Culture of Health Blog

An ambitious collaborative effort is revitalizing a long-struggling city in ways that promote not only economic growth, but health and wellness. 

“I am dying literally, at my home in Hollywood, of metastatic breast cancer ... For six years I’ve known I was going to die, I just don’t know when.”

That was written by renowned journalist Laurie Becklund, a former Los Angeles Times correspondent, shortly before she died on Feb. 8 at age 66. Her powerful Los Angeles Times essay was not a lament, however, but a fierce call to action for better cancer research; informed by much, much better data.

As she noted, each cancer patient’s disease is unique, yet there is no system in place to gather data on these tens of thousands of individual diseases. If there were, the data would enable both lab research and clinical trials to be far more efficient, and effective. “The knowledge generated from our disease will die with us because there is no comprehensive database of metastatic breast cancer patients, their characteristics, and what treatments did and didn’t help them,” Becklund wrote. “In the big data era, this void is criminal.”

Last January the Robert Wood Johnson Foundation alerted the world to its new strategy: To build a Culture of Health for all, one that would allow every one of us to make healthy choices wherever we live, work, and play. A big reach, we know, but we are nothing if not optimistic. So, 12 months on, we asked ourselves—How’re we doing? Pretty good, as it turns out. Here are the top 10 signs that America is moving towards a Culture of Health (in no particular order).

10. The evidence is in—kids are beginning to slim down.

Research published in February shows continued signs of progress toward reversing the childhood obesity epidemic: Obesity prevalence among 2 to 5 year olds dropped by approximately 40 percent in eight years, a remarkable turnaround. There is still much work to do in this area, but at least our youngest kids can look forward to a healthier future.

Along with the start of CVS Health, the sale of cigarettes and tobacco products at CVS/pharmacy ends today. By eliminating cigarettes and tobacco products from sale in our stores, we can make a difference in the health of all Americans.”—CVS Health CEO Larry Merlo

On October 20, The Campaign for Tobacco-Free Kids launched a national campaign calling on America’s retailers to stop selling tobacco products, and a new mobile-friendly website—www.ShopTobaccoFree.org—that has an interactive map that allows consumers to search for the nearest tobacco-free retailers. The website currently features more than 20 retail chains with more than 13,000 separate store locations—chief among them CVS Health.

On September 3, CVS ended sales of tobacco products at all of its 7,700 stores, a month ahead of its previously targeted date of October 1. It is the first, and so far the only, national pharmacy chain to take this step. The company also changed its corporate name to CVS Health in order to reinforce its broader commitment to the health of its customers.

RWJF applauds CVS’s actions wholeheartedly—indeed, we collaborated with CVS on the initial announcement back in February that it would end the sale of tobacco products. So we asked CVS Health executive VP and chief medical officer Troy Brennan MD, to tell us the story behind the story. Just how do you get a publicly traded company to sacrifice some $2 billion in annual sales?

Let me win, but if I cannot win, let me be brave in the attempt.”

—Special Olympics motto

The other day I cheered myself hoarse during a swim relay for a team from Maryland that put their all into the race. In fact, the whole viewing crowd cheered on this team. When they finished, the athletes were jubilant, hugging each other and their opponents, thrilled by their performance in this national event. It didn’t seem to bother them much that they finished last.

The 2014 USA Games for the Special Olympics, the world’s largest organization for people with intellectual disabilities, was held in New Jersey June 14-21. Some 3,500 children and adults from all 50 states competed in 16 different sports, and the vast majority took tremendous pleasure in the pure joy of athletics. Sure, plenty were fiercely competitive, but they were also happy and proud to have the opportunity to compete to the best of their ability.

That was pretty inspirational to the 110 staff members from the Robert Wood Johnson Foundation who volunteered at the Special Olympics.

Thanksgiving is almost upon us, ushering in a month-long season of holiday parties, groaning boards of food, favorite family recipes, cookie swaps, and an extra five pounds around the waistline. Instead of just giving in to the excess and making January the month of dieting, perhaps we could make a few adjustments. I’ve asked around the Foundation staff for some healthy holiday recipes instead of the usual green bean casserole and cream-laden sides. Here are some tried and true alternatives, that are kid–friendly as well!

In fact, why not invite any children about the house (or adults who are still kids at heart) to help whip up some of these dishes. Children love to grate, stir, and shake, and the older ones will go at chopping with a vengeance. It’s never too early to teach them to cook, as discussed on this blog a few days ago.

Some statistics worth pondering: According to the U.S. Bureau of Labor Statistics, the average American spends only 33 minutes a day on food preparation. Just over half of Americans bother to cook every day. On the other hand, 33 percent of children and 41 percent of teenagers eat fast food, every single day.

These fast food children are consuming 126 additional calories, and the teens 310 extra calories, than if they had avoided the chains, says Fast Food Facts 2013, a new report by the Yale Rudd Center for Food Policy & Obesity and funded by RWJF. Most of these children are eating adult meals, too, not the smaller-portioned children’s meals on offer. Not that it would matter, since less than one percent of all kids’ meal served at fast food chains meet recommended nutrition standards.

It’s not much of a stretch to link the lack of home cooking, a diet of fast food, and the fact that a third of U.S. children and adolescents are obese. So, what’s a parent to do? Well for one thing, we could learn to cook.

Scott Simon is a popular radio host on National Public Radio’s Weekend Edition Saturday. His mother, Patricia Lyons Gilband, a former actress, died July 29 at 7:17 p.m., in the intensive care unit (ICU) of a Chicago hospital. But you might already know that, if you are one of Simon’s 1.2 million Twitter followers, because he has been live Tweeting her final days since July 23.  

Judging by the many articles, comments, retweets, and reactions bouncing around the web, Simon’s 140-character dispatches from the frontline of death have been moving and inspirational for most—and gag-inducing for some, who believe death should be a private affair. Having lost a parent and a spouse—and both died in an ICU—I’m with the first group.

The New Yorker recently ran an excellent article by Jerome Groopman MD, Before Night Falls, about efforts to find a drug that can delay or even stop the onset of Alzheimer’s. What struck me most about this thorough piece of reporting, however, is that it covers much the same ground as a feature I wrote for Businessweek—in 2007. Despite the huge amount of money and other resources devoted to Alzheimer’s research, the quest for an effective treatment has moved forward by mere fractions in the past six years.

Almost every drug I wrote about in 2007 has since failed, which means it will be at least a decade, and probably far longer, before an effective treatment wins regulatory approval. Meanwhile, the Alzheimer’s Association recently reported that one in three seniors will die with Alzheimer’s or another form of dementia in the U.S. this year, and 5.2 million people are currently living with Alzheimer’s. By 2025, the number of people living with the disease will likely reach 7.1 million. So while we’re waiting for a cure, the medical community should also be developing better methods for caring for the millions of patients who are suffering right now.

Every year some two million people develop infections while in U.S. hospitals and some 100,000 die from them. U.S. medical centers have been fighting these hospital-acquired infections for decades, yet the virulent bacterial stew that inhabits most medical centers remains stubbornly in place, and increasingly lethal.

Particularly scary is MRSA, a deadly staph infection that is resistant to most antibiotics. In 2002, a strain of MRSA was discovered that is even resistant to vancomycin, usually an antibiotic of last resort. The Robert Wood Johnson Foundation grantee Extending the Cure has found that the overall share of antibiotic-resistant bacteria increased by more than 30 percent between 1999 and 2010.

These so-called “superbugs” contribute to more deaths than AIDS, traffic accidents and flu combined, according to Extending the Cure. The often-frustrating effort to develop new antibiotics to combat these infections was highlighted in a front-page article in The New York Times on June 3, “Pressure Grows to Create Drugs for Superbugs.” The NYT story describes the U.S. Health and Human Services Dept’s agreement, announced in May, to pay as much as $200 million to drug maker GlaxoSmithkline over the next five years to develop medications to combat antibiotic resistance and biological agents that terrorists might use. As the NYT reports:

 “We are facing a huge crisis worldwide not having an antibiotics pipeline,” said Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the Food and Drug Administration. “It is bad now, and the infectious disease docs are frantic. But what is worse is the thought of where we will be five to 10 years from now.”

But new drugs are not the only weapon against MRSA. In a report published May 29 by the New England Journal of Medicine, researchers found that scrubbing down every intensive-care unit patient with germ-killing soap and ointment was substantially more effective in reducing MRSA and other infections than screening for the superbugs and then isolating those patients already infected. The study, sponsored in part by the Centers for Disease Control and Prevention, involved some 75,000 patients in 43 hospitals nationwide and an accompanying editorial recommended that it lead to changes in infection control.

Extending the Cure, based at the Center for Disease Dynamics, Economics & Policy, believes that while we can't beat the superbugs, we can slow them down by recognizing that antibiotics are a natural resource that must be used conservatively. By issuing regular research and commentary on topics such as health care-associated infections, trends in drug resistance, and the costs—both human and economic—posed by rising resistance rates, ETC is laying groundwork for the comprehensive solutions needed to combat this problem. 

In fact, ETC just released this clever video suggesting ways to slow down the overuse of antibiotics by all of us. Check it out.