Dr. John Lumpkin, Sr. Vice President at the Robert Wood Johnson Foundation

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Mark Masse ll i: This is Conversations o n Healthcare . I am Mark Masselli .

Margaret Flinter: And I am Marg a ret Flin ter .

Mark Masselli: Well Marg a r et , a milestone has been reached for the first time
since numbers have been taken the numbers of uninsured Americans has
dropped below 10%, wow .

Margaret Flinter: And according to the National Center For Health Statistics, the
percentage of uninsured Americans has dropped to 9 . 2% in the first quarter of
2015 that’s down from 14 . 3% during the same ti me in 2013 . And the first time
the national uninsured rate has fallen this low .

Mark Masselli: And that tells of the uninsured rate at the time, the passage of the
Affordable Care Act in 2010 Margaret that was around 18% that’s a dramatic
improvement in a very short number of years .

Margaret Flinter: Remember that the measures in the ACA provided tax
subsidies for Americans who qualify to offset the purchase of insurance and that
has helped millions of Americans afford coverage .

Mark Masselli: And you know we are still not done, the nation’s Hispanic
population has seen the highest rates of uninsured in their population . Their
rates dropped from over 40% uninsured in 2013 to 26% but still a long way to go .
African Americans population uninsured ra te drop from 26% to around 15% and
those rates were noticeably lower in states that expand at medicate .

Margaret Flinter: And of course we also have to remember the elimination of
being able to deny coverage for prior conditions also went out . T he y went with
the ACA and that has made a big difference . And of course excess insurance
coverage in healthcare services is just one piece of the nation’s healthcare
puzzle . We still face one of the big threats to American health and that’s nation’s
obesity prob lem . A third of adults and the nation’s children are grappling with
overweight or obesity costing the natio n an estimated trillion dollars in healthcare
cost .

Mark Masselli: Something our g uest today is working to combat Margaret Dr .
John Lumpkin is Senior Vice President of Robert Wood Johnson Foundation .
Over seeing the foundation’s effort to combat childhood obesity Dr . Lumpkin will
discuss the progress that’s been made across the country to confront some of
the contributors to the problem .

Margar et Flinter: And Dr . Lumpkin has some promising news about how the First
L ady’s Let ’s Move! Campaign and the administration’s support for overhauling

school lunch across the nation are truly starting to have an impact . Food for
thought as the nation’s chi ldren had back to school .

Mark Masselli: And Lori Roberston will stop by the managing editor of
FactCheck . org is always on the hunt for misstatements spoken about health
policy in the public domain .

Margaret Flinter: And no matter what the topic you can hear all of our shows by
going to chcradio . com .

Mark Masselli: And if you have comments please email us at
[email protected] or find us on Facebook or Twitter, we love hearing from
you .
Margaret Flinter: We will get to our interview with Dr . John Lumpkin of Robert
Wood Johnson Foundation in just a moment .
Mark Masselli: But first, here is our producer Marianne O’Hare with this week’s Headlines News .
(Music) Maria n n e O’ Hare : I am Maria n n e O’ Hare with the se Healthcare Headlines . In an
effort to come after rising tide of heroin overdoses in this country the White House has announced a plane to target the epidemic . According to the Centers
for Disease Control roughly a 150,000 Americans have died from an O pioid
prescription drug or heroin overdose . In the past 10 years due to the highly
addi ctive nature of the pain killers and the relative cheap price of the street
heroin . The White House program has shift the agenda from prosecuting addicts
to getting to them a treatment would set aside two and half million dollars for
additional drug e nforcement agents to combat the stream of Heroin coming into the nation’s stree ts at their source . Heroin overdoses had quadrupled between
2002 and 2013 leading the CDC to urge physicians to think twice before prescribing prescription OPS to patient which for some become instantly addicting . Meanwhile the US Food and Drug Administration has approved the
use of O pioid pain killers oxycodone in patient aged 11 to 16 who haven’t
benefited enough from alternatives . A long acting drug already treats adults
suffering from round the clock pain and has been reformulated over the yeas to
combat that rising prescription drug abuse in the US unlike adult’s doctors are to
prescribe the medicine only for children who can already tolerate a minimum
dose of 20 milligrams of Oxycodone the active drug ingredi ent in Oxycontin .
Falls are leading cause of injury in older adults and researches say for those with the common lung ailments the risk increa ses significantly . A study looked at fall
rates among seniors suffering from chronic obstructive pulmonary disor der and
found that those of COPD are more likely to suffer from falls if they also have other medical problems . 40% of the patient had at least one fall and most people

who fell did so more than once . Researchers focused on 41 people over 70
years old wi th COPD past researches link COPD to increased risk of balance
difficulties, muscle weakness and thinning bones blackouts and falls . A study
lands more weight to those findings . And trying to get pregnant you might want
to skip the overtime with that hea vy lifting gig for a while . Study shows that
women who work in heavy lifting scenarios have work longer than 40 hours a
week have a harder time getting pregnant . And study of 1700 nurses seeking to
get pregnant so those who routinely engaged in heavy lifting or long work hours
16% of them still weren’t pregnant after 12 months . And 5% weren’t pregnant
after 2 years, those women who work less than 40 hours and didn’t engage in
frequent heavy lifting got pregnant 20% faster than their counterparts . I’m
Marianne O’Hare with th e s e healthcare headlines .

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Mark Masselli: We are speaking today with Dr . John Lumpkin Senior Vice
President Director of Targeted Teams at the Robert Wood Johnson Foundation .
The largest foundation in the nation dedicated to improving health and
healthcare . Dr . Lumpkin is responsible for all management aspects of the RWJ
foundation’s childhood obesity and several other teams . He is an emergency
medicine physician . Dr . Lumpk in served as the director of Illinoi Department o f
Public Health for 12 years . He is chairman o f the Board of Directors of the
Robert Wood Johnson University Hospital . The major teaching hospital of
Rutgers University . He earned his medical degree from North Western
University and his MPH from Illinois University . Dr . Lumpkin welcome to
Conversations on Healthcare .

Dr . Lumpkin: Well thank you it’s a pleasure to be here .

Mark Masselli: You know I think most Americans know that we are facing an
obesity epidemic but I am not sure that where all of the implications . And it’s
especially troubling for the nation’s children 35% of the nation’s children article
obese or overweight . And there are also dispassionate rates of obesity facing
racial or ethnic minority populations . In fact the epidemic is so alarming that
analyst predict this is the first generation that we will have a lower life expectancy
then their parents . Tell us more about the scope of this public health crisis and
the risk factors for obese children today and the toll is taking on their healthcare .

Dr . Lumpkin: I started out in medicine many decades ago and when I was taught
I learned about two types o f diabetes juvenile onset diabetes and adult onset
diabetes . And pretty much you saw in kids and you saw the other in adults . Now
we talk about type - 1 and type - 2 diabetes because what used to be adult onset
diabetes we are seeing now kids in their early teens . And this is a direct result of
this epidemic of childhood obesity . We have seen the rates of obesity over the
last 30 years have tripped among adolescents and quadrupled among children 6
to 11 years old . This generation and the one w ho are the fu ture of our nation are

at risk of being the first generation to live sicker and die younger than their
parents .

Margaret Flinter: Well Dr . Lumpkin the Robert Wood Johnson Foundation as I
think most of our listeners know is the largest foundation dedicate d to improving
health and healthcare in United States . And you just announced a sizable
commitment to a program that began back in 2007 to tackle childhood obesity,
tell us about some of the specific goals that you have established with the
childhood obesity program at the foundation and some of the results and the
outcomes that you are seeing so far .

Dr . Lumpkin: We started out actually in childhood obesity in 2003 and as we are
begun to work in we realized that of cr itical focus at that time was to do a few
things . One, we as a nation believe by enlarge that childhood obesity was a
problem of individual choice . And we have been able to identify with research
that now the public believes that the childhood obesity is a problem for all of us in
our communities . Obesity is purely an imbalance between how much food you
bring in and how much you exercise it’s that simple . When I was growing up we
used to think about you know young people as being thought those who are
involved in getting up and going now this generation is sitting downing and
watching and eating . You know that means that we have to change the way that
our environment is where people live . So how we build our communities? And
what we are seeing today i s that the rising tide of childhood obesity is slowing
down and even stopping . Children are now having access to more health
schools, meals and school snacks because of some of the Federal policies . As
well as the fact that school are adopting healthier school approaches focusing on
exercise , recess activities and healthier lunches .

Mark Masselli: Understand this new commitment of the foundation is going to
really focusing on urban neighborhood where poverty is a key factor . So tell us
our listeners ab out the new target approach to ensure that every Americans child
who went to kinde rgarten enters in a healthy way .

Dr . Lumpkin: Our priorities now are to move from where we learned to how to
work with school age children to recognize that some of the decisions that are
been made even when mothers are pregnant or early childhood . Significantly
sta cked the deck one way the other so the first goal is to show that all children
ente r kindergarten in a healthy way that we want to make healthy school
environ ment the norm not the exception across United State . We make physical
activity are part of the everyday experience for children in US . And to make
healthy food affordable, available and desire choice in all neighborhoods and
communities . And so this is a problem for every one of us in this country .
Whether it be the individuals or physicians, nurses who are in the care giving
professions . But it’s also problem for businesses or churches for communities,
for social leaders for urban planners . And then our last priority is to eliminate the
consumption of sugar, sweet and beverages among children under 5 years of

age . Evidence is clear that children start using sugary beverages at that risk the
risk for obesity and overweight goes up dramatically .

Margaret Flinter: maybe you could highlight some of the programs that you and
the foundation have observed to really work . Share some success stories across
the policy a ctivity, nutrition intervention .

Dr . Lumpkin: I think perhaps the biggest one is th e involvement of First Lady
Michelle Obama with her Let’s Move! Campaign and with her influence in
changing the rules for school lunches . As of today about 80% of the schools in
the country they are now in compliance with those new school rules . They had to
removes the fires and put in boiling un its but the food that is served is lower in fat
because of these changes children are actually selecting more fruits and
vegetables and consuming more . But we have also seen some significant
progress in New York City and Philadelphia and they are both shining examples
of what happens when a whole city decides day one to get involved . You know
there is clear evidence now that children who are active at recess who are
engaged in physical activity actually do better in academic performance . New
York has focusing also on the childcare setting they have worked with child care
centers that help them understand how to provide healthier foods, how to provide
nutrition education? Because often if you educate the child they bring that home .
They looked at ways that childcare centers can increase the amount of physical
activity and most importantly limit the amount of screen time . And we have seen
the result that the rates of childhood obesity in both New York and Philadelphia
has gone down . Now Philadelphia has done something that’s really particularly
special and we are doing some studies in Philadelphia to see exactly what they
have done but they did pays special attention to helping increase the availability
o f fruits and vegetables in communities that’s prior that’s had been food desert .
We can begin to solve this problem .

Mark Masselli: We are speaking today with Dr . John Lumpkin Senior Vice
President and Director of Targeted Teams at the Robert Wood Johnson
Foundation including the childhood obesity teams . Dr . Lumpkin there are couple
of takeaways one is that the teamwork is the new employee of every healthcare
organization . And you mentioned the First Lady in her great campaign on Let’s
Move! Any w orries from you in terms of having a broad enough coalition for the
science of what has worked so far so important about the school . Breakfast and
lunch programs how they are really transforming the nation realities for millions of
children around the country?

Dr . Lumpkin: You know I think many of us in our country and poles demonstrate
that people are becoming increasingly be fiddled by what’s going on in
Washington . Because once you get out into the communities and began to talk
to parents and you talk to business es you talk to schools . They can all
understand that what’s most important to them are their children and the children
of those communities . And when you begin to make the statements in this

country that we are all in this together people begin to see the importance of
change . Whether or not it’s the First Lady and certainly she has really champion
this issue but out in community speaking the programs like Let’s Move! A nd you
have organizations that have adopted the Let’s Move! N ame as pa rt of their
name because they are fully committed to the goal . We believe that partnership
is a critical c omponent one is one that was started by the First Lady’s called the
Partnership For A Healthier America and this is been a really interesting
organization because they just had a meeting two weeks ago I was there at the
meeting and we had businesses from across mini spectrum there were daycare
centers, there were food growers, that was just a new campaign o n fruits and
vegetables that was announced by the products industry to make it cool for
children to eat fruits and vegetables . Using movie stars like Jessica A lba and
football players and even world wrestling stars to say how important it is to eat
fruits and vegetables and broccoli . We have also worked with the alliance for
healthier generation which is partnership with the Cleen foundation . And they
have worked with our support with over 2600 schools nation wide . And these
schools all make commitments to change their policies and ch ange how food is
made available and how exercise and plays available for the children . And I
have been to so many schools and you just can’t imagine how of a change these
schools have, I was at one just last month where the principal actually lead the
spin class and the principal who had a big office and said I don’t need an office
this big and she converted half of the office into a kitchen where students can
come in and learn how to cook healthy meals . We are partnering w ith Americans
Heart Association and an organization called Voices for Healthy Kids and this is
focused at many of the key components reaching out and building partnerships
with wise and other organizations . For schools , it seems like it ought to be a no
brainer, healthy children learn better . Children who are obese are more likely to
be obese adults , to have illnesses , and business work better when t heir
employees come in everyday . So cost of care of individuals is based upon how
hea lthy they are and obesity is one of the major risk s for diabetes, for heart
disease, for stroke . So if we can began at a younger age that’s when we begin
to see real change happen .

Margaret Flinter: Well it does seem that we have seen a change in this a rea over
the last decade and you know I just have such a clear memory of so many
pointed arguments in the general assembly and so forth. Things like if you take
away the vending machines in the schools and you take away the odd program
and the football team that seems to have subsided to a large degree, but some of
these has really been about the partnership with the food and beverage industry
to make a contribution on their part to try and eliminate or reduce some of these
calories from the market place . And the foundation had looked at the
commitment from the food and beverage industry to remove 1. 5 trillion calories
from the market place and found that companies removed 6 trillion calories. Tell
us some of these large partnerships with really with t he food and beverage
industry.

Dr. Lumpkin: Sure you know I (inaudible 17:47 ) the campaign against tobacco.
This is different we will not be able to be successful in changing the whole
outlook for a country about what’s healthy without the direct involv ement and
commitment of the food industry. And we are beginning to see some changes
and have foundation we really have not been shy about pressing the industry to
do more but we also believe that we shouldn’t hesitate to (inaudible 18:16 ) and
practices th at we believe are positive and makes a difference. And that’s what
happens with the Healthy Weight Commitment, they came to us they said we
want you to be a part of our Healthy Weight Commitment we said what we will do
is, we will fund in an independent e valuation. You say you are going to move 1.
5 trillion calories we are going to follow up and make sure that that happens.
And we found not that they reduced 1. 5 trillion reduce, removed 6. 4 trillion and
that really was a major support step, it’s a fir st step. But we think it’s going to be
critical for the food industry to not only realize that it’s important for them to
change but it also makes good business sense. The industry needs to actually
believe that it can make financial sense, there are som e studies that are starting
to come out that show that companies at market better for you and lower calories
products actually do better financially. And you are beginning to see companies
like Burger king and McDonald and the Wendy's the big three of ham burgers
taking sugary beverages off of their children menu. But the other piece is all of
us who buy food need to have been better educated, the problems of high sugar
or high salt of low nutritional value. And we need to demand healthier food and
when y ou put those two together and increase demand for healthier food and the
food industry realizing that’s where they can do better financial then we began to
see a dramatic change, required to different working relationship with the industry
then we have had on other issues.

Mark Masselli: We have been speaking today with Dr. John Lumpkin is Senior
Vice President & Director of Targeted Teams at the Robert Wood Johnson
Foundation, you can learn more by following Dr. Lumpkin at Twitter@JR Lumpkin
or by going to RWJF. ORG. Dr. Lumpkin thank you so much for joining us today
on conversations on healthcare.

Dr. Lumpkin: Thank you so much.

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Mark Masselli: At Conversations on Health Care, we want our audience to be
truly in the know when it comes to the facts about Healthcare Reform and policy .
Lori Robertson is an award - winning journalist and managing editor of
FactCheck . org, a nonpartisan, nonprofit consumer advocate for voters that aim to
reduce the level of deception in US politics . Lori, what hav e you got for us this
week?

Lori Robertson: For this week Karley Sciortino claimed that emergency room
visit are up over 50% under the Affordable Care Act but that claim is unsupported

by the evidence and unlikely based on historical trend. It may be ye ars before
we know the full impact of the ACA on ER visit. Available data doesn’t include
2014 when the law began requiring individuals to have insurance. Sciortino ’s
presidential campaign didn’t respond when we asked her where she got her
figure but num bers available from the CDC and the Department of Health and
Human Services, healthcare cost and utilization project show there were more
than 130 million ER visits in 2011 or 2012. So early visits would have to have
increased by more than 65 million for fewer units to be right, that’s unlikely. The
HHS data showing average annual increase of 2% over 6 years and the
Americans Hospital Association’s data for community hospitals shows a 44%
increase in ER visits over 20 years from 1993 to 2013. There have been media
reports of an increase in ER visits since January 2014 many based on an opt in
internet survey of members of the Americans College of Emergency Physicians,
47% of the physicians who choose to respond said they had noticed slight
increases in the number of emergency patient, while 28% that there had been
significant increases. A Stanford University study mean while found some
evidence that the ACA is slowing the growth of ER visits among younger adults,
who since September 2010 have been able to stay on their parent’s insurance
policies up to aged 26. A nd that’s my f act c heck for this week . I’m Lorry
Robertson , Managing Editor of FactCheck . org .

Margaret Flinter: FactCheck . org is committed to factual accuracy from the
country's major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania . I f you have a fact, that you would like
checked, email us at Chcradio . com, we will have FactCheck . org's Lori Robertson
check it out for you here on Conversat ions on Health c are .

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Mark Masselli: Each week Conversations highlights a bright idea about how to
make wellness a part of our communities and everyday lives . In the emergency
room or the ICU clinicians are confronted with a (inaudible 23:06 ) of
unpredictable medical crisis, is that sometimes can be challenging to diagnose.
Most of these clinicians are now communicating with collogues via their smart
phones often sending images of the patient unique symptoms or chest x - rays to
one another fo r share diagnosis. ICU physician Dr. Josh Landy was noticing a
growing trend of image sharing via smart phones to crowd source second
opinions from friends and collogues across the country but he also was
concerned about the potential violation of HIPAA r egulations . So he developed
an App for that, he created a figure one a sort of Instagram for doctors in which
images can be de - identified but shared across a dedicated social media platform
that will allow input from clinicians within their network. Doct ors are using the
App to communicate not only with collogues within their hospitals settings but
around the world where someone might have superior expertise with a certain
condition. The App was recently used to share a chest image of one of the
patient who presented with a mid eastern virus MERS . Dr. Landy says the App

scale about half a million image views a day with about 80 million total views so
far. He sees the potential for this platform only growing as more young digital
natives enter the medica l workforce. Figure 1 a free downloadable App offering
secured HIPAA compliance image sharing among clinicians around the world to
reduce the time, takes the zeroing on the diagnose by taping the collective
experts instantly, now that is a bright idea.

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Margaret Flinter: This is Conversations on Health c are . I am Margaret Flinter .

Mark Masselli: And I am Mark Masselli . Peace and health .

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Conversations on Health c are, broadcast from the campus of WESU at Wesleyan
University, streaming live at Wesufm . org and brought to you by the Community
Health Center .

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