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Signals of Change: An Update to the Culture of Health Measures

Four years ago, the Robert Wood Johnson Foundation (RWJF) introduced the Culture of Health Action Framework, as well as a set of measures to help them promote and track the nation’s progress toward becoming a country that values health everywhere, for everyone. Read on for an update on the progress being made.


The Culture of Health Action Framework and its accompanying set of measures are meant to illustrate the connected role of diverse factors in health and the range of sectors that influence health outcomes. Our goals were to track how diverse stakeholders, including those outside the traditional health sector, were advancing health and well-being-and if and how health equity was improving.

In an update on our progress in creating a Culture of Health in America, we reported small, but positive, changes in the appreciation of the social determinants of health and the need for broader community health investments. However, there has been less movement in many of the structural and systems-level factors that critically influence health, well-being and equity. The new data also indicate that:

  • There is greater understanding that diverse factors influence health. A critical component of a Culture of Health is the shared understanding that we're all in this together—that we recognize our health is interdependent with others around us. See the latest data.
  • Access to care is still a struggle for too many. There have been no improvements in access to dental care, or treatment rates for mental illness and substance dependence or abuse. See the latest data.
  • Progress is stalled on key conditions that create healthier, more equitable communities, such as climate action plans, and decreased racial residential segregation in neighborhoods. See the latest data.

We have more work to do, particularly to address the structural and historic factors that influence health and well-being outcomes across generations. It will be critical for us to turn our research on these issues into real and sustainable action so all can live the healthiest lives possible.

See more data on our progress on health care and social, economic, and environmental drivers of health at

Gain insight on how 30 diverse Sentinel Communities around the country are working toward improved health and well-being.