Beyond Health Care

New Directions to a Healthier America

The Robert Wood Johnson Foundation Commission to Build a Healthier America issued 10 cross-cutting recommendations for improving the nation’s health. According to the Commission, how long and how well Americans live depend more on where we live, learn, work and play than on medical care, which accounts for only an estimated 10 to 15 percent of preventable early deaths.

The Commission, a national, independent and nonpartisan group comprising innovators and leaders with a rich diversity of experience and depth of knowledge, was charged with focusing on factors beyond medical care to identify practical and innovative strategies for improving the nation’s health. Commissioners crafted recommendations that:

  • address the Commission’s charge to identify interventions beyond the health care system that can produce substantial health effects;
  • are likely to achieve a significant positive impact on Americans’ health;
  • address the needs of those who are most at risk or most vulnerable;
  • are feasible and achievable in the current economic environment; and
  • are supported by a strong knowledge base.

The Commission found the strongest evidence for interventions that can have a lasting effect on the quality of health and life in programs that promote early childhood development and that support children and families. Therefore, many of the recommendations aim to ensure that the nation's children have the best start in life and health.

Commission Recommendations:


  • Fund and design WIC and SNAP (Food Stamps) programs to meet the needs of hungry families for nutritious food.
  • Create public-private partnerships to open and sustain full-service grocery stores in communities without access to healthful foods.
  • Feed children only healthy foods in schools.

Physical Activity

  • Require all schools (K-12) to include time for all children to be physically active every day.


  • Become a smoke-free nation. Eliminating smoking remains one of the most important contributions to longer, healthier lives.

Early Childhood

  • Ensure that all children have high-quality early developmental support (child care, education and other services). This will require committing substantial additional resources to meet the early developmental needs particularly of children in low-income families.

Healthy Places

  • Create “healthy community” demonstrations to evaluate the effects of a full complement of health-promoting policies and programs.
  • Develop a “health impact” rating for housing and infrastructure projects that reflects the projected effects on community health and provides incentives for projects that earn the rating.
  • Integrate safety and wellness into every aspect of community life.


  • Ensure that decision-makers in all sectors have the evidence they need to build health into public and private policies and practices.