It's no secret that we're big fans at IP of Robert Wood Johnson's push for a "culture of health." It's a great example of a foundation laying out a bold, values-based vision for improving U.S. society and marrying that to an ambitious plan of action. And it's hard to think of many more urgent challenges facing America.
You already know the facts. According to the Commonwealth Fund, “although the U.S. has the most expensive health care system in the world, the nation ranks lowest in terms of ‘efficiency, equity and outcomes.’”
And it's not just that our health care system stinks; our health itself is terrible, with obesity at epidemic levels and chronic disease like diabetes rising fast.
If all that makes you angry, you’re not alone.
It’s now been almost exactly one year since we introduced our readers to RWJF's ambitious plans to create a culture of health. At the time, the news that RWJF was changing course and shifting organizational focus rattled the nonprofit health care world—particularly those longtime RWJF grantees whose program areas were shuttered to make room and capital for this new, all-encompassing endeavor.
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We've been checking in often over the past year on different pieces of the "culture of health" work. In this post, we look more broadly at where things stand.
If you're new to this conversation, you may be asking yourself, what exactly is a culture of health? Here’s how RWJF defines it:
A Culture of Health is broadly defined as one in which good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities guides public and private decision making; and everyone has the opportunity to make choices that lead to healthy lifestyles.
The exact definition of a Culture of Health can look very different to different people. Ultimately, it will be as diverse and multifaceted as the population it serves.
What RWJF is trying to do, essentially, is spur a complete paradigm shift in the way we approach health and health care. It's not just about eating right and exercising. It's about poverty and the environment. It's about transportation and the physical design of our society. And, of course, it's about improving a health care system that remains deeply dysfunctional, even after the enactment of Obamacare.
I know—this sounds like a lofty pipe dream, too complex and intangible to be feasible, let alone effective. But when you have the money, relationships, and brainpower of Robert Wood Johnson—it's a $10 billion behemoth bristling with expert staff that's focused solely on health care—just maybe it's not all that crazy.
So what does the grand strategy for advancing a culture of health look like at this point in the effort?
Well, working with RAND, RWJF came out with an action framework to encompass the principles underlying the vision for a culture of health. The framework is intended to guide the foundation’s grantmaking and partnership strategy in pursuing a culture of health:
Yes, there's a lot going on in that chart. But as we said, there are many moving parts to this initiative. The foundation says that the action framework reflects a vision of
health and well-being as the sum of many parts, addressing the inter-dependence of social, economic, physical, environmental, and spiritual factors. It is intended to generate unprecedented collaboration and chart our nation’s progress toward building a Culture of Health.
The notion of cross-sector collaboration is key. A lot of organizations talk about it as an ideal, and we all know it makes sense, but not many have figured out quite how to make it work on such a grand scale. But that’s where being RWJF makes all the difference.
The foundation has championed cross-sector collaboration for many of its programs over the years. It plays nice with its fellow foundations and has successfully engaged businesses, universities and community leaders to achieve its objectives, most notably in the sprawling national campaign against childhoold obesity that it launched in 2007.
Now RWJF is working its relationships hard to move America toward its vision of a culture of health, bringing together experts from a variety of sectors—medical, urban planning, community development, education, business, housing, transportation, and social services—to discuss and deliberate all the different avenues available for reaching a holistically healthier America.
Only a year out, it's hard to speculate on the breadth and depth of the relationships RWJF has formed, and what impact those relationships will have on this undertaking. But RWJF seems fully intent on reaching every American one way or another.
For example, working with GOODcorps, RWJF has been conducting in-home and expert interviews to develop a deeper, more nuanced understanding of what health looks like in America. The foundation is seeking to understand everything, including the greatest challenges Americans face when it comes to health care, and the socioeconomic and cultural factors associated with health as a common goal and shared value. According to GOOD:
These insights will help guide $300 million in foundation grantmaking as well as inform the design and launch of new products or offerings that seek to empower middle-income millennial parents to build cultures of health with their families and communities.
Ultimately, it will take years before we begin to see how RWJF is faring in its crusade for a comprehensively healthier America. So, to be clear: We're not saying this thing is likely to work; we're just saying it's super-cool.
America's approach to health has long been overdue for a complete transformation. And while many foundations have poured millions into programs to improve the health of Americans, few have had a vision as grand in scale and scope as RWJF.
There’s a famous quote from Antoine de Saint-Exupery that says, “If you want to build a ship, don’t herd people together to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.” RWJF is certainly working hard to build a national culture of health, let's just hope they can teach us all to long for a healthier America.