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How Bitter Melon Improved Housing in Providence, Rhode Island

Dec 9, 2019, 9:45 AM, Posted by Angela Bannerman Ankoma, Sharon Conard-Wells

Many housing projects focus exclusively on putting a roof over peoples’ heads. We sought a broader approach that integrates cultural values into kitchens, homes and neighborhoods.

Illustration of a neighborhood.

The literal translation of the word “sankofa,” from the Akan tribe in Ghana, means "go back and fetch it.” Figuratively, it captures an important belief in Akan culture: While the future brings new learning, knowledge from the past must not be forgotten.

This principle guided our efforts to transform 10 formerly blighted lots into a vibrant community of 50 modern “green” apartments in Providence, Rhode Island’s diverse West End community. The $13.5 million development is connected to 30,000 square feet of community garden space. Single fathers come with sons, pastors come with children and people sit under the garden’s pergola, which was built by local youth volunteers. It is, as one article put it, a “beehive of activity.”

A Holistic Approach to Health

We’ve come a long way from where we started nearly a decade ago. Then, residents of the West Elmwood Housing Development Corporation (WEHDC)—more than a third of whom are immigrants and refugees from Central America, West Africa and Southeast Asia—didn’t have much access to fresh, high quality, affordable food that both supported their overall well-being and allowed them to preserve their cultural values.

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Disability Inclusion: Shedding Light on an Urgent Health Equity Issue

Dec 2, 2019, 11:00 AM, Posted by Richard Besser

We cannot achieve a Culture of Health until our nation is fully inclusive. Yet systemic factors prevent many people with disabilities from thriving.

Next year will mark 30 years since the Americans with Disabilities Act (ADA) became federal law—first of its kind legislation that outlawed discrimination against people living with physical or mental disabilities. It was a culmination of decades of challenging societal barriers that limited access and full participation of people with disabilities.

And yet in spite of the ADA’s passage, we still have a long way to go before society is fully inclusive of the 61 million people living in this country with some type of disability. Judy Heumann understands that while the ADA is important, in practice, “we’re not done yet." She is currently a leading advocate for disability inclusion and has been an advisor to institutions like the U.S. State Department, the World Bank, and the Ford Foundation. As a child, Judy was barred from going to school because she used a wheelchair. Years later, she was denied a teaching license for the same reason. These obstacles to education and employment are just two of many barriers that stand in the way of inclusion. Judy understood the need for strong advocacy in partnership with others experiencing continuous discrimination because of their disabilities. This discrimination is also often compounded by class, race, ethnicity, religion, gender, age, or sexual orientation among other characteristics.

I had the chance to personally meet Judy at the first convening of the Presidents’ Council on Disability Inclusion in Philanthropy this year. Darren Walker of the Ford Foundation and I are co-chairing this group of 13 other foundation executives to champion inclusion of people with disabilities in our own institutions and within philanthropy. We have a lot to learn from Judy and many others who have challenged systems and paved the way to making our nation more inclusive.

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Small Business, Big Impact: The Untapped Opportunity to Advance Health and Equity

Nov 25, 2019, 10:00 AM, Posted by Rhett Buttle

New report shows that small businesses create jobs and wealth and are imperative to healthy, thriving and equitable communities. Small businesses represent tremendous untapped potential to promote health equity and create opportunities for everyone to live healthier lives.

Four women laugh around a table in a coffee shop.

On a recent trip to Ferguson, Missouri, I visited a locally owned coffee shop that was filled with people working on laptops, visiting with friends, reading and studying. The walls were covered in fliers with community news and people were connected with neighbors. Sound familiar? It’s like thousands of other coffee shops. Across America, there are businesses like these where the owners and employees have their fingers on the pulse of what’s going on in the neighborhood.  

Small businesses of all types are in just about every community in the United States—in fact, companies with fewer than 100 employees make up 98 percent of all businesses in America and more than 43 percent are in low-income communities. They are helping to create healthy, equitable communities through the assets, income and jobs they create. People walk in their doors every day and share information or ask for advice—from barber shops and hair salons, to hardware stores and corner stores, to accounting firms and yoga studios.  

For those of us working to create a Culture of Health and advance equity, small businesses and their leaders could be ideal partners—so why don’t we engage them more often? 

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It’s Time to Connect Rural Health Equity with Community and Economic Development

Nov 14, 2019, 2:00 PM, Posted by Katharine Ferguson, Katrina Badger

It’s time to think differently about investing in rural America and the way we approach health and equity across its diverse communities. New research and resources show the critical connection between health, rural community and economic development.

Farmland and street sign.

Thursday, November 21, was National Rural Health Day. You might expect the paragraphs that follow to be about hospital closures or opioids, struggling dairy farmers and falling life expectancy among rural women. These phenomena are true, so we could do just that. However, we want to challenge conventional wisdom and prompt fresh thinking about rural America, the drivers of health, and the role of community and economic development in both. From what we are learning, this broader lens is central to realizing health equity and a better rural futures.

In our predominantly urban nation, the words “rural America” often conjure images of farm country, small towns and white people living in places that once boomed and have since busted. But the real rural America is far more diverse and complex. Dr. Veronica Womack, a political scientist, advocate for black farmers, and RWJF Interdisciplinary Research Leader, whose work has helped bring new research and investment to her rural region, is case-in-point. Womack grew up in Greenville, Alabama—population 8,000—which is part of the “Black Belt,” a largely rural region in the coastal low-land south where black folks outnumber white folks. Economic opportunity is hard to come by—and health suffers as a result—in this region where poverty, racist policies and discrimination along with systemic disinvestment persist.

All the same, Dr. Womak grew up with the idea that you give of what you have, to help those around you. No matter if what you have is not much. In Dr. Womak’s words: “If you’re not willing to share it and work for the betterment of the community, then you know, why even have it?” Womak’s experience growing up with her single mom, who worked as a nurse and spent her weekends bringing medicine and other care to elders around the community, didn’t jive with how the nation viewed her region and her people. Where others saw deficits, Womak could see assets—people willing to work hard and support each other, strong ties, and innovative ideas to get things done.

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Listening to Families and Communities to Address Childhood Obesity

Oct 31, 2019, 2:00 PM, Posted by Renee Boynton-Jarrett

Renee Boynton-Jarrett, MD, ScD, believes that children’s health and well-being are intricately and inextricably connected to their family and community.

Children and their parents participate in a school activity.

When a mother walked into my health clinic five years ago with her 13-year-old daughter, she wanted to know why her daughter had gained a significant amount of weight in a matter of months. She was concerned an underlying medical condition might have caused the sudden spike her daughter’s weight. I was concerned as well. Childhood obesity is an epidemic that affects far too many children and it is linked to other serious, chronic health conditions, including high blood pressure, type 2 diabetes, heart disease, and asthma.

I knew I would run tests and order blood work, but I also wanted to know what factors in her social world could have sparked the weight change. We sat down together to look at her daughter’s growth chart, see when the growth trajectory started to accelerate, and what could have been happening then. “Did anything change in your family? Do you recall anything that happened around that time?”

The mom suddenly realized that the changes started shortly after the girl’s father was incarcerated. That’s information I could not have gotten from a blood test. Nor if I had rattled off recommendations without first sitting down to listen.

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Researchers: How to Leverage Personal Data and Still Protect Privacy

Oct 24, 2019, 2:00 PM, Posted by Paul Tarini

The popularity of app-based research studies has soared, although plunging public trust in commercial technology companies could dampen enthusiasm and upend science if researchers don’t act quickly. 

A patient goes over app-based data with her clinician.

Nefarious cases of data sharing and data breaches are in the headlines on an uncomfortably regular basis. One recent exposé found period tracking apps were sending extremely personal information about millions of women directly to Facebook without their knowledge. This comes in conjunction with all-too-frequent corporate hacks—from credit cards to electronic health records and more—that leave consumers vulnerable and scrambling to reset passwords and freeze accounts. 

It’s a constant drumbeat that is feeding a climate of concern around our data: who has it, how safe it is, what it is being used for. 

Against this tumultuous backdrop, researchers around the world are launching studies that rely on smart phone apps and other digital devices to collect data. The hope is that these digital tools—and the data we provide through them—will enable more people to participate in studies and help accelerate medical discovery. But if researchers don’t act quickly, this turmoil around data privacy could upend their work.

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How Communities are Promoting Health and Responding to Climate Change

Sep 30, 2019, 1:00 PM, Posted by Michael Painter, Priya Gandhi

Across the United States, people are recognizing that climate change is a major threat to any vision of a healthy future. They are responding by developing solutions to not only avoid the health harms from climate change, but also actively improve health and limit climate change.

A city park offers a walking path for the community.

In Austin, Texas, city officials have grown increasingly concerned about their residents enduring more days with extreme heat. In particular, they worry that extreme heat events prevent young people from getting physical activity and harm people’s overall well-being.  

Austin leaders decided to respond by increasing green space and tree shade around some of the city’s public schools, especially those that largely serve students of color or those in lower-income neighborhoods. More trees create cooler spaces for physical activity. They also help address climate change by decreasing the need for air conditioning, which use about 6 percent of all electricity produced in the United States. Trees are effective because green space and shade reduce temperatures over heat-storing concrete.

At first glance, planting some trees may seem like a limited and short-term approach in the face of a changing global climate. Trees, however, are an important climate solution because they remove carbon from the atmosphere. Increasing levels of carbon in the atmosphere causes climate change. We need more trees—lots more.

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Policy Should Never Put a Child’s Health at Risk

Sep 26, 2019, 9:30 AM, Posted by Donald F. Schwarz

Mother bottle feeding her young son.

When I was a full-time pediatrician, I worked at a practice in the City of Philadelphia whose primary patients were teenage mothers and their children. Most of their parents were low-income with little to no outside support. Their lives were hard. Very hard. Many of the parents (grandparents to the newborns) were forced to choose between paying rent some weeks and having enough food to feed their children and grandchildren.  

I remember in particular one mother and her infant son who came to see me after he was born. She was scared because the baby was having trouble gaining weight, due in large part to the family not being able to afford much food. His grandmother was worried; given all the research showing how critical nutrition is to developing brains, I was concerned as well. Fortunately, the practice I worked in was a collaborative one, meaning that not only did we doctors work side-by-side with nurse practitioners, but also closely with social workers. And one of our social workers immediately went to work to get this family, in which the grandmother—who was the head of the household—worked full-time, enrolled in the Supplemental Nutrition Assistance Program (SNAP).

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Expert Guidance on What Young Kids Should Drink and Avoid

Sep 19, 2019, 10:00 AM, Posted by Mary Story, Tina Kauh

The nation’s leading health and nutrition organizations have issued evidence-based recommendations for parents, caregivers, health professionals and policymakers.

Young girl drinking from a cup.

“Should I be giving my toddler milk?”

“What’s the difference between fruit juice and a fruit-flavored drink?”

“I thought fat was good for my kids. Why should I switch my 2-year-old to low-fat milk?”

Every day, parents, caregivers, child-care providers and others struggle with questions like these about what kids should drink—and what they shouldn’t. They’re trying to do their best for kids’ health, but it’s not as easy as it may sound.

Ensuring that kids grow up healthy includes paying attention not only to what they eat, but also what they drink, especially during the early years when they are establishing their eating patterns. To do that, parents and caregivers need clear, consistent advice from health professionals about what drinks are healthiest for their kids. And policymakers need guidance so that they can create the strongest policies possible to help all children grow up healthy.

But, faced with an array of product choices and inconsistent messages about what’s healthy and what’s not, it can be challenging to know which beverages kids should drink, especially since recommendations seem to change every few months as kids get older.

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New Data on How We’re Measuring a Culture of Health

Sep 12, 2019, 10:00 AM, Posted by Alonzo L. Plough, Anita Chandra

Four years ago, we introduced a Culture of Health Action Framework and measures to help us track the nation’s progress toward becoming a country that values health everywhere, for everyone. Today we share progress to date.

RWJF - Allen County Kansas

It’s been four years since the Robert Wood Johnson Foundation (RWJF), along with the RAND Corporation, began using a set of national measures to help track our journey toward a culture where every person has a fair and just opportunity to live the healthiest life possible—regardless of where they live, how much they earn, or the color of their skin.

Our goals were to offer some catalytic signals of change with a focus on broader social and economic drivers of health, well-being, and equity. The initial set of measures were used to track how diverse stakeholders, including those outside the traditional health sector, were advancing health and well-being—and if and how health equity was improving.

Developing a clearer picture of what is changing via the Culture of Health measures can guide those who are working collaboratively to accelerate improvements. We offer a few highlights from recent updates to the measures (see also rwjf.org/cultureofhealth) and share some data on our progress to date.

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