Now Viewing: Health & Health Care Policy

5 Reasons to Be Excited for the Changes Coming to Menus and Food Labels

May 20, 2016, 11:07 AM, Posted by Jasmine Hall Ratliff

Menu labeling in food retail establishments can help foster a Culture of Health in communities nationwide—here’s why this is great news for American consumers.

Today, First Lady Michelle Obama unveiled big news from the Food and Drug Administration: Consumers will soon begin to see an updated and increasingly useful Nutrition Facts Panel on packaged foods and beverages. This is the first comprehensive overhaul of the label since 1994.

Soon, those little black-and-white charts will inform you of the amount of added sugars in a product, and include a “daily value” to help you understand the maximum amount of added daily sugars recommended by experts. Serving sizes will also be revised to reflect the amounts of products that people typically consume in the real world. And, calorie counts will be listed in a much larger and bolder font to make them easier to spot.

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Generation Y’s Role in Making the Marketplaces Work and Advancing a Culture of Health

Feb 24, 2014, 9:00 AM

Every New Year brings New Year’s resolutions. It is a time for reflection on years past and to develop actionable changes needed for a hopeful and productive new year. Clearly 2014 is no exception. With the New Year already in full swing, I encourage people—yes, this also includes you, Generation Y—to enroll in a health insurance plan and take advantage of the Affordable Care Act’s (ACA) current and new coverage opportunities in an effort to advance our nation’s culture of health.

You might be asking yourself a few questions such as: Who is Generation Y and why are they important? I am happy to provide answers.

The largest generation, Generation Y, or Millennials, consists of young adults born between 1977 and 1994. This important demographic is key to obtaining a sustainable health care exchange system with affordable insurance plans. Healthy Millennials must enroll in the marketplace to offset the high costs acquired by the disproportionate number of Americans with high medical costs. Unfortunately, only a small number of young adults have participated in the health care exchange since open enrollment. This isn’t surprising. 

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The Role of Emergency Departments

Jun 27, 2013, 9:06 AM

Emergency departments (EDs) play a key role in the nation’s health care system, according to a RAND Corporation study commissioned by the Emergency Medicine Action Fund, and policy-makers should pay closer attention to their operations—particularly their role as a “gateway to inpatient treatment.” It also is important to better integrate EDs into inpatient and outpatient settings, the new report says.

EDs have become an important source for hospital admissions. Nearly all of the inpatient admissions growth between 2003 and 2009 was due to an increase in scheduled admissions from EDs, the report finds, particularly among Medicare beneficiaries. As a result of this shift, ED physicians served as the major decision makers for approximately half of all hospital admissions.

The study also finds that most patients visited the ED for a non-emergent health problem because they believed they lacked a viable alternative or because they were sent by a health care provider. “Almost all of the physicians we interviewed—specialist and primary care alike—confirmed that office-based physicians increasingly rely on EDs to evaluate complex patients with potentially serious problems, rather than managing these patient themselves,” the report says. EDs also support primary care practices by performing complex diagnostic workups.

“Evidence generated by our study and other published work indicates that efforts to reduce non-emergent and non-urgent use of EDs are most likely to succeed if they focus on providing convenient and affordable options outside the ED, rather than directing ED staff to turn patients away,” the study concludes. EDs should be better integrated into inpatient and outpatient settings through more interconnected health information technology, greater user of care coordination, and interprofessional collaboration.

Read the report.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

Health Issues on Ballots Across the Country

Nov 9, 2012, 9:00 AM

Voters across the country were presented Tuesday with more than 170 ballot initiatives, many on health-related issues. Among them, according to the Initiative & Referendum Institute at the University of Southern California:

- Assisted Suicide: Voters in Massachusetts narrowly defeated a “Death with Dignity” bill.

- Health Exchanges: Missouri voters passed a measure that prohibits the state from establishing a health care exchange without legislative or voter approval.

- Home Health Care: Michigan voters struck down a proposal that would have required additional training for home health care workers and created a registry of those providers.

- Individual Mandate: Floridians defeated a measure to reject the health reform law’s requirement that individuals obtain health insurance. Voters in Alabama, Montana and Wyoming passed similar measures, which are symbolic because states cannot override federal law.

- Medical Marijuana: Measures to allow for medical use of marijuana were passed in Massachusetts and upheld in Montana, which will make them the 18th and 19th states to adopt such laws. A similar measure was rejected by voters in Arkansas.

- Medicaid Trust Fund: Voters in Louisiana approved an initiative that ensures the state Medicaid trust fund will not be used to make up for budget shortfalls.

- Reproductive Health: Florida voters defeated two ballot measures on abortion and contraceptive services: one that would have restricted the use of public funds for abortions; and one that could have been interpreted to deny women contraceptive care paid for or provided by religious individuals and organizations. Montanans approved an initiative that requires abortion providers to notify parents if a minor under age 16 seeks an abortion, with notification to take place 48 hours before the procedure.

- Tobacco: North Dakota voters approved a smoking ban in public and work places. Missouri voters rejected a tobacco tax increase that would have directed some of the revenue to health education.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

Finding an AED in an Emergency

Sep 7, 2012, 9:00 AM, Posted by Raina Merchant

Human Capital Blog: Why was it important to collect information about the location of AEDs?

Raina Merchant: Currently there is no comprehensive map or database of where all the AEDs are located—in Philadelphia or really anywhere. So when someone collapses, we have to rely on people remembering where they last saw an AED. In fact, most 911 centers don’t have databases of where AEDs are located. So, the likelihood of being able to find one in an emergency is pretty low, and as a result we have these lifesaving devices that are rarely used. We used the MyHeartMap Challenge, an innovation tournament to have the public find AEDs in Philadelphia, take a photo using a smartphone app, and tag their location so we can make this information available to anyone who needs it.

HCB: How many people or teams participated in the Challenge? How many AEDs were identified?

Merchant: We were really excited about the results. We had more than 330 participants (individuals and teams) who contributed data to the Challenge. They reported more than 1,500 locations of AEDs in the city of Philadelphia. We’re still trying to sort out who exactly participated, but we had representation from schools and health organizations, as well as a lot of individuals who recruited their friends, neighbors and colleagues.  We were worried that people would make up devices, submit false locations or send low-quality pictures, but we were really impressed with the quality of data we received. Every one took this challenge very seriously. The challenge had two winners who were each awarded $9,000 for reporting more than 430 AEDs each. Both winners were also over the age of 40.

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Science, Through a Policy-Maker's Lens

Aug 24, 2012, 9:00 AM, Posted by Allison Aiello

Allison Aiello, PhD, MS, is an associate professor of epidemiology at the University of Michigan School of Public Health, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This post is part of a series on the program, running in conjunction with its tenth anniversary.  The RWJF Health & Society Scholars program is designed to build the nation’s capacity for research, leadership and policy change to address the multiple determinants of population health.

You’ve seen it, used it, and probably even bought it. Its manufacturer claims it keeps your hands free of bacteria, and that it works better than regular old soap. For a couple decades now, Americans have been encouraged by soap manufacturers to buy anti-bacterial hand and bath soap, and many of us have taken them up on it, judging from its ubiquity on store shelves. It comes in pump bottles as well as traditional hand and bath bars, all relying on a similar active ingredient, a chemical called triclosan in liquid soaps and triclocarban in bar soaps. In fact, you can find triclosan in a range of hygiene products, including deodorants, toothpastes, mouthwashes, and more.

The marketing message behind all of them is the same: By killing bacteria—or more accurately, by stopping it from reproducing—the stuff makes us cleaner and safer.

Alas, I’ve spent years researching triclosan, and I can tell you that it’s not nearly so simple. Triclosan may have its uses, but as a soap additive, the bulk of the evidence is that it offers no particular advantage over using regular soap, while posing some worrisome threats to health and the environment. Given that, it’s a mystery to me why it’s allowed on the market years after the problems with it first came to light.

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Oral Health: Putting Teeth Into the Health Care System

Aug 22, 2012, 9:00 AM

Last week, the Robert Wood Johnson Foundation (RWJF) and The Alliance for Health Reform sponsored a briefing to discuss oral health care in the United States, particularly for children and other vulnerable populations.

The discussion was co-moderated by David Krol, MD, MPH, FAAP, RWJF Human Capital Portfolio team director and senior program officer. “Oral health is an integral part of overall health,” he said. It faces the same challenges as overall health care, including “racial, ethnic, geographic disparities in disease and access to care, financing challenges, issues of determining and maintaining quality of care, and workforce controversies.” Krol said he would like to see “all conversations on health and health care… naturally include oral health.”

In 2009, preventable dental conditions accounted for more than 830,000 emergency department visits nationwide, Julie Stitzel, MA, of the Pew Center on the States’ Children’s Dental Campaign told the audience. Children were the patients for 50,000 of those visits. “There’s a real opportunity for states to save money because these visits, again, are totally preventable,” she said. “We know that getting treated in an emergency room is much more costly than the care delivered in a dental office, and states are bearing a significant share of these expenses through Medicaid and other public programs.”

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Revolutionary Gerontology: The Intergenerational Questions

Aug 8, 2012, 1:30 PM, Posted by Cleopatra Abdou

Cleopatra M. Abdou, PhD, is an assistant professor of gerontology at the University of Southern California, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This post is part of a series on the RWJF Health & Society Scholars program, running in conjunction with the program’s tenth anniversary.

Gerontology, the study of aging, is a diverse field that integrates the biological, social-behavioral, and health sciences, as well as public policy. This means that gerontological research addresses a vast range of questions. One type of question asked by gerontologists, including myself, has to do with intergenerational processes. My own research investigates the intergenerational transmission of culture, social identities, conceptions of stress and success, and, ultimately, health. For example, how do our notions of, and relationships to, family affect our health at critical points in the lifespan? More specifically, how do familial roles and responsibilities, such as marrying, reproducing, and caring for grandchildren, correlate with life satisfaction and longevity?

My four siblings and I are the first American-born generation in our family. Our parents came to the United States from Egypt in 1969, and I am strongly identified as both an American and an Egyptian. Anyone who has complex or competing identities knows that it’s a mixed bag—a blessing and a curse. Recently, as I boarded a plane in Cairo to return to the United States, I found myself sobbing with what I think was a kind of homesickness. As happy as I was to return to my immediate family and orderly life in The States, I mourned leaving the land of my parents and all of our parents before them, especially during this important time in Egypt’s history.

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Cautiously Optimistic about the Affordable Care Act - If Older Americans and Their Advocates Speak Out as It Is Implemented

Jul 19, 2012, 10:30 AM, Posted by Margaret Moss

This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act.  Margaret P. Moss, PhD, JD, RN, FAAN, is associate professor, Yale School of Nursing and an alumna of the RWJF Health Policy Fellows program (2008 – 2009).

As I reflect upon the monumental decision by the Supreme Court to uphold the Affordable Care Act, I can’t help but be awed by how the branches of government are alive and well and operating just as they were designed to work.  But as I filter what this decision will mean for the groups I am most closely tied with professionally and personally, I am struck at how the ‘system’—public and private—has largely let them down.

My professional focus has been in aging, and in particular American Indian aging.  My profession is nursing, with a background in law.  I am optimistic that these groups, both patient and provider, will be lifted and solidified by the spirit of this law.  But I am cautious that the letter of the law must be handled with an eye toward impact, unintended consequences, short-term pilot and demonstration projects, and authorized but unfunded rules.

There can be no question that there are provisions in the Act that no-one would dispute are positive.  The most cited are: 1) no more pre-existing condition exclusions, 2) the ability to keep adult children under parents’ plans until after college age, and 3) widening the net for coverage to include those now uninsured. The opposing point being moot now with the Supreme Court’s decision, we must look forward and responsibly carry out the law before us.  Unfortunately, the devil, as they say, is in the details.

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The Affordable Care Act and Its Juncture between Health Care and Health

Jul 16, 2012, 1:39 PM, Posted by Sara Rosenbaum

This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act.  Sara Rosenbaum, JD, is the Harold and Jane Hirsh Professor at George Washington University, School of Public Health and Health Services, Department of Health Policy.  Rosenbaum received an RWJF Investigator Award in Health Policy Research in 2000, and is on the board of the RWJF Health Policy Fellows program.

In affirming the constitutionality of the Affordable Care Act, the United States Supreme Court assured the legal survival, not just of thousands of discrete legislative provisions, but also the big ideas embedded in the Act.  One of the biggest is its emphasis on strengthening the juncture between health care and health, an opportunity whose potential is only beginning to be explored.  The most publicly visible aspect of this emphasis is the Act’s expansion of coverage for clinical preventive services without cost-sharing across the principal health insurance markets recognized under the Act: Medicare; employer-sponsored health plans, state regulated individual and small group markets (including the new Exchange market) and the Medicaid “benchmark plan” market that will  serve newly eligible beneficiaries. (Ironically, the Act leaves out of this expanded clinical preventive coverage design the health plan market serving traditional Medicaid beneficiaries; other than a state option to expand coverage at slightly favorable federal financing rates, the law does not require expanded clinical preventive benefits for the very poorest beneficiaries. Although family planning services are a required benefit for all beneficiaries of childbearing age, services such as screening colonoscopies and adult immunizations remain optional for the traditional coverage group).

But the opportunities to bridge the health/health care divide go well beyond the important, threshold question of coverage design.   The biggest opportunities are those that are intended to change the way that two of the principal players in the health care system—physicians and hospitals—envision their role in society and position themselves in communities.  In the case of physicians, the Act incentivizes formation of accountable care organizations (ACOs), entities that assume responsibility not simply for health care of a defined group of patients (like any practice network) but for the health of the population they serve.   ACOs are expected to move beyond improvements in the quality of clinical services they furnish and to reach into their communities through greater involvement in community health improvement activities.   Similarly, the Act expands and strengthens the community benefit obligations of the nation’s nonprofit hospitals seeking federal tax-exempt status, upping their responsibilities related to community health improvement planning, and incentivizing investment in community health improvements and community building.

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