A New American Dream for Healthy Families and Communities

Too many trends cut against a healthy future for Americans unless we work together to build a culture of health that starts with families and communities.  

That’s the assessment of a 2014 Robert Wood Johnson Foundation commission report entitled A Time to Act calling for collaborative and multi-sector efforts to invest in communities and children. RWJF could just as easily have called this report “Investing in a New American Dream”.

The American dream promises everyone a fair chance to succeed in life. In America, social determinants should not dictate your health or your future. 

If you accept the premise that none of us are truly healthy when most of us are not, the trends are not good.  The executive summary hits us right between the eyes:  “Health in America is worse than other developed countries on a 100 different measures….. people in 26 countries can expect to live longer than we do.”  All this is happening while we are spending upwards of $2.7 trillion on healthcare. You definitely should feel something is wrong with this picture.

And if we project ahead simply on demographics the outlook is not good:  “By 2043, the majority of U.S. residents will be people of color, who are disproportionately low-income and living in disadvantaged communities. In the U.S., low-income people and people of color generally experience the worst health for reasons that are preventable and that require actions beyond health care alone.”

So RWJF and advocates rallying behind this call to action are asking us to put our talents and money behind three strategies with a better chance of bending the trend lines toward health:

  1. Make investing in America’s youngest children a high priority. This will require a significant shift in spending priorities and major new initiatives to ensure that families and communities build a strong foundation in the early years for a lifetime of good health.
  2. Fundamentally change how we revitalize neighborhoods, fully integrating health into community development.
  3. The nation must take a much more health-focused approach to health care financing and delivery. Broaden the mindset, mission, and incentives for health professionals and health care institutions beyond treating illness to helping people lead healthy lives.

It’s that last strategy that first grabbed our attention and drew us into reading the entire report. Signature i has worked with healthcare-related associations that are eager to do their part in prevention and have members ready to take a systems approach to health.  RWJF advocates a simple first step.  Health professionals should adopt new health “vital signs” to assess nonmedical indicators for health.  And if someone reports problems with poverty and living conditions that work against their health, these professionals should have the relationships to make referrals to community services that can intervene.  

As someone who cringes any time a health professional complains about patient non-compliance with treatment, I applaud this RWJF report for making it clear that lack of compliance is rarely a willful act; it often is a consequence of an environment undermining health.

What might an environment that supports health offer? In the report, there’s a great infographic entitled Building Healthy Communities Where the Healthy Choice Is the Easy Choice. The ideas in this graphic could be the key components of a New American Dream.  Let’s invest in healthy families and kids, healthy neighborhoods, and economic opportunities and mobility.  Even in our politically polarized nation, this is a platform any American that cares about our collective future should be ready to support.