Culture of Health Blog

The coronavirus pandemic has resulted in thousands of deaths in the United States and has upended daily life for millions of people across the country. Part of the emergency response at all levels of government has been to ensure that children and families continue to have access to healthy affordable foods.

The largest nutrition assistance program in the United States is the Supplemental Nutrition Assistance Program (SNAP)—sometimes known as food stamps—with the National School Lunch and School Breakfast Programs also among the largest. These programs have become even more critical during the current pandemic, but pending changes to those programs would fundamentally change how they are run and who has access to them.

I spoke with Giridhar Mallya, senior policy officer of the Robert Wood Johnson Foundation (RWJF), to better understand how recent coronavirus relief legislation impacts SNAP and school meals, as well as some of the longer-term proposals in both areas.

As coronavirus sweeps our nation it has brought deep-seated health inequities, including those linked to incarceration, to the forefront. Overcrowding and poor sanitation are putting prisoners at risk now more than ever. Reports of guards and prisoners testing positive for COVID-19 are especially sobering since quarantines are nearly impossible among incarcerated populations. To address this, some jurisdictions are releasing select prisoners.

The Robert Wood Johnson Foundation (RWJF) has long recognized how incarceration adversely affects health and health equity for prisoners as well as families and communities. With some 2.2 million adults and youth in juvenile detention facilities, prisons, and jails, the United States incarcerates many more people—and a higher percentage of our population—than any other nation in the world. There is widespread agreement that incarceration has adverse effects on health and health equity, not just for prisoners themselves but also for families and communities. That’s why, in 2018, RWJF included it among 35 illustrative measures we are using to track our progress toward building a Culture of Health in America—that is, becoming a country that values health everywhere, for everyone.

The measures linked to RWJF’s Action Framework are intended to be viewed together to identify priorities for investment and collaboration, and to understand progress being made toward realizing our vision. We are also considering the impact each individual measure has on efforts to build a Culture of Health. Because mass incarceration is a pervasive problem that undermines health and health equity, tracking it allows us to examine how it compounds the persistent challenges associated with achieving health equity nationwide and affects communities.

In times of crisis, it becomes readily apparent how interconnected we are and that sharing learning around what works and what doesn’t is of utmost importance.

We are seeing this with COVID-19, as learning from Singapore, from Italy, from South Korea and from China is informing the efforts of other countries—including the U.S. response.

The same is true of climate change.

A recent survey found that the proportion of Americans who are concerned about climate change tripled over the last five years and is now at an all-time high. 

Whether it’s raging wildfires; stronger, bigger hurricanes and tornadoes; more extreme heat events; or worsening air pollution, people in cities across the United States and around the world are seeing, living and having to manage the impact.  

What’s worse is that damage caused by global climate change magnifies inequities, placing the most vulnerable communities and individuals at greatest risk. Historic and social factors, such as access to health care; where you live or work; your age; and your income can all impact how and how much climate change harms your health.

The simple act of handwashing has always been an important factor in preventing the spread of disease. As the coronavirus gains traction, it’s all the more critical. But a quick splash of water and perfunctory spritz of soap is nowhere near sufficient to keep the virus at bay, if you’ve been exposed. Now is the time to be sure we’re washing often enough and doing it right.

With that in mind, we want to share some resources. First, the Centers for Disease Control and Prevention (CDC) offers very specific guidance as to how often. Experts there say we should wash our hands:

• Before, during, and after preparing food
• Before eating food
• Before and after caring for someone at home who is sick with vomiting or diarrhea
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• After touching an animal, animal feed, or animal waste
• After handling pet food or pet treats
• After touching garbage

For millions of people in America, having a home is an obstacle and a financial burden. Too many live in residentially segregated neighborhoods isolated from opportunity, making it difficult to break out of poverty and overcome the adversity that comes with it. 

The Robert Wood Johnson Foundation (RWJF) is offering funding for policy research aimed at overcoming deeply rooted problems related to housing stability and equity. We invite researchers, partnering with small cities or community-based organizations, to evaluate housing policies in hopes of turning up actionable lessons for other communities.

We Need Far-Ranging Solutions to Deeply Rooted Problems

RWJF president and CEO Richard Besser, MD, explained how safe and affordable housing supports positive outcomes across the lifespan—and how unsafe and insecure housing can deepen inequity and undermine a Culture of Health. Where we live can make it easier or harder for us to access opportunities: to get a good education, to have transportation options to living-wage jobs, to afford and have access to nutritious food; and to enjoy active lifestyles.

Note: This piece was originally published in February 2018.

One of my earliest and most vivid childhood memories is watching from my bedroom window as my city burned in the riots that erupted after Dr. Martin Luther King Jr.’s assassination 50 years ago.  

The next afternoon, my mother brought me to the playground at my school in Southeast Washington, D.C., which somehow was untouched. As she pushed me in a swing, she asked if I understood what had happened the day before and who Dr. King was.

“Yes,” I said. “He was working to make things better for Negroes like you.”

My mother, whose skin is several tones darker than mine, stared at me in surprise. Somehow, even at 4 years old, I had learned to observe differences in complexion.

That is particularly interesting to me now, as I eventually came to believe that “race” is a social construct.

Of course racism and discrimination exist. They are deeply embedded in America’s history and culture—but so too is the struggle against them.

The Tale of Two Boys Growing Up in Cleveland

Let’s ask two hypothetical 9-year-old boys a question: What is it like to grow up in Cleveland? 

Each boy attends school, and enjoys riding his bike and playing with Legos. Both live in Cleveland. Beyond these similarities, their life experiences are—and will continue to be—starkly different based on multiple, complex factors that lie within their neighborhoods.

Neighborhood A 

The boy living in Neighborhood A faces a host of obstacles to opportunity and well-being. 

Economic adversity is the norm. One in four families struggle with poverty, and nearly 83 percent of his peers in school need free or reduced-price lunch.

Have you noticed that most New Year’s resolutions are about developing healthier lifestyles? Most people want to eat better, exercise more, and find time for themselves. These are all worthy pursuits. But a few weeks into our new decade, for many, these resolutions will start to fade.

At the Robert Wood Johnson Foundation, we believe that good health is significantly determined by forces outside of ourselves—our health is greatly influenced by the places where we live, learn, work, and play. Having opportunities to get a good education and stable employment is foundational to our well being. Access to affordable housing and healthy foods, and feeling safe in our neighborhoods all create opportunities to help us live our healthiest lives.

This made me wonder: why not adopt community-wide New Year resolutions? Because fostering healthier communities sets individuals up for success!

The Nutrition Facts label just got its first big makeover in 20 years. Learn why the updates will be a game-changer for parents and families.

Families don’t live in silos—one silo for health care, one for child care support, and yet another for food assistance. They need all those things—and more—to build strong and healthy futures for their children.

That’s why at the Robert Wood Johnson Foundation (RWJF), we're supporting a multi-state laboratory for advancing policies that strengthen families across a range of issues. The Center on Budget and Policy Priorities (CBPP) is the hub for this initiative. We are administering $2.65 million in grants to state-based organizations working to ensure that children and families get the support and resources needed to raise healthy kids through policy and systems change.

That means instead of addressing one issue at a time—e.g., child care supports or family leave—an array of issues are beign addressed simultaneously. These include child care and family leave and minimum wage and job training and other policies that can help families get ahead. These policy levers are interconnected, playing off each other, which is why a holistic approach is needed to make real progress in families’ lives.