RWJF ‘Commission to Build a Healthier America’ Reconvenes to Focus on Early Childhood and Improving Community Health

Jun 20, 2013, 1:14 PM

What do the needs of children in early childhood and improving community health have to do with each other? Everything, according to a group of panelists who addressed the Robert Wood Johnson Foundation (RWJF) Commission to Build a Healthier America at a public meeting in Washington, D.C. yesterday.   

Early childhood education and other interventions early in life, particularly for low-income children, can set kids on a path to better jobs, increased income and less toxic stressors such as violence and food insecurity, according to testimony at the today’s meeting. And that in turn creates more stable and healthier communities. Those two issues are the focus of the Commission, which plans to release actionable recommendations in September.

Yesterday’s event marks the first time the Commission is reconvening since it issued recommendations for improving health for all Americans in 2009. It will be co-chaired again by Mark McClellan, MD, PhD, director of the Engelberg Center for Health Care Reform at The Brookings Institution and former Administrator of the Centers for Medicare & Medicaid Services, and Alice M. Rivlin, PhD, senior economist at The Brookings Institution and former director of the Office of Management and Budget.

“Although we have seen progress since the Commission issued its recommendations in 2009, we still have a long way to go before America achieves its full health potential,” said RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA at the Commission’s  public meeting in Washington. “We know what works: giving children a healthy start with quality child care and early childhood development programs, and building healthy communities where everyone has an opportunity to make healthy choices. That is why RWJF is reconvening the Commission, to concentrate on these two critical areas.”

David Williams, PHD, a professor of  public health at the Harvard School of Public Health and the staff director  of the commission, told the audience that several of the Commission’s 2009 recommendations have helped inform policy decisions in the United States. They include the Healthy Food Financing Initiative, a public/ private  partnership to improve access to healthy food by bringing grocery stores and farmers’ markets to underserved communities, as well as the National Prevention Council, made up of 17 federal departments, agencies and offices, which has developed a National Prevention Strategy that, echoing Commission recommendations, call for integration of health criteria into decision-making across sectors.

Members of the reconvened commission include Reed Tuckson, MD, recently retired as executive vice president and chief of medical affairs at UnitedHealth Group, and Angela Glover Blackwell, founder and CEO of PolicyLink.

Arthur J. Rolnick, PHD, senior fellow and co-director of the Human Capital Research Collaborative at the Humphrey School of Public Affairs at the University of Minnesota, called for a “market based approach,” suggesting that what is needed are scholarships not just for college, but for three and four years olds so they can go to high quality early learning programs. He also called for what he called “scholarships plus” which would pair funding for early education along with home visiting mentors.

“The good news is that multiple longitudinal studies indicate it is possible to buffer the negative impact of risk factors through quality early childhood interventions, especially when initiated in the very youngest years,” said Jessie Rasmussen, president of the Buffet Early Childhood Fund, who added that “access to quality early childhood experiences for children at risk is beneficial not only to the children, but also to society as a whole in terms of reduced costs of special education, remediation, juvenile justice and health care.”

On approaches to improving community health, a key suggestion came from David Fleming, MD, health director of Seattle and King county in Washington State, who recommended using global health strategies to improve health in under-resourced areas in the United States, including:

  • Employing community health workers
  • Applying technology to leapfrog delivery barriers
  • Expanding the use of public/private partnerships
  • Linking health with economic development

Recent examples from Seattle adopted from global health models include single gender exercise classes for Muslim women and using phone technology for self management of diabetes for patients with language and transportation barriers.

Among the key questions the Commission has been asked to address:

  • What is the current environment around early childhood and healthy communities and what is it likely to look like over the next five years?
  • Are there proven models, programs or services that are feasible for widespread implementation to address these issues, especially for low-income populations?

>> Read more on the RWJF Commission to Build a Healthier America

This commentary originally appeared on the RWJF New Public Health blog.