Data Maps the Impact of Where a Child Grows Up

Jan 9, 2019, 2:00 PM, Posted by Kerry Anne McGeary

The Opportunity Atlas allows users to interactively explore data on children’s outcomes into adulthood for every Census tract in the United States. This can inform local efforts to build equitable, prosperous, and healthier communities.

In the Boston Edison neighborhood of Detroit, black children raised in low-income households have grown up to have an average household income of $28,000/year as adults, and under 1 percent of that population has been incarcerated as adults. In contiguous Dexter-Linwood, just one census tract to the north, the average earnings for the same group is $17,000/year, with adult incarceration rates hovering close to 8 percent.

If some neighborhoods lift children out of poverty, and others trap them there, the obvious next step is to figure out how these communities differ. Travel to Charlotte, N.C., which has one of the highest job growth rates in America. But data reveals (surprisingly) that availability of jobs and a strong regional economy do not translate to upward mobility in this region. Children who grew up in low-income families in Charlotte have one of the lowest economic mobility rates in the nation. What does help, according to the The Opportunity Atlas (the Atlas), is growing up with less discrimination, around people who have jobs and higher incomes—but only when those factors are found in their immediate neighborhood. If they are present a mile away, it doesn’t seem to matter much according to the data.

View full post

Creative Communities Are Addressing Social Isolation

Jan 7, 2019, 3:00 PM, Posted by Maryjoan Ladden

Social connections are not just nice to have—they can significantly affect our health and well-being. Inspired by creative approaches abroad, communities across the United States are taking steps to reduce social isolation and increase residents’ sense of belonging.

A man walks over a snow covered lawn.

It’s only January and already, I’m counting down the days to spring when warm weather will arrive. The long, cold months of winter can be isolating—the snow and subzero temperatures make it difficult to get out and about. Winter is particularly tough for children who can’t go outside to play, and for newcomers from warmer climates who are not accustomed to the cold. For people who don’t have meaningful social connections, the cold weather season can exacerbate the isolation they face year-round.

Social isolation is a serious problem for many. It can lead to anxiety, depression, substance abuse, and even suicidal thoughts. Social isolation can impact our health in other ways too—by escalating unhealthy habits, stress, lack of sleep—and putting us at higher risk for coronary heart disease and stroke.

Fortunately, there are many creative ways in which communities across the United States are tackling social isolation and building a sense of community.

View full post

Healthier Communities Start With Kids

Dec 10, 2018, 11:30 AM, Posted by Joan Hunt, Sara Kendall

Focusing on our community’s youngest residents can spark broad vision and change.

A boy works on an art project at a local community center.

The small city of Hudson is nestled in Upstate New York and home to fewer than 7,000 people. The city was hit hard by deindustrialization in the late 20th century, facing economic decline as factories closed and industry jobs left. In recent years development has surged, with the opening of antique stores, restaurants and art galleries. The city has become a popular destination for tourists and second-home owners.

While our town is often celebrated as a story of revival, development has not benefited all of our community’s residents. For example, despite the presence of several high-end restaurants, there is still no grocery store. Rising costs have increased inequity, causing displacement for many families. Public funding is often directed toward maintaining Hudson as an attractive tourist destination versus addressing the needs of local youth and families.

Our organizations here in Hudson, Greater Hudson Promise Neighborhood and Kite’s Nest, have been working in partnership with many community organizations and individuals to improve conditions for youth and families.

View full post

A Free Clinic Builds “Bridges to Health” by Treating the Whole Patient

Dec 5, 2018, 11:00 AM, Posted by Catherine Malone

How one rural clinic addressed its patients’ complex health and social needs successfully—and cut emergency room use and costs drastically.

Dr. Steven Crane discusses a patient with a nurse.

There’s no bus service in his small town in rural North Carolina, so Dean* drives 10 miles to The Free Clinics ("Clinics") in Hendersonville every couple of weeks whenever he has money for gas.

Staff there helped him find affordable medications and treatments for cancer and for his shoulder, which he injured by falling 20 feet on a construction site. He’s unable to read due to learning disabilities, so they’ve also helped him find lawyers to file disability claims.

Dean is also one of the patients who attends the Clinics’ Bridges to Health ("Bridges") program, a drop-in group session where patients can discuss their social and emotional concerns as well as medical problems. He has battled depression since the age of five after enduring early childhood trauma. He credits the Bridges sessions, along with the Clinics’ holistic care, with easing his depression and improving his physical health, as well as “opening up avenues for me to get help.”

View full post

Don’t Try to Fit Rural Health Into an Urban Box

Nov 12, 2018, 2:00 PM, Posted by Melissa Bosworth

In rural areas, lack of access to adequate care can be a matter of life and death. Transforming rural health requires creative, place-based solutions and a commitment to fostering local leadership.

A corn production farm.

The amputation was scheduled for that day. John’s* uncontrolled diabetes had stopped blood flow to his lower leg. With the tissue starting to die, it seemed inevitable that his foot would have to be removed to save his life.

Thankfully, a team I work with had recently helped bring telehealth services to the rural Colorado hospital where John had been admitted. A cloud-based video system connected to electronic health records enabled his doctor to consult with an infectious disease specialist hundreds of miles away in Denver. The specialist suggested one last “cocktail” of antibiotics, to be administered by I.V. The protocol worked. John kept not only his foot, but also his livelihood as a rancher: his ability to graze cattle, grow wheat, and provide for his family.

View full post

How the Future of Work May Impact Our Well-Being

Nov 8, 2018, 1:00 PM, Posted by David Adler, Paul Tarini

The health of workers in a rapidly changing work environment is often overlooked. In a time when incomes, schedules, and health care are becoming less predictable, what are the ramifications for health?

A group of men participate in an exercise class during work hours.

When her regular job hours were cut, Lulu, who is in her 30s and lives in New York, couldn’t find a new full-time job. Instead she now has to contend with unsteady income and an erratic schedule juggling five jobs from different online apps to make ends meet. Cole, in his first week as an Uber driver in Atlanta, had to learn how to contend with intoxicated and belligerent passengers threatening his safety. Diana signed up to help with what had been described as a “moving job” on TaskRabbit. When she arrived, she had to decide whether it was safe for her to clean up what looked to her like medical waste.

Work is a powerful determinant of health. As these stories about taxi, care, and cleaning work from a new report show, it is a central organizing feature of our lives, our families, our neighborhoods, and our cities. And work—its schedules, demands, benefits, and pay—all formally and informally shape our opportunities to be healthy.

But the world of work is rapidly changing. Job instability and unpredictable earnings are a fact of life for millions. Regular schedules are disappearing. With “predictive scheduling,” a retail worker today is essentially on call, making everything from booking child care to getting a haircut impossible until the work schedule arrives. Health and other fringe benefits are less often tied to the job. Nearly six in ten low-wage workers today has no paid sick leave. Two-thirds lack access to employer-based health care benefits.

View full post

How States Can Better Engage Medicaid Patients

Oct 29, 2018, 2:00 PM, Posted by Andrea Ducas, Tricia McGinnis

Experts weigh in on practical approaches for engaging Medicaid beneficiaries to ensure that services are designed to meet their needs.

People walking in a hallway of a government building.

Medicaid is the largest health care program in the United States and impacts the lives of more than 76 million Americans, nearly one-quarter of the nation’s population. The program can play a powerful role in influencing the health and well-being of individuals and families.

State Medicaid programs can only be truly successful, however, if they are responsive to the needs and priorities of the clients they serve—not providers, but patients and their families. Medicaid officials understand this. However, in the resource- and time-constrained environments in which Medicaid staff operate, finding the right avenues for gathering meaningful consumer input can be a challenge.

The Robert Wood Johnson Foundation has been trying to address these challenges through its work to transform health and health care systems. As part of these efforts, the Foundation along with the Center for Health Care Strategies recently engaged experts, including representatives from across the patient advocacy world, around this issue. These experts include leaders from Altarum, American Cancer Society Cancer Action Network, Community Catalyst, Georgetown Center for Children and Families, Nonprofit Finance Fund, and the Patient Advocate Foundation.

View full post

How Supportive Housing Uplifts Families in Crisis

Oct 15, 2018, 11:00 AM, Posted by Kerry Anne McGeary

Irma’s troubled life culminated in being thrown down the stairs when she was six months pregnant. Thanks to a program that’s addressing system-wide change, Irma and her family are now safe and secure with a new home and a brighter future. 

Supportive Housing program case worker, Melissa Rowe (right) with her client Irma and three of Irma's four children. Supportive Housing program case worker, Melissa Rowe (in white shirt) with her client Irma and three of Irma's four children: Joel, age 5, Delicia, age 3 and Julio, age 18 months.

Editor’s Note: Although foster care placement is sometimes necessary to ensure the safety and well-being of children, research indicates that keeping families together is generally a better for children, parents, and the community. Working with the Corporation for Supportive Housing, RWJF launched Keeping Families Together in 2007. The program helps vulnerable families like Irma’s grow stronger, safer and healthier so that children—and their parents—might thrive. We are resurfacing this post in time for Children’s Health Month.

From too early an age, Irma faced a seemingly endless series of traumatic events that life threw at her as best she could—on her own.

But after a domestic crisis left her hospitalized, homeless, jobless, and in danger of losing her infant son, Irma finally received help from a supportive housing program that changed her life.

Keeping Families Together (KFT)—the Robert Wood Johnson Foundation (RWJF)-supported model for the program that helped Irma turn her life around—has become my own personal touchstone for what building a Culture of Health should look like in the real world.

Irma’s story illustrates both the power of this model and the inner resilience that so many struggling families possess.

View full post

How Collaboration Fosters Safer Communities for Kids

Oct 3, 2018, 11:00 AM, Posted by Martha Davis

Collaborative approaches can help ensure kids grow up with a solid foundation of safety and with a support system for those who are affected by violence.

Graphic depicting child playing with blocks

As the executive director of Philadelphia Physicians for Social Responsibility in the late 1990s, I worked closely with the local police department, the Women’s Law Project, and the district attorney. At the time, these forward-thinking professionals were frustrated. They were arresting the second and third generation of families involved in the criminal justice system. I knew some of these same individuals, and their histories as survivors of childhood trauma.

We were witnessing the downstream effects of unaddressed trauma in early childhood. Children who grew up traumatized landed in the juvenile justice system first and eventually within the criminal justice system as adults.

As a result, we knew we needed to find ways of building communities that would better support young children. Could we invest more upstream, in early childhood education, for example, and in doing so help prevent violence in our communities in the long-term?

Thanks to innovators like these and reams of new research on how early trauma and later violence affect individuals over a life course, we now understand that community conditions that impede children’s healthy development can impact everyone’s safety down the line.

View full post

New Data Provides a Deeper Understanding of Life Expectancy Gaps

Sep 10, 2018, 3:00 PM, Posted by Donald F. Schwarz

The more local the data, the more useful it is for pinpointing disparities and driving action. The first universal measure of health at a neighborhood level reveals gaps that may previously have gone unnoticed.

A father rides with his young daughter on a pink scooter.

When Dr. Rex Archer returned to his hometown of Kansas City, Missouri, to lead its health department in 1998, he was shocked by the city’s inequities. Life expectancy for white residents was 6.5 years longer than that of black residents. Gathering more data, he estimated that about half of the city’s annual deaths could be attributed to conditions in neighborhoods like segregation, poverty, violence, and a lack of education.

I also confronted stark disparities by neighborhood in my years as Philadelphia’s health commissioner, as does most every health commissioner/director across the country. It is truly unsettling to see how small differences in geography yield vast differences in health and longevity. In some places, access to healthy food, stable jobs, housing that is safe and affordable, quality education, and smoke-free environments are plentiful. In others, they are severely limited. Data can help us better understand the health disparities across our communities and provide a clearer picture of the biggest health challenges and opportunities we experience.

View full post