A New Approach to a Healthier New Jersey

Aug 5, 2015, 4:49 PM, Posted by

New Jersey Health Initiatives is investing in grassroots solutions to local health challenges in our own backyard, with 10 New Jersey communities serving as laboratories to learn what it will take to build a Culture of Health.

A dentist working on a patient, his assistant is helping.

We’re trying a new approach to building a Culture of Health in communities across New Jersey. It’s a creative, grassroots, on-the-ground approach that could become a model for many other cities and towns across America.

For decades, folks in the health field have been working hard to turn around health inequities that mean some kids have a better chance of growing up healthy than others. They’ve done great work, but sometimes in isolation, and often making decisions based on best practices rather than authentic community engagement. Even more often, health organizations’ hands have been tied because the true causes of poor health sit in other sectors: poverty, unaffordable and poor quality housing, fractured or nonexistent transportation systems, and uneven quality education and access to jobs.

Pursuing the Robert Wood Johnson’s vision of building a Culture of Health—which is a big part of our mission at New Jersey Health Initiatives (NJHI)—requires a broad, ambitious, and innovative approach. And maybe some risk and uncertainty. Community health is complicated. For solutions to work well, we have to create opportunities for solutions to come not from the top—not from us, not from the Robert Wood Johnson Foundation—but from community members themselves. Individuals from a cross section of the community need to agree on the biggest local challenges, what assets they have to draw on, and the best solutions for a path forward. The goal is to plant the seeds for continuing change long after the original funding has run out—because it’s owned and driven by the people who are most affected.           

That’s where our experiment comes in. NJHI has made grants to 10 communities across New Jersey to serve as laboratories for testing what it will take to build a Culture of Health. These communities are bringing together broad coalitions of organizations from across sectors; pooling rather than competing for resources, and coming up with collective solutions. While these $200,000 grants were awarded to one trusted community-based organization, the funds are supporting the coalitions of at least five organizations—groups, it should be emphasized, that were already working together.

And that’s important. These are not new coalitions. They are all pre-existing coalitions, alliances within the communities, groups of neighbors who know each other’s strengths and have a track record of working together. Our grants will give these groups the tools and leadership training to do the hard work of figuring out what to do next. They’ll find common goals and overlapping interests, and ways to support each other and the community at large. The four-year grants, which began on July 1, will help these coalitions, already recognized change agents in their communities, become better driving forces for improved health.

Our grants will give these groups the tools and leadership training to do the hard work of figuring out what to do next. They’ll find common goals and overlapping interests, and ways to support each other and the community at large.

For example, in Jersey City, a wide range of groups, from hospitals and churches to block associations and greenmarkets, are coming in with interests as varied as urban farming, fair and affordable housing, after-school programs, paid sick leave, and smoke-free parks. All of those different perspectives will come together to find shared interests and set collective priorities. We’re already seeing that the diversity of voices increases the potential for innovation and creativity.

In Salem County in the Delaware Valley, New Jersey’s least populous county and one of the poorest and least healthy, the coalition’s initial organizing sessions drew not only a terrific turnout of local officials, health providers, and private business people, but also a contingent of teenagers. The high school kids said they heard about the coalition and wanted to participate in building a Culture of Health; they want to be part of charting a path for the community’s future. That’s a great sign.

The communities are already setting their sights on ambitious goals. Trenton is focusing largely on building a healthy food network for people who live in food deserts. One of the goals for the community of Elizabeth is to create “Healthy & Safe School Zones,” with safe and welcome play spaces, access to affordable healthy food, and medical support for chronic disease conditions—all in concentrated areas around schools.

Many of these coalitions already have been effective working together on other projects. We think they will become more effective as they work together to make good health part of their local culture. And we think both local leaders and everyday citizens will become more aware of the factors that affect their health—and the health of their neighbors. We’re hopeful that this approach could be a model for other states and regions.

But we need to wait and see. It’s too early to offer any concrete results yet—but the payoff could be huge. And if it is, we’ll be that much closer to building a Culture of Health nationwide.

Bob Atkins, PhD, RN is director of New Jersey Health Initiatives and an Associate Professor at Rutgers University with a joint appointment in Nursing and Childhood Studies. Dr. Atkins has a Bachelor of Arts in Political Science and American Civilizations from Brown University and Bachelor of Science in Nursing from the University of Pennsylvania.


New Jersey Health Initiatives is a statewide grantmaking program of the Robert Wood Johnson Foundation. The program, funded through a grant to the Institute for Health, Health Care Policy and Aging Research at Rutgers University, supports innovations and drives conversations to build healthier communities through grantmaking across the state of New Jersey.