Investigator Awards In Health Policy Research Investigator Awards in Health Policy Research
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www.rwjf.org
The Robert Wood Johnson Foundation Investigator Awards in Health Policy Research supports highly-respected and innovative scholars from a wide range of fields to undertake ambitious, cutting-edge studies of significant health policy challenges facing America. This prestigious and highly-competitive program provides one of the few funding opportunities for outstanding researchers throughout the stages of their careers to explore bold new ideas for improving the nation’s health or health care system. Funded projects produce enduring insights and sophisticated analyses of pressing problems, potential solutions for improving health and health care, and evidence that can help inform policymakers, the media, and the public. The program consistently generates information that is critical to decision-making and that can have a lasting impact on health policy and the nation’s health care system. Located at the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, the program is directed by David Mechanic, Ph.D.
Call For Applications
2011 Call For Applications

The deadline for our 2011 Call for Applications has passed. Please sign-up for future funding alerts by registering at www.MyRWJF.org.

For reference only, you can click here to view a copy of our program's most recent Call for Applications. We held an optional information web conference for applicants on November 17, 2010 that described the program's funding opportunities and provided information about how to prepare a letter of intent application. Click here to listen to a recording of the applicant web conference. Click here to view or download the presentation slides.

For more information about the investigators and projects that have been funded by the program, click here.

Tuesday, Jan 24, 2012
»Interview with Eric Klinenberg featured in Smithsonian Magazine
In the February issue of Smithsonian Magazine, 2003 Awardee, Eric Klinenberg, discusses his forthcoming book,  Going Solo: The Extraordinary Rise and Surprising Appeal of Living Along, the increasingly common phenomenon of living alone, and how this social movement has impacted public life.  Klinenberg's book is published by Peguin Press and will be released on February 2nd.  The full Smithsonian Magazine interview with Klinenberg can be accessed at, http://www.smithsonianmag.com/science-nature/Eric-Klinenberg-on-Going-Solo.html?c=y&page=2

Source: National Program Office

Friday, Jan 20, 2012
»Phil Brown recieves Leo G. Reeder Award from the Medical Sociology Section of the ASA
1998 Awardee, Phil Brown, was recently named the recipient of the Leo G. Reeder Award by the Medical Sociology Section of the American Sociology Association.  The award is given annually for distinguished contribution to medical sociology and recognizes sustained productivity and a body of work that has contributed to theory and research in the filed.  Brown's research interests over his thiry-year career have included disputes over environmental causation of illness, community response to toxic waste-induced disease, race and class differences in exposure to environmental hazards, and the Jewish cultural experience in the Catskill Mountains resort area.  His latest book, Contested Illnesses: Citizens, Science and Health Social Movements, was published by the University of California Press in 2011.

Source: National Program Office

Tuesday, Jan 10, 2012
»Congratulations to David Blumenthal, Sherry Glied and Miriam Laugesen, for having articles in Health Affairs Top 10 in 2011
In its recent, January 2012 issue, Health Affairs named the 10 most read articles in 2011, and among its Top 10 are articles by 2002 Awardee, David Blumenthal, and by 1995 Awardee, Sharon Glied, and 2009 Awardee, Miriam Laugesen.  Blumenthal (along with collaborators, Melinda Beeuwkes Buntin. Michael Burke and Michael Hoaglin), authored, The Benefits of Health Information Technology: A Review of the Recent Literature Shows Predominantly Positive Results, which appeared in the March, 2011 edition of the journal.  And, Glied and Laugesen's article, Higher Fees Paid to US Physicians Drive Higher Spending for Physicians Services Compared to Other Countries, appeared in Health Affairs this past September.  Health Affairs' complete Top 10 list can be found at, http://healthaffairs.org/blog/2012/01/06/health-affairs-top-ten-articles-of-2011-medical-errors-and-more/

Source: National Program Office

Friday, Jan 06, 2012
»Articles by Awardees David Blumenthal and Jonathan Skinner published in JAMA
The January 4, 2012 edition of the Journal of the American Medical Association features the Withholds to Slow Medicare Spending article by 2005 Awardee, Jonathan Skinner (and his collaborators, James Weinstein and Elliott Fisher), and an opinion piece by 2002 Awardee, David Blumenthal, in which he reflects on his two years of service as the National Coordinator for Health Information Technology in the Obama administration. 
The Skinner article proposes a "withhold" approach to slowing Medicare spending growth by having Medicare withhold 6% from every bill and then giving each provider and supplier with a rebated based on wheter costs are contained in their region.  The proposed apporach promotes a shared commitment among health care providers to keep costs down in their region and the authors calculate that such an approach could save more than $400 billion over 10 years.

In David Blumenthal's article, A Physician Goes to Washington . . . and Safely Returns, he reflects on his two years of service at the Department of Health and Human Services and notes 5 lessons that he wishes to pass onto physicians contemplating taking a senior government role.  His lessons span from picking the correct job, to working in a collaborative fashion where listening to your staff is paramount, to retaining your perspective as a physician in all activities in which you engage.

Source: National Program Office

Wednesday, Dec 14, 2011
»New York Times features op-ed piece by 2003 Awardee, Daniel Carpenter
In an op-ed piece in today's New York Times, Daniel Carpenter, 2003 Awardee, and author of Reputation and Power: Organizational Image and Pharmaceutical Regulation at the F.D.A., outlines how Secretary of the Department of Health and Human Services, Kathleen Sebelius' decision to block the Plan-B contraceptive pill from being sold to teens without a prescription sets a radical precedent, and argues for taking the F.D.A. out of the and making it an independent agency.  Carpenter argues that until Sebelius' decision last week the ruling of the FDA Commissioner on drug approval was final, but that now that final authority arguably rests in the White House.  Carpenter states that to place the real power for drug approval with the F.D.A., the agency needs to be made an independent entity, just like the Federal Reserve.

Source: National Program Office

Monday, Dec 05, 2011
»Joseph Fins featured in New York Times Magazine article
2006 Awardee, and author of the forthcoming book, Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness, Joseph Fins is featured in the article, A Drug that Wakes the Near Dead, that ran in The New York Times Magazine this past weekend.  The article focuses on patients whose cognitive function falls between full consciousness and a vegatative state, and the ability of the drug Ambien, and its generic twin, zolpidem, to "awaken" consciousness for short periods of time.  In the article, Fins discusses the complexity of a family's decision to relieve the suffering of a family member who is not in a vegatative state, but who is likely to never regain full consciousness.

Source: National Program Office

Friday, Nov 18, 2011
»2003 Awardee, Daniel Carpenter, featured in New York Times on the FDA's revocation of Avastin
2003 Awardee, Daniel Carpenter, was quoted in today's New York times in an article on the FDA's decision to revoke the approval of the drug, Avastin, for the treatment of breast cancer.  Preliminary clinical trials showed that Avastin, in combination with the drug Taxol, delayed the progression of metastatic breast cancer by up to five and a half months.  However, further testing did not support that finding and the FDA has concluded that the use of Avastin is not prolonging or improving the quality of patients' lives.  In the article, Daniel Carpenter stated that the revocation of the drug shows the public that decisions by the FDA are neither absolute nor irreversible, and establishing this position, he believes, will allow the FDA to take more risks in granting accelerated approval to new drugs.

Source: National Program Office

Friday, Oct 28, 2011
»Article by 2009 Awardees, Jens Ludwig and Greg Duncan, featured in NEJM
2009 Awardees, Jens Ludwig and Greg Duncan co-authored (along with 9 of their colleagues), the Neighborhoods, Obesity, and Diabetes - A Randomized Social Experiment article that is featured in the October 20th issue of the New England Journal of Medicine.  The study compares the prevalence of diabetes and obesity in the nearly 1,800 women and children from high-urban census tracts who were randomly assigned to receive housing vouchers to live in neighborhoods with a lower level of poverty to the prevalence of those conditions in the 1,300 women and children in the study who remained in the high-urban environment.  The Moving to Opportunity (MTO), demonstration project, which generated the data for this study, was implemented from 1984-1989 by the Department of Housing and Urban Development (HUD) and was designed with the purpose of understanding the effects of residential location on employment, income, education and well-being.  The study's conclusion is that moving to a community with lower levels of poverty was associated with modest but potentially important reductions in the presence of extreme obesity and diabetes.

Source: National Program Office

Friday, Oct 07, 2011
»NEJM features Perspective article by 2004 Awardee, Mark Hall
The October 5th issue of the New England Journal of Medicine features the Perspective article, Not So Fast - Jurisdictional Barriers to the ACA Litigation, by co-authors, Timothy Stoltzus and 2004 Awardee, Mark Hall.  In the piece, the authors identify jurisdictional issues, having the standing for individuals and states to sue, and the doctrine of "ripeness" as barriers to contesting the constitutionality of the minimal coverage requirement outlined in the Affordable Care Act.

Source: National Program Office

RWJF Scholars, Fellows & Leadership Programs Web Site
March 16, 2010
RWJF Scholars, Fellows & Leadership Programs Web Site

RWJF launched a new Scholars, Fellows & Leadership Programs Web Site, which provides a central location to showcase the programs in the RWJF Human Capital Portfolio and allows potential applicants to explore detailed information about the programs and to determine which ones may be of most interest to them.

»For more information, please visit www.RWJFLeaders.org.

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Policy Challenges in Modern Health Care
Mechanic, D., Rogut, L., Colby, D., Knickman, J., editors
Published: 2005
Rutgers University Press
A composite look at some of the striking contemporary challenges we face in health and health care by some of the nation's leading thinkers.
»Show summary
Praise for Policy Challenges in Modern Health Care

"A marvelous collection of ideas and insights by first-rate scholars. This book lays a foundation for more creative and effective policy-making." - Stephen M. Shortell, Dean and Blue Cross of California Professor of Health Policy and Management, University of California, Berkeley

Health care delivery in the United States is an enormously complex enterprise, and its $1.6 trillion annual expenditures involve a host of competing interests. While arguably the nation offers among the most technologically advanced medical care in the world, the American system consistently under performs relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families.

Bringing together twenty-five of the nation's leading experts in health care policy and public health, this book provides a much-needed perspective on how our health care system evolved, why we face the challenges that we do, and why reform is so difficult to achieve. The essays tackle tough issues including: socioeconomic disadvantage, tobacco, obesity, gun violence, insurance gaps, the rationing of services, the power of special interests, medical errors, and the nursing shortage.

Linking the nation's health problems to larger political, cultural, and philosophical contexts, Policy Challenges in Modern Health Care offers a compelling look at where we stand and where we need to be headed.

(Rutgers University Press, rutgerspress.rutgers.edu)(ISBN:0-8135-3578-6)

Section Info
Research In Profile is a series of pieces about investigators and their work that focuses on project findings, research insights, and policy implications. Summaries are provided on the website and each issue is available for download in Adobe Acrobat PDF format. Print copies can be requested from the National Program Office by sending an email to depdir@ifh.rutgers.edu.
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Ten New Research Projects Explore Solutions to America’s Pressing Health Care Challenges
Investigator Awards In Health Policy Research
Issue 30, September 2010
»Download the full issue in PDF format
»Go to Issue Index
»Show Summary

With the passage of comprehensive health reform, the United States must redouble efforts to address our most vexing health policy issues. The need for innovative, cross-cutting health policy research is more urgent than ever. The Robert Wood Johnson Foundation (RWJF) recently announced the selection of this year’s recipients of the RWJF Investigator Awards in Health Policy Research - scholars who will tackle some of America’s most difficult health concerns and inform policy on these issues. The winning scholars, affiliated with major institutions across the country, will receive awards of up to $335,000 to support 10 innovative and cutting-edge research projects. The award recipients are:

  • Co-investigators Joel T. Braslow, M.D., Ph.D., University of California, Los Angeles, and John S. Brekke, Ph.D., University of Southern California
  • Cynthia A. Connolly, Ph.D., R.N., P.N.P., University of Pennsylvania
  • Jennifer L. Hochschild, Ph.D., Harvard University
  • James S. Jackson, Ph.D., University of Michigan
  • Aaron S. Kesselheim, M.D., J.D., M.P.H., Harvard University and Brigham and Women’s Hospital
  • Miriam J. Laugesen, Ph.D., Columbia University
  • Co-investigators Jens Ludwig, Ph.D., University of Chicago, and Greg J. Duncan, Ph.D., University of California, Irvine
  • S. V. Subramanian, Ph.D., M.Phil., Harvard University
  • Co-investigators Jason Schnittker, Ph.D., University of Pennsylvania, and Christopher Uggen, Ph.D., University of Minnesota
  • Co-investigators Robert L. Wears, M.D., University of Florida, and Kathleen M. Sutcliffe, Ph.D., University of Michigan

This prestigious and highly competitive funding program attracts investigators from a wide range of fields including medicine, nursing, public health, economics, sociology, political science, psychology, history, law, ethics, journalism, communications, public and social policy, and others. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications and makes funding recommendations to the Foundation. The members of the 2009-2010 national advisory committee (NAC), which includes seven past Investigator Awardees, are:

  • Paul D. Cleary, Ph.D., Yale University, NAC Chair
  • Sheila Burke, R.N., M.P.A., Harvard University
  • Lawrence Casalino, M.D., Ph.D., Weill Cornell Medical College, 1999 Awardee
  • Susan Dentzer, Health Affairs
  • Judy Feder, Ph.D., Georgetown University
  • Bruce G. Link, Ph.D., Columbia University, 1995 Awardee
  • Catherine G. McLaughlin, Ph.D., Mathematica Policy Research, Inc.
  • Mark A. Peterson, Ph.D., University of California, Los Angeles, 1994 Awardee
  • Jill B. Quadagno, Ph.D., Florida State University, 1999 Awardee
  • Jeannette Rogowski, Ph.D., University of Medicine and Dentistry of New Jersey
  • Sara Rosenbaum, J.D., George Washington University, 2000 Awardee
  • Mark J. Schlesinger, Ph.D., Yale University, 1993 Awardee
  • Alvin R. Tarlov, M.D., University of Chicago (retired)
  • William A. Vega, Ph.D., University of Southern California
  • Keith A. Wailoo, Ph.D., Princeton University, 2001 Awardee

RWJF created the Investigator Awards in Health Policy Research program to support talented researchers throughout the stages of their careers whose cross-cutting and bold new ideas promise to contribute meaningfully to improving U.S. health policy. Funded projects produce enduring insights and sophisticated analyses of pressing problems, potential solutions for improving health and health care, and evidence that can inform policymakers, the media, and the public. Since 1992, the Foundation has supported 167 projects involving 216 investigators.

“Through the Investigators’ program, the Foundation invests in ideas and individuals – investments that pay off long after the research grants have ended,” said Lori Melichar, Ph.D., economist and senior program officer in Research and Evaluation at RWJF. “The books and articles resulting from Investigators’ research contribute to the public discourse in health policy. The program also provides the Investigators with opportunities to join the debate on health policy issues, and influence how policymakers think about the challenges of providing and financing health care and improving the health of the nation.”

David Mechanic, Ph.D., leads the RWJF Investigator Awards program, which is headquartered at the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey. “This program supports thinking that is creative and crosses disciplinary boundaries in search of knowledge and solutions to emerging problems or vexing issues that are important for improving the nation’s health and health care,” Mechanic says.

A brief description of each new investigator project follows.

»Read More... (PDF)

Section Info
Investigator publications listed on this site relate to research funded through the Investigator Awards program. References are provided for books and selected journal articles written by the investigators. Abstracts are available for some featured publications.
Testing Baby: The Transformation of Newborn Screening, Parenting, and Policymaking
Grob, R.
Published: 2011
Rutgers University Press
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Within 48 hours after birth, the heel of every baby in the United States has been pricked and the blood sent for compulsory screening to detect or rule out a large number of disorders. Newborn screening is expanding rapidly, fueled by the prospect of saving lives. Yet many lives are also changed by it in ways not yet recognized.

Testing Baby is the first book to draw on parents’ experiences with newborn screening in order to examine its far-reaching sociological consequences. Rachel Grob’s cautionary tale also explores the powerful ways that parents’ narratives have shaped this emotionally charged policy arena. Newborn screening occurs almost always without parents’ consent and often without their knowledge or understanding, yet it has the power to alter many things including family dynamics at the household level, the context of parenting, the way we manage disease identity, and how parents’ interests are understood and solicited in policy debates.

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Patients as Policy Actors
Hoffman, B., Tomes, N., Schlesinger, M., Grob, R. editors
Published: 2011
Rutgers University Press
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Praise: "This strong volume brings together contributors of different disciplinary and experiential backgrounds, broadening our understanding of how patient voices influence American health care policy.""—Elizabeth Toon, Centre for the History of Science, Technology and Medicine, University of Manchester

Description: Patients as Policy Actors offers groundbreaking accounts of one of the health field's most important developments of the last fifty years--the rise of more consciously patient-centered care and policymaking. The authors in this volume illustrate, from multiple disciplinary perspectives, the unexpected ways that patients can matter as both agents and objects of health care policy yet nonetheless too often remain silent, silenced, misrepresented, or ignored. The volume concludes with a unique epilogue outlining principles for more effectively integrating patient perspectives into a pluralistic conception of policy-making. With the recent enactment of the Patient Protection and Affordable Care Act, patients' and consumers' roles in American health care require more than ever the careful analysis and attention exemplified by this innovative volume.

About the Editors: BEATRIX HOFFMAN is an associate professor and chair of the department of history at Northern Illinois Unversity. She is author of The Wages of Sickness: The Politics of Health Insurance in Progressive America. NANCY TOMES is a professor in the history department at Stony Brook University. She is the author of several books,among them, The Gospel of Germs: Men, Women, and the Microbe in American Life. RACHEL GROB is an associate dean of graduate studies, director of the Child Development Institute and healthy advocacy faculty member at Sarah Lawrence College. She is author of Testing Baby: The Transformation of New Born Screening, Parenting, and Policymaking (Rutgers Press, forthcoming). MARK SCHLESINGER is a professor of health policyand a fellow of the Institution for Social and Policy Studies at Yale University and past editor of the Journal of Health Policy, Politics and Law.

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Fatal Invention
Roberts, D.
Published: 2011
The New Press
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A decade after the Human Genome Project proved that human beings are not naturally divided by race, the emerging fields of personalized medicine, reproductive technologies, genetic genealogy, and DNA databanks are attempting to resuscitate race as a biological category written in our genes. In this provocative analysis, leading legal scholar and social critic Dorothy Roberts argues that America is once again at the brink of a virulent outbreak of classifying population by race. By searching for differences at the molecular level, a new race-based science is obscuring racism in our society and legitimizing state brutality against communities of color at a time when America claims to be post-racial.

Moving from an account of the evolution of race—proving that it has always been a mutable and socially defined political division supported by mainstream science—Roberts delves deep into the current debates, interrogating the newest science and biotechnology, interviewing its researchers, and exposing the political consequences obscured by the focus on genetic difference. Fatal Invention is a provocative call for us to affirm our common humanity.

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Drug Policy and the Public Good
Babor, T.F., Caulkins, J.P., Edwards, G., Fischer, B., Foxcroft, D.R., Humphreys, K., Obot, I.S., Rehm, J., Reuter, P., Room, R., Rossow, I., Strang, J.
Published: 2010
Oxford University Press
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Drug use represents a significant burden to public health through disease, disability and social problems, and policy makers are becoming increasingly interested in how to develop evidence-based drug policy. It is therefore crucial to strengthen the links between addiction science and drug policy. Drug Policy and the Public Good is collaboratively written by an international group of career scientists to provide an analytical basis on which to build relevant global drug policies, and to inform policy makers who have direct responsibility for public health and social welfare.

Drug Policy and the Public Good presents, in a comprehensive, practical, and readily accessible form, the accumulated scientific knowledge on illicit drugs that has direct relevance to the development of drug policy on local, national, and international levels. The authors describe the conceptual basis for a rational drug policy and present new epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programs in schools and other settings; supply reduction approaches, including drug interdiction and legal enforcement; treatment interventions and harm reduction approaches; criminal sanctions and decriminalization; and control of the legal market through prescription drug regimes. The final chapters discuss the current state of drug policy in different parts of the in different parts of the world, and describe the need for a new approach to drug policy that is evidence-based, realistic, and co-ordinated.

The authors describe the conceptual basis for a rational drug policy and present new epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programs in schools and other settings; supply reduction approaches, including drug interdiction and legal enforcement; treatment interventions and harm reduction approaches; criminal sanctions and decriminalization; and control of the legal market through prescription drug regimes. The final chapters discuss the current state of drug policy in different parts of the world, and describe the need for a new approach to drug policy that is evidence-based, realistic, and co-ordinated.

By locating drug policy primarily within the realm of public health, this book draws attention to the growing tendency of governments, both national and local, to consider illegal psychoactive substances as a major determinant of ill health, and to organize societal responses accordingly. It will appeal to those involved in both addiction science and drug policy, as well as those in the wider fields of public health, health policy, epidemiology, primary prevention, and treatment services.

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Reputation and Power: Organizational Image and Pharmaceutical Regulation at the FDA
Carpenter, D.P.
Published: 2010
Princeton University Press
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The U.S. Food and Drug Administration is the most powerful regulatory agency in the world. How did the FDA become so influential? And how exactly does it wield its extraordinary power? Reputation and Power traces the history of FDA regulation of pharmaceuticals, revealing how the agency's organizational reputation has been the primary source of its power, yet also one of its ultimate constraints.

Daniel Carpenter describes how the FDA cultivated a reputation for competence and vigilance throughout the last century, and how this organizational image has enabled the agency to regulate an industry as powerful as American pharmaceuticals while resisting efforts to curb its own authority. Carpenter explains how the FDA's reputation and power have played out among committees in Congress, and with drug companies, advocacy groups, the media, research hospitals and universities, and governments in Europe and India. He shows how FDA regulatory power has influenced the way that business, medicine, and science are conducted in the United States and worldwide. Along the way, Carpenter offers new insights into the therapeutic revolution of the 1940s and 1950s; the 1980s AIDS crisis; the advent of oral contraceptives and cancer chemotherapy; the rise of antiregulatory conservatism; and the FDA's waning influence in drug regulation today.

Reputation and Power demonstrates how reputation shapes the power and behavior of government agencies, and sheds new light on how that power is used and contested.

Daniel P. Carpenter is the Allie S. Freed Professor of Government at Harvard University. He is the author of The Forging of Bureaucratic Autonomy: Reputations, Networks, and Policy Innovation in Executive Agencies, 1862-1928 (Princeton).

Endorsements:

"Reputation and Power is by far the most thorough and penetrating study of the most powerful and important regulatory agency in the world--the U.S. Food and Drug Administration--and one of the best studies of any American regulatory agency. The book is essential reading for anyone seriously interested in American politics, public policy, administrative institutions, or health and medicine. This is an extraordinary work."--Paul Quirk, University of British Columbia

"Carpenter has integrated an understanding of the FDA's legal history and programmatic responsibilities with a perceptive grasp of the personalities who shaped that history. His work surpasses in depth and scope all other accounts of the FDA with which I am familiar. No one in the future will be able to write seriously about the FDA's drug approval system without taking account of Carpenter's work. His curiosity knows no limits."--Richard A. Merrill, professor emeritus, University of Virginia

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Democracy Remixed: Black Youth and the Future of American Politics
Cohen, C.J.
Published: 2010
Oxford University Press
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While Barack Obama's victory led many to believe that America's racial divide had significantly narrowed, if not been eliminated, the facts belie this. Black youth today continue to be plagued by low levels of employment, high levels of incarceration, and a profound lack of trust in the government and broader political community. Yet discussions of why this is have been largely anecdotal, often putting the blame on black youth themselves--even when the commentators are also black. Think of Bill Cosby's criticism, for example, or the writings of Stanley Crouch and Juan Williams.

In Democracy Remixed, award-winning scholar Cathy J. Cohen offers an authoritative and empirically powerful analysis of the state of black youth in America today. Utilizing the results from the Black Youth Project, a groundbreaking nationwide survey, Cohen focuses on what young Black Americans actually experience and think--and underscores the political repercussions. Featuring their stories from cities across the country, she reveals that black youth want, in large part, what most Americans want--a good job, a fulfilling life, safety, respect, and equality. But while this generation shares much in common with the rest of America, they also believe that equality does not yet exist, at least not in their lives. Many believe that they are treated as second-class citizens. Moreover, for many the future seems bleak when they look at their neighborhoods, their schools, and even their own lives and choices. Through their words, these young people provide a complex and balanced picture of the intersection of opportunity and discrimination in their lives.

The political alienation and hope of black youth is real--and it is grounded in a contradictory reality that must be addressed. Democracy Remixed provides the insight and information necessary to truly transform the future of young Black Americans and American democracy.

Cathy J. Cohen is the David and Mary Winton Green Professor of Political Science at the University of Chicago. She is the author of The Boundaries of Blackness: AIDS and the Breakdown of Black Politics, and co-editor of Women Transforming Politics: An Alternative Reader.

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Health Care in World Cities: New York, Paris, and London
Gusmano, M.K., Rodwin, V.G., Weisz, D.
Published: 2010
Johns Hopkins University Press
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New York. London. Paris. Although these cities have similar sociodemographic characteristics, including income inequalities and ethnic diversity, they have vastly different health systems and services. This book compares the three and considers lessons that can be applied to current and future debates about urban health care.

Highlighting the importance of a national policy for city health systems, the authors use well—established indicators and comparable data sources to shed light on urban health policy and practice. Their detailed comparison of the three city health systems and the national policy regimes in which they function provides information about access to health care in the developed world's largest cities.

The authors first review the current literature on comparative analysis of health systems and offer a brief overview of the public health infrastructure in each city. Later chapters illustrate how timely and appropriate disease prevention, primary care, and specialty health care services can help cities control such problems as premature mortality and heart disease.

In providing empirical comparisons of access to care in these three health systems, the authors refute inaccurate claims about health care outside of the United States.

Michael K. Gusmano, Ph.D., is a research scholar at The Hastings Center. Victor G. Rodwin, Ph.D., M.P.H., is a professor of health policy and management at New York University. Daniel Weisz, M.D., M.P.A., is a research associate at the World Cities Project, International Longevity Center, of which Drs. Gusmano and Rodwin are codirectors.

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Medical Professionalism in the New Information Age
Rothman, D.J., Blumenthal, D. editors
Published: 2010
Rutgers University Press
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Praise:

"Rothman and Blumenthal's compelling book, Medical Professionalism in the New Information Age, fills a current gap in the literature on the possible implications of information technology for practicing physicians, health care organizations, and the profession more generally, thereby advancing both policy analysis and clinical practice."—Melissa Goldstein, George Washington University Medical Center

Description:

With computerized health information receiving unprecedented government support, a group of health policy scholars analyze the intricate legal, social, and professional implications of the new technology. These essays explore how Health Information Technology (HIT) may alter relationships between physicians and patients, physicians and other providers, and physicians and their home institutions. Patient use of web-based information may undermine the traditional information monopoly that physicians have long enjoyed. New IT systems may increase physicians’ legal liability and heighten expectations about transparency. Case studies on kidney transplants and maternity practices reveal the unanticipated effects, positive and negative, of patient uses of the new technology. An independent HIT profession may emerge, bringing another organized interest into the medical arena. Taken together, these investigations cast new light on the challenges and opportunities presented by HIT.

About the Editors:

DAVID J. ROTHMAN is president of the Institute on Medicine as a Profession (IMAP) and Bernard Schoenberg Professor of Social Medicine at Columbia College of Physicians & Surgeons. His many books include Strangers at the Bedside and The Pursuit of Perfection with Sheila M. Rothman.

DAVID BLUMENTHAL is national coordinator for health information technology in the Department of Health and Human Services. When he contributed to this volume, he was director of the Institute for Health Policy at Massachusetts General Hospital/Partners HealthCare System and professor of health care policy and Samuel O. Thier Professor of Medicine at Harvard Medical School.

Section Info
This section contains information about all of the projects and researchers that have been funded through the Investigator Awards program since the first grants were made in 1993. The indexes in this section can be used to identify investigators by name, area of expertise, or year of award. Throughout the site, you will find that each investigator’s name links to details including contact and project information.
September 2010

With the passage of comprehensive health reform, the United States must redouble efforts to address our most vexing health policy issues. The need for innovative, cross-cutting health policy research is more urgent than ever. The Robert Wood Johnson Foundation (RWJF) recently announced the selection of this year's recipients of the RWJF Investigator Awards in Health Policy Research - scholars who will tackle some of America's most difficult health concerns and inform policy on these issues. The winning scholars, affiliated with major institutions across the country, will receive awards of up to $335,000 to support 10 innovative and cutting-edge research projects.

This prestigious and highly competitive funding program attracts investigators from a wide range of fields including medicine, nursing, public health, economics, sociology, political science, psychology, history, law, ethics, journalism, communications, public and social policy, and others. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications and makes funding recommendations to the Foundation.

RWJF created the Investigator Awards in Health Policy Research program to support talented researchers throughout the stages of their careers whose cross-cutting and bold new ideas promise to contribute meaningfully to improving U.S. health policy. Funded projects produce enduring insights and sophisticated analyses of pressing problems, potential solutions for improving health and health care, and evidence that can inform policymakers, the media, and the public. Since 1992, the Foundation has supported 167 projects involving 216 investigators.

"Through the Investigators' program, the Foundation invests in ideas and individuals - investments that pay off long after the research grants have ended," said Lori Melichar, Ph.D., economist and senior program officer in Research and Evaluation at RWJF. "The books and articles resulting from Investigators' research contribute to the public discourse in health policy. The program also provides the Investigators with opportunities to join the debate on health policy issues, and influence how policymakers think about the challenges of providing and financing health care and improving the health of the nation."

David Mechanic, Ph.D., leads the RWJF Investigator Awards program, which is headquartered at the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey. "This program supports thinking that is creative and crosses disciplinary boundaries in search of knowledge and solutions to emerging problems or vexing issues that are important for improving the nation's health and health care," Mechanic says.

For details of the 2009 Investigator Awards click "Show Awards" below.

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Joel T. Braslow, M.D., Ph.D.
John S. Brekke, Ph.D.
From the Curative Asylum to the Broken System: Understanding Hopes and Realities in Mental Health System Transformation
Award Year: 2009

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Based on concepts of personal strength and empowerment, the Recovery Movement has become the major driving force of American mental health policy, and like similar efforts over the last two hundred years, recovery-oriented transformation promises dramatic hope for the care, treatment, and lives of those with severe mental illness. For their Investigator Award project, Joel T. Braslow, M.D., Ph.D., Frances M. O’Malley Chair in Neuroscience History at the University of California, Los Angeles, and John S. Brekke, Ph.D., Frances Larson Professor of Social Work and Associate Dean of Research at the University of Southern California, focus on the California Mental Health Services Act, a massive mental health policy endeavor and the largest effort to date aimed at a statewide recovery-oriented transformation. The investigators will describe the impact of California’s mental health reform initiative in Los Angeles County and analyze how state and county policies, clinician practices, and cultural values shape treatment of mental illness. Their project, From the Curative Asylum to the Broken System: Understanding Hopes and Realities in Mental Health System Transformation, will also evaluate how networks of clinics, which provide integrated medical and social services and move patients from higher to lower levels of care as they recover, impact patients’ outcomes and experiences. Drs. Braslow and Brekke will integrate the L.A. County experience with lessons learned from the past to examine whether the Recovery Movement provides a sound basis for viable mental health policy or whether alternative approaches hold promise for better meeting the complex needs of people with chronic mental illness. Project findings will help inform policy changes under consideration by states and counties throughout the country.
Cynthia A. Connolly, Ph.D., R.N., P.N.P.A Prescription for a Healthy Childhood: A History of Children and Pharmaceuticals in the United States
Award Year: 2009

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The growing use of pharmaceuticals in children raises complex and troubling policy issues. How can we conduct research on safety and efficacy, ensure patient safety, provide access to promising treatments, and encourage private sector innovation and product development – all the while protecting children? Cynthia A. Connolly, Ph.D., R.N., P.N.P., an associate professor of nursing at the University of Pennsylvania, probes the many dimensions of this dilemma through a historical lens. Her project, A Prescription for Healthy Childhood: A History of Children and Pharmaceuticals in the United States, addresses four major health policy issues: how beliefs about children and their place in American society informed policy debates surrounding pharmaceuticals for children; how stakeholders have responded to debates about use, testing, advertising, and regulation of pharmaceuticals for children; how ideas about children’s best interests shifted over time and shaped health policy; and how politics and legislative and regulatory choices led to reforms with both intended and unintended consequences. Dr. Connolly’s findings will shed light on current controversies such as the escalating use of behavioral drugs in children, off-label prescribing of anti-depressants, use of over-the-counter products, and the appropriate role of drug studies on children to ensure safety and efficacy. Her research should help expand our understanding of the costs, benefits, risks, coverage, and access issues associated with children’s pharmaceuticals.
Jennifer L. Hochschild, Ph.D.Genomics, Medicine and Race: Political Valences and Health Policy Implications
Award Year: 2009

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The use of genomics in medicine has the potential to transform concepts of racial identity – making it immaterial, highly salient, or possibly both in different circumstances. Treatment for genetic diseases may eventually be tailored to fit an individual’s genome, in which case the patient’s self-defined race will not matter. Alternatively, genomic medicine may result in treatments that are licensed only for people of a particular race, as in the case of BiDil, an FDA-approved drug for treating congestive heart failure only in African Americans. Jennifer L. Hochschild, Ph.D., Henry LaBarre Jayne Professor of Government at Harvard University, and colleague Maya Sen, J.D., will explore the growth of politics, ideologies, and policies in this rapidly evolving field. Their study, Genomics, Medicine and Race: Political Valences and Health Policy Implications, will examine the growth of individuals’ direct access to their own or family members’ genetic information; how genetic information is changing the practice of medicine; and the extent to which genetic medicine affects how Americans think about their race and ethnicity. They will focus on how government can support genomic research while protecting citizens from risks, and how policymakers’ beliefs or partisan affiliations can influence their opinions about regulation, funding, prohibitions, and acceptable risks. They will conduct a national survey of 5,000 people, as well as 100 in-person interviews with key players in the field from genomic scientists to legislators and judges. Their project will lead to policy options addressing the appropriate role of race in drug approval, improvements in medical diagnosis and treatment, and guidelines for legitimate use of information from individual DNA profiles.
James S. Jackson, Ph.D.Race Differences in Physical and Mental Health Disparities: Biological Mechanisms and Behavioral Change
Award Year: 2009

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Despite well-known physical health disparities between blacks and whites, a puzzling research paradox shows no major differences in mental health disorders between the racial groups. James S. Jackson, Ph.D., Daniel Katz Distinguished University Professor of Psychology and Director of the Institute for Social Research at the University of Michigan, will explore the reasons behind these seemingly conflicting findings. His study, Race Difference in Physical and Mental Health Disparities: Biological Mechanisms and Behavioral Change, will consider the connection between mental and physical health and examine how the effects of stressful living conditions combined with unhealthy behaviors may create the patterns of health disparities that many policymakers and health care providers find perplexing. Using the Affordances Framework, a new and complex way of thinking about disparities, Dr. Jackson will analyze how available coping strategies, such as overeating, smoking, alcohol and drug use, may lead to non-compliance with medical advice contributing to the onset and course of chronic diseases in blacks, while buffering the downward spiral toward mental illness. Dr. Jackson believes the framework offers a fundamentally different approach to how we might view the root causes of disparities (especially in cardiovascular disease and type 2 diabetes), if blacks and other highly-stressed population groups preserve their mental health by continuing to engage in unhealthy behaviors, rather than adhering to recommended lifestyle changes. His findings should produce information that can enhance understanding and guide the design of more effective interventions and programs for reducing health disparities.
Aaron S. Kesselheim, M.D., J.D., M.P.H.Sources of Transformative Innovation in Medication Development
Award Year: 2009

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How can the engine of pharmaceutical innovation in the United States, sluggish now despite substantial investment, be jump-started again? Whether the right pathway involves increased government support of basic research or a transformation of industry product development and clinical trial work, patent law will play a key role. Aaron S. Kesselheim, M.D., J.D., M.P.H., explores a number of questions related to this issue, including how basic, translational, and product-development research combine to create breakthrough drugs and how patent-based incentives facilitate or impede drug development. His project, Sources of Transformative Innovation in Medication Development, will identify the most transformative drugs that have emerged in the past 25 years, examine their scientific origins, and assess the intellectual, social, and financial factors that influenced their development. Dr. Kesselheim also will analyze whether patents have rewarded the most important contributors to new pharmaceutical breakthrough products and test an alternative to the current patent system. His project addresses whether new legal or resource-allocation strategies are needed to reinvigorate pharmaceutical innovation and how possible reforms might encourage drug development, apportion rewards more appropriately, and help contain research costs.
Miriam Laugesen, Ph.D.The Politics of Relative Values: Physicians and Medicare Fees
Award Year: 2009

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Two decades after Congress reformed Medicare physician payment, Medicare costs continue to rise, physicians are still paid for each service provided to each patient, and payment incentives remain skewed toward highly specialized, procedure-oriented care. Although spending for physician services exceeded annual targets from 2003 to 2010, Congress postponed nine scheduled cuts in physician fees. Clearly, Medicare’s system for paying physicians needs fixing. In a project titled, The Politics of Relative Values: Physicians and Medicare Fees, Miriam J. Laugesen, Ph.D., examines why Medicare payment reforms fell short of their original objectives to contain costs and equalize payment gaps between primary care physicians and specialists. Her study will investigate the impact of the Resource-Based Relative Value Scale (RBRVS) implemented in 1992 for determining Medicare’s fee schedule for physician services, including the role of physicians’ participation in the scheduled reviews of the RBRVS, a largely undocumented process. Dr. Laugesen’s findings will address the strengths and limitations of the process used to determine Medicare physician fee levels, as well as the future role of physicians in determining payment policies. Her project should provide policymakers with a better understanding of possible payment reforms that are technically and politically feasible and could encourage more coordinated, effective, and better-compensated primary care for Medicare beneficiaries.
Jens Ludwig, Ph.D.
Greg Duncan, Ph.D.
Neighborhood Effects on Health
Award Year: 2009

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In 2000 roughly 8 million Americans – a disproportionate number of them minorities – lived in neighborhoods with poverty rates of more than 40 percent, and also suffered alarmingly high rates of poor health outcomes. In a new book, Jens Ludwig, Ph.D., McCormick Foundation Professor of Social Service Administration, Law, and Public Policy at the University of Chicago, and Greg J. Duncan, Ph.D., Distinguished Professor of Education at the University of California, Irvine, will explore how various “place-based’’ public policies might improve health and other outcomes for some of the nation’s most disadvantaged families living in some of our most distressed urban neighborhoods. Their book will focus on lessons from one of the most ambitious randomized environment experiments ever undertaken, the five-city U.S. Department of Housing and Urban Development’s Moving to Opportunity program. Through a random lottery, some very low-income families living in public housing were offered a chance to relocate to less distressed areas. Using a range of outcomes data, the investigators expect to produce “gold standard” evidence illuminating the ways in which changing neighborhoods affect health and well-being. Their study, Neighborhood Effects on Health, will also analyze the costs and benefits of mobility and community-level interventions and has the potential to inform a wide range of health, education, community development, and other social policies.
Jason Schnittker, Ph.D.
Chris Uggen, Ph.D.
The Effects of Incarceration on the Health of Individuals, Families, and Communities
Award Year: 2009

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State and federal correctional facilities in the United States house over 2 million people, more than all other nations, and release nearly 650,000 inmates each year. What effect does incarceration have on the health and health care of current and former inmates, and what role does it play in health disparities, since black Americans are incarcerated at much higher rates than whites? Jason Schnittker, Ph.D., and Christopher Uggen, Ph.D., will study this exceedingly important but neglected issue, especially with respect to the health of people after they are released. In their project, The Effects of Incarceration on the Health of Individuals, Families, and Communities, Drs. Schnittker and Uggen will explore the impacts of incarceration on mental and physical health, on families and children, and on health and health care quality at local and state levels. Using an assortment of datasets, they will take a close look at risk factors such as unemployment, marital instability, stigma, chronic stress, discrimination, neighborhood segregation, and access to health care. In the end, they will outline the health policy implications of incarceration, with the goal of informing debates on criminal justice reform and on strategies for improving the health of current and former inmates and their families.
S. V. Subramanian, Ph.D, M.Phil.Neighborhood Disadvantage and Health: A Lifecourse Perspective
Award Year: 2009

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Although health outcomes vary dramatically across neighborhoods, we lack an in-depth understanding of the inter-relationship between neighborhood environments and the health of their residents. In an effort to grasp this, S. V. Subramanian, Ph.D., M.Phil., a geographer and associate professor in the department of society, human development, and health at Harvard University, will use empirical data from three long-range studies: the Framingham Heart Study, the Health and Retirement Survey, and the National Longitudinal Study of Adolescent Health. In his project, Neighborhood Disadvantage and Health: a Lifecourse Perspective, Dr. Subramanian will examine the complex interaction between environment and health across an individual's lifespan. The study also will look at the possibility that residents’ health status may influence their choice of neighborhood. He will explore whether neighborhood socioeconomic disadvantage correlates with the degree of resources such as accessibility to parks and recreational facilities, health care services, public transport, food environment, and educational opportunities. Results should help advance our understanding of the role of neighborhoods in health and of the potential to improve quality of life in disadvantaged neighborhoods through investments in infrastructure and other community resources.
Robert L. Wears, M.D.
Kathleen M. Sutcliffe, Ph.D.
Medicalizing Patient Safety
Award Year: 2009

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Since publication of the Institute of Medicine’s landmark 1999 report To Err is Human, patient safety has become the shibboleth for health care providers nationwide. Yet, patient safety today means something much different – and much less radical – than it did 20 years ago, when the movement’s pioneers focused on cross-disciplinary efforts to reduce health care hazards and harms. Robert L. Wears, M.D., professor of emergency medicine at the University of Florida Health Science Center, and Kathleen M. Sutcliffe, Ph.D., Gilbert and Ruth Whitaker Professor of Business Administration at the University of Michigan Ross School of Business, are examining the subtle issues around how patient safety has been transformed, and, in essence, become medicalized – controlled by health care organizations and professionals in ways that ensure their continued authority over care processes. Part of the study, Medicalizing Patient Safety, will explore changes in the numbers and proportions of prominently involved clinicians and safety scientists and in patient safety research content and methodologies. The researchers believe that the policy implications from this project will fall into two broad areas: building the human capital to support collaborations between clinical and safety scientists, and expanding the reach and aims of safety research and implementation activities. Findings will identify options for advancing progress in patient safety and for investing in promising avenues of research.