Category Archives: Investigator Awards in Health Policy Research

Jul 17 2014
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RWJF Scholars in the News: Gun violence, suicide, ‘structural’ versus ‘cultural’ competency, 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:

An NPR story quotes RWJF Health & Society Scholars program alumnus Andrew Papachristos, PhD, citing his extensive research on gun violence. Papachristos criticizes the lack of context in media coverage of violence, noting that incidents such as the series of shootings over the Fourth of July weekend in Chicago tend to be treated simply as a long stretch of violent incidents. “Treating Chicagoland violence as merely a tally necessarily dehumanizes its victims, but it also obscures so much of the larger story about that violence. It's data without context.” Not only is the murder rate steadily declining in Chicago, but there is a massive disparity in victims of these crimes: “Eighty-five percent of violence—any shootings—happens among 5 percent of people,” Papachristos says.

In an article about libertarianism and state laws related to guns and other topics, the Economist cites a study about the social costs of gun ownership by RWJF Investigator Award in Health Policy Research recipients Philip Cook, PhD, and Jens Ludwig, PhD. It finds that “more guns empirically lead to more gun-related violence, largely because legally purchased guns somehow end up in the hands of criminals via theft,” gun shows, and online sales, which are largely unregulated. To address these issues, Cook and Ludwig suggest making it costlier to buy guns in high-crime areas, and improving the records used to screen gun buyers by including more information on possible mental-health problems, among other proposals. (Free registration required to view article.)

A study co-authored by RWJF Health & Society Scholars program alumnus Alexander Tsai, PhD, MD, finds that men who are more socially connected are half as likely to commit suicide as men considered loners, NBC News reports. The study looks at data on nearly 35,000 men, ages 40 to 75, and finds that those who are more isolated are at greater risk, even if they are not mentally ill. “Public health practitioners think about things like cardiovascular disease as warranting public health attention,” says Tsai, suggesting that suicide may also need attention.

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Jul 10 2014
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RWJF Scholars in the News: Healthcare.gov, depression and mortality, stress among nurses, 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:

Young adult users of Healthcare.gov, the health insurance marketplace established under the Affordable Care Act, recommend that the site offer better explanations of terminology, more clarity about the benefits various plans offer, and checkboxes and other features that make it easier to compare plans. Those are among the findings of a study conducted by RWJF Clinical Scholar Charlene Wong, MD, along with alumni David Asch, MD, MBA, and Raina Merchant, MD, that looked at the experiences of young adults who used the website. The scholars write about their findings in the Philadelphia Inquirer. Wong told the Leonard Davis Institute of Health Economics blog that these users “may not know what insurance terms mean but they have a lot of expertise and insights about maximizing the usability of the digital platforms that have always been such an integral part of their lives.”

Major depression (also known as “clinical depression”) is associated with an elevated risk of death from cardiovascular disease, according to research covered by Kansas City InfoZine. The study, co-authored by Patrick Krueger, PhD, an RWJF Health & Society Scholars program alumnus, also found that the relationship between depression and early non-suicide mortality is independent of such factors as smoking, exercise, body mass, education, income, and employment status. The authors say the findings indicate that the relationship between depression and mortality is not due solely to the interplay between depression and health-compromising risk factors.

Expanding scope of practice for advanced practice nurses and implementing better management practices could alleviate some stress factors for nurses and improve patient care, Matthew McHugh, PhD, JD, MPH, FAAN, tells Healthline News. For example, in some medical facilities, nurses are empowered to decide if a patient’s urinary catheter should be removed without consulting a doctor, thus preventing delays in care. “Lots of things that don’t require policy change” can have an important impact on patient outcomes and nurses’ job satisfaction, said McHugh, an RWJF Nurse Faculty Scholars alumnus.

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Jun 26 2014
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RWJF Scholars in the News: Unemployment and suicide, prescription painkiller abuse, veterans’ care, 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:

More generous unemployment benefits can lead to lower suicide rates, according to a study co-authored by RWJF Health & Society Scholars program alumna Maria Glymour, MS, ScD. The Huffington Post covers the study, describing it as the first of its kind to reach that conclusion. Glymour and colleagues speculate that higher benefits help mediate some of the stressors that contribute to suicide.

A survey of licensed nurses in Wyoming examines factors involved in their decisions about whether to continue their education. In a Wyoming Business Report story, Mary Burman, PhD, RN, an alumna of the RWJF Executive Nurse Fellows program, notes that the Institute of Medicine’s Future of Nursing: Leading Change, Advancing Health report recommends that 80 percent of nurses have baccalaureate degrees or higher by 2020. She says findings from the new survey point to strategies that might help achieve that goal, noting “the positive role that employers can play by encouraging and supporting nurses to return to school for their baccalaureate degree.” Burman is dean of the University of Wyoming’s Fay W. Whitney School of Nursing, which collaborated on the survey.

Nicholas King, PhD, MA, an RWJF Health & Society Scholars program alumnus, investigates the sharp increase in deaths from prescription painkillers in the United States and Canada over the past 20 years, reports Medical Xpress. King and colleagues analyzed research about the “epidemic,” concluding that Internet sales and errors by doctors and patients have not played a significant role in the increase. Rather, they “found evidence for at least 17 different determinants of increasing opioid-related mortality, mainly, dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like OxyContin and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic factors.” Outlets covering King’s work include the Toronto Sun, Fast Company, and the National Pain Report

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Jun 23 2014
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RWJF Milestones, June 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

Emery Brown, MD, PhD, an alumnus of the Harold Amos Medical Faculty Development Program has been elected a member of the National Academy of Sciences.

RWJF Investigator Award in Health Policy Research recipient James Perrin, PhD, is the new president of the American Academy of Pediatrics. He took office on January 1, 2014, beginning a one-year term.

The American Association of Colleges of Nursing (AACN) has named Deborah E. Trautman, PhD, RN, as its new chief executive officer, effective June 16. Trautman, an RWJF Health Policy Fellows program alumna, currently serves as executive director of the Center for Health Policy and Healthcare Transformation at Johns Hopkins Hospital.

The American College of Physicians (ACP), the nation’s largest medical specialty organization, has voted Wayne Riley, MD, MPH, MBA, its president-elect. Riley is a former RWJF senior health policy associate.

Kenneth B. Chance, Sr., D.D.S. has been appointed dean of the Case Western Reserve University School of Dental Medicine and will begin his duties on July 1, 2014. He is an alumnus of the RWJF Health Policy Fellows program, and served on its national advisory committee. His is a current member of the national advisory committee of the RWJF Summer Medical and Dental Education Program.

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Jun 19 2014
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RWJF Scholars in the News: Debt and health, tax exemption controversy, peer influence on adolescent smokers, 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 the context of the Obama administration’s efforts to ease student loan debt, TIME reports on a study by RWJF Health & Society Scholars program alumna Elizabeth Sweet, PhD, that explores the toll debt takes on the borrower’s physical health. Past studies have focused on mental health issues, TIME writes, but Sweet’s research links debt not just to mental health, but also to high blood pressure and general health problems. Sweet says the problem has long-term implications. “These health issues are a warning for more health problems down the road,” she says, “so we have to think about this as a long-term phenomenon.” Forbes also highlights her research.

A Medscape story about a study that shows a direct correlation between vaccinating health care personnel against influenza and reducing cases of flu in the community quotes Mary Lou Manning, PhD, RN, CPNP, an RWJF Executive Nurse Fellows alumna. “We now actually have evidence indicating that higher health care worker vaccination rates in hospitals are having a community effect; they’re actually resulting in lower rates of influenza in the community. That’s remarkably exciting,” says Manning, who is president-elect of the Association for Professionals in Infection Control and Epidemiology. The article is available here (free login required).

Modern Healthcare reports on federal efforts to address concerns about tax exemption for certain nonprofit hospitals, citing research by Gary Young, JD, PhD, recipient of an RWJF Investigator Award in Health Policy Research. In order to obtain tax-exempt status, the Affordable Care Act requires nonprofit hospitals to track and report the charity care and community benefits they provide. Young found wide variation in the contributions of nonprofit hospitals. “The current standards and approach to tax exemption for hospitals is raising concerns about a lack of accountability for hospitals,” he says, and creating problems because “hospitals don’t really know what’s expected of them.” The Internal Revenue Service has proposed a rule to address the issue. (Free registration is required to view the article.)

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Jun 16 2014
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Should There Be Public Access to Data from Clinical Trials?

Michelle Mello, JD, PhD, is a professor of law and public health at the Harvard School of Public Health, and a fellow with the Edmond J. Safra Center for Ethics at Harvard University. She is a recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

Michelle Mello

For years, pharmaceutical companies have been lambasted in the media and government prosecutions for concealing information about the safety and efficacy of their products. In one particularly splashy example, GlaxoSmithKline (GSK) agreed to pay $3 billion in 2012 to settle criminal charges that it failed to report safety data concerning its antidepressant drug, Paxil, and its diabetes drug, Avandia, and engaged in unlawful marketing of these products and one other drug. One mechanism proposed for avoiding such problems is to establish a system through which participant-level data from clinical trials, stripped of identifying information about patients, would be available to the public.

A potential benefit of sharing clinical trial data would be that independent scientists could re-analyze data to verify the accuracy of reports prepared by trial sponsors, which might deter sponsors from mischaracterizing or suppressing findings. Data sharing would also allow analysts both within and outside drug companies to pool data from multiple studies, creating a powerful database for exploring new questions that can’t be addressed within any given trial because the sample is too small to support such analyses. 

The potential value of shared data in improving our understanding of the safety and efficacy of drugs, medical devices, and biologics has sparked considerable discussion about how to make data sharing happen. Earlier this year, the European Medicines Agency—the counterpart to the U.S. Food and Drug Administration (FDA) in the European Union—decided to start making data from trials of approved products available in 2014. This begs the question, should the FDA follow suit?

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Jun 12 2014
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RWJF Scholars in the News: Alzheimer’s disease, violence against women, drug marketing, 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:

Jason Karlawish, MD, participated in the design of new research that offers “an opportunity to study the future of the way we’re going to think about, talk about and live with the risks of Alzheimer’s disease,” he tells the Associated Press. The study is aimed at testing an experimental drug to see if it can protect seniors who are healthy but whose brains “harbor silent signs” of risk, such as a sticky build-up of proteins that can be a precursor to Alzheimer’s. Karlawish is an RWJF Investigator Award in Health Policy Research recipient. Read more about his work on Alzheimer’s disease here and here.

The work of RWJF Scholars in Health Policy Research alumni Ted Gayer, PhD, and Michael Greenstone, PhD, is featured in an Economist article about incorporating into federal cost-benefit analyses the global benefits of regulation to reduce carbon emissions, rather than benefits that accrue only to the United States. Agencies conduct such analyses before promulgating regulations to test whether the estimated benefits of a regulation exceed the estimated costs. Typically, estimated benefits include only those that accrue to the United States, but because global warming reaches far beyond U.S. borders, the Obama Administration’s calculations include global benefits. Greenstone was also recently cited in the New York Times.

Chris Uggen, PhD, an RWJF Investigator Award recipient, writes about the decline in the incidence of sexual violence and intimate partner violence against women since 1993 in a Pacific Standard article. Rates of sexual violence and intimate partner violence decreased from almost 10 per 1,000 in 1994 to 3.2 per 1,000 in 2012, Uggen writes. While those numbers are encouraging, “misogyny and violence against women remain enormous social problems—on our college campuses and in the larger society,” he says. Uggen’s post also appeared on Sociological Images, a Pacific Standard partner site.

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Jun 5 2014
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RWJF Scholars in the News: Diversity in the nursing workforce, barriers to breast-feeding, child maltreatment, 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:

HealthLeaders Media features New Careers in Nursing (NCIN), a joint initiative of RWJF and the American Association of Colleges of Nursing (AACN) that is increasing diversity in the nursing workforce. “The reason [increasing diversity] is important, of course, is because the population of nursing does not really reflect the population at large,” Polly Bednash, PhD, RN, FAAN, says in the story. “We are now working very aggressively to have the number of people entering the profession look more like the population of the United States.” Bednash is NCIN program director and AACN’s CEO.

In an opinion piece for the Philadelphia Inquirer, Jooyoung Lee, PhD, writes that, in the aftermath of mass shootings, the media and public often focus chiefly on the shooters and forget about the families of those slain. “Instead of fixating on the shooter, or retreating into our own lives, let’s remember and honor those who are left behind. Their lives are often difficult and grinding; their grief is immeasurable. Healing from murder is rarely—if ever—a quick or complete process,” writes Lee, an RWJF Health & Society Scholars program alumnus. Read more about Lee’s work.

Living in neighborhoods with high rates of violence can affect students’ academic performance, according to a study from RWJF Health & Society Scholars program alumnus from Patrick Sharkey, PhD. The Washington Post reports that the study found that neighborhood violence that occurred within seven days of a test appeared to reduce Black children’s performance on language arts assessments. “When violence is in the air, when the threat of violence is in the air, then it becomes something that spills over to affect not just people who are involved, but everyone who lives in the community,” Sharkey says.

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May 22 2014
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RWJF Scholars in the News: DNA and depression, health impact of foreclosures, 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:

Hurricanes Katrina and Rita significantly increased the number of stillbirths in the Louisiana parishes most affected by the storms, according to a study by RWJF Health & Society Scholar Sammy Zahran, PhD. The research team concluded that 117 to 205 fetal deaths could be attributed to distress caused by the storms, the New York Times blog Well reports. “You can have two mothers with equal characteristics—age, race, and so on,” Zahran said. “[B]ut if one happens to be in a more severely destroyed area, the risk of stillbirth is higher.” The study was also covered by Daily Mail and HealthDay. Read more about Zahran’s work on the Human Capital Blog.

Genetics play an important role in whether stress makes people depressed, and in how quickly they recover, Madison.com reports. RWJF Health & Society Scholars alumnus Jason Fletcher, PhD, looked at data before and after the 9/11 attacks and correlated it with DNA information reported by survey respondents. He found that 60 percent of participants who carried a particular gene appeared to be at an increased risk for sadness after the attacks. “Overall, the evidence suggests that genetic endowments are an important source of variation in response to a stressful event, in producing some depressive symptoms in young adults,” Fletcher said. MedicalXpress also covered the study.

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May 15 2014
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RWJF Scholars in the News: Budget cuts and babies’ health, nurse engineers, 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:

New research led by RWJF Clinical Scholar Nicole Brown, MD, MPH, suggests that children with attention deficit hyperactivity disorder (ADHD) are more likely to be from families affected by such stressors as poverty, divorce, neighborhood violence, or substance abuse, HealthDay reports. Researchers analyzed survey responses from parents of more than 65,000 children. Approximately 12 percent of the children had been diagnosed with ADHD, and their parents reported higher rates of those stressors than other respondents. “Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," Brown said. The HealthDay article was republished in Philly.com, U.S. News & World Report, and WebMD.

RWJF Nurse Faculty Scholar Betty Bekemeier, PhD, MPH, RN, examined 11 years of data on budget cuts at 100 county health departments in Washington state and Florida in order to understand and quantify how the cuts affected children’s health, My Northwest (Washington) reports. She focused on the impact of funding reductions to such services as the Women, Infants and Children program and nutrition advice for mothers. Bekemeier found a direct correlation between budget cuts for such programs and the number of low birthweight babies. Children born with low birthweight, she notes, often have greater health care needs that may end up costing counties as much or more than the money saved by the original budget cuts.

Duquesne University is pioneering the nation’s first dual degree in nursing and biomedical engineering this fall, according to the Tribune-Review (Pittsburgh). Mary Ellen Glasgow, PhD, RN, ACNS-BC, dean and professor of the Duquesne University School of Nursing, said the dual major will provide engineers with hands-on clinical experience in patient care that will give them a better perspective on the practical applications of solutions to health care problems. “We aren’t going to be putting out millions of nurse engineers,” Glasgow, an RWJF Executive Nurse Fellow, said, predicting that nurse engineers will help pioneer advances and efficiencies in health care through their direct experience with patient care.

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