Now Viewing: Social Determinants of Health

Lifting the Weight of Incarceration

May 3, 2018, 3:00 PM, Posted by Michael Matza

If your organization is creating a healthier community through sport, check back in early 2019 to apply for the Sports Award! Learn more about how the 2016 winner, InnerCity Weightlifting, is helping at-risk youth.

InnerCity Weightlifting

An hour before his next client is due, Edgardo “Chino” Ortiz is in the glass-walled break room of InnerCity Weightlifting (ICW) in Cambridge, Mass., poring over a study guide to become certified as a personal trainer. Fiercely focused on achieving that goal, he is rarely separated from his worksheets.

“Prescribe RICE,” he says, circling the acronym for “rest, ice, compression and elevation” on a sample quiz question about injury.

All across America, men and women with similar ambitions are prepping for careers in physical fitness. But few share the unique drive that fuels 33-year-old Chino’s determination. For him, getting certified as a fitness trainer is a life-changing turning point, built on his smarts, his talent, and his grit.

Chino recently completed a sentence of five years in a Massachusetts state prison for shooting a man in the leg over drugs. For most former inmates, finding a good job is notoriously difficult. But Chino’s future looks promising because of his connection to ICW. 

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Surgeon General Jerome Adams and the Power of Partnerships

Apr 26, 2018, 11:00 AM, Posted by Najaf Ahmad

The 20th United States Surgeon General Jerome Adams joined RWJF President and CEO Rich Besser to discuss how the power of partnerships can help transform communities and advance equity.

SG Jerome Adams, Richard Besser

As a child, the United States Surgeon General Jerome Adams, MD, MPH, suffered from asthma so severe that he spent months at time in the hospital, even once being airlifted to a children’s hospital in Washington, D.C. During these stays he was struck by the fact that he’d never encountered a black physician. That finally changed when as an undergraduate he met a prominent African-American doctor who had overcome his own significant life obstacles. Seeing another African-American making important contributions to the field of medicine inspired the young Jerome Adams to decide, “I can do that too.”

With that resolve, he embarked on a path that led to becoming an anesthesiologist and culminated in his appointment as the nation’s 20th surgeon general.  

Reflecting on his journey, Dr. Adams notes, “that’s why your efforts at the Robert Wood Johnson Foundation (RWJF) are so important. You’re providing mentorship and leadership opportunities to those who wouldn’t otherwise know how to navigate the world of public health.”

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New Narratives of Hope This Black History Month–And Beyond

Feb 22, 2018, 1:00 PM, Posted by Dwayne Proctor

More than 50 years after the civil rights movement, an RWJF-funded survey shows we still have a lot to do to reduce discrimination and increase health equity. Dwayne Proctor reflects on these findings and the role of stories in the search for solutions.

An older student plays around with a younger student in a school auditorium.

One of my earliest and most vivid childhood memories is watching from my bedroom window as my city burned in the riots that erupted after Dr. Martin Luther King Jr.’s assassination 50 years ago.  

The next afternoon, my mother brought me to the playground at my school in Southeast Washington, D.C., which somehow was untouched. As she pushed me in a swing, she asked if I understood what had happened the day before and who Dr. King was.

“Yes,” I said. “He was working to make things better for Negroes like you.”

My mother, whose skin is several tones darker than mine, stared at me in surprise. Somehow, even at 4 years old, I had learned to observe differences in complexion.

That is particularly interesting to me now, as I eventually came to believe that “race” is a social construct.

Of course racism and discrimination exist. They are deeply embedded in America’s history and culture—but so too is the struggle against them.

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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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Help Us Find Solutions for Social Isolation

Oct 19, 2017, 2:00 PM, Posted by Maryjoan Ladden

We’re providing a total of $2.5 million in funding, looking for the best ideas from around the world that can address social isolation in the United States.

A teenage boy looks out of a window.

I remember reading the story of a dying patient who, when asked who to call as his life was ending, he replied, “no one.” He had absolutely no immediate family or close friends. Dr. Druv Khullar who wrote the piece noted "the sadness of his death was surpassed only by the sadness of his solitude. I wondered whether his isolation was a driving force of his premature death, not just an unhappy circumstance."

This profoundly sad story struck me to my core.

Not everyone has a social network to call on when they need people by their side. Many people feel disconnected from society and from life, and that contributes to a host of physical, mental and emotional health problems. In fact, according to experts, social isolation is as bad for your health as smoking, obesity, elevated blood pressure, and high cholesterol.

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Helping Students Save For—and Stay in—College

Aug 30, 2017, 12:00 PM, Posted by James McGowan

A higher education degree has a big impact on future health. Here’s how one man is leveraging his personal experience to help students pursue a brighter future.

A young woman receives a diploma at her graduation ceremony.

Like many of the college-bound students I counsel at Normandy High School in Wellston, Mo., I was a first-generation college student. Thrilled to head off to Georgia Tech on a full scholarship, I had no idea I wasn’t actually getting a full ride with all costs paid for. Suddenly, I found myself on the hook for room and board, books, and other expenses. I took out loans, but they weren’t enough. I maxed out my credit cards. It took me years to pay off the debt.

I share this story with my students as a cautionary tale and to underscore the value of Viking Advantage, the college savings and preparation program they participate in. Each student in the program gets a college savings account called an Individual Development Account (IDA). For every dollar they save for college, up to $500, they get an additional $3 from my organization, Beyond Housing, and its funding partners—for a maximum total of $2,000. When students head to college, the money is sent directly to the college bookstore or cashier’s office for tuition, textbooks, dorm deposits, room and board, and supplies they need for classes.

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How Lessons From Abroad Are Uplifting Youth in the United States

Aug 23, 2017, 12:00 PM, Posted by Jennifer Ng'andu

Creative programs in Latin America are inspiring U.S. communities to pursue similar approaches that connect young adults to education and employment.

International Youth Foundation

Like many high school graduates in Brazil, Caroline was eager to find a job. She desperately needed money to continue her studies and pursue her dream of becoming an engineer. But two years after graduating, she was still unemployed. Caroline eventually managed to improve her job prospects in an unlikely way—through drawing, dance and breath work.

Intent on breaking free from a family history of women who weren’t able to get good jobs or finish high school, Caroline discovered a job training program run by Rede Cidadã (The Citizen Network). The non-profit organization connects youth to jobs and apprenticeships throughout Brazil, where the youth unemployment rate is nearly 25 percent.

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Innovations from Abroad Are Keeping Seniors Socially Connected

Apr 13, 2017, 10:00 AM, Posted by Susan Mende

From a dementia village to the next AirBnB for seniors, global entrepreneurs are searching for ways to improve the lives of a rapidly aging population. Their lessons can inform efforts right here in the United States where the elderly population is expected to more than double by 2060.

At a nursing home, a nurses' aide sits with a senior who is drinking a glass of water.

Through the plate glass window of the café where I sipped my coffee, I watched an older gentleman bend to pick something off the ground. He did this repeatedly: down and up, down and up. I learned that he did this every day for hours, picking up fallen leaves.

The man had dementia and lived in Hogewey, a community outside Amsterdam where older people with advanced dementia lead largely autonomous lives in familiar, welcoming surroundings. This particular gentleman liked to pick up leaves—and why not? It did him no harm; in fact, it gave him a little exercise, and he probably found the activity relaxing.

Hogewey is unique—a gated, village-like community where those with dementia live in small-group homes that look and feel like real homes, with people of similar backgrounds and experiences. Caregiving and other staff support them in everyday activities and blend into the environment, serving as grocery store clerks, hairdressers, bartenders, and neighbors.

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A Conversation on the Future of Health Equity Research

Jan 12, 2017, 4:43 PM, Posted by Tracy Orleans

In the past decade, the healthy equity research landscape has shifted from building the evidence to identifying solutions. David Williams and Paula Braveman share thoughts on the evolution of research with a look to the future.

Everyone deserves to live the healthiest life possible.

The latest National Academies of Science Engineering and Medicine report notes that compared to other fields of health research, health inequities is still a relatively new field that faces significant research and practical application challenges. The consensus report provides specific recommendations including: expanded health disparity indicators, longer-term studies, an examination of structural factors, and new research funding opportunities. RWJF’s Tracy Orleans talks with two of the nation’s leading experts on health equity and health disparities, Dr. David R. Williams and Dr. Paula Braveman, who share their thoughts on some of these issues and the evolution of research with a look to the future. 


Tracy Orleans: Nearly ten years ago you started work together on the RWJF Commission to Build a Healthier America. At the time, gaps in health between groups of people or communities were not news to health experts, but they were surprising to a lot of others. We’ve come a long way since then with a more explicit focus on health equity research. How do you view this shift?

 

David Williams: For a long time, researchers focused on documenting the health differences between populations. Those differences are now well-established and we’re able to point to more scientific evidence about why the gaps exist. For example, there’s a growing body of research around the effects of epigenetic aging, which shows that people who experience discrimination or other trauma are biologically older than people of the same chronological age. Science shows that their telomeres, which protect chromosomes from fraying, are shorter among both children and adults who are black, poor, or from unstable homes. This type of more explicit health equity research is a rapidly growing field.

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Tackling Life Expectancy Gaps in New Jersey

Nov 9, 2016, 9:00 AM, Posted by Bob Atkins

New Jersey Health Initiatives is driven by five key principles for building empowered, equitable and healthier communities and narrowing the gaps in life expectancy across the state.

Trenton, New Jersey, life expectancy map

It’s a dismaying fact that we’re all familiar with: where you live has an enormous impact on your life expectancy. Indeed, some researchers now quip that your ZIP code may matter just as much, if not more, than your genetic code when it comes to your health. As one journalistic account put it, it’s “Death by Zip Code.”

New Jersey is no different. This summer, the Robert Wood Johnson Foundation (RWJF), together with Virginia Commonwealth University, published analyses of Mercer County, a prime place to showcase the impact of geography on health. It’s home to both affluent Princeton and economically strapped Trenton. And perhaps not surprisingly, life expectancy reflects the gulf in resources between the two towns. While a person born in Princeton can expect to live 87 years, his or her neighbor in Trenton has a life expectancy of 73 years—a staggering 14 year age gap across only a dozen miles.

These results are sobering. It’s easy to get despondent over them and locked into a narrative of failure and decline. But RWJF’s Culture of Health efforts involve cultivating potential, even in places where we wouldn’t normally think to find it. That’s where New Jersey Health Initiatives’ (NJHI) work comes in.

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