The Commission to Build a Healthier America Comes to a Close
After a year and a half, two major reports and national events, three regional field hearings, nine issue briefs, two chart books, and more than 50 meetings with leaders from government and the private sector, the Robert Wood Johnson Foundation Commission to Build a Healthier America has come to a close.
The Commission was launched in February 2008 and charged with investigating why Americans aren’t as healthy as they could be and to look outside the health care system for ways to improve health for all. At the Foundation, we were very purposeful in launching the Commission – an entity that by definition had a specific assignment and purpose – as well as a finite period of time to get its work done.
For me, it has been a journey marked by countless thoughtful discussions and innovative ideas about improving the health of all Americans. And I have to admit, what I’ve seen during the past year and a half makes me wonder if we shouldn’t just keep the Commission and its conversation going. But, we know that discussion is just the beginning.
When it came to answering the tough questions we asked the Commission to answer--about why some Americans are so much healthier than others and why Americans aren’t the healthiest people in the world—it was because we knew action was needed.
To guide this national discussion and catalyze action toward a healthier nation, we sought a new kind of leadership to point us in a new direction. Alongside 12 engaged Commissioners who provided a wide range of expertise, our two co-chairs, Alice Rivlin and Mark McClellan, brought both thoughtfulness and a focus on action that made this effort a success. We are very grateful to each of them.
This Commission was not the first time this country has addressed health disparities or the social determinants of health – but it’s the first time in a long time that we have been able to look at these issues squarely in the face and have hope.
Hope that there are ways to help all Americans make healthy choices. Hope that we can get more out of our nation’s investment in health and health care. And hope that we can be successful in eliminating the enormous gaps that exist between the healthiest and least healthy among us.
The Commission crystallized for all of us that health is more than health care. Health is where and how we live, learn, work and play. So, reaching beyond traditional health care communities is essential if we are going to make any headway in improving the health of all Americans.
Next Steps for the Foundation: The Influence of the Commission’s Recommendations
The Robert Wood Johnson Foundation has a long history of commitment to the issues the Commission explored in its search for solutions to improve health. The Commission’s recommendations both reflect and reinforce the Foundation’s own priorities, our commitments and our mission. We at the Foundation have learned from and absorbed the Commission’s findings and participated in the conversations held across the country. And now, we are integrating these important outcomes into our own work.
I’d like to highlight some of the ways we at the Foundation see the Commission’s work making a difference in many of our efforts going forward. The Commission’s deliberations and recommendations have influenced our work in four ways:
FIRST: Reinvigorating Our Efforts
The Commission has reinforced the Foundation’s commitment to programs we have supported and known to be important. It has strengthened our resolve to finding more ways to overcome the great variances we see in health from one American to another.
The Foundation’s work in the social determinants of health, which has been ongoing for some time, will continue to build. We have new and powerful language to frame and position this work in ways that will reach and connect with all kinds of leaders and decision makers.
And, the Foundation has been a key player in reducing childhood obesity, increasing physical activity, reducing tobacco use and improving communities—all subjects of Commission recommendations. This work will continue.
We will also continue our commitment to programs like the Nurse Family Partnership, one of our longtime grantees. We are excited that this program is expected to be a primary recipient of proposed new funding in President Obama’s 2010 budget.
SECOND: Identifying Priority Areas
The Commission highlighted the need to raise the priority of some of the work that the Foundation had started, encouraging us to ramp-up investment in areas supported by the Commission’s research, findings and recommendations.
One example is the Pennsylvania Fresh Food Financing Initiative that helps meet the financing needs of supermarket operators moving into neighborhoods where infrastructure costs and credit needs cannot be met solely by conventional financial institutions.
We will continue to work to expand access to grocery stores in low-income neighborhoods. In fact, at a recent meeting I had with the Grocery Manufacturers’ Association, I challenged them to get involved in helping to establish grocery stores in low-income neighborhoods to help make affordable, nutritious food available.
The link between accessing healthy foods and good health was one of the key findings of this Commission. (Healthy Foods: watch the webinar, read the fact sheet, and see the recommendations)
THIRD: Funding New Projects
The Commission’s work has spurred us to investigate and fund new commitments.
For example, we are funding new research on the Women, Infants and Children (WIC) program and its effectiveness in providing nutritious food to children at high risk for obesity through our Healthy Eating Research program.
We are looking very seriously at how we can influence national policy to make schools healthier places for children. And we’re looking at how to ensure that children have access to healthier food.
We were quite moved by the research which demonstrated how the earliest years of our lives set us on paths leading toward—or away from—good health. So, we also are in the early stages of working with researchers at Harvard on ways to reduce toxic stress in early childhood.
With the Pew Charitable Trusts and in collaboration with the National Academy of Sciences, the Foundation has established a national coordinating center to advance the use of health impact assessments through 2014—another Commission recommendation.
To ensure that there are sufficient data to make the case for improvements in health, we are funding a new standardized approach to measure and report the health of counties across the country as it relates to social determinants.
Exciting new investments, all related to the Commission’s work.
FOURTH: Continuing the Conversation
This Commission has sparked a lot of discussion about best practices for addressing the social determinants of health and engaged a lot of stakeholders, many of whom are participating in conversations about their role in health for the first time. To keep that conversation going, we’re exploring the idea of creating an online community—a place online to share best practices, discuss challenges and encourage progress toward a healthier nation—for those interested in continuing the discourse.
I’d be grateful to hear from those of you reading this about your interest in that kind of virtual community since you are exactly the people we would envision taking part in the conversation (you can contact us with ideas here). Because the truth is, while these Foundation activities are indeed a lot of effort, it will amount to little if we go it alone.
We know there is a great deal of work going on in the areas the Commission addressed, and it’s our hope to continue to lend our support and interest to advance this important cause. It is a commitment that certainly extends beyond philanthropy, and one we hope you will join with us as engaged partners.
Why Act Now?
I’ve been thinking lately just how much the world has changed around us – such a different place than when I was a child. I know in my family, my pediatrician mother made sure we had a home-cooked dinner every night. Most of the food was fresh. Portions were smaller. We ate dinner on dishes the size of today’s salad plates.
Kids were more active, too. I walked to school. And that was in Seattle, so half that walk was uphill. Half the other kids walked, too, or rode bikes. And after school and on weekends, we played outside. It was safe, fun, and good for us.
This was how we grew up.
If you look outside today, it looks much different. Everything around us has changed significantly – our neighborhoods, our schools, the places where we eat and the time we spend at work. At the same time, not everyone is aware about the implications of those changes.
Take a moment to consider the world around us – today’s world – how much our health is influenced by where we live, learn, work and play, and what that means for our health and the health of future generations. It’s essential that we do what we can to improve these places as a way to improve health.
Because at the end of the day, if we all do our part, we won’t just be changing the course of health in America, we will be changing the course of our history.
Related: Listen to the Commissioner Podcast Series