Market in the Culture of Health Prize-winning city of Brownsville, Texas

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.

View full post

Adding Diversity to the Ranks of Public Health Nursing Leadership: Q&A with Shirley Orr, MHS, APRN

Nov 19, 2014, 11:39 AM

APHABanner

Today at the American Public Health Association annual meeting in New Orleans, Shirley Orr, MHS, APRN, a Robert Wood Johnson Foundation Executive Nurse Fellow and public health consultant, and Doris Brown of the Louisiana Department of Health, will be talking about opportunities for nursing leaders to implement the recommendations of a 2010 Institute of Medicine Report entitled “The Future of Nursing.” This report looks at ways that the nursing profession can transform itself in order to better align with population health and more effectively collaborate to create a healthier overall population.

NewPublicHealth recently spoke with Orr about how nurses can help improve community and population health. This interview has been lightly edited for clarity and length.

Orr Shirley Orr, MHS, APRN

NewPublicHealth: What does the nursing profession need to do in order to align itself with a focus on population health?

Shirley Orr: A couple of things in particular that stand out are education and diversity. We recently did a public health nursing enumeration that was funded by the Robert Wood Johnson Foundation, and we found two things in particular relating to the recommendations. First, that overall, public health nurses need new skills and they need higher levels of education to be able to function more collaboratively and within collaborations—both within health care and with other community partners.

Second, we found that nationwide, the demographic profile of public health nurses does not look like the population that we serve. Ethnic minorities are very much underrepresented among public health nursing—particularly in leadership roles.

We have a very urgent need to recruit more nurses of color into the ranks of public health nursing leadership.

NPH: Why is that necessary?

Orr: A core component of nursing curriculum today is culture competency. That being said, we also know that having nurses who understand populations very, very deeply by having a frame of reference for that population and being a member of that population really are able to help to get the highest level of engagement from the population. They’re also best prepared to understand the culture, the needs, the motivations about populations, so they’re really best positioned to be able to carry out in partnership strategies that are going to make a difference long-term in the health of populations. 

View full post

New Research Shows How Sugary Drinks Are Marketed to Children in the Age of Social Media

Nov 19, 2014, 10:27 AM

APHABanner

Beverage companies spent $866 million to advertise unhealthy drinks in 2013, and children and teens remained key target audiences for that advertising, according to a new report released today at APHA by the Yale Rudd Center for Food Policy & Obesity. The report “Sugary Drink FACTS 2014” highlights some progress regarding beverage marketing to young people, but also shows that companies still have a long way to go to improve their marketing practices and the nutritional quality of their products to support young people’s health.

“Despite promises by major beverage companies to be part of the solution in addressing childhood obesity, our report shows that companies continue to market their unhealthy products directly to children and teens,” said Jennifer Harris, PhD, Rudd Center’s director of marketing initiatives and lead author of the report. “They have also rapidly expanded marketing in social and mobile media that are popular with young people, but much more difficult for parents to monitor.”

Harris and her team examined changes in the nutritional content of sugar-sweetened drinks including sodas, energy drinks, fruit drinks, and others. They also analyzed marketing tactics for 23 companies that advertised these products, including changes in advertising to children and teens on TV, the internet, and newer media like mobile apps and social media. Researchers also examined changes in the nutrition and marketing of diet beverages, 100% juice, and water. The report was funded by the Robert Wood Johnson Foundation.

Learn more about the key findings of the report in the following exclusive interview with Harris. The interview has been lightly edited for clarity and length.

NPH:  You issued the first version of this new report in 2011. What are the changes since then?

Jennifer Harris: The biggest change that we saw was a very significant decline in advertising on television. Preschoolers are seeing 33% fewer TV ads for sugary drinks in 2013 than they saw in 2010. Children are seeing 39% fewer, and teens are seeing 30% fewer. So, that was really some great news to see, but some categories had bigger declines than others. Fruit drinks went down by about 50%, but advertising for energy drinks that kids see actually increased. So, there was some good news and some bad news. 

View full post