Poll finds US public sees ill health as resulting from a broad range of causes

Good study. However I would like to see how this compares with what researchers believe are causes/correlations of ill health and how best to address the causes/correlations.

From the 2 March 2015 Harvard School of Public Health press release

Many believe their health has been impacted by negative childhood experiences

A new NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll finds that more than six in ten people living in the U.S. (62%) are concerned about their future health. Nearly four in ten (39%) said that they had one or more negative childhood experiences that they believe had a harmful impact on their adult health.

Causes of ill health

“When the public thinks about the causes of ill health, it’s not just about germs. They also see access to medical care, personal behavior, stress, andpollution as affecting health,” said Robert J. Blendon, Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.

When given a list of 14 factors that might cause ill health, the top five causes cited by the public as extremely important are lack of access to high-quality medical care (42%), personal behavior (40%), viruses or bacteria (40%), high stress (37%), and exposure to air, water, or chemical pollution (35%).

Those rankings diverge, however, among ethnic groups.

…

Actions to improve health

Given the wide range of reasons given for why ill health occurs, it is not surprising that people in the U.S. have a very broad view of the actions that could be taken to improve people’s health. The top five things (from a list of 16) that the public believes would improve people’s health a great deal are: improving access to affordable healthy food (57%), reducing illegal drug use (54%), reducing air, water, or chemical pollution (52%), increasing access to high-quality health care (52%), and improving the economy and the availability of jobs (49%).

 

 

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[Report] Investing in the Health of Young Adults

From the 30 October 2014 Institute of Medicine Report

Young adulthood—ages approximately 18 to 26—is a critical period of development with long-lasting implications for a person’s economic security, health, and well-being.

Recognizing the need for a special focus on young adulthood, the Health Resources and Services Administration and the Office of the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services, the Robert Wood Johnson Foundation, The Annie E. Casey Foundation, and the Department of Defense commissioned the Institute of Medicine (IOM) and National Research Council (NRC) to convene a committee of experts to review what is known about the health, safety, and well-being of young adults and to offer recommendations for policy and research.

The resulting report, Investing in the Health and Well-Being of Young Adults, offers federal, state, and local policy makers and program leaders, as well as employers, nonprofit organizations, and other community partners’ guidance in developing and enhancing policies and programs to improve young adults’ health, safety, and well-being. In addition, the report suggests priorities for research to inform policies and programs for young adults.

 

Related report –> 2014 Consumer Health Mindset (Aon Hewitt,)
Excerpt from Full Text Reports

From press release:

A new analysis from Aon Hewitt, the global talent, retirement and health solutions business of Aon plc (NYSE:AON) finds that Millennials put a lower priority on medical care than other generations. However, they are the most likely to want employers to play an active role in supporting their overall health and wellbeing.

The analysis is based on data from the 2014 Consumer Health Mindset report, a joint survey of more than 2,700 U.S. employees and their dependents conducted by Aon Hewitt, the National Business Group on Health and The Futures Company. Aon Hewitt analyzed the perspectives, behaviors and attitudes of employees from different generations towards health and wellness.

According to the analysis, Millennials are the least likely to participate in activities focused on prevention and maintaining or improving physical health compared to other generations. About half (54 percent) have had a physical in the last 12 months, compared to 60 percent of Generation X and 73 percent of Baby Boomers. In addition, just 39 percent say preventive care is one of the most important things to do to stay healthy, compared to 49 percent of Generation X and 69 percent of Baby Boomers.

Millennials are also less likely to participate in a healthy eating/weight management programs (21 percent), compared to Generation X (23 percent) and Baby Boomers (28 percent). Interestingly, they are the most likely generation to engaging in regular exercise (63 percent), compared to 52 percent of Generation X and 49 percent of Baby Boomers.

[Report] Surveying Health Care Quality & Value

Surveying Health Care Quality & Value

From the 24 November 2014 Robert Woods Foundation report

Recent years have brought numerous efforts to educate and engage Americans in what “quality” health care is, how to find it and how they can get better value for their dollars. To better understand the latest trends, the Robert Wood Johnson Foundation funded the AP-NORC Center for Public Affairs Research at the University of Chicago to conduct three surveys through the summer and fall of 2014.

The surveys each individually examined how consumers and employers, as purchasers, perceive health care quality and how they use quality information and performance data on health plans and providers. Learn more about the research and access links to the full reports with accompanying materials.

 

Consumer Awareness of Provider Quality and Value

A number of initiatives in recent years have aimed at engaging consumers in making informed health care decisions, including empowering patients and their caregivers with data on provider quality, performance, cost and value. The first in the series of surveys looks at the inroads these efforts have made.

Thirty-seven percent of respondents don’t believe that higher health care costs correlate with better quality care—but 48 percent think they do. The poll also found that more than two-thirds say finding a doctor or hospital that offers the highest quality at the lowest possible cost is important to them. The survey also showed getting Americans to find quality information and use it in their health care decisions remains a challenge, with only 11 percent of Americans reporting they have done so.

View chartpack

See the full survey results

Cost- and Coverage-Based Decision-Making

As more provisions of the Affordable Care Act (ACA) are implemented over the next decade, the government projects that approximately 12 million additional people younger than 65 will enter the private insurance market. The second in the series of surveys looks at consumer opinions on health care costs and coverage, and how it impacts their decision-making.

It shows that nearly a fifth of insured Americans report skipping a trip to the doctor when they’re sick or injured to save money, and only 36 percent are confident they can pay for a major, unexpected medical expense. Those enrolled in health plans with high deductibles are greatly impacted by the out-of-pocket cost of health care—they are concerned with the uncertainty of major expenses, skip necessary medical treatment, and experience real financial burden when obtaining health care.

View chartpack

See the full survey results

Employers Use of Quality Information in Purchasing

As a group, employers represent the largest purchaser of care in the United States. Given this, it is critical that they demand good value for the money they spend, ensuring that the plans offered to employees be high quality. The third and final report in the series of surveys looks at the opinions of private sector employers, including small-, medium- and large-sized businesses.

It shows that American firms are hesitant to say they would pay more for higher quality care, and when it comes to measuring quality, 90 percent don’t know or don’t use independent quality information when deciding on what plans to offer employees. And while many employers are indeed providing wellness programs to benefit their employees’ health, relatively few are actively promoting those programs or offering incentives for participation.

View chartpack

See the full survey results

[Reblog] Article about a doctor who shunned research to serve under- and uninsured

I do admire this physician’s initiative and perseverance in finding financial resources to serve the costliest patients in Camden.

From the  20th November blog item at -Jot Sheet –  “I’d just sit there and play with the data for hours.”

I’m re-reading an essential healthcare article by Atul Gawande, published in the New Yorker in January, 2011. **I can hardly believe that was only about three years ago. It made a huge impression on me. The article begins with a profile of Dr. Jeffrey Brenner, whose explanation of his work to identify trends in emergency room use in Camden is the title of this post.

As a medical student at Robert Wood Johnson Medical School, in Piscataway, he had planned to become a neuroscientist. But he volunteered once a week in a free primary-care clinic for poor immigrants, and he found the work there more challenging than anything he was doing in the laboratory. The guy studying neuronal stem cells soon became the guy studying Spanish and training to become one of the few family physicians in his class. Once he completed his residency, in 1998, he joined the staff of a family-medicine practice in Camden. It was in a cheaply constructed, boxlike, one-story building on a desolate street of bars, car-repair shops, and empty lots. But he was young and eager to recapture the sense of purpose he’d felt volunteering at the clinic during medical school.

I like to read this article every year or so. I appreciate the appeal of untangling complicated problems and balancing your work between data-driven analytics and the expertise of real, live people.

“For all the stupid, expensive, predictive-modelling software that the big venders sell,” he says, “you just ask the doctors, ‘Who are your most difficult patients?,’ and they can identify them.”

A lot of what Brenner had to do, though, went beyond the usual doctor stuff.

Here I would argue that nurses are trained for the type of work Brenner describes. Yes, there are special doctors who are turned on by this kind of work, but far more common are nurses who take a holistic view of their patients’ lives.

If it were up to him, he’d recruit a whole staff of primary-care doctors and nurses and social workers, based right in the neighborhoods where the costliest patients lived. With the tens of millions of dollars in hospital bills they could save, he’d pay the staff double to serve as Camden’s élite medical force and to rescue the city’s health-care system.

But that’s not how the health-insurance system is built. So he applied for small grants from philanthropies like the Robert Wood Johnson Foundation and the Merck Foundation. The money allowed him to ramp up his data system and hire a few people, like the nurse practitioner and the social worker who had helped him with Hendricks. He had some desk space at Cooper Hospital, and he turned it over to what he named the Camden Coalition of Healthcare Providers.

There is so, so much more good stuff in this piece. It’s getting to the point where I am just copying and pasting, any it’s better to simply read the whole thing.

** THE HOT SPOTTERS – Can we lower medical costs by giving the neediest patients better care?
New Yorker, January 2011

Related articles

• “Visionary Family Physician Seeks to Revamp Health Care Delivery System” (aafp.org)
• Doctors Burn Out (precisionmedicalbilling.wordpress.com)
• New Jersey hospitals reach out to patients to reduce ER visits (nj.com)
• Readers Write: Help Us, Atul Gawande, You’re Our Only Hope (histalk2.com)
• With expanding coverage doctors likely to accept new Medicaid patients (medicalnewstoday.com)

 

[Report] Fast Food Facts 2013 Measuring Progress in the Nutritional Quality and Marketing of Fast Food to Children and Teens

Thinking my reaction to advertising was formed during weekly grocery trips when I was in grade school (back in the 60’s)
When we checked out the groceries I remember the candy, gum, and other goodies in the check out area.
While I did look at the items longingly, I knew not to ask for any of them. So, this carried over to advertising on television, especially Saturday morning cartoons.
McDonald’s? Thinking maybe, and just maybe we went there once during my grade school years.

 

From the November 2013 Robert Wood Johnson Report

 

The nutritional quality of fast-food meals, and how those meals are marketed to children and teens, has improved, but more work is needed.

The Issue:
Fast Food FACTS 2013, issued by the Yale Rudd Center for Food Policy & Obesity, examines the nutritional quality of fast food, and how restaurants market their foods and beverages to children and teens. The report examines 18 of the top restaurant chains in the United states, and updates a similar report released in 2010.

 Key Findings

• A total of $4.6 billion was spent on all advertising by fast food restaurants in 2012. This was an 8 percent increase over 2009. McDonald’s spent 2.7 times as much to advertise its products as all fruit, vegetable, bottled water, and milk advertisers combined.
• Less than 1 percent of all kids’ meal combinations met recommended nutrition standards.
• On average, U.S. preschoolers viewed 2.8 fast food ads on TV every day in 2012; children aged 6-11 years viewed 3.2 ads per day; and teens viewed 4.8 ads per day.
• Fast food restaurants continued to target black and Hispanic youth, populations at high risk for obesity and related diseases.

Conclusion:
Researchers conclude that while improvements have been made, there is more work to be done to improve the overall nutritional quality of fast food. Additionally, the researchers call for fast food restaurants to stop targeting children and teens with marketing that encourages frequent visits to these restaurants.

About the Study:
The Yale Rudd Center for Food Policy & Obesity used the same methods as it did for the original Fast Food FACTS in 2010. Nutritional data were collected in February 2013, and most marketing data examine practices through 2012. The report was funded by the Robert Wood Johnson Foundation.

• Download the full report (PDF) 
• Download the report summary(PDF) 
• Read the press release 
• Read the NewPublicHealth Q&A with lead author Jennifer Harris

Related articles

• Fast Food Companies Relying on Social Media to Target Younger Consumers (healthland.time.com)
• Fast-Food Experts Analyze 5,427 Kids’ Meals – Only 33 are Healthful (latimes.com)
• Fast-food experts find 33 ‘healthy’ kids’ meals among 5,427 (bangordailynews.com)
• Study: Fast food companies using new marketing pitches for kids (kdvr.com)
• Fast food companies target kids with marketing for unhealthy products (alternativenewsalert.com)
• Less Than 1% of Fast Food Kids’ Meals Are Healthy (kcet.org)
• So This Is Why Children Are Craving That Fast Food Burger (huffingtonpost.com)
• Fast Food Ads: Kids Seeing Less on TV, More on Social Media (livescience.com)
• Yale Study: Fast Feeders Still on the Hook for Kids’ Health (adage.com)
• Fast Food Kids’ Meals Fail Nutritional Grade, As Marketers Target Teens On Social Media (medicaldaily.com)

New Interactive Map with Information About Individual Community’s Health

From the Web page at  County Health Rankings and Roadmaps **

Results from my zip code (of 43611)

For more detailed information at the state and county levels, click on learn more within the images or go to the home page

Also, check out their Tools and Resources page

**The County Health Rankings & Roadmaps program is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Related articles

• Top 15 wealthiest ZIP codes in Greater Philadelphia (bizjournals.com)
• Risk-based cancer screening, open data ideas win more time with Robert Wood Johnson Foundation (medcitynews.com)
• University of Wisconsin Partners with Survey Analytics to Track Flu Activity Through Crowdsourcing Smartphone App (virtual-strategy.com)

How to access journal articles [Repost with additional link]

Some great information that I did not include in a previous post – How to obtain free and low cost medical articles from biomedical journals. Remember, if all else fails, try contacting the author(s). I have about a 75% success rate.

From the Web site How to Access Journal Articles by Partners in Information Access for the Public Health Workforce.

The information resources and service that you became accustomed to using while pursuing your public health training may not be freely available. Leverage the materials that are freely available to you as an employee, an association member, an alumnus/ae or a taxpayer. Contact the National Network of Libraries of Medicine (NN/LM) Staff for support with exploring any of the options and resources mentioned below, or other questions you might have.

Additional literature resources including Journal Article Databases, Individual Journal Titles, and Reports and Other Publications, are available on the PHPartners.org Literature and Guidelines page.

Free Full Text Journal Articles

Collections of Full Text

• Directory of Open Access Journals – Public Health Journals – Links to open access full text of 130+ journals that fit into a loose classification of public health. This multinational collection includes journals in a variety of languages.

• Education Resources Information Center (ERIC) – (Department of Education (ED) USA)  – Online digital library of education research and information.

• Free Public Health Online Journals – (Lamar Soutter Library, University of Massachusetts Medical School)

• PMC – (National Library of Medicine (NLM) U.S.)  – PMC, formerly PubMed Central, is a free archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM).

Institutional Repositories from Universities with Schools of Public Health

• Digital Repository at the University of Maryland: School of Public Health – (University of Maryland)  – Search or browse by title or author in one of five categories: Epidemiology and Biostatistics, Family Science, Health Services Administration, Kinesiology, or Public and Community Health.

• Directory of Open Access Repositories – OpenDOAR – (Centre for Research Communications, University of Nottingham)  – Search for the author’s institution or browse the 100 repositories in the Health and Medicine subject area.

• iDEA: Drexel E-repository and Archives: School of Public Health – Scholars may contribute their papers to institutional repositories. Also search for their individual faculty pages which may provide access to the full text of papers.

Sponsored Special Issues or Open Access Individual Articles

• Access Journal Special Issues – Active Living Research – (Robert Wood Johnson Foundation (RWJF))  – Funders will often support thematic special issues or supplements on a particular topic to make them available freely.

• Public Health Finance and Public Health Accreditation Special Issues – (Journal of Public Health Management and Practice)  – See issues marked “Free Access.” March/April 2007 – Volume 13- Issue 2 on public health finance and July/August 2007 – Volume 13 – Issue 4 on public health accreditation were sponsored by the Robert Wood Johnson Foundation (RWJF). However, other issues in other publications sponsored by RWJF are not open access.

 

Strategies to Obtain Journal Articles

Alumni Benefits

• Alumni Services – Rollins School of Public Health, Emory University – An example of a school of public health’s alumni services page that talks about library resource access. Your school may have a similar web page.

• Council on Education for Public Health – The list of accredited Schools of Public Health and Public Health Programs contains the website for each school. See if your school has special benefits for alumni by checking the public health program site or going directly to the academic library site.

Association Memberships

• American Journal of Public Health – (American Public Health Association (APHA) – Current two years are free for members/subscribers only. Older issues are available free online in PubMedCentral. Be sure to activate the online access for the subscriptions to which you are entitled.

• Health Education and Behavior/Health Promotion Practice – (Society for Public Health Education (SOPHE))  – Be sure to activate the online access for the subscriptions to which you are entitled. Other related publications may be offered at discounted rates.

Continuing Education

• Area Health Education Centers Directory – Area Health Education Centers (AHECs) provide continuing education based on the recent literature. Many AHECs also have libraries or resource centers.

• Library Services – University of South Florida Area Health Education Center – The USF AHEC Program provides free library services to health care providers working with the medically underserved in Charlotte, Citrus, DeSoto, Hernando, Hillsborough, Pasco, Pinellas, Manatee and Sarasota counties. These services include interlibrary loan of journal articles and loan of AHEC-owned books and other materials and ability to access the USF Health Science Center Library electronic resources

International Public Health

• Blue Trunk Libraries – (World Health Organization (WHO))  – The collection, which is organized according to major subjects, contains more than one hundred books on medicine and public health. Blue Trunk Libraries are available in English, French, Portuguese, and Arabic.

• Global Health Library – (World Health Organization (WHO))  – Global and regional indexes tot he scientific and technical literature. Many of the articles found in searches are free online such as those in the Bulletin of the World Health Organization.

• HINARI Access to Research Initiative – (World Health Organization (WHO))  – The HINARI Programme, set up by WHO together with major publishers, enables developing countries to gain access to one of the world’s largest collections of biomedical and health literature. Over 6200 journal titles are available to health institutions in 108 countries, areas and territories.

Libraries

• College and University Libraries – Academic libraries generally are included in WorldCat or have their own online catalog on their website. State university or community college libraries are usually open to the public living or working within that state. Look for a community college with health training programs. Those with EMS Training Programs may have disaster preparedness journals, for example. Most libraries have print subscriptions or license electronic journals to allow on site use. Friends of the Library memberships may be available for a reasonable charge and may allow you to check out materials or receive other information services.

• Directory of National Network of Libraries of Medicine Members – (National Network of Libraries of Medicine (NN/LM))  – Searchable directory of a nationwide network of health science libraries and information centers. The directory can be searched by state, type of library, and by services offered to the public including reference services, database search training, and delivery of full text journal articles.

• Law Libraries – Law librarians are experts in finding legal information to support policy making and cases. Law libraries are often open to the public for legal research. Use of resources such as Lexis-Nexis and Westlaw is generally restricted, but a wealth of other information in environmental and occupational health, infectious disease control, animal control and other topics with legal components is available.

• List of Public Health Libraries – (Medical Library Association, Public Health/Health Administration Section)  – This website provides links to international, U.S. government, state and local public health libraries, and to libraries from schools of public health.

• National Network of Libraries of Medicine NN/LM – Your regional medical library can help you locate any type of library of figure out what options you have to efficiently find access to the information you need. The NN/LM also provides training on how to use information resources such as PubMed.

• Public Libraries – Public library subscriptions and services may include remote access to collections of full-text journals and newspaper articles. Interlibrary loan may be available at no charge or a minimal cost. Library cards are generally available to those who live or work in the jurisdiction at no charge.

• State Libraries – State agency libraries may be designated to serve state public health workers. If not, they should at least be open to state residents. State libraries work with public libraries to ensure access to resources for users statewide. Find your state library.

• WorldCat – See what libraries closest to you own the journal you need, just search on the title and include your zip code – one may be close enough to visit in person to print or copy the article. If not, follow the web links to the owning library to see if document delivery services are offered for a fee. Note: Most hospital libraries do not appear in Worldcat.org, so you may need to call your closest hospital library to see if they have what you need.

Organizational Partnerships and Staying Connected with Academia

• College of Medicine Voluntary Faculty – (University of South Florida (USF))  – Example of library services available to voluntary faculty involved in teaching health professional students. Maintain an adjunct faculty role or offer to precept students. The students will have remote access to the university resources, and the academic institution may also be able to provide resources or services to you as a preceptor depending on their licensing arrangements.

 

Paying for Full Text Journal Articles

Ordering Journal Articles

• Loansome Doc – (National Network of Libraries of Medicine (NN/LM))  – Arrangements may be made with a health sciences library to provide specific materials you request for a pre-arranged, per-item fee. Prices may be very low, or even free, when ordering from a library mandated to serve health workers in their area.

• Using Loansome Doc® – (National Network of Libraries of Medicine (NN/LM))  – Learn how to order full-text articles through a local health sciences library.

Subscriptions to Individual Titles or Packages of Titles

• AHEC Digital Library Annual Subscription – North Carolina AHEC Program (Example) – This is one example of an AHEC that offers digital library memberships for individual practitioners. Check the Area Health Education Centers Directory to find your local AHEC and to see if they offer library memberships.

• Journal of Public Health Management and Practice (Example) – Most journals are available as either individual or institutional subscriptions. If you purchase the journal with organizational funds and intend for it to be used by multiple staff, then you should purchase an institutional subscription. Institutional subscriptions often allow you to set up online access using your organization’s IP addresses so that all on the organization’s network may access the publication. You may also buy individual articles on a pay per view or pay per download model.

• Veterinary Information Network (VIN) – Fee-based knowledge resource center for animal health and infectious diseases that includes many full text journals, conference proceedings and electronic books, as well as online expert forums for veterinarians.

Related articles

• Journal of Young Medical Researchers (docrohan.wordpress.com)
• Elsevier Launches First Video Journal in Gastrointestinal Endoscopy (prnewswire.com)

Health Care’s Blind Side: Unmet Social Needs Leading To Worse Health

From the 8 December 2011 article by the Robert Woods Johnson Foundation

In new, national survey, three in four physicians wish the health care system would pay for costs associated with connecting patients to services that address their social needs

In a new, national survey, physicians say unmet social needs — like access to nutritious food, transportation assistance and housing assistance — are leading to worse health for all Americans.

As our nation grapples with increasing poverty, joblessness and homelessness, these findings provide new insights into what it takes for Americans to get and stay healthy.

“America’s physicians understand that our health is largely determined by forces outside of the doctor’s office. Housing, employment, income and education are key factors that shape our health, especially for the most vulnerable among us,” said Jane Lowe, team director for the Vulnerable Populations portfolio of the Robert Wood Johnson Foundation. “Physicians are sending a clear message: The health care system cannot continue to overlook social needs if we want to improve health in this country.” …

….

If physicians were able to write prescriptions for social needs, they would frequently prescribe fitness programs, nutritious food and transportation assistance. Physicians whose patients are mostly low-income would write prescriptions for pressing needs such as employment assistance, adult education and housing assistance.

Related articles & resources

• RWJF: Survey Suggests that Physicians Overlook Connection Between Health and Social Needs (asapnys.wordpress.com)
• Investments in Public Health and Prevention Save Lives and Money (jflahiff.wordpress.com)
• New from Health Affairs: Community development and health(phlibraryres.wordpress.com)
• Health Leads
  “Health Leads mobilizes undergraduate volunteers, in partnership with providers in urban clinics, to connect low-income patients with the basic resources — such as food, housing, and heating assistance — that they need to be healthy.”
• Social Prescribing within the Northeast (NorthEast Mental Health Development Unit, (British) National Health Services)

              “Social prescribing refers to the process of linking patients with non-medical sources of support within the community, largely through Primary Care. It includes, for example, arts, learning and exercise on referral, bibliotherapy, self-help materials, volunteering and time banks. As these activities are multi- sectoral, social prescribing therefore has the potential to transcend health and social care, the community and voluntary sectors and private sector boundaries, at a time when changes within the NHS and Local Government attempt to draw these sectors more closely together. “

Aligning Forces for Quality – Initiative to Improve Health Care in Targeted Communities

Image via Wikipedia

From the Cornflower announcement (Nov 2011)

Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s (RWJF) signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform.

AF4Q asks the people who get care, give care and pay for care to work together toward common, fundamental objectives to lead to better care. The Foundation has made an unprecedented commitment to improve health care in 16 geographically, demographically, and economically diverse communities that together cover 12.5 percent of the U.S. population.

The 16 Alliances in Aligning Forces for Quality serve demographically, economically, and geographically diverse communities. From the sparsely populated Humboldt County to the whole state of Maine, Alliances are multi-stakeholder coalitions focused on lifting the quality of health care in their region.

There are six of these alliances in the GMR:

Cincinnati, OH: http://www.forces4quality.org/alliance/cincinnati-ohio#facebook
Cincinnati Aligning Forces for Quality (Cincinnati AF4Q) is led by the Health Collaborative. Established in 1992, the Health Collaborative is a diverse coalition of health care stakeholders representing the hospital, physician, employer, insurer, government, education and consumer sectors. Its mission is to stimulate significant and measurable improvement in the health status of the people in Greater Cincinnati through collaborative leadership.

Cleveland, OH: http://www.forces4quality.org/alliance/cleveland-ohio#facebook
Cleveland Aligning Forces for Quality (Cleveland AF4Q) is led by Better Health Greater Cleveland, an alliance of  providers, patients, purchasers, and health plans.   Established in 2007, the mission of the nonprofit collaborative is to improve the health and value of health care provided to people with chronic medical conditions in Northeast Ohio. Through its growing number of clinical partners, Better Health reaches more than 70% of the chronically ill in Cuyahoga County.

Detroit, MI: http://www.forces4quality.org/alliance/detroit-mich#facebook
The Aligning Forces for Quality (AF4Q) initiative in Detroit is led by the Greater Detroit Area Health Council (GDAHC), a multi-stakeholder regional health coalition that has served the residents of seven counties in southeastern Michigan for more than 60 years.  Members of this nonprofit community organization represent the region’s major purchasers (corporations and labor organizations), health systems and health plans, insurers, government, universities, physician groups, consumer and community opinion leaders, as well as other health care organizations and associations.  As the region’s foremost health care coalition, GDAHC provides a forum for multi-stakeholder collaboration and partnerships to develop, facilitate, and execute promising solutions aimed at improving cost, quality, and access to care.

Minnesota: http://www.forces4quality.org/alliance/minnesota#facebook
MN Community Measurement leads the AF4Q initiative in Minnesota, guided by a broad stakeholder group forming the AF4Q Leadership Team. Organizations represented on the Leadership Team include: the American Cancer Society, Buyers Health Care Action Group, Institute for Clinical Systems Improvement, Minnesota AARP, Minnesota Department of Human Services, Minnesota Hospital Association, Minnesota Medical Association, Stratis Health, plus health plans, consumers, and physician and nursing leadership.

West Michigan: http://www.forces4quality.org/alliance/west-michigan#facebook
The Aligning Forces for Quality (AF4Q) initiative in West Michigan is led by The Alliance for Health (the Alliance), a 60-year-old 501(c)(3) nonprofit membership corporation operating as a regional health improvement collaborative. The Alliance represents those who receive care, give care and pay for care, including providers, citizens, employers, community organizations, government, organized labor, academic institutions and health plans. Its mission is encouraging optimal health for all through high quality health care services at the lowest cost.

Wisconsin: http://www.forces4quality.org/alliance/wisconsin#facebook
The Aligning Forces for Quality (AF4Q) initiative in Wisconsin is led by the Wisconsin Collaborative for Healthcare Quality (WCHQ). Established in 2002, WCHQ is a voluntary consortium of organizations learning and working together to dramatically improve the health and increase the value of healthcare for the people of Wisconsin. The mission of WCHQ is to publicly report and bring meaning to performance measurement information that improves the quality and affordability of healthcare, in turn improving the health of individuals and communities.

Related articles

• EHRs Produce Better Clinical Outcomes In Cleveland (informationweek.com)
• Blue Cross / Tufts Medical Center Impasse – Who’s Looking Out for the Patients? (hcfama.org)
• Will technology save our ailing health-care system? (theglobeandmail.com)
• Cleveland health advocacy group adds six to board (medcitynews.com)
• Invitation to a Dialogue: The Health Care Law (nytimes.com)
• Health-care system ‘not necessarily’ unsustainable: economist (canada.com)
• Prime Healthcare Services Files Anti-Trust Lawsuit Against SEIU (prnewswire.com)