RWJF to Focus on Building a 'Culture of Health'

The Robert Wood Johnson Foundation has launched a major effort to help build a "culture of health" in communities across the country, signaling a shift in the grantmaking priorities of the largest health philanthropy in the United States.

Announced by RWJF president and CEO Risa Lavizzo-Mourey at the Aspen Ideas Festival's Spotlight: Health summit, the new strategy aims to "chang[e] our current understanding of health and creat[e] a society where everyone has the opportunity to lead a healthy life." According to Lavizzo-Mourey, that could mean everything from helping low-income patients with housing, food assistance, and other needs during medical visits, to creating a workplace culture that encourages healthy behaviors during the workday. "We won't achieve a true 'culture of health' if some Americans are faced with much greater barriers to health than others," she added, noting that nearly 20 percent of Americans live in neighborhoods with limited job opportunities, low-quality housing, pollution, and unhealthy food options. "We have to make a seismic shift in the way we deal with health — and it has to come from the ground up."

While the foundation's ongoing efforts to stem and reverse the childhood obesity epidemic, expand outreach to and enrollment of those eligible for healthcare coverage under the Affordable Care Act, encourage businesses to invest in the well-being of local neighborhoods and communities, and address community violence are aligned with the "Culture of Health" strategy, several initiatives in progress promise to stake out new ground. They include the "Flip the Clinic" project, which seeks to change the prevailing dynamic between doctors and patients and empower patients with the knowledge they need to be actively engaged in their health and health care; and MakerNurse, an effort to support and accelerate innovation by nurses by providing them with an online community, tools, and other resources.

Because it will result in cuts to existing programs, the new approach has drawn criticism, the Philadelphia Inquirer reports. For example, the foundation's Clinical Scholars program, which has helped train doctors to be leaders for more than thirty years, will be wound down in 2017, and nursing and health policy programs are also being terminated. The new strategy also is so expansive that it may be difficult to measure its success, Ian Morrison, author of Leading Change in Health Care: Building a Viable System for Today and Tomorrow, told the Inquirer. "There's a danger in dissipating the effort if you go broader," said Morrison. "How do you know you've made a difference?"

RWJF officials said the new approach is needed in order for it to drive bigger and more sustainable change, and that the foundation will identify new metrics to help keep the effort on track. "We'll be looking for measures that are trackable and usable," said Jim Marks, SVP and director of program portfolios at the foundation.

"Building a Culture of Health in America." Robert Wood Johnson Foundation Blog Post 06/25/2014. Rachel Zamzow. "Robert Wood Johnson Foundation Makes Major Changes in Health Funding." Philadelphia Inquirer 06/26/2014.