Food = Health for employers, hospitals, health plans and consumers

Jane Sarasohn-Kahn

Food is inextricably bound up with health whether we are well or not. Several key areas of the Food = Health ecosystem made the news this week which, together, will impact public and personal health.

On the employer health benefits front, more media are covering the story on CVS strongly incentivizing employees to drop body mass index (BMI) through behavioral economics-inspired health plan design of a $50 peer month penalty. (more…)

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Join us on Friday: National Summit on Environmental Education and Sustainability

This Friday, January 18, Disruptive Women will be at an exciting event in Washington, DC: The National Summit on Environmental Education and Sustainability. Presented by the Environmental Protection Agency, Green for All and Amplify Public Affairs, the summit is a national dialogue on how individual environmental actions can make a positive impact on the environment. (more…)

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December Man of the Month: Michael Bloomberg – What HASN’T he taken on?

What is more disruptive than changing the law so that you can run for a third term as mayor of New York City? Not much… except that our December Man of the Month, Mayor Michael Bloomberg, used his third term to take on some of the most controversial issues of our time.

Mayor Bloomberg made headlines earlier this year with his soda ban. In an effort to curb the rising rate of obesity he put in motion a ban on the sale of sodas and other sugary drinks larger than 16 ounces at restaurants and concession stands. While this was not his first anti-obesity effort — he is well known for requiring fast-food and chain restaurants to label their menus with calorie information — the soda ban was particularly disruptive, causing both outrage and praise in New Yorke and across the country. Whether or not you agree with this ban, one thing is for sure: the entire country will be watching to see what impact it has on obesity rates. (more…)

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A conversation on community health

Yesterday the Atlantic held the second of three events in its Community Health Tour, in which leaders on the frontlines of community health join panelists in a conversation to identify and solve problems. Yesterday’s conversation in St. Louis, MO featured panelists Robert Fruend, CEO of the St. Louis Regional Health Commission; Joy Krieger, Executive Director of the Asthma and Allergy Foundation of America, St. Louis Chapter; Melba Moore, Health Commissioner for the City of St. Louis; and Dr. Jason Purnell, Assistant Professor at the Brown School of Social Work and Public Health at Washington University.

The panelists weighed in on the progress being made and challenges to be reckoned with in St. Louis. Socioeconomic disparities remain one of the toughest hurdles to overcome in creating healthier communities. Low incomes and lack of education and information tend to be indicators of other health factors such as smoking and poor diet. Add this to a general lack of access to health services and you begin to see a population that is becoming sicker over time, unable to tackle either disease management or prevention. (more…)

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SXSWi Disruptive Women Style

By Andre Blackman (July 2009 Man of the Month). Earlier this month, members of the digital and interactive community from all around the world descended upon the city of Austin, TX for another round of South by Southwest Interactive (SXSWi) or “Southby”. Basically the entire SXSW conference is divided into 3 parts: Interactive, Film and Music. The last two categories being the longest running aspects and Interactive being the newest but undoubtedly the fastest growing part of the weeks long event.

As SXSWi continues to develop, this is the second year that Health and Wellness has been given a spotlight. Looking at exciting new ways to improve positive behavior change, reshape the healthcare system and build better public health is exactly what we need these days – being disruptive is quickly becoming a necessity if we want to see sustainable change for our communities.

One of the fantastic (and especially relevant for Disruptive Women) panels that I attended first at SXSWi was Tech Superwomen: Mentors and Mentees, FTW. Basically looking at how to grow the dynamic relationship between mentors and those who they mentor – most notably in the tech/entrepreneurship realm. Other than having a brilliant panel of accomplished women, including Washington DC’s own Leslie Bradshaw of JESS3 (also columnist at Forbes), the premise of the panel session rang true to what needs to happen in order to foster the continued shaking up of the healthcare world. More disruptive women need to see role models to inspire and motivate them to step outside of their comfort zone and solve problems in a consistently smart way. You can hear the podcast of the entire panel session at the link above.

I was also able to visit one of our wonderful Disruptive Women, Halle Tecco, who is part of the founding team at Rock Health – the first incubator for health tech startups. The Rock Health team at SXSWi hosted the Zen Den, a place for conference goers to recharge, relax and catch up with some of the startups rocking the health tech innovation world.

Halle and her team also gave us a video tour of what they’re up to and the brilliant, savvy women who are working on pretty cool disruptive companies. target=”_blank”>Check it out. Stay tuned for more video content coming soon to the Disruptive Women blog. It’s important to capture the stories of the innovative disruptors changing our lives for the better!!

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Disaster Preparedness: Lessons for an Aging America

Janice Lynch Schuster

By Janice Lynch Schuster. Public health officials are sounding the alarm over the looming catastrophe of an aging America, a time in which 78 million Boomers will arrive at old age, only to find a health care system that can’t meet their needs or sustain their lives. Social and financial costs will be devastating: Boomers will live longer and with more chronic conditions than any other generation; they will need more years of care than any of our current systems can provide. Half of those who live to the age of 65 will require nursing home care at some point in their lives; half of those who make it to 85 will experience dementia.

A health care system predicated on acute illness and injury is not equipped to meet the long-term, ongoing needs of people who have multiple chronic conditions—a situation Boomers will face. In short, it’s a disaster we know will happen, but whose impact we might, with planning, lessen.

So how could we prepare? We might take a page from the Federal Emergency Management Administration (FEMA), which, in the aftermath of Katrina, stepped up preparedness planning. Indeed, it  has outlined eight principles of disaster management. These principles will sound familiar to anyone interested in creating a better health care system. According to the disaster planning experts, good plans are comprehensive, progressive, risk-driven, integrated, collaborative, coordinated, flexible, and professional.

These principles will sound remarkably familiar to anyone enaged in public health and health care. Where today America has fragmented, uncoordinated systems of care, we need a future in which coordinated, comprehensive care is the norm. Where today there are unconnected silos of activity, we need to foster improvements that lead to collaborative systems, ones in which each participant knows and understands how, when, and why to interact with other elements of the system.

America needs a progressive system, in which, in the words of FEMA, “managers anticipate future disasters and take preventive and preparatory measures to build disaster-resistant and disaster-resilient communities.” Mapped to the health care system, a progressive system would mitigate the ways in which things go wrong in our current system, fix those errors, and learn from them to prevent their recurrence. (more…)

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Can a picture make a difference?

Lois Privor-Dumm

By Lois Privor-Dumm. How many times have you seen a single photograph that has caused you to stop what you’re doing and find out more, tell a friend or donate money?  We read so much about the problems of the world today and, if you’re like me, unless the issue is already close to your heart, words alone may not be enough to register.

Salim Khan, 3 year old pneumonia survivor from Bijnor, India by Ándre J. Fanthome

A photo contest seems like such a simple thing, but it’s a way to enable a problem to reach into our hearts and minds.  Pneumonia is a leading killer of the world’s young children, but the disease has very real and practical solutions.  Although I see the statistics and understand the scientific pathways, nothing impacts me more than seeing how the disease affects families and children or reaches the heart of a pediatrician.  These moments are often captured powerfully with the click of a camera.  While one child with pneumonia may seem just like a number to many, it is these stories and images that can make a difference.

Photoshare, Kids 4, Health, the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health and The Global Coalition Against Child Pneumonia are sponsoring a photo contest to find the image that will make a difference in our minds.  Nikon will award digital cameras to category winners.  And, if you’re fans of Ann Curry of the Today Show and Nicholas Kristof of the New York Times, you’re in luck.  They, along with a professional photographer, are the judges.   Submitting a photo that jumps off the page and tells an important story would be a great way to get your experience and talent, or that of a friend, family or colleague in front of our celebrity panel.  For more information, click here.  Details on the time and place of the photo exhibit to unveil contest winners and finalists will be announced shortly. (more…)

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Saving Money while Saving Lives: The Economic Argument for Childhood Vaccination

Lois Privor-Dumm

The following post by Lois Privor-Dumm, IMBA, Director of Alliances and Information for the PneumoADIP at Johns Hopkins Bloomberg School of Public Health, is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series.

Lois heads up several vaccine projects related to advocacy and communications as well as access and implementation. She is currently working as Director, Large Country Introduction for the Accelerated Vaccine Introduction Technical Assistance Consortium (AVI TAC), a GAVI-funded project with an aim to accelerate introduction of pneumococcal and rotavirus vaccines in low-income countries. Lois has been at Johns Hopkins since 2005 helping guide strategies and accelerated uptake on both the Hib Initiative and PneumoADIP and has been leading projects in developing and donor countries to support strengthening of policies and awareness for childhood pneumonia as part of a global World Pneumonia Day Coalition effort.

Hib, pneumococcal and rotavirus vaccines that have long been available in the US, offer significant promise to the children in developing countries. Not only could these vaccines, save millions of lives over the course of the next couple of decades, but they also have the potential to add to the wealth of nations. Yet, despite enormous promise, there are still delays 1-2 decades before children in developing countries have access.

Vaccines have long been considered one of the most affordable and cost-effective public health interventions available today. Historically, they have been pennies per dose. According to the World Bank’s Disease Control Priorities Report, at $7 per DALY averted in Sub-Saharan Africa for the Expanded Program on Immunization (EPI), a package of six WHO recommended vaccines including diphtheria, tetanus, pertussis, polio, measles and represents excellent value for money. By comparison, statin with aspirin, beta blocker and ACE inhibitors for ischemic heart disease costs $2,028/DALY averted.

However, with newer vaccines costing not pennies, but dollars per dose, do we need to reestablish our paradigm for affordability?

A recent review of the economic case for expanding vaccination coverage of children done by researchers at Harvard and Johns Hopkins suggests that new vaccines are a good investment. Cost-benefit analyses of Hib vaccination, for example, indicate that the cost of vaccination is less than the savings accrued by preventing mortality, lowering future health care costs, and reducing productivity losses among parents (who no longer have to stay home with a sick child). However, even these analyses may underestimate the true economic benefits of childhood vaccination.

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Employment : A Public Health Intervention

Ellen DorschThe following guest post by Ellen Dorsch, Founder of Creative Women, is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series.

Building on her commitment to women’s well being, her love of travel, her desire to experience the challenges of the private sector, and her love of hand-made products, Ellen Dorsch decided to leave the non-profit sector and start Creative Women. Today, Creative Women imports elegant hand-woven products from women-owned businesses in Ethiopia, Afghanistan, Swaziland, and Mali. Each product Creative Women sells, allows the company’s colleagues to hire more workers and to pay them decent wages and benefits helping them, and their families, to live a healthier lifestyle, and to receive health care when needed.

When I left my consulting business about seven years ago, friends and colleagues asked me if I thought I would miss working in Public Health. I had been working, for over 30 years, in Vermont (my home), nationally, and in East Africa, Central American, and Russia … in program development, evaluation, and administration. I had decided that I no longer enjoyed writing grants or looking for new contracts, and I very much wanted to experience working in the private sector.

I left and started Creative Women, an importer of elegant textiles from Ethiopia and a business with a social mission … to create jobs. I soon realized that I didn’t leave public health, but rather was impacting on women’s lives from another perspective. I saw that with some independent money, women would have more options about their lives, including (hopefully) the ability to leave a relationship where they or their children are not safe.

After 7 years working with women-owned businesses in Ethiopia, Swaziland, Afghanistan, and now Mali, I’ve expanded my definition of Public Health and believe that employment is as necessary for good health as vaccines and clean water. Initially, I argued that financial independence, or at least some earning power, meant a woman could say no to an abusive partner, or could pay school fees for her daughter(s). This became more real to me as I heard stories from some of the sewers and cleaners who worked at Menby’s Design, the first business I worked with in Ethiopia. A woman whose husband beat her up because she objected to him having a “second wife” was able to take her children and leave her unsafe home. And because she had some income, she could return to her parent’s home and not be a financial burden to them. This income meant the difference between safety and abuse to her and her children.

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Getting life-saving vaccines to those who need it most: the nuanced solution for access

Lois Privor-Dumm

Why is it that you can buy a Coke or mobile phone refill cards in a remote African village but in these same villages, you cannot consistently get basic lifesaving medicines? Why are pneumonia and diarrhea still the biggest infectious disease threats for children when effective and affordable solutions to prevent and treat a large portion of deaths already exist?  What is the contribution of vaccines in creating a more productive society and wealth of nations?  These are just a few of the questions asked at the new International Vaccine Access Center (IVAC), launching on Monday December 7th at the Johns Hopkins Bloomberg School of Public Health. IVAC seeks to translate evidence into policy, and policy into access to life-saving vaccines for all children.

Indeed, access is a hot topic. When I told several people about IVAC, the most common reaction is great – we really need this! There are many groups working in research or policy or in program implementation, but the bridge to ensuring access remains a challenge. On the surface, solutions can seem simple – show the need, build awareness and provide the solution at a low enough price and it will reach those that need it most.  Some try to help by providing vaccines, medicines or supplies, but that often creates more challenges than benefit because of concerns about sustainability.    Even with country level policies and commitments from donors to fund new interventions, implementation can see many stumbling blocks with uptake not reaching forecasted levels.  Sometimes it is because the health system is not strong enough.  Should that be a reason for delay of a life-saving intervention if the delivery platform is imperfect?  If the implementers are not entirely convinced, it is a strong barrier and one with the potential to impact manufacturers’ willingness to supply or donors’ willingness to fund if countries can’t show that they are appropriately using resources.  This must be played against the potential to save lives, however.


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Reporting from the Classroom

As this first full term at the Johns Hopkins Bloomberg School of Public Health has unraveled, I see how much they were prepping us during summer term.  My days have been filled with work, outside activity, caffeine, and a test of how long I can go without sleep and still be productive—similar to what I imagine the days are like for most of the Disruptive Women in Healthcare!  Classes this term included biostatistics, evolution of infectious diseases, program planning for health behavior change, health policy I, and public health economics seminar.  I chose the more rigorous biostatistics course (and will take others throughout the year) in an effort to become more quantitative and enhance my ability to analyze and conduct cost-effectiveness studies and economic evaluations in particular.  The course has its challenges, and there are certainly days when I wonder if I should have taken the other class, fondly known as “baby stats” to fulfill the requirement.  Health policy I: the social and economic determinants of health has been my favorite class, because not only have I learned about what the name of the course suggests (and health disparities is of great interest to me) but also how to develop a conceptual framework for a health policy problem and how to write testimony in an effort to get such an issue on a policymaker’s agenda.

In between classes, I have busied myself with all that the MPH program has to offer outside the classroom, as there is no shortage of activity competing for students’ every “free” moment.  For instance, I am part of a monthly health disparities journal club and am working with a professor on a book about Taiwan’s national health insurance system.  I am also now VP of Communications for Students Promoting HEalthcare REform (SPHERE), an organization spanning the school of public health and school of medicine whose goals are to assure that every person in the United States has the right to affordable, high-quality healthcare and to educate the Hopkins community.  So far the organization has had one event this year in which we heard from a panel that included representatives from Kaiser Family Foundation/The Commonwealth Fund, Johns Hopkins faculty, and local news radio, on the state of play in health reform.  We will be having other health reform educational events throughout the year and one major advocacy event in the spring.  As VP of Communications, I will be promoting events at the school, updating and enhancing our website, and possibly forming partnerships with other similar, local student groups.


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National Consumers League – National Medication Adherence Campaign

Sally Greenberg

As Robin illustrated in her post, poor medication adherence results in poor health outcomes for millions of Americans, and costs billions of dollars in increased medical costs.  When three-quarters of Americans concede they don’t take their prescription medications as directed, we are faced with a public health problem that demands a broad, multi-faceted response.

As the nation’s oldest consumer organization, the National Consumers League has long worked to improve medication safety, patient education, and consumer education in the health community.  With planning funds from the Agency for Healthcare Research and Quality (AHRQ), NCL is spearheading a first-of-its-kind national education campaign to raise consumer awareness of the importance of good medication adherence.  As called for in the 2007 NCPIE report, a public-private education campaign to motivate patients to improve their medication-taking behavior should be a national health priority.

Since the campaign planning phase got under way just a little more than a year ago, we have worked around the clock to bring together a diverse and committed group of stakeholders interested in improving medication adherence.  From government agencies to health care practitioner professional associations, community health plans to national health plans, pharmaceutical manufacturers to consumer advocates, the list of supporting organizations tops 100 and continues to grow.

The campaign, which NCL anticipates launching publicly in the third quarter of 2010, aims to educate consumers through mass media, including many new social media tools.  The depth and breadth of involvement from stakeholders will help reinforce the messages to ensure that consumers are educated, engaged, and empowered as they manage their health.  The campaign has involved health care practitioners (HCP) from the start, and HCPs will play an active role in improving adherence as they engage their patients.


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mHealth: Using mobile technology for improvement of health

Andre BlackmanThis month, Disruptive Women welcomes Andre Blackman, Health Communications Analyst at RTI International, a non profit research organization, as our July Man of the Month.

Andre Blackman has an extensive background associated with science, technology and public health, conducting research in institutions such as the Naval Research Lab, NASA and WESTAT. This merging of technology and health has proved helpful in his current work in Health Communications.

Andre is very passionate about the role of new media, mobile technology and other emerging technologies as it relates to health communications and public health in general. You can find his thoughts on the intersections of health and technology through his blog, Pulse + Signal and via Twitter.

The past few years have seen a significant increase in the use of emerging technologies to improve public health all around the world. From grassroots initiatives empowering citizens in low-resource areas to making sure consumers get the healthcare they need – changes are happening for the better. This article will aim to look at a specific area of the ‘citizen empowerment’ – the application of SMS (Short Messaging Service – or texting) and mobile phones in public health.

With the onset of social tools such as social networking sites (Facebook, Myspace, etc.) and real time information hubs such as Twitter, we are exposed to numerous ways to stay connected to each other. Our mobile devices are equipped with applications that allow us to do a myriad of things – many of which focus on entertainment and productivity. Another very important part of our lives is maintaining good health and the mobile phone is making strides in that area. mHealth is the term that has been coined to describe the interaction of mobile technology with the improvement of health.

mHealth is exploding onto the scene as the next big technology boon for public health – the main reasons this is true are twofold: ease of implementation and relative low cost of operation/maintenance. This is especially true in the developing world and in low-resource areas where technology options are relatively sparse. The use of SMS has become a tremendously powerful way for health clinics in Africa to communicate with their community health workers who are traveling to villages to tend to patients. Imagine the ability to significantly reduce fuel consumption and get real time data on medical adherence in a world where it make take several weeks to get this information.

All of that from a technology that for many of us in the developed world may take for granted.

A few months ago I presented this information at the North Carolina Division of Public Health – here is the presentation that touches on the basics of mobile technology and how it can be applied to the public health landscape. It is by no means comprehensive but gives a good idea of where things are and thoughts on where things can go in the near future.

Private sector organizations such as Voxiva have been taking the lead on mobile initiatives, especially in health. Nonprofit organizations and local health departments have also been dipping their toes into the use of SMS technologies to get health information out to residents. The government has also become a supporter of mHealth initiatives and the Centers for Disease Control and Prevention (CDC) continues to innovate in this area. Several weeks ago, I wrote about a hypothetical situation in which public health could benefit from a mobile application called The Extraordinaries, which uses the free time of consumers to volunteer their time for good.

From a recent article on mobile communications in health via
“Mobile provides a fantastic channel for communication,” said Erin Edgerton, senior social media strategist at the CDC. “It’s always on, always with you and provides personal access to information.”

I heartily encourage you to begin exploring this venue of health communications and figure out how you or your organization can integrate strategy with mobile technology.

Additional Articles/Resources:

Mobile Active – a great starting point for learning about using mobile technology for social impact. Contact them with any questions

PopTech – Can Your Cell Phone Change Lives? My article on mHealth

Texting4Health – conference and newly published book

ISIS initiative – sexual health information/STD prevention through SMS technology

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Condoms, Condoms, Condoms

Diana Mason

For several years, my family has held a grab bag holiday get-together. People are to bring inexpensive gifts, often intended more for laughs than for use. My extended family includes nieces and nephews ranging in age from 15 to 30, some with children and others who are sexually naïve, even if not virgins. Mine is not a family that discusses sex. My living siblings are reborn Christians, who deem appropriate only discussions of abstinence for those youth not yet married. However, as a nurse, I’ve made it clear that their auntie will not shy away from sexual discussions. I have been known to initiate such conversations with a niece or nephew and even their friends when I have some time with them.

NYC Condom wrapper


So this year, one of my grab bag gifts was condoms. My courage to make this a visible ‘gift’ at the holiday party arose from New York City’s model of making condoms available anywhere and everywhere. The city has rightfully been aggressive in distributing condoms since Thomas Frieden assumed the position of Commissioner of the Department of Health and Mental Health and saw that a large proportion of people in the city who are HIV-positive don’t know it and can be spreading it unintentionally by having unprotected sex. In 2007, the city launched a NYC-branded condom and has since given out over 70 million of them for free. (more…)

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Yin Yang of Healthcare

Sharon Terry

Transforming health through genetics. That is the mission of the organization I lead – Genetic Alliance.  Almost 5 years ago I took on the leadership of this organization.  I had some strong inklings at the time, about transformation, about health.  While I was developing Genetic Alliance’s path to transformation, both internally and externally, with some phenomenal colleagues, the world around us was changing in similar fashion.

I sometimes see genetics as a leading edge, a knife that is cutting through the old, crusty, barriers.  It does this perhaps because it is new, but after leading with the novel edge, it has a great deal more punch.  I believe it will be an innovative disruption (a la Clay Christensen) because the health care system will not be able to adjust enough to fit its value inside the system (or lack thereof).

Starting with the power of understanding family history (still perhaps the most powerful genetics tool) to the sophistication of personalized medicine (using genetics and genomics to tailor diagnosis and treatment), genetics and genomics will both buoy and stress an overstressed healthcare system.  It is time for change.  It is in the works, on the drawing tables and in people’s hearts and minds. (more…)

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