Robert Wood Johnson Foundation

Last updated

Robert Wood Johnson Foundation
AbbreviationRWJF
Founded1936
Founder Robert Wood Johnson II
PurposeImproving the health and well-being of all in America
Location
Area served
National
MethodGrantmaking and social change
CEO
 Richard Besser
Key people
 Julie Morita
Disbursements~$500 million annually
Endowment $13 billion [1] (2020)
Employees
270
Website www.rwjf.org

The Robert Wood Johnson Foundation (RWJF) is an American philanthropic organization. It is the largest one focused solely on health. Based in Princeton, New Jersey, the foundation focuses on access to health care, public health, health equity, leadership and training, and changing systems to address barriers to health. [2] RWJF has been credited with helping to develop the 911 emergency system, reducing tobacco use among Americans, lowering rates of unwanted teenage pregnancies, and improving perceptions of hospice care. [2]

Contents

The Robert Wood Johnson Foundation: supports the development of programs that can be used in community-led initiatives or by government bodies; [3] funds research through surveys and polls; [4] and makes impact investments. [5] According to Pensions & Investments and Foundation Center, the foundation was the fifth-largest in the U.S. in investment assets, as of 2015. [6] [7] As of 2020, the value of its endowment was $13 billion. [1]

History

The Robert Wood Johnson Foundation was initially established as the Johnson-New Brunswick Foundation in December 1936, and focused on charitable efforts in New Brunswick and Middlesex County, New Jersey. The original board of trustees included Robert Wood Johnson II, John Seward Johnson II, and others. [8] It was renamed the Robert Wood Johnson Foundation in 1952. [9] Robert Wood Johnson II left a bequest of 10,204,377 shares of Johnson & Johnson stock to the foundation upon his death in 1968. The foundation became a national philanthropy in 1972. [10] [3] The value of the stock was more than US$1 billion, making it the second-largest private foundation at the time. [11]

1972–1985

Initially, the foundation worked on improving access to health care, with a focus on impoverished and minority groups, infant and elder care, and mental health. [12] It created a $15 million grant program to contribute to the development of emergency services systems in the United States. Then-president David E. Rogers established a partnership with the National Academy of Sciences to increase oversight of how the funds were used and assess project outcomes. Ultimately, the funds were distributed to 44 grantees in amounts ranging from $350,000 to $400,000. The program funded primary aspects of emergency medical services, including: technology access, such as equipping ambulances with radios; training for ambulance drivers and dispatchers; interagency coordination through a national centralized, regional-based system; and development of the 911 emergency system. In 1973, 11 percent of areas covered by the foundation's program had access to a centralized emergency services system. By 1977, when the program ended, coverage had increased to 95 percent. [11]

In 1985, the foundation partnered with The Pew Charitable Trusts to launch a new program to improve access to health care for the American homeless population. The organizations committed $25 million over five years to 19 pilot programs as part of their Health Care for the Homeless initiative. Approaches to the issue varied by city. For example, a Philadelphia program connected hospitals with homeless shelters, so individuals experiencing homelessness had access to inpatient and outpatient care. Another program in New York City focused on providing care in soup kitchens. [13] Congress followed the foundation's program for providing health care through shelters by passing the McKinney–Vento Homeless Assistance Act. [3]

Other early foundation efforts included: support for the Nurse-Family Partnership, which partners at-risk pregnant women with nurses; [14] establishing the Minority Medical Faculty Development Program (renamed the Harold Amos Medical Faculty Development Program in 2004); [15] and supporting development of the "swing bed" concept in rural hospitals, which allows patients to transition from acute care to skilled-nursing without having to transfer to a nursing home. [16]

1986–2001

Beginning in 1986, the foundation focused on funding programs for the treatment HIV/AIDS, despite the stigma surrounding the disease. [3] It launched the AIDS Health Services Program in 11 communities around the U.S., which aimed to integrate a network of human services agencies for case management and favored community-care models for patients. [17] By May 1989, the foundation had given $50 million to care services and prevention campaigns. [3] The Ryan White CARE Act was partially modeled on RWJF's program. [18]

After Steven A. Schroeder became the foundation's president in 1990, he made substance abuse a major focus of the foundation's work. [19] Between 1991 and 2003, the foundation spent approximately $408 million on a variety of tobacco-related programs, including awareness campaigns on smoking cessation and the negative effects of tobacco use. The foundation launched Smokeless States in 1993, a program designed to educate local groups about the effects of tobacco and options for regulating tobacco usage. By 2007, 31 states and the District of Columbia had adopted the program. The foundation's Center for Tobacco-Free Kids was asked to participate as a "disinterested and trustworthy party" in state litigation leading up to the Tobacco Master Settlement Agreement of 1998. [19]

Apart from substance abuse, the foundation also funded studies on palliative care and worked with researchers to develop the chronic care model. [20] In 1989, the organization funded a five-year, $28 million study on palliative care, publishing the results in 1995. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment found that most Americans die alone in hospitals while receiving high-cost care and treatment, often against the patient's desires. The study led to the formation of several groups by the foundation, including Last Acts, 900 entities that have drafted best practices for palliative care. Between 1989 and 2007, the foundation gave more than $148 million for research related to palliative care. By 2007, more than 500 hospitals throughout the U.S. had palliative care programs, most of which were created after the foundation and George Soros's Open Society Institute began research and advocacy efforts. [21]

During this period, the foundation also contributed to efforts to enroll more uninsured U.S. children in medicare. A study published in Health Affairs noted that RWJF spent $55 million on its Covering Kids campaign, which lasted from 1997 until 2002. The study found that the overall rate of uninsured children in the U.S. decreased during the campaign. [22]

2002–2017

In the early 2000s, under the leadership of Risa Lavizzo-Mourey, the foundation prioritized childhood obesity, and pledged of $1 billion for research and advocacy to raise awareness on the topic. [23] Grants from this pledge, the first $500 million of which came in 2007, have been used to fund projects in cities throughout the United States. As early as 2003, the foundation was working in Louisville, Kentucky, providing more than $740,000 in grants between 2003 and 2011 to make infrastructure updates that encourage physical activity, such as widening sidewalks and adding the city's first bicycle lane. [24]

The foundation also continued to work on eldercare topics and provided funding for the Green House Project, a non-profit that offers a long-term care alternative to nursing homes. While nursing homes tended to be regimented, the Green House model allows residents to set their own schedules, and houses fewer people in more units designed like a single family home. [25] In 2011, the foundation established a $100 million impact capital fund to develop the Green House model. [5] By 2014, 27 states had adopted versions of the Green House Project. [26] A 2017 study on Green House nursing homes funded by the foundation found that while imperfect, the model had better outcomes for residents, including fewer hospitalizations and a lower occurrence of conditions such as pressure ulcers. [27]

The foundation established the commission to Build a Healthier America in 2008. The non-partisan group included individuals from business, academia, and politics and focused on studying ways to improve health in the U.S. outside of the health care system. [28] The commission compiled five years' worth of research into a report it released in 2014. The report focused on social determinants of health and detailed three strategies to improve health in the U.S.: early-childhood education; community-based health initiatives; and preventative care. [29]

In 2010, the Robert Wood Johnson Foundation partnered with the University of Wisconsin's Population Health Institute to launch the County Health Ranking program, which calculates and compares the health of each county, nationwide. The counties are measured and ranked on various health and social factors, which include more than 30 indicators such as obesity, tobacco use, mental health, employment and poverty rates, and access to healthy food. [30] Over time, the foundation added coaches and competitions to the program to support communities' efforts to improve local health. This was done in response to growing evidence showing that social factors and individuals' actions could affect a population's health more than the quality of medical treatment. [31] The foundation also partnered with Federal Reserve Banks to engage impact investors, banks, and community developers in health and wellness-based projects through the Healthy Communities Initiative. [32]

In 2014, the foundation announced a major shift in its approach to health issues. It had previously focused on specific health issues, and would instead focus on changes that could lead to large-scale social shifts by building what it called a "culture of health." [33] The change built on the Culture of Health Action Framework adopted by the foundation in 2013. [34] Critics of the shift expressed concern that funding for some areas—such as leadership training for doctors, and programs for nursing and health policy—was being discontinued as part of the shift. When describing the changes at the Aspen Ideas Festival, Lavizzo-Mourey said, “We have to make a seismic shift in the way we deal with health, and it has to come from the ground up.” [33]

A 2017 survey conducted by RWJF, NPR, and Harvard T.H. Chan School of Public Health found that people in America report that their personal experience with discrimination regularly affects their lives and drives decisions that influence their health, safety, and well-being. Experiences with discrimination correlated to an increased risk for health conditions such as coronary heart disease. [35] In 2018, the foundation co-funded a study along with the National Institutes of Health that found police killings of unarmed black Americans led to adverse mental health affects among black American respondents. [36] Other public opinion polls RWJF worked on with NPR and Harvard University have covered issues such as the burden of stress in America (2014), education and health in schools (2013), trust in public health (2021), income inequality (2020), and experiences during the pandemic (2021). [37]

2018–present

Under Richard Besser's leadership, the foundation prioritized health equity and removing barriers to health resulting from discrimination. In an address given at the Sanford School of Public Policy at Duke University, Besser pointed to where people live, recreate, and work as well as access to healthy food and livable wages, and removal of cultural barriers as important factors in individual health. [38] The foundation funded a 2021 analysis by the Urban Institute which found that black patients experience "dangerous bleeding, infections and other serious problems related to surgical procedures" more frequently than white patients who receive care in the same hospital. [4]

In 2019, the foundation worked with the Global Reporting Initiative and others to develop the Culture of Health for Business Framework. The framework provides 16 best practices for companies to measure health policies and practices against, ranging from environmental to social and governance issues. [39]

During the COVID-19 pandemic, the foundation partnered with organizations such as NPR to research financial, educational, and health impacts of the pandemic. [40] [41] The foundation also has ongoing surveys with the Rand Corporation, one of which found that many Americans agree that minority communities have been more affected by the pandemic, but do not believe structural racism is a barrier to health. [42]

The foundation's other activities in response to the COVID-19 pandemic included collaborating with Boston University to develop a database of state policies enacted in response to the pandemic, [43] and hosting teleconferences and virtual discussions on how the pandemic unveiled the impact that systemic racism and other forms of discrimination have on health in America. [44] [45]

During this period, RWJF partnered with the Ford Foundation to establish the Presidents' Council on Disability Inclusion in Philanthropy. The group includes 17 grant making organizations. The council's focus is on improving inclusion of disability issues in philanthropy. [46] The foundation also funded the Childhood Opportunity Index, which ranks neighborhoods across the U.S. on access to childhood development resources that can affect health and life expectancy, and income later in life. The index was initially published in 2014, and an updated version was released in January 2020. [47]

Leadership

The foundation's first president was David E. Rogers, who served from 1972 until 1987. [12] Leighton E. Cluff served as the foundation's president from 1986 until February 1990, when he was succeeded by Steven A. Schroeder. The foundation's board of trustees selected Schroeder to lead the foundation, knowing he wanted to take it "in the direction of working on substance abuse problems". [19] [48]

Risa Lavizzo-Mourey was the first woman and African American to be the foundation's chief executive officer, a role she held between 2002 and 2017. [49] [50] She was succeeded by Richard E. Besser, who was named president and CEO in April 2017. Besser previously worked as the medical editor for ABC News and acting director of the Centers for Disease Control. [51]

Related Research Articles

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

<span class="mw-page-title-main">Marie Curie (charity)</span> United Kingdom charitable organisation

Marie Curie is a registered charitable organisation in the United Kingdom which provides hospice care and support for anyone with an illness they’re likely to die from, and those close to them, and campaigns for better support for dying people. It was established in 1948, the same year as the National Health Service (NHS).

<span class="mw-page-title-main">Julio Frenk</span> Mexican physician and politician

Julio José Frenk Mora is a Mexican physician and sociologist. He has been the president of the University of Miami since 2015. He is the University of Miami's first Hispanic and native Spanish-speaking president. At the University of Miami, he is also a professor of public health science at the university's Leonard M. Miller School of Medicine, professor of health sector management at the university's Herbert Business School, and professor of sociology at its College of Arts of Sciences.

<span class="mw-page-title-main">Ira Byock</span> American physician and author

Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.

<span class="mw-page-title-main">Risa Lavizzo-Mourey</span> American healthcare administrator

Risa J. Lavizzo-Mourey is an American medical doctor and executive who served as president and CEO of the Robert Wood Johnson Foundation from 2003 to 2017. She was the first woman and the first African-American to head the foundation, which has an endowment of about $8 billion and distributes more than $400 million a year. She has been named one of the 100 Most Powerful Women by Forbes several times, and one of The Grio's History Makers in the Making. She was elected a Member of the American Philosophical Society in 2016.

<span class="mw-page-title-main">Hospice</span> Organization that cares for the dying or the incurably ill

Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.

<span class="mw-page-title-main">Richard E. Besser</span> American doctor and executive (born 1959)

Richard E. Besser is an American doctor and executive who has served as president and CEO of the Robert Wood Johnson Foundation since April 2017. Besser served as the acting director of the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) from January to June 2009. He was ABC News' former chief health and medical editor. Besser is a brother-in-law to Scottish singer Annie Lennox.

Diane E. Meier, an American geriatrician and palliative care specialist. In 1999, Dr. Meier founded the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. She continues to serve as CAPC's Director Emerita and Strategic Medical Advisor. Meier is also Vice-Chair for Public Policy, Professor of Geriatrics and Palliative Medicine and Catherine Gaisman Professor of Medical Ethics at the Icahn School of Medicine at Mount Sinai Hospital in New York City. Meier was founder and Director of the Hertzberg Palliative Care Institute at the Icahn School of Medicine in New York City from 1997 to 2011.

Rebecca Onie is the co-founder with Rocco J Perla of The Health Initiative, a nationwide effort to spur a new conversation about - and new investments in - health. In 2017, she was elected to the National Academy of Medicine as a nationally recognized leader in the intersection of social determinants, population health, and healthcare delivery. Onie is also the co-founder and Chief Executive Officer Emerita of Health Leads.

AcademyHealth is a nonpartisan, nonprofit professional organization dedicated to advancing the fields of health services research and health policy. It is a professional organization for health services researchers, health policy analysts, and health practitioners, and it is a nonpartisan source for health research and policy. The organization was founded in 2000, in a merger between the Alpha Center and the Association for Health Services Research (AHSR). In 2008, the organization had approximately 4000 health services researcher members.

Aligning Forces for Quality is a U.S. national program of the Robert Wood Johnson Foundation aiming to lift the quality of health care in 16 targeted communities, reduce racial and ethnic disparities in those communities and provide models for national reform. Each regional Health care improvement collaborative aims to create sustainable improvements in health care quality throughout its targeted communities by 2015. To do so, the initiative fosters collaboration among multiple stakeholders in a community. Aligning Forces For Quality focuses its efforts on three main areas: Performance measurement and public reporting, consumer engagement, and quality improvement. Aligning Forces for Quality is the single largest philanthropic effort of its kind undertaken to improve the quality of U.S. health care.

<span class="mw-page-title-main">Health Leads</span> Non-profit organization in the US

Health Leads is a national non-profit organization based in Boston with a stated vision of "health, dignity, and well-being for every person, in every community." The organization runs community-based programs and learning initiatives across the U.S. that focus on addressing social, racial, and economic factors that impact health.

Keeping Families Together is a program of the Corporation for Supportive Housing (CSH) that aims to provide supportive housing to vulnerable families in order to enhance children’s safety and help prevent foster care placement. It brings together affordable housing with other social services and city agencies to help families with issues like substance abuse, medication management, parenting skills and career counseling.

<span class="mw-page-title-main">Better Futures Minnesota</span>

The Network for Better Futures d/b/a Better Futures Minnesota is a non-profit social enterprise based in Minneapolis, Minnesota, dedicated to reintegrating high-risk adults, primarily African-American men, into society by providing a platform to help them succeed. The agency works with men with histories of incarceration, substance abuse, chronic unemployment, and homelessness—men who have a high risk of being repeat offenders.

<span class="mw-page-title-main">Bloomberg Philanthropies</span> Charitable organization

Bloomberg Philanthropies is a philanthropic organization that encompasses all of the charitable giving of founder Michael R. Bloomberg. Headquartered in New York City, Bloomberg Philanthropies focuses its resources on five areas: the environment, public health, the arts, government innovation and education. According to the Foundation Center, Bloomberg Philanthropies was the 10th largest foundation in the United States in 2015, the last year for which data was available. Bloomberg has pledged to donate the majority of his wealth, currently estimated at more than $54 billion. Patti Harris is the CEO of Bloomberg Philanthropies.

The John A. Hartford Foundation is a private United States-based philanthropy whose current mission is to improve the care of older adults. For many years, it made grants for research and education in geriatric medicine, nursing and social work. It now focuses on three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness, and end-of-life care.

The End-of-Life Nursing Education Consortium (ELNEC) project is a national education initiative whose mission is to improve palliative care. The project provides an undergraduate and graduate nursing faculty, CE providers, staff development educators, specialty nurses in pediatrics, oncology, critical care, and geriatrics, and other nurses with training in palliative care so they can teach this information to nursing students and practicing nurses. ELNEC is a partnership between the American Association of Colleges of Nursing (AACN), Washington, DC and the City of Hope, Duarte, CA. The project provides undergraduate and graduate nursing faculty, CE providers, staff development educators, specialty nurses in pediatrics, oncology, critical care, and geriatrics, and other nurses with palliative care training. Once trained, these healthcare professionals go on to teach this essential information to nursing students and practicing nurses. The project, which began in February 2000, was initially funded by a major grant from The Robert Wood Johnson Foundation (RWJF). The National Cancer Institute (NCI), American Association of Colleges of Nursing (AACN), US Cancer Pain Relief Committee, the Aetna, Archstone, Oncology Nursing, California HealthCare, Milbank, Stupski, Open Society, and Cambia Health Foundations, and the Department of Veterans Affairs (VA) have provided additional funding.

Lorraine Quinn Frazier is an Irish-American nurse. She is the dean of the Columbia University School of Nursing, having previously served in similar roles at the University of Texas Health Science Center at Houston and University of Arkansas for Medical Sciences.

<span class="mw-page-title-main">Mother Cabrini Health Foundation</span> American health charity in New York State

Mother Cabrini Health Foundation is a private American charitable foundation that provides funding for healthcare and health-related initiatives in the U.S. state of New York, aimed at low-income and underserved communities. It is the largest health foundation focused only on New York.

Naheed Dosani is a palliative care physician based in Ontario, Canada, who founded and leads the Palliative Education and Care for the Homeless (PEACH) program. For his efforts in providing mobile healthcare to individuals with vulnerable housing or are homeless, Dosani has received a Meritorious Service Cross from the Governor General of Canada (2017), and a Canadian Medical Association Award for Young Leaders (2020).

References

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  2. 1 2 Syp, Mark (2012-11-17). "Robert Wood Johnson marks its anniversary with an eye toward the future of public health". Times of Trenton. Retrieved 2014-03-22.
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  12. 1 2 Altman, Lawrence (December 6, 1994). "Dr. David E. Rogers, 68, Leading Medical Educator, Dies". The New York Times . Retrieved September 21, 2021.
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  46. ↑ Lindsay, Drew (October 15, 2021). "Once Left Out of the Ford Foundation's Strategy, Disability Rights Gets Its Own Program". Chronicle of Philanthropy . Retrieved November 17, 2021.
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