Dec 7, 2015, 8:00 AM, Posted by
With the right data to inform priorities, and a powerful commitment to equity, places like Tulsa, Okla., are making progress to close health gaps.
What would your ideal future look like? For me and my colleagues at the Foundation, it would be one where everyone has the opportunity to live the healthiest life they can.
An unfortunate reality in this country, however, is that while we continue to realize substantial gains in health, the things that help people become and stay healthy are not evenly distributed across states or even metropolitan areas. Access to healthy foods, opportunities for exercise, good-paying jobs, good schools, and high quality health care services may be readily available in one area, and difficult to come by or nonexistent in another just a few miles away.
Sometimes the differences are particularly stark: In some communities, two children growing up just a short subway or car ride apart could be separated by a 10-year difference in life expectancy.
So how do we square this reality with the Culture of Health we’re working hard with others to build? An important first step is recognizing those disparities and what’s driving them, and ensuring that people in communities across America have strategies – and the data – they can use to proactively close health gaps.
Let’s use Oklahoma, and within it the city of Tulsa, as an example.
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Nov 4, 2015, 3:03 PM, Posted by
A call for proposals seeks to support evaluation of disruptive innovations that improve the health of low-resource communities—without increasing costs.
Many of the resources that influence whether or not people are healthy vary widely from one community to the next. Income, education and employment levels, access to quality, affordable health care, the availability of social services, and the cultural and physical environment—all have a significant impact on health outcomes. Poorer communities, lacking in resources may struggle to offer all the components that create a healthy environment to live, learn, work and play.
By necessity, however, these low-resource communities often find new and creative ways to do more with less to promote health. In an effort to uncover such fresh and disruptive approaches to improving health in these communities, the Robert Wood Johnson Foundation (RWJF) is issuing a call for proposals.
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Aug 10, 2015, 3:25 PM, Posted by
It's been a year since Brownsville, Texas, won the Culture of Health Prize for its engagement of leaders across sectors to improve local health outcomes. Here's what the community has been up to since.
Brownsville, Texas, had plenty to celebrate when it became one of six communities to win the Robert Wood Johnson Foundation’s Culture of Health Prize in June 2014. This predominantly Hispanic city along the U.S.-Mexico border is one of the poorest in the country. Seven in 10 residents are uninsured, 8 in 10 are overweight or obese, and 1 in 3 has diabetes. Yet the community’s efforts to improve health—including new bike trails, community gardens, and a successful bilingual public health education campaign—have earned it wide respect and national recognition, along with $25,000 that goes with the RWJF Culture of Health Prize.
City officials are still discussing how to use the prize money. One option is commissioning a piece of artwork that could be moved around to highlight various initiatives, such as the periodic CycloBia events that make some of the city’s streets car-free for a day so that residents can bike, run, or engage in other physical activity.
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Jul 8, 2015, 4:59 PM, Posted by
Ellen Lawton, Megan Sandel
Civil legal aid agencies are a proven resource for clinics to support patient needs and achieve health equity by addressing the social barriers to health.
A lawyer as part of the health care team? It's not as strange as it sounds. Many of the social conditions that impede health, such as housing, education, employment, food and insurance, can be traced to laws unfairly applied or under-enforced, often leading to the improper denial of services and benefits designed to help vulnerable people.
There are eight thousand civil legal aid lawyers in the U.S., and much of their work is directly related to improving health. They ensure access to food, health benefits and insurance for their clients. By fighting for better housing conditions and preventing evictions, they help create healthier physical environments. They help keep families safe and stable by establishing guardianships.
There is evidence that lawyers are more critical than ever to the health of vulnerable people. Each year the Department of Veterans Affairs surveys homeless veterans; the most recent CHALENG survey found that six of the top 10 barriers to housing were legal in nature. And a recent study at Lancaster General Hospital found that each of the hospital's highest-need, highest-cost patients had two to three health-harming civil legal problems.
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Jun 10, 2015, 2:52 PM, Posted by
Two Atlanta neighborhoods, Buckhead and Bankhead, are separated by a mere five miles. Even their names are just two small letters apart. And yet the high-end shopping mecca dubbed Buckhead boasts an average life expectancy of 84 years, while in Bankhead—a neighborhood in transition that’s home to a newly burgeoning arts community—its residents face a life expectancy that’s a full 13 years shorter.
This map of Atlanta—one of a series from the Center for Society and Health at Virginia Commonwealth University (VCU), funded by RWJF, shows that our zip codes might be a better predictor of health than our genetic codes. Why? Because where we live affects our health and wellbeing in complex ways. Among them, according to VCU, are a scarcity of jobs and quality schools, and fewer opportunities to access healthy affordable foods and safe places to be active.
This isn’t the first time Atlantans have bore witness to to inequity in their community, and today, community leaders are drawing inspiration from their past. Here in the city that served as the capitol of the Civil Rights Movement, community leaders are responding just as previous generations once did—by bringing together a diverse coalition to advance health equity and serve as a model for communities far beyond the Peachtree State.
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Jun 1, 2015, 11:46 AM, Posted by
How a section of Birmingham, Alabama is redeveloping and offering greater opportunities for people at multiple income levels. The secret? Engaging the community throughout the process.
With its elegant homes, pleasant park and bustling stores, the Woodlawn section of Birmingham, Alabama was described in a 1950 news article as “a really great section of Birmingham...typical of the fine things in life." Then came the racial unrest of the 1960s, disruption from urban renewal gone awry and white flight to Birmingham’s suburbs. Joblessness and poverty took root; the housing stock decayed. Today, median income in Woodlawn is just $21,000, less than half the level for Birmingham as a whole.
But now Woodlawn is in the midst of a turnaround, aiming to become not just a neighborhood that prospers economically, but also one where people live healthier lives.
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May 19, 2015, 9:00 AM, Posted by
Change leadership means thinking big about impact, responding to urgent needs, and actively tolerating risk. This is the kind of big, bold way of working—together—that will get us to a Culture of Health.
Just over a year ago, I started in a new role at the Robert Wood Johnson Foundation. Not long after, my colleagues and I began the exciting, challenging, and collaborative process of co-designing four new programs that will develop, train, and network change leaders who will help build a Culture of Health.
You may be wondering – What is change leadership? How do we know it when we see it? And, why is it essential for achieving RWJF’s vision?
>>Could your organization serve as a National Leadership Program Center? View the call for proposals.
Here's the type of challenge our nation's leaders often face:
For a half-century, charities, nonprofits and local and federal governments have poured billions of dollars into addressing the problems plaguing [many] Americans. But each issue tends to be treated separately – as if there is no connection between a safe environment and a child’s ability to learn, or high school dropout rates and crime. –The Wall Street Journal, September 2013
Now here's an example of what change leadership looks like:
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May 6, 2015, 3:38 PM, Posted by
With convenient weekend and after-hours care, retail clinics have the potential to expand access to basic primary care and help address some non-clinical needs underlying the social determinants of health.
My husband had been suffering from a very painful sore throat for a couple of days when he finally decided to call his doctor. Just one problem: It was a Friday morning and the office was booked for the day. The doctor called back later in the afternoon and told my husband it sounded like a virus and he should simply “wait it out.” With the weekend approaching, the next available appointment—if needed—was on Monday. Rather than suffer all weekend with a raw throat, my husband followed the advice of a relative (who also happens to be a physician) and went to a clinic at our local CVS. Less than an hour later he was diagnosed with strep throat and started on antibiotic therapy he picked up at the pharmacy. By Saturday evening he was feeling a lot better.
Access to quick, convenient care on nights and weekends is one of the prime selling points of “retail clinics” based in pharmacies, groceries, and big-box retailers. With longer operating hours and no need for an appointment, these clinics, sometimes called “doc-in-a-box,” give patients more flexibility to avoid time away from work and family. Plus, a trip to a retail clinic costs about one-third less than a visit to a doctor’s office, and is far cheaper than an emergency room. Retail clinics usually accept private insurance, Medicare, and, in many cases, Medicaid; yet people without insurance or a personal physician also are using them for treatment of routine illnesses, basic health screenings, and low-level acute problems like cuts, sprains, and rashes.
New shopping list: Pick up milk, breakfast cereal, and toilet paper; get a flu shot and that weird rash checked out.
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Apr 9, 2015, 9:27 AM, Posted by
The South Bronx's Via Verde, an award-winning affordable housing complex designed around equity and social cohesion, shows us a new era of healthy design is here—and it's contagious.
Each winter, Raquel Lizardi and her heartiest garden club members brave the New York City cold to tend their community’s apple trees. “They are very delicate,” Lizardi says, sharing her training at GrowNYC, a nonprofit that seeks to create a healthier environment in the city, block by block. Their efforts ensure that the small orchard yields barrels of sweet Red Delicious, Gala, and slightly tart McIntosh apples for Lizardi and her neighbors in the fall.
Come spring, the group turns its attention to planting enough organic spinach, collards, kale, berries, tomatoes, other vegetables, and herbs to keep all of their tables filled with free, fresh produce.
The orchard, gardens, and grove of evergreens where Lizardi and her neighbors come together are a center of community activity at Via Verde/The Green Way, an award-winning, affordable housing development that rises above a quiet street just off bustling Third Avenue in the South Bronx. Built on a former garbage-strewn lot and Brownfield in 2012, Via Verde is now an international symbol of healthy design achievement.
“The fact that a project like Via Verde can be created as affordable housing means that we can and should do this for everyone,” says Dr. Karen Lee, MD MHSc, of Dr. Karen Lee Health + Built Environment Consulting, and co-author of Active Design: Affordable Designs for Affordable Housing, a report based on Robert Wood Johnson Foundation-funded research. Her active design guidelines helped shape the project, and those in more than 40 other cities worldwide.
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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.
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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