Now Viewing: Social Determinants of Health

New Narratives of Hope This Black History Month–And Beyond

Feb 5, 2020, 4:00 PM, Posted by Dwayne Proctor

More than 50 years after the civil rights movement we still have a lot to do to reduce discrimination and increase health equity. Dwayne Proctor reflects on the role of stories in the search for solutions.

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

Note: This piece was originally published in February 2018.

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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Why Neighborhoods—and the Policies that Shape Them—Matter

Jan 23, 2020, 2:00 PM, Posted by Dolores Acevedo-Garcia

The Child Opportunity Index 2.0 uses contemporary data to measure and map inequities in all 72,000 neighborhoods in the United States. The tool helps researchers, city planners, community leaders and others identify and address inequities in their metros.  

Boys and girls run and play in the park. Image credit: iStock

The Tale of Two Boys Growing Up in Cleveland

Let’s ask two hypothetical 9-year-old boys a question: What is it like to grow up in Cleveland? 

Each boy attends school, and enjoys riding his bike and playing with Legos. Both live in Cleveland. Beyond these similarities, their life experiences are—and will continue to be—starkly different based on multiple, complex factors that lie within their neighborhoods.

Neighborhood A 

The boy living in Neighborhood A faces a host of obstacles to opportunity and well-being. 

Economic adversity is the norm. One in four families struggle with poverty, and nearly 83 percent of his peers in school need free or reduced-price lunch.

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A Holistic Approach to State Policymaking That Strengthens Families by Advancing Equity

Dec 16, 2019, 1:00 PM, Posted by Monica Hobbs Vinluan

A multi-state laboratory explores the interconnectedness of programs and policies to find ways for all families to thrive.

Kids jumping on an interactive exhibit at a museum.

Families don’t live in silos—one silo for health care, one for child care support, and yet another for food assistance. They need all those things—and more—to build strong and healthy futures for their children.

That’s why at the Robert Wood Johnson Foundation (RWJF), we're supporting a multi-state laboratory for advancing policies that strengthen families across a range of issues. The Center on Budget and Policy Priorities (CBPP) is the hub for this initiative. We are administering $2.65 million in grants to state-based organizations working to ensure that children and families get the support and resources needed to raise healthy kids through policy and systems change.

That means instead of addressing one issue at a time—e.g., child care supports or family leave—an array of issues are beign addressed simultaneously. These include child care and family leave and minimum wage and job training and other policies that can help families get ahead. These policy levers are interconnected, playing off each other, which is why a holistic approach is needed to make real progress in families’ lives.

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Where Mental Health and Social Justice Meet

Mar 11, 2019, 1:00 PM, Posted by Dwayne Proctor

A leader committed to the mental health and healing of black communities shares his insights.

Face graphic.

A few years ago, I read a painfully insightful account in the New York Times of what it means to be a black American struggling with mental health. The author vividly describes how socio-historical “trauma lives in our blood,” materializing in our daily lives, and ultimately affecting our mental health.

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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.

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.

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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, learn about the RWJF Sports Award. InnerCityWeightlifting, a 2016 Sports Award Winner, helps at-risk youth and former inmates restore their standing in society.

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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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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