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Progress and Promise

A lot can happen in five years. Advances in medical treatment, new technologies, changes in political leadership—a multitude of factors can influence the field of public health and change the course of history—or at least research, policy and practice.

In the five years since its inception at the George Washington University Milken Institute School of Public Health (Milken Institute SPH), the Sumner M. Redstone Global Center for Prevention and Wellness (Redstone Global Center) has supported new and innovative approaches to many
of the world’s most complex public health challenges. Focused on nutrition, physical activity and obesity, the Redstone Global Center has made meaningful contributions to the field of public health through research, publications, and the application of evidence- based policy into real-world practice.

Redstone Center Director William H. Dietz, MD, PhD, still remembers the call from Milken Institute SPH Dean Lynn Goldman to discuss the new organiza- tion and the director’s position. “It was a tremendous opportunity to accelerate the fight against the growing epidemic of obesity in our country and build a new academic center to address the gaps between research, policy and practice,” said Dietz, who had previously served as
the Director of the Division of Nutrition, Physical Activity, and Obesity in the Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control (CDC) in Atlanta. “With the support of my family and colleagues, I said yes, moved to DC, and have enjoyed expanding the work of the Center over the past five years.”

Flash forward to 2019, and the Redstone Global Center is making the kind of differ- ence that is simply not possible by focusing solely on the clinical side. “Today’s complex health problems need to be addressed at the population level if we are going to make a real impact,” Dietz said.
As part of Milken Institute SPH, the Redstone Global Center is located in the heart of the nation’s capital, just miles from the Halls of Congress and many federal health and science agencies.

“Under Bill’s leadership, the Redstone Global Center has weighed in to help inform policymakers, federal officials and lawmakers as they grapple with some of the most difficult public health issues of the times,” Dean Goldman said. “Here, the Redstone Global Center can have an outsize role in informing local, state and federal policies that impact public health.”

A National Impact

A cornerstone of the Redstone Global Center’s work is to promote innovative initiatives that can stave off unhealthy weight gain, poor nutrition and chronic diseases. “We know that inactivity and obesity can lead to diabetes and other chronic conditions that are difficult to treat after they are established,” said Dietz. To help carry out this mission, the Strategies to Overcome and Prevent Obesity Alliance (STOP Obesity Alliance), initially created at GW in 2007 joined the Redstone Global Center portfolio in 2014.

Cristy Gallagher, Research Project Director with the STOP Obesity Alliance, has been with the organization since 2011. “Dr. Dietz was a founding member of the STOP Obesity Alliance in his role at the CDC, so it was a great opportunity to transition to the Redstone Global Center family when he joined GW in 2014,” she shared. “In the past five years STOP Obesity Alliance has focused on addressing the continuum of care for the prevention and treatment of obesity, from ensuring patients have access to appropriate care, to identifying oppor- tunities for providers to have more training in the area of obesity.” These efforts have resulted in significant contributions to the field, including the creation and curation of Provider Competencies for the Prevention and Management of Obesity and an analysis of Obesity Coverage in Medicaid and State Employer Health Plans over a decade, featuring an interactive U.S. map docu- menting coverage.

In 2018, STOP Obesity Alliance convened a series of roundtable meetings to answer the questions of who should provide obesity care, where obesity care should be delivered and what care should be provided by whom. The result was a practical, tangible, measur- able and simple standard of care for the treatment of adult obesity, providing health professionals, payers, community organi- zations, policymakers and those affected by obesity with guidance on foundational components of evidence-based obesity care across care settings.

As Gallagher puts it, “STOP Obesity Alliance is looking at all the factors that may prevent treatment for obesity from happening—why are patients reluctant to get treatment? What do providers need to start the conversation? What is covered by insurance?” By tackling these ques- tions and building resources for the field, the STOP Obesity Alliance is poised to continue to advance strategies for obesity treatment and prevention.
The Redstone Global Center also recog- nizes that the root causes of many chronic diseases such as obesity, heart disease, and diabetes stem from childhood and commu- nity adversity. In 2015, the Redstone Global Center became the academic home to the Building Community Resilience Network
and Collaborative (BCR). BCR grew from a doctoral research project to an internation- ally recognized public health movement that seeks to prevent Adverse Childhood Experiences by addressing Adverse Community Environments (the “Pair of ACEs”).

Using the BCR process and tools, commu- nities work to align multiple sectors—such as health care, city and county government, and education—with community-based partners, including parenting support services and grassroots health advocates. Teams also develop strategies that bolster strengths, fill gaps, and ultimately build child, family, and community resilience. On a broader scale, BCR fosters the implemen- tation of trauma-informed practices, data sharing, and advocacy for policy change.

The national BCR team at Milken Institute SPH, led by Wendy Ellis, PhD, one of the school’s original Michael and Lori Milken Public Health Scholars, provides technical assistance, including strategic planning, facilitation of cross-sector information sharing, support for data and measurement, development of policy strategies, convening, and communications support. In discussing the success of the BCR process across nine states and DC, Ellis says that “BCR translates the science of the ‘Pair of ACEs’ into action in communities for long-lasting impact. Our work to build community resilience is not just an academic pursuit but really the beginning of a movement for change.” Going forward, BCR will continue to focus on the drivers of inequity in the systems that most influence a community’s access to the resources and supports neces- sary for early child development, health and well-being.

A Global Reach

The Redstone Global Center is not just focused on moving the needle here in the U.S. Dietz is co-chair of the Lancet Commission on Obesity, composed of an international group of commissioners and fellows. Following a series of convenings, including two hosted by Milken Institute SPH, The Lancet released the Commission’s seminal report, “The Global Syndemic of Obesity, Undernutrition and Climate Change,” in 2019. The report is the first to definitively place and critically examine obesity in a wider context of the global interactions of the pandemics of obesity, undernutrition, and climate change.

“The notion of a Global Syndemic is novel. People have been receptive to our recogni- tion of the intersection of climate change, undernutrition and obesity—which are driven by the underlying systems of agricul- ture, transport, land use, and urban design,” shares Dietz. The linkages between these three pandemics suggests double- or triple- duty solutions that simultaneously mitigate two or all three pandemics.

Looking forward, Dietz is optimistic about the two complementary tracks of the Global Syndemic work. “Not only do we have a real possibility of engaging people in making individual changes that will mitigate climate change and have positive benefits for nutrition within the food system, but we are developing plans to leverage commu- nications and policy strategies to bridge silos and address the common drivers of the Syndemic in the U.S.”

The Next Five Years

The successes from the Redstone Global Center’s first five years provide a roadmap for future opportunities. Dietz and the entire team remain committed to improving nutrition, physical activity, and obesity and other activities to address health disparities. “With the ability to leverage the advantages and resources of Milken Institute SPH, the Redstone Global Center’s next five years and beyond will continue the drive to make our communities and others across the globe healthier and more equitable,” Dietz said.

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