2018 National Survey of Health Attitudes

Gauging people’s perceptions of health and measuring progress toward a Culture of Health in the United States.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led a pioneering effort to advance a Culture of Health that “enables all in our diverse society to lead healthier lives, now and for generations to come” (Plough et al., 2015). Together with the RAND Corporation, RWJF developed a Culture of Health Action Framework, including four Action Areas and a set of 35 measures to help monitor the United States’ progress toward this goal. The Action Framework and measures were selected as a means of defining, operationalizing, and measuring the United States’ progress toward this goal.

Action Area 1 in the Action Framework calls for making health a shared value. This Action Area is the primary focus of the survey described in this report. It focuses on individual and community values, expectations, and civic engagement around health. This Action Area emphasizes the importance of achieving, maintaining, and reclaiming health as a shared priority. We believe that achievements in this Action Area will fuel a greater sense of community; an increased demand for healthy places and practices; and a stronger belief that individual actions can make a difference in the well-being of others.

To gauge people’s perceptions of health and measure progress toward a Culture of Health in the United States, RWJF worked with RAND researchers to design and field the Robert Wood Johnson Foundation National Survey of Health Attitudes in 2015. An updated version was fielded in 2018.

This report provides an overview of the 2018 National Survey of Health Attitudes, including survey development and content, and a top-line summary of descriptive statistics. The report complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016) and is organized similarly for consistency. Other information about the Culture of Health vision—including the Action Framework, details about measures, technical reports, and other information—can be found at www.rwjf.org/cultureofhealth.

The 2018 survey measures the attitudes, values, and beliefs of a probability-based representative sample of adults in the United States on issues related to a Culture of Health. The survey covers a variety of topics, including:

  • views regarding social determinants of health and disparities
  • change agents and action on health
  • health status and experiences
  • views of the role of government in health
  • general views on equity and health equity
  • community well-being, and
  • priorities for health relative to other social issues

Survey Findings

A sampling of results from the 2018 survey indicated that:

  • 36.5 percent of adults recognized a strong or very strong influence of social and physical factors on health

  • 28.3 percent did not consider investment in community health a top priority

  • 11.1 percent reported a strong sense of membership in their community

  • 19.4 percent reported a strong emotional connection to their community

This report concludes with detailed top-line results for each of the 34 questions included in the survey and sociodemographic characteristics of the sample. The report also includes appendices that present top-line findings for rural vs. urban adults and for adults in cities of various sizes.

Researchers from RAND and RWJF jointly conducted the research described here; the report is intended for individuals and organizations interested in learning more about public attitudes about a Culture of Health. Given that RWJF is focused on using the Action Framework and measures to catalyze a national dialogue about approaches and investments to improve population health and well-being, the report should be beneficial to a range of national, state, and local leaders across a variety of sectors that contribute to health.

This research was sponsored by the Robert Wood Johnson Foundation and conducted within RAND’s Social and Economic Well-Being division. Anita Chandra led this research study with a large, diverse team of RAND researchers.