Culture Change Policy Projects & Programs

The Commission To Build A Healthier America’s Ten Recommendations To Improve The Health Of All Americans

York County, SC (Nov. 23, 2017) What are some goals for community members to work towards together to create a healthier York County? This serves as a reminder that, this Thanksgiving, we are thankful for our local partners who are working to improve the health of  our York County community.

Back in 2008, the Robert Wood Johnson Foundation charged the Commission to Build a Healthier America with identifying factors beyond the health care system that could improve the health of all Americans. The commissioners, led by Alice Rivlin and Mark McClellan, made ten recommendations that we should continue to strive for today.

The Commission To Build A Healthier America’s Ten Recommendations To Improve The Health Of All Americans

To promote early childhood development and health

1 Ensure that all children have high-quality early developmental support, especially in child care and education

2 Provide only healthy food for children in schools

3 Require all schools from kindergarten through grade 12 to include daily physical activities for students

To promote good nutrition for Americans of all ages

4 Create public-private partnerships to open and manage full-service grocery stores in communities without access to healthful food

5 Meet hungry families’ need for nutritious food through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutritional Assistance Program (SNAP, formerly known as food stamps)

To promote healthy communities

6 Integrate safety and wellness into every aspect of community life, including schools, workplaces, religious institutions, and neighborhoods

7 Create “healthy community” demonstration projects to evaluate the effects of a range of policies and programs

8 Develop a “health impact” rating system for housing and infrastructure projects that provides incentives for projects to increase community health

9 Eliminate smoking

Overarching recommendation

10 Obtain reliable data, perform evaluations, and conduct research in order to promote accountability for outcomes and to identify the most successful methods of achieving goals stated in recommendations 1–9

Sandra Braunstein and Risa Lavizzo-Mourey go on to summarize in their 2011 article, “How the health and community development sectors are combining forces to improve health and well-being:”

Many of the commission’s recommendations centered on the aspects of communities that make them vibrant and are often missing from most low-income neighborhoods—for example, safe and accessible walking and bike paths and public transportation; well-equipped parks and organized community recreation; well-stocked grocery stores offering nutritious food; and well-kept homes and tree-lined streets. In particular, the commissioners provided a blueprint for addressing the characteristics of communities that enable residents to make, and follow through on, healthy choices. Although each person ultimately must bear some responsibility for his or her own health, the commissioners understood that many Americans live in neighborhoods where the obstacles to embracing healthy choices are too high, even when personal motivation is great. Taking this broader perspective is critical as society strives to ensure that everyone has the opportunity to live a long and healthy life.

The necessity of looking beyond the health care system to improve health also becomes apparent when one looks at the relative contributions of factors associated with premature death. Health care plays a surprisingly small role (10 percent). In contrast, social circumstances, environmental exposure, and behavior are estimated to account for 60 percent of the risk of premature death. For example, life expectancy increases as income rises: upper middle-class adults can expect to live more than six years longer than poor adults. Similarly, American college graduates can expect to live at least five years longer than those who have not finished high school. Closing the gaps in life expectancy and overall health will require changes in policies, practices, and personal behavior as well as investments in infrastructure—high-quality affordable housing, child care centers and schools, community health centers, and playgrounds.

Summary taken from: Braunstein, S., & Lavizzo-Mourey, R. (2011). How the health and community development sectors are combining forces to improve health and well-being. Health Affairs, 30(11), 2042–2051.