Culture of Health Progress Report: Lessons for a New Direction

In partnership with others, we work to develop a Culture of Health rooted in equity that provides every individual with a fair and just opportunity to thrive.

About the Assessment

Westat, in collaboration with The Mirror Group and Dr. Shiriki Kumanyika, made a detailed evaluation on the Foundation’s work from 2018–2022. RWJF refined its strategic direction in 2020 to address structural racism and other barriers to achieving health equity. The Phase Three evaluation report examined these questions:

• What has been learned about systems change?
• What have we learned about the Foundation’s progress in addressing health equity and removing barriers to structural racism?
• How can equitable evaluation practices be incorporated?
• What have we learned through evaluation synthesis?
  
  

To inform the report, the evaluators conducted:

• An analysis of $1M+ grants since 2018
• An analysis of research grants
• A review of Foundation documents
• A synthesis of outcomes of recent evaluations
• An analysis of the extent to which evaluations are conducted in an equitable manner

Key Findings

The report includes a deep analysis of how grantee work maps to the Foundation’s strategic direction.

Among the findings, Westat reported that RWJF’s health equity grants grew from 7% to 63% between 2018 and 2022, and that two-thirds of all grants aligned with at least one generation goal.

Deeper analysis is needed to understand the efficacy, gaps, and points of leverage among grantee work when considered in whole.

Conclusion

While systems change is hard, the report acknowledged that RWJF has acted swiftly in its work to create systems change to promote greater health equity. Long-term impact takes time, and requires the participation and perspectives of many people, most of all the communities most affected by the systems.

The report concludes with systems-change advice to:

• Clearly articulate the Foundation’s vision for change
• Provide sufficient capacity-building resources and expertise to move levers
• Identify and involve champions of health equity effortsReach agreement with stakeholders on clearly articulated measures of success.