Investigator Awards In Health Policy Research Investigator Awards in Health Policy Research
55 Commercial Ave.
Third Floor
New Brunswick, NJ 08901-1340
Tel: (732) 932-3817
Fax: (732) 932-3819
Email: depdir@ifh.rutgers.edu
www.investigatorawards.org

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.
2010 Call For Applications
We expect our program's next CFA to be released in the fall of 2010 - please be sure to visit our web site in October for details. We also recommend that you register for email alerts from RWJF on future funding opportunities by visiting RWJF Services Login & Registration.
»Go To: RWJF Services Login & Registration
Friday August 27, 2010
»Hot Off the Press - Democracy Remixed - New Book by 2004 Awardee Cathy Cohen, PhD
A new book by 2004 Awardee Cathy Cohen has just been published by Oxford University Press. Titled Democracy Remixed: Black Youth and the Future of American Politics, the book 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. 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.

Cathy J. Cohen, Ph.D. is the David Mary Winton Green Professor of Political Science and Deputy Provost for Graduate Education at the University of Chicago.

Source: National Program Office

Wednesday August 18, 2010
»We Moved Our Office
The RWJF Investigator Awards National Program Office has moved. Our address and phone numbers have changed but our email addresses remain the same. Our new phone number is 732-932-4105 ext. 23817. Our new address is 112 Paterson Street, 2nd Floor, New Brunswick, NJ, 08901.

Source: National Program Office

Thursday August 12, 2010
»Hot Off the Press: Book on Medical Professionalism in the New Information Age edited by 2003 Awardee David Rothman and 2002 Awardee David Blumenthal
A new book by a group of our program's investigators, Medical Professionalism in the New Information Age, has just been published by Rutgers University Press. With computerized health information receiving unprecedented government support, the book's editors and chapter authors analyze the intricate legal, social, and professional implications of the new technology. According to one reviewer, "Rothman and Blumenthal's compelling book 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."

2003 Awardee David J. Rothman, Ph.D. is president of the Institute on Medicine as a Profession (IMAP) and Bernard Schoenberg Professor of Social Medicine at Columbia College of Physicians & Surgeons. 2002 Awardee David Blumenthal, M.D., M.P.P. is national coordinator for health information technology in the U.S. 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. Chapter authors include investigators Eugene Declercq, Mark Hall, Mark Rodwin, Sara Rosenbaum, Sheila Rothman, Mark Suchman, and Nancy Tomes as well as outside scholars, Kristin Madison, Michael Painter (RWJF), Matthew Dimick, and Natassia Rozario.

Source: National Program Office

Thursday July 15, 2010
»New York Times Publishes OpEd Piece by 2007 Awardee Peter Ubel
An OpEd piece by 2007 Awardee Peter Ubel, MD and his colleague George Loewenstein, PhD appears in today's New York Times. The piece, "Economics Behaving Badly", discusses both the potential and limits of behavioral economics for guiding the kinds of far-reaching policies we need to tackle our nation's challenges in health care and other sectors.

Source: National Program Office

Tuesday July 6, 2010
»Keith Wailoo, 2001 Awardee and NAC Member, Appointed Professor of History and Public Affairs at Princeton University
Congratulations to Keith Wailoo, Ph.D., 2001 Awardee and NAC Member, who has been appointed Townsend Martin Professor of History and Public Affairs at Princeton University. He is jointly appointed to the department of history and the Woodrow Wilson School of Public and International Affairs. Previously, Dr. Wailoo was the Martin Luther King, Jr. Professor of History at Rutgers and was also appointed to the Institute for Health, Health Care Policy, and Aging Research.

Source: National Program Office

Thursday July 1, 2010
»Congrats to 1996 Awardee Lisa Iezzoni and 2009 Awardee Aaron Kesselheim, AcademyHealth Award Winners
Earlier this week, AcademyHealth recognized the research contributions of Lisa Iezzoni, MD, MSc and Aaron Kesselheim, MD, JD, MPH at its 2010 Annual Research Meeting.

• Lisa Iezzoni, 1996 Awardee, received the Distinguished Investigator Award, which recognizes investigators who have made significant and lasting contributions to the field of health services research through scholarship and teaching, advancement of science and methods, and leadership. Lisa was recognized for her work in a number of areas including risk adjustment and for her Investigator Award research on health care quality and policy for persons with disabilities.

• Aaron Kesselheim, 2009 Awardee, received the Alice S. Hersh New Investigator Award, which recognizes the contribution of new scholars to the field of health services research. Aaron’s Investigator Award research focuses on the role of patents in drug development.

Source: National Program Office

Tuesday June 22, 2010
»Congratulations to 1995 Awardee Sherry Glied - Confirmed as HHS Assistant Secretary for Planning and Evaluation
Sherry Glied, PhD, professor in the Department of Health Policy and Management at Columbia University's Mailman School of Public Health, has been confirmed as Assistant Secretary for Planning and Evaluation, Department of Health and Human Services. The Assistant Secretary is the principal advisor to the Secretary on policy development, and is responsible for major activities in policy coordination, legislation development, strategic planning, policy research, evaluation, and economic analysis.

Sherry is a 1995 Awardee and served on the National Advisory Committee of the RWJF Investigator Awards program from 1999 to 2005.

Source: National Program Office

Monday June 21, 2010
»Research on Nurse Staffing by 1998 Awardee Linda Aiken Cited in New York Times OpEd Piece on June 19, 2010
Research findings by 1998 Awardee Linda H. Aiken, PhD, FAAN, RN on the relationship between nurse staffing levels in hospitals and patient outcomes, as well as nursing staff turnover, were featured in an OpEd piece by Theresa Brown that was published in The New York Times on June 19, 2010. The piece, titled Is There a Nurse in the House?, urges Congress to mandate a federal standard for nurse-patient ratios to help ensure patient safety. Dr. Aiken is the Claire M. Fagin Leadership Professor of Nursing and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania.

Source: National Program Office

Tuesday June 1, 2010
»2008 Awardee Stephen Hinshaw Quoted in Today's New York Times in Article on Testing for ADHD
2008 Awardee Stephen P. Hinshaw, PhD, Professor and Chair of the Department of Psychology at UC Berkeley, was quoted in an article by Katherine Ellison titled, "Seeking an Objective Test for Attention Disorder," which appeared in The New York Times on June 1, 2010. With an RWJF Investigator Award, Steve and co-PI Richard Scheffler are studying ADHD Medication in America: Society, Schools, and Public Policy.

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.
DanielCarpenter
Reputation and Power in the Balance at the FDA
Daniel P. Carpenter, Ph.D.
Issue 29, June 2010
»Download the full issue in PDF format
»Go to Issue Index
»Show Summary

The U.S. Food and Drug Administration (FDA) is one of the world’s most powerful regulatory agencies. No new drug can be marketed legally in the United States unless the FDA declares it to be “safe and effective” for its intended uses. Having set the scientific standards and processes for drug approval, the FDA has played a key role in the industry’s evolution worldwide and shapes how pharmaceutical companies develop, market, and manufacture their products. More subtly, the FDA undergirds public confidence in pharmaceuticals.

According to Daniel Carpenter, the Allie S. Freed Professor of Government and Director of the Center of American Political Studies at Harvard University, the primary source of the agency’s power is its professional and scientific reputation, carefully cultivated over time and guarded by FDA career officials.

But how did the FDA’s reputation invest it with so much influence? And how exactly does the FDA wield its extraordinary power? Carpenter has probed these and other intriguing questions about the FDA’s history, evolution and behavior, more deeply perhaps than any other scholar ever.

Carpenter traces the roots of his interest in the curious and sometimes troubled intermingling of regulation, power, and politics to his grandfather, Edward Krumbiegel, who served for 33 years as health commissioner for the city of Milwaukee, Wisconsin. The stories he heard from his grandfather and from his mother, Kathleen, who worked as a radiologist, about battles over fluoridation, pest control, and other public health issues led him to understand early on that health policy does not emerge purely or even largely from the world of science. “I learned that public health was an endeavor not only of science, but of politics in its best and worst aspects,” Carpenter says.

»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.
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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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»Show summary
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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»Show summary
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
»More details
»Show summary

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.

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The Heart of Power: Health and Politics in the Oval Office
Blumenthal, D., Morone, J.A
Published: 2009
University of California Press
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»Show summary
Even the most powerful men in the world are human—they get sick, take dubious drugs, drink too much, contemplate suicide, fret about ailing parents, and bury people they love. Young Richard Nixon watched two brothers die of tuberculosis, even while doctors monitored a suspicious shadow on his own lungs. John Kennedy received last rites four times as an adult, and Lyndon Johnson suffered a "belly buster" of a heart attack. David Blumenthal and James A. Morone explore how modern presidents have wrestled with their own mortality—and how they have taken this most human experience to heart as they faced the difficult politics of health care. Drawing on a trove of newly released White House tapes, on extensive interviews with White House staff, and on dramatic archival material that has only recently come to light, The Heart of Power explores the hidden ways in which presidents shape our destinies through their own experiences. Taking a close look at Franklin D. Roosevelt, Harry S. Truman, Dwight Eisenhower, John Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, Ronald Reagan, George Herbert Walker Bush, Bill Clinton, and George W. Bush, the book shows what history can teach us as we confront the health care challenges of the twenty-first century.
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Toward the Healthy City: People, Places, and the Politics of Urban Planning
Corburn, J.
Published: 2009
MIT Press
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»Show summary
In distressed urban neighborhoods where residential segregation concentrates poverty, liquor stores outnumber supermarkets, toxic sites are next to playgrounds, and more money is spent on prisons than schools, residents also suffer disproportionately from disease and premature death. Recognizing that city environments and the planning processes that shape them are powerful determinants of population health, urban planners today are beginning to take on the added challenge of revitalizing neglected urban neighborhoods in ways that improve health and promote greater equity. In Toward the Healthy City, Jason Corburn argues that city planning must return to its roots in public health and social justice. The first book to provide a detailed account of how city planning and public health practices can reconnect to address health disparities, Toward the Healthy City offers a new decision-making framework called "healthy city planning" that reframes traditional planning and development issues and offers a new scientific evidence base for participatory action, coalition building, and ongoing monitoring. To show healthy city planning in action, Corburn examines collaborations between government agencies and community coalitions in the San Francisco Bay area, including efforts to link environmental justice, residents' chronic illnesses, housing and real estate development projects, and planning processes with public health. Initiatives like these, Corburn points out, go well beyond recent attempts by urban planners to promote public health by changing the design of cities to encourage physical activity. Corburn argues for a broader conception of healthy urban governance that addresses the root causes of health inequities.
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 2009

The Robert Wood Johnson Foundation (RWJF) has announced the selection of this year's recipients of its Investigator Awards in Health Policy Research. Sixteen scholars affiliated with major universities across the country will receive awards of up to $335,000 to support 10 new research projects. The winning researchers will tackle major challenging policy issues facing America today, as well as wide-ranging concerns about the nation's health and health care system.

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, and public and social policy. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications.

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 157 projects involving 202 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 stimulates thinking that is creative and crosses disciplinary boundaries in search of knowledge and solutions to vexing issues affecting health and health care in the United States," Mechanic says.

For details of the 2008 Investigator Awards click "Show Awards" below.

»Show Awards
Alan S. Gerber, Ph.D.
Eric M. Patashnik, Ph.D., M.P.P.
Inadequate Medical Evidence: Political Incentives and the Prospects for Sustainable Reform
Award Year: 2008

»Show Abstract
The effectiveness of many medical treatments and procedures remains unknown, despite concerns that the United States spends too much on ineffective care. Why has the federal government invested so very little in rigorous effectiveness research up to now? Co-PIs Alan S. Gerber, Ph.D. and Eric M. Patashnik, Ph.D., M.P.P. believe that the answer lies in the incentives built into our political system. Their project, Inadequate Medical Evidence: Political Incentives and the Prospects for Sustainable Reform, explores the lack of a strong policy response to the need for medical evidence. Drs. Gerber and Patashnik consider a range of factors, including the influence of health care providers and other special interests, lack of policy initiative, insufficient federal agency capacity, the limits of patient advocacy, and the silence of the wealthy and powerful. Results should provide fresh insights into the opportunities and challenges that emerge as the Obama Administration adopts comparative effectiveness research as a strategy for controlling U.S. health care spending by reducing ineffective care.
William K. Hallman, Ph.D.
Neal H. Hooker, M.A., Ph.D.
The Diet-Health Nexus: Communicating Emerging Evidence
Award Year: 2008

»Show Abstract
As increasing numbers of Americans try to eat healthily and reduce their risk of chronic disease, they are paying more attention to product ingredients, labeling, advertising, and information from a variety of sources about the health benefits of foods and beverages. They are also spending more on foods that they believe are "heart-healthy" or can reduce their risk for certain cancers. But given the level of scientific uncertainty surrounding the health effects of food, what are consumers getting for their money? Co-PIs William K. Hallman, Ph.D. and Neal H. Hooker, Ph.D. study how information is used in food claims and marketing, as well as how adeptly consumers grasp the information provided. Their project, The Diet-Health Nexus: Communicating Emerging Evidence, examines how information is crafted and conveyed; how older consumers understand and evaluate food claims and dietary advice; and whether the Food and Drug Administration's (FDA) regulatory approach has educated consumers about the limits of scientific evidence and the accuracy of health claims. Drs. Hallman and Hooker will produce recommendations on how to inform consumers better. Their project should help shape the FDA's efforts to revise, or perhaps even revamp, its policies for regulating health claims by food and beverage manufacturers and producers.
Sherman A. James, Ph.D.After the Walls Came Tumbling Down: The Health Legacy of the 1960s Civil Rights Era in a Southern Community
Award Year: 2008

»Show Abstract
During the years immediately following the passage of the Civil Rights Act of 1964, gaps in health and access to medical care between black and white Americans began to narrow. How did civil rights legislation and newly created social programs help lead to those health improvements? Sherman A. James, Ph.D. probes this question in his project, After the Walls Came Tumbling Down: The Health Legacy of the 1960's Civil Rights Era in a Southern Community. Through a case study of Pitt County, North Carolina, a poor rural southern community, Dr. James looks at the activities of those who led the desegregation of the county hospital and efforts by citizen activists, voluntary organizations, community leaders, and the press to open the doors of opportunity. Using the fundamental cause framework developed by Investigator Awardees Jo Phelan, Ph.D., and Bruce Link, Ph.D., Dr. James analyzes how access to money, knowledge, prestige, power, and social connections is linked to population health and to the success of public policies. His findings should help illuminate the role civil society plays in distributing life-enhancing resources more fairly and in facilitating or impeding public policies aimed at improving the health of all Americans.
Jason Karlawish, M.D.The Making and Unmaking of Alzheimers Disease
Award Year: 2008

»Show Abstract
When is Alzheimer's disease (AD) a diagnosis and when is it a prediction? As we develop new tests to identify a person's propensity for the disease, and as we expand the definition of Alzheimer's to include patients with "preclinical AD", "prodromal AD", and mild cognitive impairment, we blur the line between diagnosis and risk assessment. With that comes the potential to harm patients and to overburden our system by treating what is actually normal, age-related cognitive change. Jason Karlawish, M.D. explores how our understanding of brain aging is changing and raising controversies. In The Making and Unmaking of Alzheimer's Disease, he examines issues such as disagreements among experts about how to define and treat dementia, the use of neuroimaging, Medicare reimbursement for PET scans, genetic testing, healthy brain initiatives, and the emerging market for brain fitness activities. Dr. Karlawish considers the actors involved - from clinicians, researchers, and pharma to advocacy organizations, patients, and families - as well as the ethical, economic, and policy implications of changes in how AD is defined and measured. The project's results will contribute to policy debates about the value of costly testing, preventive treatments, and public health initiatives to maintain brain health.
Naa Oyo A. Kwate, Ph.D.
Ilan H. Meyer, Ph.D.
On the Content of our Character: The Myth of Meritocracy and African American Health
Award Year: 2008

»Show Abstract
Many people believe that, with the right mix of talent, ability, hard work, and opportunity, anyone can achieve the wealth and success that the American Dream has come to represent. Yet the rise to the top in America is limited, especially for those who live in segregated neighborhoods and those who have few educational and economic opportunities. Co-PIs Naa Oyo A. Kwate, Ph.D. and Ilan H. Meyer, Ph.D. propose that, for African Americans, living in a culture that so highly values self-determination can lead to demoralization, unhealthy coping strategies, and higher rates of illness and early death. In their project, On the Content of Our Character: The Myth of Meritocracy and African American Health, Drs. Kwate and Meyer look at how widely ingrained such beliefs are across the United States. They also consider how meritocratic beliefs may be linked to political views about the role of government and the plight of the disadvantaged, and to disparities in health and well being. This project will shed light on the hidden consequences of meritocratic beliefs.
Edward W. Maibach, Ph.D., M.P.H.
Matthew C. Nisbet, Ph.D.
Mobilizing Citizen Support for Climate Stabilization and Adaptation Policies
Award Year: 2008

»Show Abstract
Climate change poses a potentially significant threat to the public's health, and addressing it is among President Obama's top priorities. Co-PIs Edward W. Maibach, Ph.D., M.P.H. and Matthew C. Nisbet, Ph.D. believe that citizens and stakeholders need to play an active role in formulating effective public policies and investments in greenhouse gas reduction. Their project, Mobilizing Citizen Support for Climate Stabilization and Adaptation Policies, investigates how best to engage Americans on climate control issues and analyzes the extent to which a health perspective can enlist community interest and participation. Through surveys and interviews, Drs. Maibach and Nisbet explore people's beliefs and motivations and test their reactions to various policy proposals and messages about climate change and its health implications. Their research findings could help galvanize the public health community and provide policy experts, government agencies, journalists, and other stakeholders with practical guidance on how best to increase public understanding of the implications of climate change.
Alberto Palloni, Ph.D.
Carolina Milesi, Ph.D.
Analyzing the Relationship Among Early Childhood Conditions, Reproduction of Socioeconomic Inequalities and Adult Health Disparities
Award Year: 2008

»Show Abstract
Despite increased attention to the disturbing problem of disparities, certain groups of Americans remain healthier than others, due largely to differences in race and ethnicity, income, education, residential segregation, and other social factors. Co-PIs Alberto Palloni, Ph.D. and Carolina Milesi, Ph.D. seek to better understand the mechanisms that lead to health gaps by probing the connections between child and adult health. Their project, Early Childhood Conditions, Reproduction of Socioeconomic Inequalities, and the Persistence of Adult Health Disparities, employs innovative methods to study how pathways to fair or poor health in adulthood unfold from early childhood. Drs. Palloni and Milesi analyze a host of factors, including the effects of parents' socioeconomic status, their health and use of tobacco and alcohol, child health outcomes, development of personality traits such as tenacity and perseverance, exposure to stressful environments, and educational attainment. Project findings should help improve the design of strategies aimed at reducing disparities by identifying options for mitigating the consequences of poor health in children.
Richard M. Scheffler, Ph.D.
Stephen P. Hinshaw, Ph.D.
ADHD Medication in America: Society, Schools, and Public Policy
Award Year: 2008

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Attention deficit/hyperactivity disorder (ADHD) affects over 4 million children in the United States. The disorder inhibits academic achievement and the development of social relationships, life skills, and independence. Yet the causes of ADHD and its diagnosis and treatment remain mired in controversy. Co-PIs Richard M. Scheffler, Ph.D. and Stephen P. Hinshaw, Ph.D. examine clinical and policy issues surrounding the diagnosis and treatment of ADHD. Their project, ADHD Medication in America: Society, Schools, and Public Policy, considers ADHD's biological basis and risk factors; market influences on diagnosis and medication rates; prevalence and treatment disparities; the impact of relevant federal and state laws on schools, children, and their parents; and the cost effectiveness of treatment options. Drs. Scheffler and Hinshaw will produce evidence-based policy recommendations for reducing diagnostic and treatment disparities, for improving access to effective treatments, and for increasing use of the most cost-effective treatments. Their research findings should inform policy debates and expand our understanding of how to treat children with ADHD more effectively and improve their quality of life.
Gary A. Taubes, M.S.E., M.S.The Sweetening of a Nation: The History, Politics and Health Effects of Sugar and High-Fructose Corn Syrup
Award Year: 2008

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Over the last 150 years, Americans have increased their intake of sugar and high-fructose corn syrup (HFCS) dramatically, so that caloric sweeteners now comprise 20 to 25 percent of the calories we consume. While most experts agree that such large amounts of either sugar or HFCS are bad for our health and should be avoided, we still don't know if they can lead to obesity, diabetes, and heart disease. Gary Taubes, M.S.E., M.A. seeks to learn more about the possible relationship between excess consumption of sweeteners and chronic health problems and about how special interests may have influenced research and policy development in this area. In The Sweetening of a Nation: The History, Politics, and Health-Effects of Sugar and HFCS, Mr. Taubes investigates not only past research on the health effects of sugar consumption, but how the Western diet became saturated with caloric sweeteners to begin with, and how industry and other special interests may have thwarted government efforts to rein in sugar consumption and limit scientific inquiry. Mr. Taubes' investigation should enhance the knowledge we need to develop a fuller range of policy options that protect Americans' health and more adequately address the epidemics of obesity and diabetes.
Celeste Watkins-Hayes, Ph.D.Health, Hardship, and Renewal: Economic Strategies among Black Women Living with HIV/AIDS
Award Year: 2008

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People with HIV are living longer than ever before, giving us a new window on chronic illness and economic hardship. How do poor and working-class black women with HIV continue to make ends meet and take care of themselves as their disease progresses? Celeste Watkins-Hayes, Ph.D. collects the first longitudinal ethnographic data to study the economic and social survival strategies these women use to get by. In Health, Hardship, and Renewal: Economic Survival Strategies among Black Women Living with HIV, Dr. Watkins-Hayes examines employment opportunities and barriers, disability benefits, access to a complicated array of public services and providers, help from family and friends, and other informal sources of support. She also investigates how survival efforts might promote or undermine the health and well being of disadvantaged black women with HIV, and whether they are at increased risk of becoming homeless, engaging in prostitution or drug dealing, or being exposed to other infectious diseases. Research findings should help advance our understanding of the economic and social challenges that women coping with HIV/AIDS must face.