In particular, I was concerned that an intense focus on "being healthy and staying healthy" might not offer enough support to those who struggle with illness, or to clinicians whose work it is to care for "sick people."
The CEO of the Robert Wood Johnson Foundation, Dr. Risa Lavizzo-Mourey, was kind enough to write a response on THCB, and several people commented on both posts.
Furthermore, on October 17th, Dr. Lavizzo-Mourey posted a comment announcing that RWJF had made some tweaks to their message, to better clarify that a Culture of Health includes everyone, "be they sick or well."
I am, of course, hugely grateful to RWJF for taking the time to thoughtfully consider the issue.
I'm also especially grateful to those who took the time to comment and relay their own reactions to RWJF's previous definition of a Culture of Health; I'm sure this input was vital to the process of considering the Culture of Health messaging.
In this post, I want to share the "tweaks" so far in defining the Culture of Health. I'll also share some of the complementary meme ideas I heard from other people this month. And then I'll close with some thoughts on the power of blogging and social media.
Culture of Health before and after
“We believe an American Culture of Health is one in which:
- Good health flourishes across geographic, demographic and social sectors.
- Being healthy and staying healthy is valued by our entire society.
- Individuals and families have the means and the opportunity to make choices that lead to healthy lifestyles.
- Business, government, individuals, and organizations work together to foster healthy communities and lifestyles.
- Everyone has access to affordable, quality health care.
- No one is excluded.
- Health care is efficient and equitable.
- The economy is less burdened by excessive and unwarranted health care spending.
- The health of the population guides public and private decision-making.
- Americans understand that we are all in this together.”
As I said, other people's comments provided truly vital input to the conversation. I especially want to highlight Dr. Peter Elias, a remarkably thoughtful primary care physician who I know through the Society of Participatory Medicine. He commented:
"[This] talks about being and staying healthy, but doesn’t speak to the people who are ill and struggle for even some improvement in health, let alone those who just want dignity and comfort because health is no longer an option for them.
I think I understand the intent: a society that values the things that foster health. But the message I hear (and my patient heard) is that health is not just the goal, but the only acceptable state. That’s pretty hard on the ill. It lends itself to a culture of blaming patients for their misfortunes, something I see on a regular basis.
How does a dying patient related to a culture of health? Probably by feeling alienated, disrespected and disposable. How will clinicians behave in a medical culture of health? Will they be unwilling to care for patients who cannot become healthy or do not try hard enough (by someone’s definition) to get healthy?
I fear that a culture of health would make it less acceptable to care about those who are not healthy."
Again, it is a HUGE credit to Dr. Lavizzo-Mourey and RWJF that they really took these comments under consideration. They could have ignored me and Dr. Elias and kept doing what they do, and we all still would have mostly kept loving them because their foundation plays a vital role in improving health and health care.
But instead, RWJF made some modifications. And here's how they are now defining a Culture of Health: