2014 President's Message

A Bird's Eye View

A few months ago, I watched a documentary that presented a unique perspective on the world by attaching high-definition cameras onto the bodies of birds. As they swept across the sky, the familiar trappings of ground-level life—highways, neighborhoods, buildings, streams, mountains and oceans—looked completely different. Soil was bridged to sky. Near was bridged to far. From a bird’s-eye view, it was all part of a grander, connected whole.

This made me think about the new vision that we at the Robert Wood Johnson Foundation (RWJF) have been working over the past year to refine. It calls for us, as a nation, to strive together to build a Culture of Health enabling all in our diverse society to lead healthier lives, now and for generations to come. What, I thought, is the bird’s-eye view of this? What does a Culture of Health look like on a grand scale? What new bridges must our Foundation help build to make a Culture of Health part of the grander whole of what it means to be an American?

This year’s President’s Message takes a closer look at our new vision—how we intend to help build a national movement to achieve it, and how building a Culture of Health will require us to think and work differently.

If those birds with cameras flew over America today, they would not see a flourishing Culture of Health. Instead, they would see a nation that has for too long mistakenly defined being healthy as simply not needing to seek health care. They would see a population whose health can be unduly and unequally influenced by income, education, ethnicity, and where a person lives. They would see a disjointed system of health care that does not systematically extend beyond the walls of medical offices to the places where people live, learn, work, and play.

Yet the birds would also see a nation dotted with points of promise. They’d see the growing number of communities planting the seeds of a Culture of Health, leading the way in demonstrating what is possible. They’d see bright spots such as post-Katrina New Orleans, where public officials, schools, businesses, and community members joined forces to create a recovery plan that included a focus on nutrition, physical fitness, and equal access to quality health care for everyone. The state of Pennsylvania, where Gov. Tom Corbett signed a transportation bill that dedicates millions of dollars to bicycle and pedestrian projects, with an eye toward addressing obesity by making it easier to remain active. And Canton, Ohio, where community leaders, faith-based organizations, businesses, social workers, health care leaders, and residents of a struggling neighborhood called the “northeast quadrant” have worked together to revitalize the area with housing, health, employment, education, and security at top of mind.

What Does Culture Of Health Mean To You?

It may mean having easy and affordable access to health care. It may mean creating neighborhoods where moms can feel comfortable letting their kids walk to school, play outside, and go to a nearby grocery store stocked with fresh and healthy choices. It may mean providing an elder with the helping hands she needs to remain in her home. Or it may mean living in a community where policy-makers, civic leaders, educators, employers, and residents work together to make the health of their entire community a priority.

There is no single definition, which means when America ultimately achieves a Culture of Health it will be as multifaceted as the population it serves.

We believe an American Culture of Health is one in which:

1. Good health flourishes across geographic, demographic and social sectors.
2. Attaining the best health possible is valued by our entire society.
3. Individuals and families have the means and the opportunity to make choices that lead to the healthiest lives possible.
4. Business, government, individuals, and organizations work together to build healthy communities and lifestyles.
5. Everyone has access to affordable, quality health care because it is essential to maintain, or reclaim, health.
6. No one is excluded.
7. Health care is efficient and equitable.
8. The economy is less burdened by excessive and unwarranted health care spending.
9. Keeping everyone as healthy as possible guides public and private decision-making.
10. Americans understand that we are all in this together.

Adjusting Our Lens

It is rare to recognize the beginning of great change while you are living it because it does not present itself as spectacular. It trickles in. Carried and cultivated by everyday people. Our job is to find the earliest and strongest examples of a Culture of Health, share the lessons they have to offer, and serve to link together the leaders of change so they can join forces and build small victories into a national movement.

To best achieve this, we are making some adjustments in how we approach what we do. RWJF will continue to work on issues we believe are key to the well-being of all Americans. But within our organization we will no longer divide our efforts into the silos of health and health care. All that we do will serve one goal–building a Culture of Health.

We will work in tandem with others to transform what it means to be a healthy nation. We will amplify the voices calling for change. We will connect those who are willing to carry the banner and shine a spotlight of support on advancements that have already been made. We will build on many of our signature initiatives, focus our direct investments on a few new priorities, and update our approach to some of our best-known initiatives and leadership programs.

Health Care Coverage

For decades, RWJF has worked to improve access to affordable, high-quality coverage for all Americans, and we will continue to do so. Despite the frustrating problems incurred during the launch of the federal health care exchange website, the implementation of the Affordable Care Act has created new opportunities for tens of millions to acquire health insurance. As Americans adjust to the new offerings, we will maintain our objective to ensure that all who are eligible for coverage know what benefits are available to them and how they can make the most of them.

Cost, Quality, and Value

RWJF will continue to seek the highest value for each dollar spent to keep Americans healthy both inside and outside of health care clinics and organizations. Getting the most for our dollar as a nation means building a better understanding of how the cost and price of care relates to health outcomes. It means carefully implementing strategies to reduce wasteful spending, while at the same time maintaining or increasing quality. It also means stressing both the economic and human value of other factors that influence our nation’s health—education, housing, transportation, clean air and water—as well as the built environment and public/business policies that encourage healthy living.

Healthy Places and Practices

If being healthy and staying healthy is to become a core American value, we must foster individual and community actions that promote good health from the start of life until its end. We must support efforts that reinforce a Culture of Health, and we must spread the word about efforts that are succeeding.

Last year, we introduced the RWJF Roadmaps to Health Prize, honoring communities that have placed a priority on the health of their citizens. Some of the communities are urban. Others are rural. Some are affluent. Others are struggling. But they all have one thing in common: In each of these places community leaders, individuals, business, government and educators have forged powerful partnerships to inspire people to live healthier lives. This year there are 12 finalists for the 2014 award—which we now call the RWJF Culture of Health Prize. Stretching from Alaska to Georgia, with Texas, Iowa, and the Taos Pueblo Indian reservation in between, these communities are building a Culture of Health in their own backyards. Our goal is to use the visibility of this award to bring national attention to their strategies, and create enthusiasm for other communities to follow suit.

Equal Opportunity

If we are to achieve a Culture of Health that benefits our entire nation, we must ensure that all in our society—regardless of where they live, how much money they make, or where they come from—have the opportunity to make the most of their health. In the past, RWJF has endeavored to acknowledge the issue of equal opportunity in all the programs we have supported. But we have come to believe that we must make a more defined commitment, and take a more coordinated approach, to minimize the barriers that continue to compromise the health of so many in our society.

Personal responsibility plays an important role in getting and staying healthy. But too many Americans still do not have access to an equal measure of choices and opportunities to pursue healthy lifestyles. Research shows some will die 20 years earlier than others who live just a few miles away because of differences in education, employment, housing, safety, community development, and access to quality health care. RWJF will join with other foundations, organizations, and businesses that have long worked to increase opportunities in education, housing, and community development to make the fruits of good health available to all.

In 2013, we established Forward Promise, a $9.5 million initiative focused on promoting opportunities for the health and success of middle school and high school-aged boys and young men of color. And we have formed an alliance with 25 other philanthropies to expand the potential for boys and young men of color to grow up safe and healthy, obtain a good education, and find lasting and meaningful employment. Taking the long view, RWJF will continue to delve more deeply into the causes of the unacceptable gaps in opportunity for good health and identify additional areas that we believe call for immediate attention.

21st Century Leaders

Since the Foundation’s founding more than 40 years ago, the Foundation has placed a high premium on fostering great leadership and supporting strong professional development. We take great pride in our legacy of identifying leaders with the potential to transform our nation’s health, and providing them the support to realize their promise. We remain deeply committed to investing in the development of health innovators. And we intend to tailor our programs to better meet tomorrow’s demands for effective leadership. They must create strong connections between, and across, disciplines and professions. They must encourage networking. They must reflect the rich diversity of our nation. And they must be committed to a vision of building a Culture of Health. This year, we will start the process of restructuring and refocusing many of our human capital programs with these goals in mind, and we will introduce a new RWJF Leadership Network. 

Fueled by social media—the RWJF Leadership Network will create a dynamic professional space where practitioners, scholars, policy-makers, community activists and thousands of others connected to RWJF can exchange ideas, promote research, collaborate on initiatives, and learn. It will underscore the power of collaboration, and it will call for action. There is an African proverb that teaches “it takes many hands to cover the sky.” Building a national Culture of Health will, indeed, take many hands and the RWJF Leadership Network will encourage everyone involved to walk toward success together.