Recommendations from the RWJF Commission to Build a Healthier America

In 2008, the Robert Wood Johnson Foundation (RWJF) convened the Commission to Build a Healthier America to help us find better ways to improve the health of our nation. The Commission—a national, nonpartisan group of leaders from both the public and private sectors—issued 10 sweeping recommendations aimed at improving the health of all Americans.

The Commission’s work sparked a national conversation that has led to a marked increase in collaboration among a wide variety of partners aimed at addressing the many determinants of health. Eager to build upon this progress, RWJF asked the Commissioners to come together again. This year, the Commission tackled immensely complex matters that underlie profound differences in the health of Americans: experiences in early childhood; opportunities that communities provide for people to make healthy choices; and the mission and incentives of health professionals and health care institutions.

They found that to improve the health of all Americans we must:

• Invest in the foundations of lifelong physical and mental well-being in our youngest children
• Create communities that foster health-promoting behaviors
• Broaden health care to promote health outside of the medical system

Recommendation 1

Make investing in America’s youngest children a high priority. This will require a significant shift in spending priorities and major new initiatives to ensure that families and communities build a strong foundation in the early years for a lifetime of good health.

• Create stronger quality standards for early childhood development programs, link funding to program quality, and guarantee access by funding enrollment for all low-income children under age 5 in programs meeting these standards by 2025. 
  
• Help parents who struggle to provide healthy, nurturing experiences for their children.
• Invest in research and innovation. Evaluation research will ensure that all early childhood programs are based on the best available evidence. Innovation will catalyze the design and testing of new intervention strategies to achieve substantially greater impacts than current best practices.

Recommendation 2

Fundamentally change how we revitalize neighborhoods, fully integrating health into community development.

• Support and speed the integration of finance, health, and community development to revitalize neighborhoods and improve health.
• Establish incentives and performance measures to spur collaborative approaches to building healthy communities. 
  
• Replicate promising, integrated models for creating more resilient, healthier communities. Invest in innovation.

Recommendation 3 

The nation must take a much more health-focused approach to health care financing and delivery. Broaden the mindset, mission, and incentives for health professionals and health care institutions from treating illness to helping people lead healthy lives.

• Adopt new health “vital signs” to assess non-medical indicators for health.
• Create incentives tied to reimbursement for health professionals and health care institutions to address non-medical factors that affect health.
• Incorporate non-medical health measures into community health needs assessments.

Taking Action

All of us have a role to play in creating a healthier nation.

From individuals and community organizers,to businesses, investors and community developers, to education leaders and policymakers, we all have a stake in a healthy America.

See how you can take action

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