Alonzo Plough: building a culture of health

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  • Posted:Tuesday 20 October 2015

Alonzo Plough shares how the Robert Wood Johnson Foundation is improving population health and wellbeing in the USA by building a ‘culture of health for all’.

More from the event: Integrated care summit 2015


You know, I believe, and the Robert Wood Johnson Foundation believes, that we have a lot to learn from each other and the truth is that improving health is a real challenge regardless of where you live, but it’s become more and more evident to us as an endowed private foundation, we can play a special role in a bold, long-term movement towards systemic change. There’s good news about what’s happening in America that you will maybe not see on those front pages. Remarkable collaboration and innovation outside the capital that shines really a light on what happens in states, cities and neighbourhoods.

In our country as you get more local, you get more collaborative, so again we see these efforts happening on a state level in the United States, in Republican dominated states, in Democratic dominated states, lots of different signs of progress and we’re seeing a broadening public covenant amongst individuals, families and communities to make healthier choices but also to recognise that our major challenge, and I’m hearing it here today, is improving health equity, equity in social conditions, housing conditions, economic conditions, that allows people to make healthy choices. 

So last year the Foundation unveiled a vision of America where we all strive to build a national culture of health and we would define this, and I’ll define it in a couple of different ways, enables all in our diverse society to lead healthier lives, now and for generations to come. But in brief, a culture of health means providing every person with an equal opportunity to live in the healthiest, most fulfilling life possible, no matter who they are, where they live, what their physical challenges happen to be, and it means recognising that health is an essential part of everything we do, far beyond medical care. It’s the bedrock of personal fulfilment, of a backbone of prosperity and the foundation for a strong and competitive nation. In a culture of health business and industry leaders know that wellbeing boosts the bottom line and they do their part to keep employees and their communities vital and productive. Doctors and other healthcare providers work as partners with their patients and care as much about actively promoting health as in treating illness, and in a culture of health, we also recognise that health and wellbeing can greatly be influenced by complex social factors where we live, where we work, the soundness and safety of our surroundings and the strength and resilience of our families and communities. 

We also recognise that building a national movement towards better health, which is what we are really about, is not a short-term initiative and it’s going to require a cultural shift that may take a generation or more to achieve. I know we in the United States have spent the majority of our time trying to improve the healthcare system and where there’s work to be done there, that approach as a singular approach is really woefully short-sighted. So building a culture of health requires action across sectors because progress in one area will advance progress in another but we have to ask what actions should we work towards? How should our actions be connected to one another? What specific measures will gauge progress? We really need metrics to know where we’re going. So over the past 18 months, the Robert Wood Johnson Foundation in collaboration with the RAND organisation, a major research thinktank in the States, has developed this action framework and we hope it will spark integrated collaborations here in this country, in our country as well as abroad.

Ask one big question in developing this project, what is holding the United States back from the health that we aspire to and the equity in health outcomes we aspire to? And all of the research we’ve done with RAND and all of our analysis has really shown that as a nation at least we haven’t addressed the interdependence of the many social, economic, physical and environmental factors that improve health and wellbeing. So here’s the graphic and as you can see, the framework is grounded in four interconnected action areas that show health and wellbeing as the sum of many parts, and I want you to notice how many times equity is on this particular slide. So making health a shared value, fostering cross-sector collaboration to improve wellbeing, creating healthier, more equitable communities and strengthening integration of health services in the system… If we do all this work, and again the Foundation has made a 20 year commitment with our funding level that’s about $15 billion to lever this kind of activity over the next 20 years, with the partnerships and the alignment we’re talking about, we actually believe we’ll be able to measure and gain improvements in population, health, wellbeing and equity.

So kind of in conclusion, what we’re doing as a foundation is aligning other organisations with even more assets than we have and certainly more reach in the communities to amplify this and really lift up the success stories, what works and frankly what doesn’t work and I would hope that we could also learn from you in your efforts to do, I think, similar kinds of things, what is working, what’s not working and have this kind of international dialogue, because I think we really need to improve and pool our ideas and talents and the tenacity I’ve heard over the last day to really get to a different place in health and healthcare, integration of health and healthcare and the vision of a population health as a focus, so thank you very much, it’s really a privilege to be with you. 


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