FAQs

What does the Robert Wood Johnson Foundation hope to accomplish through the Commission to Build a Healthier America?

But don’t Americans have the best overall health in the world?

The United States is rich and resourceful. We should be one of the healthiest countries in the world, but we are not. Americans on average do better than their counterparts in most developing (lower-income) countries in Africa, Asia, and Latin America on several key measures of health. However, the U.S. continues to rank near or at the bottom in comparison with all industrialized (higher-income) countries, even ranking below a number of less affluent nations. People in 22 countries (including Spain, Canada and Greece) live longer on average than Americans. Babies born in the U.S. are more likely to die before reaching their first birthdays than babies in Canada, the Czech Republic, Greece and more than 20 other countries.

What affects a person's health?

Where and how people live, learn, work and play has an enormous impact on their health. Housing, education, good diet, regular exercise, and avoiding tobacco and other personal behaviors greatly affect the health outcomes of Americans. Many non-medical factors have significant influences early in life and can affect a person across a lifetime – and transcend generations. And whether one's neighborhoods and neighbors encourage and support healthy behaviors and activities makes a big difference.

Aren’t the problems of differences in health mostly related to access to medical care and racial and ethnic disparities?

Most of our nation’s strategies to improve health have targeted improving the quality, access to and affordability of care, even though a greater determinant may be the relationship between how we live our lives and our economic, social and physical environments. And differences in health outcomes exist beyond race or ethnicity. The Foundation’s report to the Commission, Overcoming Obstacles to Health, details the substantial role that social factors – neighborhoods, income, education and environment – play in shaping health behaviors and health. For example, higher rates of death due to heart disease are often seen in communities where fewer adults have a college education and the prevalence of heart disease is nearly 50 percent higher among poor adults than among adults in the highest income group.

It sounds like much of the problem is related to poverty and income. Is this another Commission that will look at solving the problem of poverty?

There is no question that poor health and poverty are inter-related, but this Commission is not focused on addressing poverty in America. This Commission is committed to providing better health opportunities for Americans in every community to grow up and stay healthy. The Commission will seek answers to questions that impact all of us – including but not limited to those living in poverty. For example, what would happen to their health if all children ate three healthy meals a day? What would happen if everybody exercised? What would happen to our nation’s health if everyone completed high school and post-secondary education? What would happen if everyone lived in a safe neighborhood?

Can a privately-funded Commission have a significant impact on the health of Americans?

Yes. This Commission will propose practical policies – public and private – to improve the health of Americans. Past Commissions have led the way. For example, the Pew Health Professions Commission led to significant changes in the way that medical schools train physicians and the numbers of physicians trained. The Sullivan Commission on Diversity in the Healthcare Workforce led to collaborations between state universities and historically black colleges to expand the number of minority health care professionals. The Foundation believes that this Commission, with the stature and diversity of its commissioners, will change the way we look at health in this country and ultimately improve the health of all Americans.

Aren’t individuals ultimately responsible for the health decisions they make?

Without doubt, individuals play an important role in determining how healthy they are. Adopting healthy lifestyles – including for example, good diet, regular exercise, avoiding tobacco and drug and alcohol abuse – could have a huge impact on the health outcomes of Americans. But regardless of how motivated individuals are to be healthy, there are some social and environmental factors that are beyond individual control. The Commission will seek to identify ways to ensure that these factors encourage and support rather than block healthy behavioral choices.

Hasn’t this work already been done?

The Foundation is investing in this initiative because there is a strong need to look beyond the medical care system for ways to improve health. While there has been significant research in Western Europe on socioeconomic factors that affect health, there is little research in the U.S. that addresses how non-medical factors affect health, and policy attention has been largely focused on disparities in medical care and health insurance coverage. Commissioners represent and bring diverse expertise related to the broad range of factors that impact health. Given this expertise, the Commission has the ability to look beyond the medical care system for ways to improve health.

Why now?

The health of America depends on the health of all Americans. Despite enormous investment, America is not achieving its full health potential. Americans at every income and education level should be healthier. To make a difference, we must think about health differently. There is currently a lot of discussion about how to improve health care. In addition, we need to look beyond the important national debate on reforming the health care delivery system (and access to it) to ways of changing other factors influencing health. There’s more to health than health care.

Who are the Commissioners?

This national, independent and nonpartisan health Commission represents a diverse group of innovators and experts with the ability to cross traditional boundaries mobilize partners to action and identify practical, timely solutions. The Commission Co-Chairs are Mark B. McClellan, Director of the Engelberg Center for Health Care Reform and Senior Fellow, Economic Studies at the Brookings Institution and Alice M. Rivlin,  Senior Fellow, Economic Studies Program at the Brookings Institution and Director of the Greater Washington Research Program.  See the full list of Commissioners.