Category Archives: Disparities

Apr 10 2014
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RWJF Scholars in the News: Electronic health records, nurse mentoring, ‘longevity gaps,’ and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

The California Action Coalition has developed a mentorship program that is helping prepare the next generation of nurses to serve as leaders on health care reform. The state’s mentorship program dovetails with the 2014 leadership focus of the Future of Nursing: Campaign for Action, a national effort backed by RWJF and AARP that is working to transform health care through nursing. “Mentoring is key to strengthening any leader,” Mary Dickow, MPA, tells Nurse Zone. “Having strong mentors in my life helped me think differently and advance. I wouldn’t be where I am today without them.” Dickow is statewide director of the California Action Coalition.

A recent interview in the Atlantic with David Blumenthal, MD, MPP, has generated numerous comments from readers weighing in on the merits of electronic health records (EHRs). Blumenthal is former national coordinator for health information technology at the U.S. Department of Health and Human Services and a recipient of an RWJF Investigator Award in Health Policy Research. He points out in the interview that EHRs offer “substantial” benefits for patients, but notes that in the short-term, providers incur significant costs and that it will take time to make the transition to EHRs. The Atlantic has now published several articles highlighting reader comments, which can be found here, here, and here. FierceEMR published a story about the give-and-take, which notes that many of the commenters who are skeptical about the value of EHRs are physicians.

RWJF Health & Society Scholars program University of Wisconsin-Madison Site Director David Kindig, MD, PhD, appeared on the Kojo Nnamdi Show on Washington, D.C.’s WAMU radio to discuss the “longevity gap,”—the growing gap in life expectancy between the rich and the poor. Kindig and other guests explore how health care reform and policies to address income inequality might affect the gap.

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Apr 3 2014
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RWJF Scholars in the News: Medical debt disparities, nurses providing primary care, technologies that maximize time with patients, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

In a study of women diagnosed with breast cancer, RWJF Physician Faculty Scholars alumna Reshma Jagsi, MD, PhD, found that Black and Latina patients were more than twice as likely as White patients to have medical debt and to skip treatments due to concerns about costs. Jagsi tells Reuters that “our findings suggest that racial and ethnic minority patients appear to be more vulnerable, as are those who are too young to qualify for Medicare, those who lack prescription drug coverage, those who reduce their work hours after diagnosis, and those with lower household income at the time of diagnosis.”

Expanding nurse practitioners’ role in primary care could help meet new demands on California’s health care system, as millions of previously uninsured residents gain coverage under the Affordable Care Act, according to Susan Reinhard, RN, PhD, senior vice president of the AARP Public Policy Institute. “We should make sure that the nurse practitioners can use every ounce of their talent for what is needed,” she tells the AARP Bulletin. “Consumers should have a choice of different clinicians who will suit their preferences and their needs.” Reinhard is chief strategist for the Center to Champion Nursing in America, a partnership of AARP, AARP Foundation, and RWJF and co-director of the Future of Nursing: Campaign for Action.

At a recent information technology summit, Ann O’Brien, MSN, RN, an RWJF Executive Nurse Fellow, discussed her work with Kaiser Permanente to leverage new health care technology to maximize nurses’ valuable time providing patient care. O’Brien explains that “you have to look at what can enable small amounts of change,” because saving seconds with each repeated use of rapid sign-on technology, for example, can mean gaining extra minutes in a day for a nurse to provide direct care, FierceHealthIT reports.

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Feb 19 2014
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School-Based Health Centers: A Bridge to a Healthier Future

Elizabeth Dickson, MSN, RN, is a fellow in the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at University of New Mexico. Earlier in her career, she worked at a school-based health center (SBHC). This post is part of the “Health Care in 2014” series.

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As a public health nurse, I have worked with children in schools for much of my career.  From 2009 until 2013, I worked at a SBHC in New Mexico that was located in an alternative high school in southern Albuquerque. Although small, many students at this school came from families of mixed immigration status and had experienced high levels of street violence, alcohol and drug abuse and overdose, suicide, poverty and food scarcity, minimal health care access, and high teen pregnancy rates.

These kids saw and experienced more than many outsiders of the community could have imagined. The SBHC was open one day a week during school hours and employed a staff that included a nurse practitioner, a physician assistant, public health nurses, administrative staff, and mental health counselors. I worked with an incredible team that provided many health services and screenings, including mental health support, in the limited time that we had.

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Feb 13 2014
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In the Media: Women’s News Organization Honors Nurse Practitioner

This is part of the February 2014 issue of Sharing Nursing’s Knowledge.

Kimarie Bugg, MSN, MPH, CLC, a nurse practitioner and breastfeeding advocate, earned a prestigious award earlier this year from Women’s eNews, an online news organization that covers news of particular concern to women.

Women’s eNews named Bugg one of its “21 Leaders for the 21st Century” in January for her work to promote breastfeeding among Black women. Bugg will receive the award later this year at a ceremony in New York City.

Bugg is president and CEO of Reaching Our Sisters Everywhere (ROSE), Inc., a member network that was founded to address breastfeeding disparities among people of color nationwide through culturally competent training, education, advocacy, and support. With a focus on increasing breastfeeding initiation and duration rates, ROSE seeks to normalize breastfeeding by serving as a catalyst that provides resources and networking opportunities for individuals and communities.

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Feb 6 2014
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Human Capital News Roundup: Avoiding aneurysms, healthy food, gun safety, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

In a Huffington Post Latino Voices blog, Harold Amos Medical Faculty Development Program alumna Paloma Toledo, MD, discusses obesity among Hispanic Americans and how parents can influence children’s behavior, particularly regarding physical activity. She also flags influences that impede efforts to improve health for Hispanic youth: “In the U.S., food advertising on Spanish-language television is more likely to promote nutritionally-poor food than English-language advertising, hindering Hispanic children.”

During months when low-income individuals have access to Earned Income Tax Credit benefits, they spend more on healthy food, according to a study by RWJF Scholars in Health Policy Research alumna Diane Whitmore Schanzenbach, PhD. The study suggests that people with low incomes also buy more healthy food when their income increases, reports the Wall Street Journal Real Time Economics blog.

Health care professionals could make a vital contribution to educating children about the dangers of gun-related injuries, according to a study by RWFJ Clinical Scholar John Leventhal, PhD. He told Fox News: “Pediatricians and other health care providers can play an important role in preventing these injuries through counseling about firearm safety, including safe storage.”

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Feb 5 2014
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Be Heart Smart: Addressing the High Burden of Cardiovascular Disease Among African-American Women

Nadia Winston, MSPH, is a graduate student at the University of Illinois at Chicago, School of Nursing, pursuing dual nurse practitioner studies in family practice and occupational health. She has a master of science in public health degree from Meharry Medical College and is a former scholar with the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College. This post is part of the “Health Care in 2014” series.

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Cardiovascular disease is the number one killer of African American women. It has become imperative for the nation to take back the reins of its health status and educate the public about this threat. The statistics are alarming. Black women are twice as likely to suffer from cardiovascular disease as women of other ethnicities. And according to the American Heart Association, cardiovascular disease kills nearly 50,000 African-American women annually. The reason for this disparity can be attributed to a lack of health knowledge, being overweight or obese, and lack of physical activity. Early intervention and action has been identified as the key to reducing this population’s risk of mortality from cardiovascular disease and related diagnoses.

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Addressing and raising awareness of the health risks associated with cardiovascular diseases for African American women has been quite challenging. Recognizing this issue, Vanessa Jones Briscoe, PhD, MSN, then a Health Policy Associate at the Center for Health Policy at Meharry Medical College, developed and implemented a culturally appropriate health education program to educate minority populations about unhealthy lifestyles. It is called the “Be Heart Smart” program.

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Feb 3 2014
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Evidence to Improve the Quality of Care

Richard Kronick, PhD, was named director of the Agency for Healthcare Research and Quality (AHRQ) in August 2013. Kronick is a health policy researcher with a background in academia as well as in federal and state government. He received a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research in 1998.

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Human Capital Blog: Congratulations on your new position at AHRQ. This is an exciting time for health care. What do you see as AHRQ’s place in the U.S. health care universe?

Richard Kronick: Thank you! You’re right—this is an exciting time.

We have an almost $3 trillion health care system. We pour tremendous resources into the delivery of medical care—but comparatively little effort into trying to understand how health care can be delivered more safely, with higher quality, and be more accessible and affordable. AHRQ’s role is to produce evidence that can be used to make health care safer, higher quality, more accessible, equitable, and affordable, and to work with the U.S. Department of Health and Human Services (HHS) and other partners to make sure that the evidence is understood and used.

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Jan 30 2014
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Human Capital News Roundup: HIV treatment for ex-offenders, ‘healthy’ fast food myths, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Making new medical device technology quickly available is important, but research suggests there is a risk associated with swift Food and Drug Administration approval of implantable heart devices. Aaron Kesselheim, MD, JD, MPH, recipient of an RWJF Investigator Award in Health Policy Research, told USA Today that the medical community should be wary of the expedited review process because it can compromise product safety and effectiveness. The Boston Globe also covered Kesselheim’s research.

Health Canal featured a study co-authored by RWJF Health & Society Scholars alumna Chyvette Williams, PhD, MPH, that examines gender differences in HIV treatment outcomes among recently released prisoners. Williams and colleagues found that women were considerably less likely than men to attain any of the three optimal HIV treatment outcomes six months after release from jail, and thus had significantly more negative health outcomes.

Despite media campaigns promoting healthy eating, customers at fast food restaurants such as Subway do not necessarily make better food choices, according to a Medical Daily article. Citing research from Lenard Lesser, MD, MSHS, an RWJF Clinical Scholar alumnus, the article states that people consume nearly as many calories, and as much sugar, carbohydrates, and sodium from Subway as they would at another fast food restaurant. Lesser’s research was also covered by WNCN. Read more about Lesser’s research.

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Jan 22 2014
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Overcoming Health Disparities: Promoting Justice and Compassion

By Janet Chang, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) New Connections Program and an assistant professor of psychology at Trinity College in Hartford, Connecticut. Chang received a PhD from the University of California, Davis, and a BA from Swarthmore College. She studies sociocultural influences on social support, help seeking, and psychological functioning among diverse ethnic/racial groups. Her RWJF-funded research project (2009 – 2012) examined the relationship between social networks and mental health among Latinos and Asian Americans.

“Injustice anywhere is a threat to justice everywhere.”  
Dr. Martin Luther King, Jr. (Letter from Birmingham Jail, April 16, 1963)

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Dr. Martin Luther King, Jr. is well known for his fight against racial injustice, but he also advocated for socioeconomic justice. In particular, Dr. King said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane” (Second National Convention of the Medical Committee for Human Rights, March 25, 1966). His profound words still resonate with us today.

While strides have been made in the past several decades, there continues to be inequality and unequal treatment. In 1978, the President’s commission reported ethnic/racial disparities in health services, and this is still a vexing societal problem in the United States. Compared to non-minorities, American Indians, Latino Americans, Asian Americans, African Americans, and other ethnic/racial minorities are significantly less likely to receive the care that they need and more likely to receive lower quality health care. Ultimately, these disparities compromise the quality of life of most Americans.

The factors that contribute to heath disparities are complex. As a social-cultural psychologist, I also believe that our tolerance for injustice stems in part from larger cultural forces that shape our psychological tendencies, which simplify our world and constrain our ability to take the perspective of others. In the United States, the cultural values that make our society distinctive, independent, and strong may also serve to limit our potential for greater growth—a healthier, happier, and more productive society. 

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Jan 20 2014
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Compassion and a Coffee Cup

Mia R. Keeys, BA, is a 2008 graduate of Cheyney University of Pennsylvania. Keeys has worked with loveLife, the HIV/AIDS prevention youth campaign of South Africa. She served as a U.S. Fulbright Fellowship in East Nusa Tenggara, Timor, Indonesia and is today a first-year doctoral student in sociology at Vanderbilt University and a Robert Wood Johnson Foundation Health Policy Fellow (2013).

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“'Scuse me, can I sit here?” she asked me.

I could have moved away. But, in a sea of patrons, it would have signified more than discomfort. What was I implying by staying seated? Was it a statement—a sit-in, if you will—to prove to myself she is no less valuable in our shared humanity? Was it to quell the guilt that I felt because I wanted to move and, furthermore, failed to ask her name? Her tawny hoodie reeked of the cold of black nights she likely endured in the last week, while I was home wrestling with my white feather-down comforter. From my seat and hers on a faux-leather brown couch—the brown of both our faces—the flames perform within the fireplace in front of us, as I perform indifference for those around me. I am not prejudice. I cross one leg sophisticatedly over the other. I am not prejudice.

A furtive leftward glance at my cell phone (albeit an archaic flip phone) exposed in my open bag—the only object separating our arms from touching. I am not prejudice. A chill in the air tickles my nose, but I resist a sneeze or even a nose-crinkle, lest the gesture of an otherwise trivial facial contortion suggest any discomfort associated with the stench of her clothes. 

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