What are systems changes and how is the Robert Wood Johnson Foundation (RWJF) investing in them?
Systems are the policies, practices, and procedures of institutions, corporations, agencies and other organizations that shape the determinants of health. Improving systems—and the way they work together—is our approach to eliminating health disparities.
By taking a hard look at these systems—be they access to quality health care, income, public safety, community environment, employment, housing, education— we can find solutions to improve lives and reduce health disparities. We believe everyone in our country deserves an equal opportunity to live a healthier life which is key to building a Culture of Health.
But it's frustrating to acknowledge the current reality. As RWJF’s own Dwayne Proctor noted, if you’re Black you’re 21 percent more likely to die from heart disease than if you’re white. If you live in the Deep South your life expectancy is an average of three years shorter than if you live in other parts of the country. Health disparities like these don't just harm individuals. They also threaten the prosperity of entire communities. We want to change this.
To do so, we are launching the RWJF Awards for Eliminating Health Disparities to honor and celebrate those who have successfully created systems changes to eliminate health disparities. In doing so, we’re delving deeper into the determinants that impact health—the neighborhoods we live in, the schools our children attend, the jobs we work and the resources inside our communities. And we’re hoping to heighten awareness around the power of systems change.
Jose’s story: From school suspension to college
Last year our colleague Maisha Simmons met Jose, a bright student from Chicago who used art to express love, fear, joy and pain. He spread his art everywhere—on notebooks, text books and eventually the walls and fences of his community. Despite efforts of a relative to channel Jose's passion into a community art program, one day Jose found himself in the principal's office where teachers wrongly accused him of vandalizing school property. Unable to prove his innocence, the school suspended Jose. He fell behind in his schoolwork which jeopardized his chances of graduating. Since art now reminded Jose of his struggles at school, he stopped pursuing his passion.
But Jose was lucky to live in the city of Chicago with the Safe Schools Consortium, a coalition that offers alternatives to traditional harsh school discipline. A nonprofit partner of Safe Schools—VOYCE—offered Jose a chance to share his story and reconnect with art in a way that uplifted his community. Thanks to this partnership, rather than dropping out of school, Jose is now in college.
Oscar and Jose are just two examples of what's possible when we change systems. We know that systems once pushed people like them toward unhealthy outcomes. But together, we can reimagine these same systems to guide everyone toward healthier and brighter futures and the Culture of Health that we are working toward.
About the Authors
Najaf Ahmad is senior managing editor of the Culture of Health Blog where she highlights perspectives about how the Foundation is advancing health equity in communities across the nation.
Catherine Malone is a program officer who works in the areas of diversity and nursing. Malone has worked on programs aimed at improving nursing retention, transforming the organizational culture of hospitals and engaging partners to address nursing issues.