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Rebuilding Healthier and More Resilient Communities Together

Dec 7, 2015, 4:01 PM, Posted by Reed Tuckson

Our nation spends billions of dollars to respond to, and rebuild from, disasters, which is why disaster planning must move beyond a narrow focus and create an optimally healthy community.

Trauma and Resilience Illustration.

It felt like a nightmare to watch the floodwaters rise across New Orleans in August 2005. Yet as the hours turned into days, our nation realized we were watching reality–the reality of a great American city coping with a disaster for which city, state and country had not fully prepared.

The good news is that in the decade since, New Orleans has worked towards a new reality by not just rebuilding what was lost, but by asking how it can rebuild better. In so doing, the city is setting an example for us all.  

Rebuilding better means repairing critical infrastructure (roads, hospitals, businesses, levees), and reforming the organization and interpersonal relationships that are essential to promoting well-being and community engagement. As has been well chronicled, such efforts include fostering neighbor-to-neighbor ties, using data to guide community health strategic planning, and encouraging multi-sector partnerships between government, business and community organizations. In New Orleans, initiatives such as Fit NOLA and NOLA for Life have united the city’s health department, schools, community-based organizations, and businesses in ways that were unimaginable before the storm.

New Orleans’ efforts align closely with the recommendations of the report, “Healthy, Resilient and Sustainable Communities after Disasters: Strategies, Opportunities, and Planning for Recovery,” intended as a call to action and an action guide. The Institute of Medicine and the National Academy of Science was commissioned to produce this report by the Robert Wood Johnson Foundation. I was honored to serve as chair of the committee, which was composed of disaster planning, and health and human service experts. We were tasked with identifying ways in which local and national leaders can work together to mitigate disaster-related health impacts and optimize the use of disaster resources to create communities that are healthier and more resilient.

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Measuring What Matters: Introducing a New Action Framework

Nov 11, 2015, 11:30 AM, Posted by Alonzo L. Plough

It's time to change our culture into one that values health everywhere, for everyone. Introducing a new Action Framework and Measures to help us get there.

A Culture of Health is where communities can flourish and individuals thrive.

Our nation is at a critical moment. There is plenty of data that reveals discouraging health trends: We are living shorter, sicker lives. One in five of us live in neighborhoods with high rates of crime, pollution, inadequate housing, lack of jobs, and limited access to nutritious food.

But there is other data that gives us glimpses of an optimistic future. There’s increasing evidence that demonstrates how we can become a healthier, more equitable society. It requires a shared vision, hard work, and the tenacity of many, but we know it is possible.

Starting with a Vision

Last year, the Robert Wood Johnson Foundation (RWJF) shared our vision of a country where we strive together to build a Culture of Health and every person has an equal opportunity to live the healthiest life they can—regardless of where they may live, how much they earn, or the color of their skin.

As my colleagues and I traveled throughout the country, we met many of you and heard your views on an integrated, comprehensive approach to health. You told us that in order to achieve lasting change, the nation cannot continue doing more of the same. Realizing a new vision for a healthy population will require different sectors to come together in innovative ways to solve interconnected problems. 

A First Friday Google+Hangout discussion on "Measuring What Matters in Building a Culture of Health" took place on Friday, November 6

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Why Nursing is Key to a Culture of Health

Oct 9, 2015, 1:38 PM, Posted by Susan Dentzer

Two nurses take patient's blood pressure.

If a Culture of Health means recognizing health’s central importance in our lives, then nurses can be among that culture’s leading ambassadors. More often than not nurses are fully immersed in their patients’ lives, and there are case studies throughout the nation of nurses using that involvement to guide patients in innovative ways to better health.

Consider Stephen and Sandra Sheller 11th Street Family Health Services, a nurse-led Philadelphia clinic serving residents of four low-income public housing projects. Their health center was created in direct response to residents’ requests, and includes not just primary care, but also mental and behavioral health, dental health, and couples and family therapists. There’s a small urban farm producing fruits and vegetables, and a “teaching kitchen” where residents can learn healthy cooking techniques.

At the 11th Street Clinic, nurse-led teams carefully consider each patient’s unique needs. “We don’t ask, ‘What’s wrong with this person?’," the clinic’s founder, public health nurse Patricia Gerrity, said at a recent Robert Wood Johnson Foundation Google+Hangout. “We ask, ‘What’s happened to this person?'" that could affect his or her health.

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Building Healthy, Safe, and Nurturing Schools

Sep 8, 2015, 4:44 PM, Posted by Jennifer Ng'andu

Promoting good health for kids early in life and in their learning environments can provide all children with the foundation they need to achieve their potential—now and throughout their lifetimes.

A group of children writing words on a blackboard with a teacher watching.

My aunt, a teacher in Connecticut, likes to say that her students carry more into their classrooms than just their backpacks. As some 50 million students enter the classrooms of our nation’s public elementary, middle and high schools this month for a new year of learning and growth, it’s important to remember that schools are more than places of academic achievement. They’re also key community institutions that influence the health and wellbeing of our nation’s children.

We already know that schools are important places to promote kids’ health. That’s why, for nearly a decade, RWJF has worked to improve food choices and increase physical activity in schools nationwide. Through our longtime support of the Alliance for a Healthier Generation’s Healthy Schools Program—which this year celebrates its 10th anniversary—we have helped students in nearly 30,000 schools eat better and move more. This is important because research shows that health has an impact on kids’ academic and lifelong success.

But schools also teach kids social and emotional skills like sharing, cooperating, and engaging positively with each other and with adults. These are critical skills—a recent study shows that kids with better social emotional skills are more likely to graduate from college and secure good-paying jobs later in life. The opposite holds true as well. Kids with weaker social skills are more likely to drop out of high school, abuse drugs and alcohol or spend time in jail.

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Reaping the Rewards of the Culture of Health Prize

Aug 10, 2015, 3:25 PM, Posted by Susan Dentzer

It's been a year since Brownsville, Texas, won the Culture of Health Prize for its engagement of leaders across sectors to improve local health outcomes. Here's what the community has been up to since.

Brownsville, TX 2014 Culture of Health Prize Winner

Brownsville, Texas, had plenty to celebrate when it became one of six communities to win the Robert Wood Johnson Foundation’s Culture of Health Prize in June 2014. This predominantly Hispanic city along the U.S.-Mexico border is one of the poorest in the country. Seven in 10 residents are uninsured, 8 in 10 are overweight or obese, and 1 in 3 has diabetes. Yet the community’s efforts to improve health—including new bike trails, community gardens, and a successful bilingual public health education campaign—have earned it wide respect and national recognition, along with $25,000 that goes with the RWJF Culture of Health Prize.

City officials are still discussing how to use the prize money. One option is commissioning a piece of artwork that could be moved around to highlight various initiatives, such as the periodic CycloBia events that make some of the city’s streets car-free for a day so that residents can bike, run, or engage in other physical activity.

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Building Healthier Places in Birmingham and Beyond

Jun 1, 2015, 11:46 AM, Posted by Susan Dentzer

How a section of Birmingham, Alabama is redeveloping and offering greater opportunities for people at multiple income levels. The secret? Engaging the community throughout the process.

With its elegant homes, pleasant park and bustling stores, the Woodlawn section of Birmingham, Alabama was described in a 1950 news article as “a really great section of Birmingham...typical of the fine things in life." Then came the racial unrest of the 1960s, disruption from urban renewal gone awry and white flight to Birmingham’s suburbs. Joblessness and poverty took root; the housing stock decayed. Today, median income in Woodlawn is just $21,000, less than half the level for Birmingham as a whole.

But now Woodlawn is in the midst of a turnaround, aiming to become not just a neighborhood that prospers economically, but also one where people live healthier lives.

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Opening the Care Conversation through OpenNotes

May 4, 2015, 10:01 AM, Posted by Susan Dentzer

More than 30 health systems have adopted the practice of sharing clinicians' notes with patients, making OpenNotes more than just a revolutionary idea but a movement in health care.

A female patient gets an allergy checkup in a doctor's office.

It’s a memory aid. It’s truth serum. Using it can transform relationships forever. These may sound like come-ons for the type of product typically hawked on late-night television. But in fact, they’re some of the things people are saying about OpenNotes.

OpenNotes isn’t a product, but an idea: That the notes doctors and other clinicians write about visits with patients should be available to the patients themselves. Although federal law gives patients that right, longstanding medical practice has been to reserve those visit notes for clinicians’ eyes only.

But Tom Delbanco and Jan Walker, a physician and nurse at Beth Israel Deaconess Medical Center in Boston, have long seen things differently. Their personal experiences with patients, and inability to access care records for their own family members, persuaded them that the traditional practice of “closed” visit notes had to change. So, with primary support from the Robert Wood Johnson Foundation, they launched what has now become a movement.

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The 2015 Rankings and Philadelphia’s Power of ‘Brotherly Love’

Mar 25, 2015, 12:15 AM, Posted by Donald F. Schwarz

Rather than taking poverty and its ravaging effects on health as a given, Philly leaders and citizens came together to usher in change that would make the city a healthier and better place to live for everyone.

A group painting a mural on the side of a building.

If you want to understand the texture of a large city, drive from its downtown and make your way out to the suburbs. With few exceptions, you’ll encounter pockets of poverty transitioning into mixed income neighborhoods and, finally, wealth and privilege in the suburbs.

I have lived in Philadelphia—the nation’s 5th most-populous city and 21st most populous county—for most of my adult life, and that is her reality. As a former public health official, I can tell you that such income gradients have a profound impact on the health of our populations.

The 2015 County Health Rankings released today are unique in their ability to arm government agencies, health care providers, community organizations, business leaders, policymakers, and the public with local data that can be applied to strengthen communities and build a true Culture of Health.

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What Will it Take to Help All Kids Grow Up at a Healthy Weight?

Mar 4, 2015, 11:16 AM, Posted by Susan Dentzer

We can all play a role in helping children grow up at a healthy weight, including the U.S. Soccer Foundation. Their work is helping make strides in reducing childhood obesity rates. Here's how.

A group of teens playing soccer.

Washington, D.C.’s Shaw neighborhood is named after Colonel Robert Gould Shaw, who commanded the famed 54th Massachusetts Volunteer Infantry, the all-black regiment that fought for the Union during the Civil War. Today, the multi-ethnic neighborhood is home to the U Street Corridor, a revived commercial district known in the early 1900s as “Black Broadway"; Ben’s Chili Bowl, a celebrated city landmark; and Seaton Elementary, a public school whose students are mainly Hispanic, African-American, and Asian.  

It’s also home to the young goalie of Seaton’s soccer team, sixth grader Kevin Alvarez.

Like many kids in his neighborhood, Kevin, age 13, never played sports until recently, and was seriously overweight. Then his school was fortunate to become home to Soccer for Success®, a program managed locally by DC SCORES, a Washington, D.C., nonprofit.

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Roadmaps Out of Fantasyland: RWJF’s Outbreaks Report and the National Health Preparedness Security Index

Jan 30, 2015, 5:47 PM, Posted by Susan Dentzer

“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.

And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.

One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.

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