Princeton’s Robert Wood Johnson Foundation is the nation’s largest foundation devoted to health, awarding about $400 million in grants each year to support health research and programs nationwide. Advancing what it calls a “culture of health” in America is a major focus of RWJF, said veteran public health expert Dr. James…Marks joined RWJF in 2004, when he retired as assistant surgeon general after a decade directing the national center for chronic disease at the Centers for Disease Control and Prevention. In January, RWJF named him executive vice president for the culture of health initiative.
Encouraging a healthier America means RWJF increasingly will partner with other stakeholders, including government, civic organizations, businesses, employers and nonprofits to leverage resources and share ideas, Marks said.
“We recognize that our nation has to embrace the notion of health as being much more than clinical care,” Marks said. “When we think about the elements that build a culture of health, it’s that a community has a shared sense of value about the healthiness of a place to raise a family, and as a good place to live.”
Good health often hinges on “the choices that people make and are able to make,” he said. And that gets into issues like whether people have access to stores that sell fresh fruit and vegetables, and whether they are exposed to toxins in their neighborhood or workplace.
“All of those things contribute to a community and a nation being a good place for being and staying healthy,” Marks said.
A new program RWJF is funding in New Jersey illustrates how the foundation will support the culture of health right here in the Garden State.
On July 1 the foundation will announce 10 winners of its “Building a Culture of Health in New Jersey — Communities Moving to Action” initiative. Each grant is for $200,000 over four years. The application deadline was Jan. 15, and “we had a tremendous response,” Marks said.
The winning proposals will be those that bring multiple stakeholders together into coalitions to work on improving the health of their population, he said.
“No single organization in the community is going to succeed on its own,” Marks explained. “A group has to come to the table and say ‘We are going to work on this in our community.’”
The winning coalitions will have diverse priorities: “They might work on violence, they might work on obesity or improved access to health care. It depends on their own needs and concerns. We want them to choose the issues that they will work on and commit to making progress on.”
The goal is that, once they achieve initial success, these coalitions “will then look at other issues,” Marks said. “So they will continue to grow their partners and continue to grow the number of things they’re working on that will help their community.”
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The role of RWJF “is to be a catalyst for change,” he said. “And the changes that are going to be the most effective and last the longest will be ones the people and organizations and leaders from that community embrace.”
Part of the foundation’s role is promoting awareness of ideas that successfully address similar problems elsewhere. To that end, RWJF will provide the coalitions with coaching to “help them know what others are doing, what the best examples are, from other states and from New Jersey.”
The program has attracted applications from across the entire state, said Diane Hagerman, spokeswoman for New Jersey Health Initiatives, a national program office of RWJF that oversees the foundation’s grant making in New Jersey. Since each application involves multiple stakeholders, all told they represent “well over 400 organizations that are addressing health issues in the state,” she said. The 10 winning proposals will be announced July 1.
Encouraging healthier New Jersey communities is a major goal of the New Jersey Health Care Quality Institute. Janan Dave coordinates the institute’s Mayors Wellness Campaign, launched in 2006 with the New Jersey State League of Municipalities to leverage grassroots leadership to improve community health. So far, 357 out of the state’s 565 mayors, from rural townships to New Jersey’s largest cities, have joined the campaign.
Dave said, “The Robert Wood Johnson Foundation’s emphasis on building a culture of health benefits the Garden State in multiple ways, especially by raising awareness of the fact that good health goes beyond how you eat and exercise, and by placing emphasis on the new NJHI grants to support building leadership capacity at the community level.”
Dave said the Mayors Wellness Campaign provides members with “a constantly refreshed toolkit of activities and strategies to promote healthy living and aging in place. We advise many of the participating towns on creating local partnerships to support their wellness activities, and we develop specialized programs for specific cohorts of towns.”
The campaign’s newest initiative, “Conversation of a Lifetime,” is a multifaceted project to facilitate communitywide conversations about advanced care planning.
Marks said RWJF will be taking new approaches to grant making as it reframes its vision around a culture of health.
For example, the foundation funds a number of fellowships for scholars.
“Now we’re making sure that those scholars have an element of leadership development in their training,” Marks said. “So when they finish their training, they are more ready to take on leadership roles in their institutions and their communities.”
RWJF funds efforts to reduce childhood obesity and, “One thing we’ve realized is the nation needs to do more to reduce disparities in obesity, so we are going to emphasize that more.”
He said the foundation will “continue to work in some of our most important areas, but we can modify them so that we are really dealing with some of the long-term challenges we face as a nation.”
Marks said RWJF will increasingly partner with the business community on projects that improve the health of workplaces and communities. For example, “We are in discussions with health insurers to see how they can encourage healthiness in communities” where many of their members live. And the foundation has set up forums with restaurants “to discuss what they can do to offer healthier options, especially for children.”
A key message from the foundation is that it wants to partner with all stakeholders, Marks said.
“It is when you get the business community and the schools and the civic leadership all recognizing how important health is to making their community a place that families want to be part of — that is when we will have a nation embracing a culture of health.”
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