Now Viewing: Public and Community Health

Rich Besser’s Journey of Service

May 11, 2017, 11:00 AM, Posted by Najaf Ahmad

From his Princeton roots to his experiences as a pediatrician, public health practitioner and journalist, Rich Besser shares stories and lessons from a career dedicated to service in this Q&A.

Richard Besser stands near a mural at RWJF in Princeton, N.J.

Rich Besser was a fourth-year medical student when he found himself performing his first (and last!) solo emergency Cesarean section at a hospital tucked within a rural Himalayan village in Manali, India.

He had come to Lady Willingdon Hospital eager to learn about health problems facing people within the developing world, and worked under a gifted local surgeon, Dr. George “Laji” Varghese. Providing care for the underserved population there was no small feat. For instance, the power would often go out during surgeries, requiring someone to hold a flashlight over the operating table.

Dr. Laji one day left Rich in charge as he departed for a week-long meeting. Before leaving, as a precaution, he walked Rich through how to perform an emergency Cesarean section since they were high up in the mountains and hours away from the next health care facility.

Sure enough, a few days later a woman who’d struggled through labor for over a day arrived. A senior nurse noted that the baby’s heart didn’t sound good.

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New Effort Will Give Researchers Access to Valuable Health Datasets

Apr 24, 2017, 9:00 AM, Posted by Katherine Hempstead

A new program is providing research teams with $750,000 in funding and access to rich health data. In doing so, we're hoping to create opportunities for researchers to use this data to inform policy and improve systems.

Health professional in a hospital typing patient information into a computer.

Many of us track health data without even thinking about it. With our step counters, fitness tracker apps, and “smart” watches, we collect thousands of points of data about ourselves—data we hope to use to make us healthier and more fit (or motivate ourselves to work harder). Now think about all the data health care providers and insurance companies track. That data, if put together and de-identified to protect privacy, could help researchers spot health trends in certain geographic areas. That data could help researchers see if there are linkages between people with chronic conditions and what type of health plans they choose.

Now, imagine you know about a library of health data, but it’s locked in a room that is in a building that costs money to enter, requires legal negotiation, and is not organized for researchers to use.

For many researchers, this analogy is more real than you think. Many valuable health datasets are actually this elusive. Proprietary datasets may be hard to obtain due to cost, or have technical/systems requirements that make it difficult for researchers to access and actually use.  

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System and Services Research for Better Health

Apr 18, 2017, 8:30 AM, Posted by Oktawia Wojcik

How can we identify the system-level strategies needed to improve the delivery of medical, public health, and social services? With $2 million in funding, we’re calling on research teams to find out.

Community members walk together downtown.

What does it look like when systems work better together?

At Arizona State University, a research team is exploring this very question. By integrating data sources from Arizona’s medical, mental health, and criminal justice systems, they’re looking for ways to effectively coordinate health and support services for those confronting mental health or substance abuse challenges. The study uses systems modeling and network analysis methods to see how individuals and dollars move between and within these systems. These insights will help us better understand how changes in financing and service delivery can improve health outcomes.

Over at Drexel University, a team is studying how aligning Medicaid coverage for behavioral services with the Temporary Assistance for Needy Families program (TANF) can reduce children’s developmental risks, improve future employment and income, and reduce the return of beneficiaries to the TANF program.

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Working Together to Take on the Opioid Crisis

Mar 29, 2017, 8:00 AM, Posted by Tim Soucy

Drug overdose deaths are fueling a dramatic increase in premature deaths nationally. This community is taking action—here’s how.

A boy standing by a sink, opening a bottle of pills.

I’ve lived in Manchester, New Hampshire, my entire life and led the health department here for more than a decade. So for me, the opioid crisis that has hit the city and surrounding region hard feels like a very personal kick to the gut. Between 2003 and 2015, overdose deaths in Manchester increased 12-fold, and until recently, our emergency responders were seeing 60 to 70 suspected overdoses each month in this city of 110,000 people.

We’ve seen more and more in the news that the drug overdose epidemic has become a national crisis, and the 2017 County Health Rankings released today reveal the extent of its terrible impact. Drug overdose deaths are now the leading cause of death in the United States among 25- to 44-year-olds, cutting short the lives of too many people and underlying a national rise in premature death rates.

Fueled largely by overdose deaths from opioid prescription drugs, heroin, and illegally manufactured fentanyl, the epidemic killed more than half a million people from 2000 to 2015.

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How Can We Design Communities Where Kids and Families Thrive?

Mar 23, 2017, 2:00 PM, Posted by Katie Wehr, Sara Cantor Aye

A funding opportunity engages teams in six selected communities to create healthier environments for kids and families.

Man and child gardening.

How can we build healthier communities where children and families thrive?

Every community would likely answer this question differently.

And these unique approaches are exactly what RWJF and Greater Good Studio hope to leverage through a project called Raising Places: Building Child-Centered Communities.

Six selected communities engaged in cross-sector collaboration will be awarded $60,000 each, along with support to take part in a process that identifies priorities, gathers diverse insights from residents and stakeholders, and tests and refines practical solutions for sustainable change. Greater Good Studio, which specializes in addressing social needs through human-centered design, will guide participating communities through this process.

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What You Need to Know About Hospital Roles in Community Investment

Mar 15, 2017, 2:00 PM, Posted by Donald F. Schwarz

Hospitals and health systems are well-positioned to invest resources in creating healthier communities—a few are already leading the way. Their valuable lessons can help others rethink the role hospitals can play in improving health beyond their walls.

Mother pushes kids on a tire swing.

Hospitals have a long tradition of serving their communities—not only by providing health care, but by hiring local workers and contractors, buying locally, and building new clinical facilities within their communities.

But you probably wouldn’t think of hospitals as financial investors in their local communities. Nor might you consider them experts in managing community revitalization efforts.

And yet, why not? After all, hospitals and health systems have unique assets that go far beyond their clinical offerings. These include deep community connections and relationships, the ability to make loans, expertise in real estate, finance, and project management, and significant property holdings. All of these can collectively be leveraged to benefit both the community at large and hospitals themselves.

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Four Ways Artists Can Help Heal Communities

Mar 2, 2017, 10:00 AM

Leaders from Louisville—one of seven winners of the 2016 Culture of Health Prize—share how artists can play a role in creating healthier, more equitable communities.

A mural on a brick wall. Smoketown Women's Mural by Steam Exchange and Smoketown community members.

Our Louisville, Kentucky, neighborhood of Smoketown sits across the street from the largest concentration of health care services in our state. Yet people here live 9 years less than the typical Louisville resident. Poverty, racism, unemployment and other social determinants of health have created this gap between residents of Smoketown and those from more affluent parts of the city.

An artist’s creativity has helped make that disparity concrete. Andrew CozzensSmoketown Life Line Project documents the impact of trauma on many aspects of people’s lives and health, as revealed through interviews with more than 20 local residents.

You see the impact in metal rods of different lengths—each representing the length of one community member’s life. Crimps in the rods marked with bands of color represent adverse experiences—violence (red), addiction (white), incarceration (black), trauma (blue)—showing how lives have, in effect, been shortened.

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The 500 Cities Project: New Data for Better Health

Feb 23, 2017, 12:00 PM, Posted by Oktawia Wojcik

For the first time ever, the CDC and CDC Foundation are providing city and neighborhood level data for 500 of the largest U.S. cities, making it possible to identify emerging health problems and effective interventions.

A man holds his child.

Old Colony YMCA in Brockton, Massachusetts recently discovered something startling: a single neighborhood more burdened by poor health such as asthma, high blood pressure, and elevated cholesterol than surrounding areas. Most surprising, however, was that this particular area had a lower prevalence of unhealthy behaviors like binge drinking than other locations within Brockton.

In the past, public health officials may have expended limited resources on the entire Brockton metropolitan area because they wouldn’t have been able to pinpoint the specific neighborhood facing the spike and determine why it was happening.

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How a Healthy Food System Can Transform Your Community

Nov 28, 2016, 9:00 AM, Posted by Dana Harvey

Mandela MarketPlace understands that community members hold the key to positive change. By lifting up a culture of community ownership, Mandela is increasing access to healthy food and sustainable business opportunities.

Oakland residents shop at the Mandela Marketplace booth

Sixteen years ago, I embarked on what I thought would be a year-long project to help the residents of West Oakland gain reliable access to affordable, nutritious food.

More than 23.5 million people live in low-income areas that are more than a mile from a supermarket, according to the USDA. That includes West Oakland, one of the city’s poorest areas. The community has a high rate of crime, pollution and unemployment—along with dozens of liquor stores and fast food outlets. Health outcomes are dismal; residents are two times more likely to be born at a low birth weight and 2.5 times more likely to die of stroke than residents in the nearby affluent area of Oakland Hills.

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Lessons from Culture of Health Prize Winners in the Northeast

Oct 26, 2016, 4:00 PM, Posted by Amy Slonim

Past prize-winners recently convened to discuss their experiences. They share powerful lessons on how they are improving health and health equity within their communities.  

Community members shake hands and speak with a police officer.

We started the day with an icebreaker.

“I harness the collective power of leaders, partners, and community members,” read the moderator.

“That’s me!” shouted the group of several dozen people gathered on the campus of Yale University in New Haven, Conn., for a reunion of sorts. They came from diverse sectors and systems—from health care, education, nonprofits and government agencies—and their communities all had this in common: They are past winners of the RWJF Culture of Health Prize.

Each year, RWJF honors and elevates U.S. communities that are making great strides in their journey to better health and well-being. So far, 27 places—cities, counties, tribes, and more—across the country have claimed the distinction of receiving the Prize.

This year, communities across the United States have until November 3rd to apply for the Prize. Winners will receive up to $25,000 and have their stories spread broadly to inspire others toward locally-driven change.

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