Dr. Donald Schwarz helped Philadelphia reduce childhood obesity, adult smoking, HIV and homelessness during his more than six years as the city's deputy mayor and health commissioner. Today he starts a new job at the Robert Wood Johnson Foundation in Princeton, where his mission is making good health contagious by fostering a “culture of health” across America.
Schwarz said he was drawn by RWJF’s “insightful and inspirational strategic plan: to activate every American to live in a healthier way by creating what is called a culture of health. That resonated with me, because Philadelphia is a city with enormous challenges and we have been able to move the city forward to becoming healthier.”
A pediatrician, Schwarz was on the faculty of the University of Pennsylvania School of Medicine before moving in 2008 to city hall in Philadelphia, which struggles with issues such as poverty and homelessness that take a huge toll on public health.
He said making a difference meant going beyond the clinician’s role of preventing and curing disease and “helping health care providers understand that health care is only one aspect of health: the role of social factors in health is critically important.”
Schwarz said he worked to put health on diverse agendas — from encouraging conversations about health in the city’s faith community to teaching take-out Chinese restaurant chefs how to reduce the salt in their dishes.
The appointment of Schwarz as director of the foundation’s portfolio dedicated to “catalyzing demand for healthy places and practices” signals an important change, said Dr. James S. Marks, senior vice president of the foundation, the nation’s largest philanthropy devoted to public health.
He said the “culture of health” initiative reflects a growing awareness among health policy experts: “We cannot treat ourselves out of our health care cost crisis. We’ve got to embrace prevention, much of which happens outside medical care.”
"Creating demand for healthier communities is an important step in making it easier for all of us to be healthier," said Risa Lavizzo-Mourey, chief executive of RWJF.
She said Schwarz's " background, vision, and leadership make him an obvious choice to help us build a culture of health in America."
In 2007 RWJF launched a $500 million, multiyear effort to fight childhood obesity. Marks said among the early revelations “was that for the most challenged neighborhoods, safety was a big reason why parents wouldn’t let their kids go out and play, even if there was a park.”
A healthy culture involves “safety, physical activity, access to healthy food, good child care — all of those things are part of what makes for a culture of health.”
Philadelphia saw a 5 percent reduction in childhood obesity during Schwarz’s tenure. He said he mined RWJF research for ideas he could quickly implement and scale up across the city: removing fried foods, chocolate milk and soda from the schools; increasing exercise for schoolchildren; persuading corner stores to stock healthy snacks kids could buy when walking to and from school. The idea was “to create a portfolio of impactful change — at the policy level as well as at the neighborhood level,” he said.
"It’s absolutely wonderful that RWJF is leading the charge in creating a culture of health throughout the United States and here in New Jersey,” said Linda Schwimmer, vice president of the New Jersey Health Care Quality Institute. It lines up with efforts by the institute, such as the Mayors Wellness Campaign, which equips local leaders with tools to help their constituents embrace healthy eating and active living: “We have always prioritized initiatives that looked beyond the hospital walls and the doctor’s office to help people embrace healthy living.”
She said, in Schwarz, RWJF “has picked an innovator and a true leader in the field of public health to lead this initiative.”
There are economic benefits that flow from a health-conscious community, one that offers parks for family exercise and supermarkets with fresh healthy foods: “It helps make a place attractive for businesses to come, attractive for families to move to and it makes for a good local business climate,” Marks said. Some business leaders have already taken on the community health issue, and the work by Schwarz will “give them a bigger platform in which to express their views, and a way to bring in more of their colleagues who might not have been thinking that way.”
Schwartz said, “We think there are real opportunities to engage business owners who want to do the right thing but haven’t necessarily received the information on how to do it.”
Joel Cantor, director of the Rutgers Center for State Health Policy, said the focus on creating a culture of health “acknowledges that the biggest determinants of health are not from within the health care system. These drivers are related to our living environments, economic circumstances and other factors.”
And he said the emphasis on health culture “recognizes that if we are to tackle affordability and value in health care, doctors, hospitals and other providers must take a population perspective: work outside the traditional boundaries of the medical encounter to support patients to live healthy lives and manage their health conditions.”
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