Seven Lessons I've Learned About Improving Health In America

"A few months ago, not long after I announced that 2017 would be the year I would step down as president and CEO of this remarkable organization, I experienced a deeply moving and defining moment."       —Risa Lavizzo-Mourey, former RWJF President and CEO

It happened during our annual Culture of Health Prize celebration, when the Foundation honors the men and women of communities across the nation who are working to make their towns, their tribes, their cities, and their neighborhoods as healthy as they can be. These are people who are passionate about making a difference. They are mayors, teachers, bankers, architects, and religious leaders. They are mothers, fathers, and irrepressible teens. They work in housing, transportation, education, private industry, community development, criminal justice, and yes, health care. And every one of them knows that meaningful change—the kind that morphs hope into possibility—doesn’t come from the top down. It is built from the ground up by the very people who crave it.

One of these folks is James W. McGee, the mayor of Vinita Park, Mo., population 1,881. And the moment that touched my heart happened as I listened to him tell his story. Mayor McGee is part of a unique community collaboration that calls itself 24:1. The name refers to a group of 24 small municipalities, spread across 11 square miles of America’s heartland.

In 2008, these towns realized they could do much more for their people together than by themselves, and they made the groundbreaking decision to unite their leadership and their resources. As 24:1 they brought a grocery store to the area—the first since the 1960s. They revitalized their struggling school district and built the area’s first movie theater. They are providing every kindergartner with a college savings account. They are offering families free health, dental, and early childhood development services. And they are nurturing strong relationships between police and residents in a time when that is disappointingly rare. “We decided that if we wanted to move forward, we had to do it together,” Mayor McGee explained. “We had to make the best decisions for our residents, our employees, and our children. And to do that, we had to leave our egos at the door and start trusting each other.”

That was the moment that gave me chills, because Mayor McGee had boiled the recipe for change down to its two most essential ingredients: trust and teamwork. I was sitting in a room filled with people from all walks of life who are tenaciously putting those ingredients to work in their hometowns. These people recognize that, when it comes to our health, the choices we make often depend on the choices we have. They know that judging those who are struggling undermines progress, and they are devoted to building a Culture of Health that benefits everyone, no matter what it takes.

Over the past 14 years, I have had the great privilege of helping to seed, support, and grow many of these efforts and hundreds of others. And the wisdom I have gleaned from the work we’ve done together has taught me seven important lessons about improving health in America.