Oct 9, 2015, 1:38 PM, Posted by
If a Culture of Health means recognizing health’s central importance in our lives, then nurses can be among that culture’s leading ambassadors. More often than not nurses are fully immersed in their patients’ lives, and there are case studies throughout the nation of nurses using that involvement to guide patients in innovative ways to better health.
Consider Stephen and Sandra Sheller 11th Street Family Health Services, a nurse-led Philadelphia clinic serving residents of four low-income public housing projects. Their health center was created in direct response to residents’ requests, and includes not just primary care, but also mental and behavioral health, dental health, and couples and family therapists. There’s a small urban farm producing fruits and vegetables, and a “teaching kitchen” where residents can learn healthy cooking techniques.
At the 11th Street Clinic, nurse-led teams carefully consider each patient’s unique needs. “We don’t ask, ‘What’s wrong with this person?’,“ the clinic’s founder, public health nurse Patricia Gerrity, said at a recent Robert Wood Johnson Foundation Google+Hangout. “We ask, ‘What’s happened to this person?“ that could affect his or her health.
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Oct 6, 2015, 11:05 AM, Posted by
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.
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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Sep 30, 2015, 1:21 PM, Posted by
Alonzo L. Plough
Schools are usually considered to be part of a system separate from the health care system, but they play an important role in building a Culture of Health. See how cross-sector collaborations can ensure children strong starts to healthy, productive lives.
At Cincinnati's Oyler School, I watched as a third-grader received a free eye exam and then pored over the selection of eyeglasses, trying on several pairs, eventually settling on a pair of funky blue frames. He shared that he was looking forward to receiving his glasses, which he'd be able to take home for free the following week. The student’s teacher had noticed that he was having trouble seeing the board in their classroom and was empowered to do something about it. By forging partnerships with nonprofits and government agencies, Oyler has created a vision center, health clinic and dental clinic—all within the school.
Oyler has undergone a transformation over the last decade—from a school plagued by increasing poverty and declining enrollment to a school that is boosting graduation rates and helping improve the surrounding community. Oyler ensures students and their families have access to healthy meals by providing kids breakfast, lunch and dinner and sending them home with food on the weekends. It is part of a movement to create "community schools" that address kids' health needs and get them access to resources that allow them to succeed in the classroom and for years to come.
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Sep 17, 2015, 10:32 AM, Posted by
The Atlas of Caregiving is using new methods to uncover the unique challenges and rewards that caregiving presents, from economic, emotional, and mental stressors to the moments of compassion, joy, and intimacy.
We are at a moment in history when technology is allowing us to collect information about ourselves more effectively and reliably than ever before, from the cell phone in our pocket to the Fitbit on our wrist. This technology can help us device wearers—and even the health care providers, researchers and designers we share our data with—track behaviors related to health and figure out how to improve them. But how can this technology be used to help all of us understand and shape the work of family caregivers?
It is widely believed that family caregivers frequently underestimate how long they spend caring for loved ones and the level of stress induced. This is why RWJF is supporting the Atlas of Caregiving project, which will work with 12 families to collect data using technology with the goal of getting a more accurate picture of how caregivers spend their time, and the physical and mental impact of those activities.
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Sep 15, 2015, 10:16 AM, Posted by
Aligning Forces for Quality not only transformed care in 16 communities, but it provided insights to help shape efforts building a national Culture of Health through high value care.
In a Culture of Health, how can communities improve the quality and value of health care? What happens when people who get, give, and pay for health care locally work together? In 2007, the Robert Wood Johnson Foundation (RWJF) set out to answer these questions when it launched Aligning Forces for Quality with an audacious goal: To transform the quality, equality, and value of regional health care markets.
Along the way, we explored what happens when the people who get, give, and pay for health care locally, work together. Our investment sparked deep and meaningful change in 16 very different communities across America, and important lessons learned in each and every one. But three lessons in particular helped drive success and can be applied to our work to build a national Culture of Health.
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Sep 10, 2015, 3:35 PM, Posted by
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.
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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Sep 8, 2015, 4:44 PM, Posted by
Promoting good health for kids early in life and in their learning environments can provide all children with the foundation they need to achieve their potential—now and throughout their lifetimes.
My aunt, a teacher in Connecticut, likes to say that her students carry more into their classrooms than just their backpacks. As some 50 million students enter the classrooms of our nation’s public elementary, middle and high schools this month for a new year of learning and growth, it’s important to remember that schools are more than places of academic achievement. They’re also key community institutions that influence the health and wellbeing of our nation’s children.
We already know that schools are important places to promote kids’ health. That’s why, for nearly a decade, RWJF has worked to improve food choices and increase physical activity in schools nationwide. Through our longtime support of the Alliance for a Healthier Generation’s Healthy Schools Program—which this year celebrates its 10th anniversary—we have helped students in nearly 30,000 schools eat better and move more. This is important because research shows that health has an impact on kids’ academic and lifelong success.
But schools also teach kids social and emotional skills like sharing, cooperating, and engaging positively with each other and with adults. These are critical skills—a recent study shows that kids with better social emotional skills are more likely to graduate from college and secure good-paying jobs later in life. The opposite holds true as well. Kids with weaker social skills are more likely to drop out of high school, abuse drugs and alcohol or spend time in jail.
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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.
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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Aug 20, 2015, 12:00 PM, Posted by
Galina Gheihman, Laura Leviton
What can a small Swedish county teach us about building a Culture of Health in the United States? We visited Sweden and brought back some valuable lessons on patient and citizen engagement.
Imagine a society where everyone has the means and opportunity to make choices that lead to the healthiest lives possible––a society where health is valued by all, and no one is excluded because of chronic illness or other limitations. This is what we call a Culture of Health, and it’s what, in collaboration with others, the Robert Wood Johnson Foundation is working to build in the United States.
We know that to achieve this ambitious vision, we must look to––and learn from––promising approaches across industries, disciplines and geographic borders. This is why we recently visited Jönköping, a small county in south-central Sweden, where patient and citizen engagement has brought about remarkable results: kidney failure patients operate dialysis machines on their own schedule, complex patients—such as people with schizophrenia—actively participate in designing their own care and children’s preferences and experiences are listened to, so services can improve from the children’s point of view.
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