Ambitious Goals to Transform Health in Our Lifetime
Julie Morita, MD, former executive vice president of RWJF, shares how her family’s experience of state-sanctioned racism, and their search for community, solidified her commitment to transform opportunities for health within our lifetime.
Cut Off From Health and Opportunity
Every family wants their children to grow up in a vibrant, nurturing community where they can thrive into adulthood.
My parents were able to find this kind of community for me, as I have for my kids. But my parents’ childhood was different. During World War II, they were among more than 100,000 people of Japanese descent who were forced from their homes and incarcerated in camps—living in tarpaper barracks surrounded by barbed wire. Who can thrive in an environment like that?
Dr. Morita's mother's family and their fellow detainees in Minidoka incarceration camp. (From The Minidoka Interlude Yearbook, 1943)
Dr. Morita's parents at their Chicago home. (Erin Hooley / Chicago Tribune)
The Promise of Community
After enduring the pain and indignity of state-sanctioned racism, my parents’ families set down roots in Chicago, seeking sanctuary in a community full of promise, connection, and opportunity. Our home was surrounded by parks and green space, good public transportation, and a community that recognized our humanity, supported our wellbeing, and instilled in me a strong sense of identity, purpose, and belonging. My mom didn’t have a driver’s license, so we walked everywhere and got to know our neighbors. Belonging, safety, feeling welcome—these are essential ingredients for health.
Confronting Persistent Barriers to Health
Yet, while working for the Chicago Department of Health, I saw that this is not everyone’s experience. Like many American communities, Chicago is segregated in a way that provides abundant opportunities for some and barriers that make it harder to be healthy for others. Those barriers could include highways built through once-thriving Black communities or ingrained norms that deny the experiences and needs of people of color seeking healthcare.
While the barriers of my parents' generation were literal fences, the barriers to opportunity faced by so many families today are invisible—but barbed, nevertheless.
I bring these experiences to my work at RWJF, where we have crystallized our view that we cannot make progress without addressing one of the biggest barriers to health in America: structural racism.
Dr. Morita during her time serving as Commissioner of the Chicago Department of Public Health. (City Club of Chicago)
Dr. Morita's father and his youngest sister when they were in the incarceration camp in Minidoka, Idaho. (From a private family photo album, taken in 1945.)
Dr. Morita giving a flu shot at a clinic during her tenure with the Chicago Department of Public Health. (Charles Rex Arbogast / Associated Press)
Dr. Morita's father's family with neighbors in Oregon just before they were forcibly removed from their homes and incarcerated in internment camps. (From a private family photo album, taken March 1942.) taken March 1942.) taken March 1942.) taken March 1942.) taken March 1942.) taken March 1942.) taken March 1942.)
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Economic Inclusion for Family Wellbeing
We believe we can be a nation where all families have the resources they need to raise healthy children, and where the economic system works for everyone. All caregivers should have the power to shape the policies and systems that affect their lives, but we must put mechanisms in place to make this possible.
Through our Family Advisory Council, a group of diverse parents and caregivers, we are learning what matters most to families. Our family advisors help us shape policies that can better support caregivers to nurture and protect their families fully and joyfully. They also help us to understand the ways families encounter structural racism and other forms of discrimination, how current public systems often fail them, and how challenging it can be to raise children in today’s social climate. There is near universal agreement that stronger governmental supports are needed, from paid family leave to housing and tax credits that make our economy more inclusive. The wisdom of our family advisors is critical to helping us realize a future where every family has what they need to thrive.
Equitable and Accountable Public Health and Healthcare Systems
Everyone deserves a healthcare system that provides respectful, high-quality care and a public health system that works with communities to dismantle the root causes of health disparities. I’ve seen what’s possible when the healthcare and public health systems deeply partner with and are held accountable by the communities they serve. For example, the Chicago Department of Health worked with trusted community organizations to center the needs of people of color, reduce barriers to vaccination and ultimately close racial gaps in COVID vaccination rates. At RWJF, we’re learning from Voices for Health Justice and others about how critical it is to empower community members and organizers with financial and technical resources to help shape healthcare systems into the inclusive and accountable institutions we need them to be.
Another way we’re championing the voices of communities is by working to close the Medicaid coverage gap. Medicaid pays for 65 percent of births to Black mothers and is associated with better outcomes, demonstrating why this policy is critical for health equity. Together for Medicaid from Community Catalyst has already supported wins in 13 states bringing coverage to nearly three million adults and is supporting community organizations to build their collective power and grow demand for Medicaid expansion in the 10 remaining states that have not expanded Medicaid. Together, we hope to close the Medicaid coverage gap once and for all—and show how it’s possible for those most affected to lead the way to a more equitable set of health systems and policies.
Healthy and Equitable Community Conditions
Finally, we envision flourishing communities like the one where I grew up—where everyone has access to clean drinking water and safe, stable housing; where jobs pay a living wage; and all residents can expect respect and dignity.
To change this, we must take a more equitable and inclusive approach to how our communities are planned and built; center residents’ voices in development decisions; dismantle housing discrimination; and expand how leaders think about who is “deserving” of investment. Our work in our own backyard is anchored by a policy agenda for a healthier, more equitable New Jersey—so all New Jerseyans will have a safe, affordable place to live in a neighborhood of their choosing, and power over decisions affecting their lives. These new approaches to designing more equitable neighborhoods are powerful pathways to healthy communities for all.
How We’ll Get There
Across our work toward these big, bold goals, we are using approaches proven to help make transformational progress that lasts across generations, such as cultivating leaders, influencing policy change, and sharing actionable data. For example, since people created the policies and practices that privilege some and disadvantage others, we can reinvent them in a way that explicitly considers and repairs from the harms of racism. While some are challenging these types of policies—called race-conscious policymaking—in courts and state legislatures, RWJF is supporting civil rights organizations that are defending them.
RWJF will also continue to commission and share the best available evidence, analysis, and science, openly debated, to inform action. For example, we helped support the largest-ever survey of the lives and experiences of trans people—data that will lead to a better understanding of the health and wellbeing of a frequently misunderstood and marginalized population, and help shift narratives on health, wellbeing and belonging in America.
Creating the Future We All Deserve
These are undeniably ambitious goals. But my family’s story shows what is possible in a generation—with economic opportunities that welcomed instead of excluding us, with a health and public health system for the people, and with a supportive community. These days, when my husband and I walk in our neighborhood, at least one person will stop us to ask about my parents or our kids. That sense of belonging is what makes it possible for us to be healthy and to give back—and that’s what we’re working to create for everyone, in every community.
But we at RWJF can’t get there alone. That's why we are eager to work alongside you—our grantees, partners and co-thinkers, and our fellow philanthropists and thought leaders—to bring these goals to fruition. We don’t have it all figured out, by any means. At RWJF we will continue to share stories from our journey, and hope you’ll do the same. Your wisdom will be a guide to help us shape the way forward and hold us accountable as we pave the way, together, to a future where health is for everyone.
Three Goals to Achieve Health for All
A Future Where Health Is No Longer a Privilege, But a Right
RWJF is taking steps to focus on one of the biggest barriers to health in America: structural racism
About the Author
Julie Morita, MD, former executive vice president of the Robert Wood Johnson Foundation, is a U.S. public health expert. Before coming to RWJF, she led the Chicago Department of Public Health for nearly 20 years, overseeing public health for over 2 million Chicago residents. She has also been called to serve as an advisor to the White House, U.S. Health and Human Services, the Centers for Disease Control and Prevention, and the National Academy of Medicine, as well as numerous state and local public health agencies.