Science tells us with increasing precision that health and well-being in American communities is shaped by a complex web of determinants and contributing factors extending far beyond the reaches of the medical care sector. The physical environment, human and social capital, and economic opportunities and constraints exert a profound influence on health at molecular, person and population levels. One consequence of this fact is that actions taken outside of the health sector can have profound and even profoundly unintended consequences on health and well-being, and these effects are often distributed unevenly across society. Efforts to solve a transportation or housing or education problem, for example, may shift exposures to health risks and protective factors in ways that persistently alter the health trajectories of affected population groups. Economists and other social scientists refer to these phenomena variably as interactions, synergies, externalities, or spillovers across sectors, institutions and systems.
Unfortunately, our knowledge about these system spillovers is incomplete and still evolving, and so our ability to manage these spillovers in ways that optimize population health outcomes and minimize health inequities remains quite limited. The result is our current constellation of fragmented approaches for delivering and financing medical care, public health, and social and community services in the U.S., and our many missed opportunities for collective actions in improving health.
Earlier this month the Robert Wood Johnson Foundation (RWJF) announced a new funding opportunity to help build scientific knowledge about how to solve these systems problems as part of its $25 million investment in research to build a Culture of Health. The Systems for Action research program will develop a rigorous body of applied scientific work that reveals how best to align, coordinate, and integrate the many delivery and financing systems that shape health and well-being in American communities, including but not limited to the medical and public health sectors. This new work is not starting from scratch, but rather it builds from the strong foundation of health services research (HSR) and public health services and systems research (PHSSR) that has helped us understand and improve delivery and financing systems found within the health sector.
We invite you to review the research agenda developed for this exciting new program, along with the new funding opportunity announcement. Join us this Friday December 18 from 1-2pm for a webinar on the new research opportunity (registration required).