New National Culture of Health Needs to Accompany Healthcare Reform, Commission Says

Janice Simmons, for HealthLeaders Media , April 6, 2009

While the quest to reform healthcare and promote affordable medical care steadily moves forward on Capitol Hill, a gap remains on how healthy Americans actually are—and how healthy they could be in the future. By failing to take proven steps to promote better health throughout communities—including discouraging smoking and promoting healthy foods and physical activity—children today face having sicker, shorter lives than their parents, according to recommendations released Thursday by a panel of healthcare experts.

A new definition of health reform is needed that addresses people's daily lives, said Mark McClellan, MD, PhD, co-chair of the Commission to Build a Healthier America that was launched by the Robert Wood Johnson Foundation just over a year ago. "The evidence is clear that how we live, learn, work and play has a much greater influence over how well and how long we live than our healthcare."

"It's time to take a wider view of what we need to do to improve our health," added McClellan, the former administrator of the Centers for Medicare and Medicaid Services and the Food and Drug Administration, who is now director of the Engelberg Center for Healthcare Reform at the Brookings Institution, Washington.

The commission called for individuals to take more responsibility for their health choices. But, it also recognized that many individuals face obstacles in making healthy choices outside the healthcare system. For instance, the lack of grocery stores in various lower-income communities may hinder attempts to include more fresh fruits and vegetables in daily diets.

To help break through these barriers, the commission called for initiatives that promote a "national culture of health"—especially among children. They include:

  • Banning junk food from schools.
  • Getting children to be physically active at least an hour every day.
  • Designing public programs that support the needs of hungry families for nutritious foods.
  • Eliminating smoking and promoting a smoke-free nation.
  • Giving children, especially those from low-income families, a healthy start by ensuring that they have high-quality education and child care.

Commission member Gail Warden, MD, president emeritus of the Henry Ford Health System in Detroit, suggested that emphasis needs to be placed on creating sophisticated school-based health programs in which "all aspects of the mental and physical needs of individual students are taken into consideration."

These programs should "put great emphasis on wellness and prevention" and "educate [children and parents] about their own personal responsibilities about their health," he said. A recent example of these programs involve getting childhood immmunizations that have received high compliance rates nationwide.

The full report, "Beyond Healthcare: New Directions for a Healthier America," which includes examples of community programs successfully addressing various health issues, is available at the Commission's website (

Janice Simmons is a senior editor HealthLeaders Media. She may be reached at

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