Moving Forward Together: An Update on Building and Measuring a Culture of Health

A child plays on a playground jungle gym in Manchester, N.H.

The Robert Wood Johnson Foundation (RWJF) remains committed to its vision of a Culture of Health, an organizing principle for changing how America thinks about health.

To learn more about our journey to build a Culture of Health, and the progress made since 2015, take a look at our Action Framework and our national measures which have been updated with 2019 data.

Our vision calls for everyone to “strive together to build a Culture of Health, enabling all in our diverse society to lead healthier lives, now and for generations to come.” The Action Framework continues to inform the Foundation’s programming and funding and serves as a catalyst and guide for individual, organizational, and community initiatives.

To chart and measure the nation’s progress to improve population health, well-being, and equity, in 2015 RWJF and the RAND Corporation developed an Action Framework (introduced in the report titled From Vision to Action) and set of 41 National Measures to help individuals and organizations understand the vision and the opportunities for action.  

The 2018 update reflects work done to understand how the Measures (refined now to a set of 35) have been, and can be, used by diverse constituents. In an effort to inspire ongoing engagement, we have included a supplement outlining different ways sectors may find the Framework valuable in their work. We are committed to learning how the Framework is used by different groups and ensuring that it remains a valuable catalyst for actions to improve health, well-being, and equity, and will update the Measures periodically.

Four Action Areas

  • Making Health a Shared Value. Individual health is influenced by community health and conditions as well as our feeling of belonging and engagement in civic and volunteer activities. Health flourishes when people make health a priority in personal decisions and in public policies.

  • Fostering Cross-Sector Collaboration. Hospitals, as well as non-traditional partners to health care such as corporations, businesses, policymakers, and law enforcement, can contribute to a Culture of Health working with public health experts and across nonhealth sectors (education, housing, transportation, employment) to promote community health and well-being.

  • Creating Healthier, More Equitable Communities. The basic conditions for a Culture of Health include affordable housing in racially/ethnically integrated neighborhoods that offer safe places to play, good air quality, public libraries, and quality pre-school programs.

  • Strengthening Integration of Health Services and Systems. High-quality, efficient, and affordable care is a hallmark of a Culture of Health community. Action area measures include access to comprehensive public health services; health insurance coverage; routine dental care; and treatment for alcohol, substance use, or mental health issues. Nurse practitioners working at the top of their license can help expand care availability.


When we, as a nation, make progress in these four action areas, the outcome will be improved population health, well-being, and equity. This will be evidenced by enhanced individual and community well-being, fewer people incarcerated, a reduction in the number of children with adverse childhood experiences, chronic diseases prevented or the risks of them reduced, and health care costs reduced.

About the Report

The Framework and this report were developed by RWJF in collaboration with the RAND Corporation.

Learn more about the Culture of Health Action Framework

From the Blog

New Data on How We’re Measuring a Culture of Health

RWJF's Culture of Health Action Framework helps us track the nation’s progress toward becoming a country that values health everywhere, for everyone. It’s been 4 years since we began tracking our journey toward a Culture of Health. What has changed?

Read the blog post