Author Archives: David Adler

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.

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How SNAP Benefits Seniors—and Health Care's Bottom Line

Feb 1, 2018, 12:38 PM, Posted by David Adler, Ginger Zielinskie

New research shows that seniors who participate in the SNAP program are much less likely to be admitted to nursing homes and hospitals, demonstrating the power of investing in social services to reduce health care costs and improve health outcomes.

SNAP benefits for health care

The fresh fruit, frozen vegetables and salad Karen Seabolt eats help her “do more of what I need to do to live a better life,” she says. The 66-year-old from Tulsa, Oklahoma, has diabetes and is paralyzed on her right side from a stroke.

As a diabetic, Karen needs to eat the fresh fruits and vegetables her doctors recommend, and the $15 dollars per month she gets from SNAP—the Supplemental Nutrition Assistance Program—help her do that.

“It really comes in handy towards the end of the month. You may run out of money, but you always have your SNAP benefits. They’re for food only, so you’re not tempted to do without medicine to get food,” she told us.

SNAP benefits go far beyond a healthy meal. We now know that they can be a critical link to lower health care costs and better health for millions of seniors like Karen. A new study suggests—for the first time—that accessing SNAP benefits helps keep low-income seniors out of nursing homes and reduces hospital admissions

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Bringing the Technology Revolution to Caregiving

Sep 17, 2015, 10:32 AM, Posted by David Adler

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.

An elderly couple, the woman in a wheelchair sitting in front of a large window showing a view of mountains.

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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Entering the Final Stretch

Feb 3, 2015, 6:15 PM, Posted by David Adler

As we head into the final weeks of this year’s open enrollment season, we can all be proud of the progress that’s been made. New numbers released last week show 9.5 million Americans signed up for health coverage through marketplaces across the country. Behind each number is someone who now has quality, affordable health coverage with access to health care when they need it and protection from financial ruin if they get sick.

But there are still millions more who are eligible for coverage this open enrollment period. RWJF and our partners are doing all we can to get as many people enrolled as possible before the February 15 deadline. These collective efforts focus on breaking down the biggest enrollment barriers for people to get covered. Our research shows that consumers are more motivated to enroll when they understand the benefits of coverage, believe they can afford the cost, and know they can find enrollment support to complete the process.

Enroll America, an RWJF grantee, is addressing the need for in-person help head on—operating grassroots efforts in 11 states and connecting consumers to enrollment tools and help nationwide. Their connector tool, allows consumers to schedule appointments for in-person help right away. Drawing from lessons learned from the first open enrollment period we know this one-on-one support will be critical for many consumers during these final weeks.

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If You’re Not at the Table, You’re on the Menu

Nov 25, 2014, 11:03 AM, Posted by David Adler

A diabetes patient, Toni Martin, who participates in Pathways to Health a self management group.

I hear the phrase in the title used a lot when people talk about the important role advocacy plays in health policy-making, and it’s very appropriate. But there is one voice often missing in the conversation about how to fix the way we deliver, pay for, and think about health care: Consumers, the very people the system is designed to help. We must make sure that the people at the center of the health care system have a say in how it changes.

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Health Policy Wit or Wit-Out Consumer Input

Dec 13, 2013, 10:56 AM, Posted by David Adler

Consumer advocates brainstorm about rising health care costs.

Whether you’re a Philadelphia native, a visitor, or just a cheesesteak aficionado, you need to know how to order. When you get to the front of the line at one of Philadelphia’s long-established cheesesteak stands you order your sandwich wit or wit-out. Either with onions or without. Whatever you do, don’t stand at the window and first think about this important decision. Let’s just say it won’t end well. But, as much as I love cheesesteaks (in moderation of course) this is not the most important wit or wit out decision we have to make as a country.

The decision we really need to make is how we want our health policy decisions made. You can have it wit or wit out consumer input. At a recent meeting on health care costs sponsored by the Robert Wood Johnson Foundation and Consumers Union, my colleague Anne Weiss drove this point home.

I’m paraphrasing a bit, but the gist of her remarks (and indeed of the meeting) was that efforts to contain spending and to get more value out of our health care system are going to come about with or without consumer input. She wants it to proceed with it. In other words, Anne’s ordering her health care value steak wit. I second her choice. Personally I think it’s ridiculous to eat a cheesesteak without onions, and I think it’s equally problematic to address health care costs without consumer input.

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