Turning Point: Collaborating for a New Century in Public Health

An RWJF National Program

Field of Work: Strengthening the public health system

Problem Synopsis: According to an Institute of Medicine (IOM) report, The Future of Public Health, by 1988, the nation had lost sight of its public health goals, and allowed public health to fall into disarray. The report noted that America's public health system was expected to do too much with too few resources. It also stated that capabilities for effective public health actions were inadequate, and the health of the public was "unnecessarily threatened as a result."

Synopsis of the Work: Turning Point: Collaborating for a New Century in Public Health, a national program of the Robert Wood Johnson Foundation (RWJF) and the W.K. Kellogg Foundation, defined its mission as to "transform and strengthen the public health system in the United States to make the system more effective, more community-based and more collaborative." The two foundations partnered to support 22 states and 41 local communities in those states. RWJF also supported five National Excellence Collaboratives that allowed states to work together on important public health infrastructure challenges.

Key Results

  • According to national program office staff, evaluators from the Public Health Institute, RWJF program officers and the W.K. Kellogg Foundation program director, Turning Point strengthened the public health infrastructure through state/local partnerships that engaged stakeholders that had not previously been involved with public health activities (e.g., businesses, educators, faith communities and community organizations). It also contributed to the national movement toward accreditation for state and local health departments and contributed to the expansion and growth of statewide public health institutes.

Key Findings

  • The evaluators reported the following key findings from the outcomes evaluation of Turning Point:

    • Improved relationships between state and local public health entities have contributed to better use of public health funds, enhanced coordination of emergency response systems and, to a limited extent, improved local input into priority-setting for state health issues.
    • Infrastructure changes in the Turning Point states have made it easier to recruit public health workers, helped retain the workforce and facilitated the development of leaders.
    • Despite many political and funding changes over time, most of the Turning Point states were able to sustain the public health system changes they made during the program.