Spreading the Health

Allen County, Kansas, may be small—just 13,000 people—but the community’s big thinking on health and economic development attracted the attention of the Robert Wood Johnson Foundation.

The county’s initiatives to bring new businesses to the area doubled as health improvement strategies, earning it the foundation’s Culture of Health Prize in 2017.

“Our vision of a culture of health is creating a society in which health is the easy option,” Richard Besser, MD, president and CEO of the foundation, said at a March 28 Dean’s Lecture at the Johns Hopkins Bloomberg School of Public Health, “Changing How America Thinks About Health.”

Referring to Allen County’s successful projects, Besser said, “They weren’t going to get anyone to invest or locate businesses there without a supermarket or hospital or places for kids to play. It’s the economic engine driving people’s interest, but what they’re doing is a health intervention.”

Besser has practiced public health in a variety of roles—as physician, researcher, administrator, reporter and author. Now, as the leader of America’s largest private foundation devoted solely to improving the nation’s health, he’s committed to harnessing the power of philanthropy to shift conventional thinking about health.

To that end, the foundation is crafting a broader definition of health that extends beyond examining rooms and hospitals to encompass housing, economics, education and leadership as key drivers of health.

“If you don’t have safe housing, asking people to eat right and exercise won’t matter,” Besser said. “We recognize that everyone in America should have a fair and just opportunity for health.”

Besser pointed to the shocking discrepancy in life expectancy—87 and 67 years of age—between two Baltimore neighborhoods just miles apart as a stark illustration of health inequity in the US.

“We talk about choice being such a big part of health, but the choices you make depend on the choices you have,” he observed. “So many people in America don’t have those health options.”

Besser said that the culture of health vision of making health “the easy choice” means looking at health through different lenses.

As for the traditional players in health culture—hospitals, clinics, research institutions—Besser stressed that the foundation is committed to supporting their work to become or remain “anchor institutions,” with deep community connections.

He cited the organization’s Health Leads program—piloted in thousands of health care locations—which aims to go beyond an individual’s immediate health needs. A doctor can prescribe healthy food or heating assistance to a patient, for example, and a Health Leads specialist can help the patient to access the appropriate support resources.

On the training front, Besser said that the foundation’s revamped leadership programs are developing future health leaders to work with communities and experts across diverse sectors.

“Training leaders is one of the most important things we do,” he said. “I think we are moving toward a different way of thinking about health that’s likely to have a profound impact on the lives of entire populations.”

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