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Can a Single Question Help Families Confront Poverty?

Apr 13, 2016, 10:30 AM, Posted by David Krol

A new recommendation for pediatricians aims to help the one in five children in the United States who live in poverty.

Father holds young child at doctor's office.

During most of the week, I spend my time here at RWJF working on programs to develop leaders in health and health care and to address childhood obesity. But on Friday afternoons, I am at Eric B. Chandler Health Center in New Brunswick, N.J., seeing children and families. Eric B. Chandler is a federally qualified health center, and we serve a lot of poor, immigrant families. The children I see are more likely to have asthma or tooth decay than are children who live not too far away. They’re also more likely to be overweight, and to face adverse childhood experiences like family trauma or violence.

In some sense, this isn’t surprising. Poverty is one of the biggest health risks that children face today. One in five young people in the United States lives in poverty, and it’s present in urban, suburban, and rural communities across the country. My colleagues James Marks and Kristin Schubert recently described what lasting impact poverty can have on children.

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A TED Dare: Here’s Reality. Now Do Something About it.

Mar 19, 2015, 12:31 AM, Posted by Jessica Mark

A poster for TED 2015 about ensuring healthy communities.

Everyone in America deserves a chance to live the healthiest life possible. The reality is a bit more complicated: A person’s ZIP code, after all, can be as important as their genetic code when it comes to determining health. A true Culture of Health in the United States won’t be possible unless we address the inequities that allow some full access to a healthier life, while others are left to struggle.

This week, RWJF arrived at the TED conference in Vancouver, British Columbia, with a challenge for attendees: Try to understand what millions of people face in their pursuit of a healthy life. And in the spirit of the conference’s “Truth & Dare” theme, we dared the TED participants to envision a future in which everyone had access and a path to a healthier life. How might that happen? So far we’re hearing incredible ideas: let’s get to a place where we can celebrate justice rather than seek justice. Let’s make smarter choices about where we spend our health care.

We’ve enlisted five talented—brilliant, really—young filmmakers to help us. We asked each of them to tell the stories of their lives and to document the challenges that sometimes seem distant, but that are all too real for the people in their worlds. Check out their remarkable stories:

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Seizing Opportunities to Reinvent Public Health

Dec 2, 2014, 10:57 AM, Posted by Susan Dentzer

A doctor talks in a friendly manner to a disabled patient sitting in a wheelchair.

“The only thing we know about the future is that it will be different,” wrote the late management guru Peter Drucker.  To the list of society’s sectors that are struggling with that conclusion, add government-funded public health.

State and local health departments face growing challenges, including infectious disease threats such as Ebola and chikungunya; a rising burden of chronic illness; an increasingly diverse population; even the health impact of global warming. At the same time, fiscal constraints accompanying the 2007–2008 recession and its aftermath hammered local, state, and territorial health agencies, which lost nearly 30,000 jobs—6 percent to 12 percent of their total workforces—from 2008 to 2013.

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Mental Health Challenges of Hurricane Sandy’s Aftermath

Oct 29, 2014, 8:31 AM, Posted by Vicki Philips

View of damage from Hurricane Sandy in N.J. Driftwood Cabana Club, Sea Bright, N.J.

On her 90th birthday, instead of celebrating, Dottie (whose last name is withheld for privacy) lost her home in Superstorm Sandy. Two years later, she is still displaced, living in temporary rentals.

Dottie’s nephew is trying to change that. He’s been rebuilding Dottie's home. Like so many New Jersey residents, he says he’s going to keep at it until reconstruction is complete. Meanwhile, he’s getting some much needed support from groups like BrigStrong, the County Long Term Recovery Group, and the Mental Health Association in New Jersey (MHANJ).

It’s been two long years since Hurricane Sandy slammed into New Jersey on October 29, 2012. As a mental health worker, I still see the aftereffects firsthand.

For the past two years MHANJ, along with other local groups, has been on the front lines of the battle to maintain the mental health of Jersey Shore residents. Thanks to a major RWJF grant, MHANJ has been able to leave the county in a better position to deal with the next disaster:

  • We’ve given mental health first aid training to city employees who, in their daily work, encounter community members with mental health issues.
  • Through our Certified Recovery Support Practitioner program, we’ve improved our ability to reach out to the most vulnerable. Many community members certified through the program have faced mental health challenges themselves, which only increases their credibility.
  • We counseled populations with mental health issues on how to safely evacuate or shelter in place, thus ensuring that first responders will be safer in future emergencies.

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Let’s Talk About Stress

Oct 2, 2014, 9:52 AM, Posted by Michael Painter

I recently returned from the Health 2.0 conference in California, which drew 2,000 health care innovators. One of the most popular Health 2.0 sessions was called “The Unmentionables”—where speakers discussed those important things that affect our health but we are often afraid to address. I participated in this year’s session where we talked stress—what it is and how it’s making us sick.

I’m an avid cyclist. That means I train a lot. Training on a bike means purposefully and intensely stressing your body—sometimes ridiculously hard—in order to make your body stronger, fitter and faster. In that sense stress can be really good. You can’t get stronger without it.

But here’s the key: as you ratchet up that stress—the miles, the hours on the bike, the intensity—you must work just as hard on the flipside, the buffering. The more you train, the more you have to focus on the rest, the sleep, your social supports, the yoga, the nutrition—whatever it takes.

If you don’t buffer you will burn out, get injured or sick, or all of the above. Without buffers, the stress will crush you.

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I’m RWJF’s Newest Entrepreneur in Residence

Sep 23, 2014, 1:54 PM, Posted by Susannah Fox

Susannah Fox offers office hours at RWJF. Susannah Fox offers office hours at RWJF.

I am thrilled to begin my job as the entrepreneur in residence (EIR) at the Robert Wood Johnson Foundation.

You might think that the EIR role is traditionally associated with venture capital firms, not foundations. But scratch the surface and you’ll find commonalities between the two industries. Both VCs and philanthropists have daring ambitions, place lots of bets, and hope for a big pay-off every once in a while. The difference is that a philanthropy like the Robert Wood Johnson Foundation places a priority on societal dividends, such as greater access to health care or a reduction in childhood obesity.

I also like this definition of entrepreneurship: “The pursuit of opportunity without regard to resources currently controlled.” That fits the Foundation to a T as we pursue the audacious goal of building a Culture of Health in the United States.

But how will we measure success? How will we know if our bets ever pay off, especially when we are talking about culture change? I have a story to tell that I think illustrates how a small grant can make a big difference in the world.

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Stress: Withstanding the Waves

Sep 23, 2014, 11:42 AM, Posted by Ari Kramer

As a kid, when you went to the beach, did you ever play that game where you’d wade into the ocean and test your strength against the waves? You'd stand your ground or get knocked over, and after a few minutes, you'd head back to shore.

We didn’t realize it at the time, but as we felt those waves roll by, we were getting an early glimpse of the stresses of everyday life. The difference is, as adults we can't choose to stand up to just the small ones. And for the most part, going back to shore is not an option.

In a survey RWJF conducted with the Harvard School of Public Health and NPR, about half of the public reported experiencing a major stressful event in the past year. In more than four in 10 instances, people reported events related specifically to health. Many also reported feeling a lot of stress connected with jobs and finances, family situations, and responsibility in general.

Over time, those waves can take their toll. And when they become overwhelming, they can truly wear us down, seriously affecting our both our physical and emotional health.

So how can we deal with these waves of stress? Certainly, there are proactive things we can all do help manage its effect on our lives—exercise, for example. At the same time, we’ve probably all experienced instances when we’d love nothing more than to get up early for a run or brisk walk—but don’t have the energy because stress kept us up at night. Or we may just be too tapped out from long hours, relationship struggles, caring for loved ones, etc., to spare the energy or the time.

If this sounds familiar, consider yourself human. Right next to you, whether at work, on the train, in your grocery store, is probably someone whose waves are similar to or bigger than your own. So at the same time as you try to manage your stress, ask yourself: What could be done to help others achieve a solid footing? In this ocean of ours, there’s never a shortage of opportunity to lend a helping hand.

Have an idea to help move from a culture of stress to a Culture of Health in the home, workplace or community? Please share below—we’d love to hear from you.

Special Olympics Holds Lessons, and Inspiration, for All of Us

Jun 24, 2014, 2:30 AM, Posted by Catherine Arnst

 

Let me win, but if I cannot win, let me be brave in the attempt.”

—Special Olympics motto

The other day I cheered myself hoarse during a swim relay for a team from Maryland that put their all into the race. In fact, the whole viewing crowd cheered on this team. When they finished, the athletes were jubilant, hugging each other and their opponents, thrilled by their performance in this national event. It didn’t seem to bother them much that they finished last.

The 2014 USA Games for the Special Olympics, the world’s largest organization for people with intellectual disabilities, was held in New Jersey June 14-21. Some 3,500 children and adults from all 50 states competed in 16 different sports, and the vast majority took tremendous pleasure in the pure joy of athletics. Sure, plenty were fiercely competitive, but they were also happy and proud to have the opportunity to compete to the best of their ability.

That was pretty inspirational to the 110 staff members from the Robert Wood Johnson Foundation who volunteered at the Special Olympics.

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Graduate Medical Education Funding Is Not Helping Solve Primary Care, Rural Provider Shortages, Study Finds

Jun 19, 2013, 9:00 AM

From 2006 to 2008, 158 of the country’s 759 residency sponsoring institutions and teaching sites did not produce any primary care graduates, according to a study published online last week by Academic Medicine. Less than one-quarter of medical school graduates entered primary care during those years.

The study also found that physician shortages in rural and underserved areas persist; only 4.8 percent of 2006-2008 graduates practice in rural areas. Nearly 200 institutions produced no rural physicians, more than half produced no Health Service Corps graduates, and 283 produced no physicians practicing at Federally Qualified Health Centers or Rural Health Clinics.

Graduate medical education (GME) distribution is uneven, the researchers found, and provides more support to subspecialty programs than to primary care programs. The top 20 primary care producing institutions (where 41 percent of graduates were in primary care) received $292 million in total Medicare GME payments, while the bottom 20 (where only 6.4 percent of graduates were in primary care) received $842 million in these funds.

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Nursing School Enrollment Continues to Increase, Capacity Still an Issue

Dec 12, 2012, 11:00 AM

The American Association of Colleges of Nursing (AACN) last week released preliminary findings from its annual nursing education survey showing an increase in enrollment in all types of nursing programs from 2011 to 2012.

The AACN survey finds a 3.5 percent increase in entry-level Bachelor of Science in Nursing (BSN) program enrollment, and a significant increase in the number of students in graduate nursing programs. Master’s degree nursing programs reported an 8.2 percent increase in enrollment, while Doctor of Nursing Practice program enrollment increased by 19.6 percent and PhD/DNS programs by 1.3 percent.

Baccalaureate degree completion programs (RN to BSN) saw an increase in enrollment of 22.2 percent, which marks the 10th year of enrollment increases for these programs.

Though enrollment has increased, the survey finds that many potential students are still being turned away. In 2012, more than 52,000 qualified applicants were turned away from entry-level baccalaureate nursing programs because of a shortage of clinical placement sites, faculty, and funding.

In addition to its annual survey, AACN also released data showing that baccalaureate nursing graduates are at least twice as likely as those in other fields to have a job at the time they graduate. The survey also finds hospitals and other employers prefer hiring new nurses with BSNs.

One goal of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, is that 80 percent of nurses have bachelor’s degrees or higher by the year 2020.

Learn more about the survey results.

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