Remarks by Brian Castrucci, CEO of the de Beaumont Foundation
CityHealth Medaling Ceremony
JFK Presidential Library and Museum
June 8, 2018
“We are fortunate to live in a nation where our healthcare system is filled with dedicated providers offering cutting-edge, innovative clinical practice, but our clinical efforts alone are no longer enough. Our focus on pills and procedures should be met with an equal focus on policy. Concentrated poverty, struggling schools, and unsafe neighborhoods mean very different opportunities than those available to people with stable incomes and thriving communities.
“This means that public decisions — the laws and rules that shape our communities — are a vital part of our chances at living healthy lives. We need advances in the clinic, but we equally need advances from our city political leaders.
“At the de Beaumont Foundation, we recognize that policy is a powerful tool and has a profound impact on our health. The nine policies CityHealth promotes were chosen not only because they have been shown to not only improve health in measurable and significant ways, but also because they go beyond improving health to making our communities more vibrant, attractive, and productive places to live.
“Working at the city level was a natural choice for us. We see cities as innovation labs, and we believed that in partnership with mayors like you, we could demonstrate real impact and bring about lasting change. And we’re starting to see important progress. While CityHealth rates the largest 40 cities, this package of policies is relevant to all of your cities, large or small. We’d love to see cities across the country lead with health, and we invite you to talk to us about how we can support you.”
Castrucci spoke at the 86th annual meeting of the U.S. Conference of Mayors, where the de Beaumont Foundation, CityHealth, and Kaiser Permanente recognized cities for outstanding leadership in adopting policies that are proven to improve health. View the ceremony here:
See the city ratings in the 2018 CityHealth report.
Following the appointment of Brian C. Castrucci, MA, as Chief Executive Officer, the de Beaumont Foundation continues to demonstrate its ability to attract top-level talent, appointing its first Vice President of Communications and Vice President of Impact. “It’s an exciting time to be at the de Beaumont Foundation and work in the field of public health,” Castrucci said. “We are thoughtfully building a team designed for change and impact.”
Mark Miller, Vice President of Communications, has held leadership positions in philanthropy, healthcare, politics, and policymaking, including the White House, the Case Foundation, AmeriCorps, and Children’s National Health System. He will support the Foundation’s programs and grantees through innovative communications strategies and will work with the Foundation’s partners to elevate the field of public health. “Mark’s skills and experience are a perfect fit for the de Beaumont Foundation as we anticipate the future needs of public health,” Castrucci said. “With his unique set of skills in communications, politics, health, and philanthropy, he brings new talent and a fresh perspective to the Foundation and the entire public health field. His expertise in digital strategy will be especially beneficial as we build on our momentum and expand our reach and impact.”
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Katie Sellers, DrPH, CPH, who has 20 years of experience in public health, is the Foundation’s new Vice President for Impact. She recently served as Senior Vice President for Science and Strategy at the March of Dimes and Chief Science and Strategy Officer at the Association of State and Territorial Health Officials (ASTHO). In her newly created role, she will demonstrate the impact of the Foundation’s investments and inform decisions about how to achieve the greatest impact. “Dr. Sellers’ decades of experience in research and evaluation, strategic planning, and collaborative leadership make her an excellent addition to our team at this time,” Castrucci said. “Not only does she bring deep knowledge and experience in public health, but she also has worked with us as a grantee, which provides an important perspective to our partnerships.”
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After spending this fellowship year learning about the public health workforce, I think about what type of career I will build as one of its newest members. Luckily, I have met inspiring and thoughtful public health practitioners who were willing to help me wrestle with big questions about where I may fit in the public health landscape. I’ve discovered what seem to be two ways in which public health workers are guided by their values in pursuing population health — one focused squarely on social justice and one incorporating a more diverse spectrum of moral foundations. These two sets of values are not competing; instead, they are similar in their ability to motivate public health practitioners and advocates to communicate our values and solve health challenges.
Fighting Injustice and Inequity
One nonprofit that represents public health values at work is Human Impact Partners (HIP), which, among other things, builds the capacity and leadership of the public health workforce to create healthy communities and a just society. HIP calls on public health professionals to lead and work with personal and professional values stemming from social justice. At the center of their philosophy is a dedication to communities, particularly those that are vulnerable. They imagine a public health workforce that is wholly committed to health equity and humbly centers their work on the voices of the community. HIP understands that health inequities result from lack of access to basic social and physical needs, which stem from power imbalances and forms of oppression, like racism. All of their work is inspired by this understanding. For example, they host webinars that instruct health department workers in health equity practice and how to engage with communities to build power.
I had the opportunity to speak with Jonathan Heller, one of HIP’s co-directors, who told me that the country needs people who are willing to put communities first and not compromise our values of social justice. When I asked Heller if there are any drawbacks to fighting for health equity in areas where people might not be ready to listen, he responded, “If not us, then who? If not now, then when?” This response speaks to the real and human consequences to health inequity. If public health wants to be a field that truly serves communities, we must act urgently to lessen the loss of life and livelihood caused by health inequality. Talking with Jonathan reminded me why I chose to study public health in the first place, after witnessing the destructive impact of the inequalities in health, education, and housing on families in St. Louis where I studied. HIP projects a vision of the kind of public health worker I want to be: one who focuses on the people I serve, prioritizes health equity, and leads with my values.
The Six Moral Foundations
Early on during my time at the de Beaumont Foundation, I met a group of public health lawyers, a health director, and a health system chaplain from North Carolina when they presented at a meeting of deputy state health officials. Their framework, “Crafting Richer Messages: Advocacy for Public Health Leaders,” represents another way of conceptualizing public health values and their role in public health practice.
The group’s work stemmed from the six moral foundations described by Jonathan Haidt in his book The Righteous Mind: Why Good People are Divided by Politics and Religion. The powerful revelation in Haidt’s research was that liberal-minded folks communicate primarily in the moral foundations of fairness, care, and liberty, while conservative communication tends to encompass the whole spectrum of the six moral foundations. This could explain the disconnect public health workers face when communicating public health work to conservative leaders; we forget to use the full spectrum of values. In this context, the “Crafting Richer Messages” framework presents an inclusive way for public health workers to work with partners of all political and ideological stripes, in order to find common ground and meet the shared goal of improving population health.
This operationalizing of moral foundations played out in a public health agency when Sue Lynn Ledford, the Wake County Health Director, helped pass 2016 legislation for a needle exchange program in North Carolina – in a heavily conservative General Assembly – in partnership with the NC Harm Reduction Coalition and the state law enforcement community. Together, these partners used persuasive arguments based on respect for law enforcement (authority) as well as appealing to the compassion for communities and families (care, loyalty, sanctity). Ledford listened to the values of lawmakers and communicated her position with moral foundations across the liberal/conservative spectrum, ultimately establishing a life-saving and highly controversial policy.
This work and the “Crafting Richer Messages” framework taught me that working across aisles, differences, sectors, and backgrounds is not a compromise of public health values, but an extension of them. As a public health worker, I will strive to speak many moral languages, so I can be an effective advocate for population health strategies.
Embracing the Spectrum of Approaches
The Human Impact Partners point due north, reminding the field of our highest ideals and greatest commitments. The “Crafting Richer Messages” initiative teaches us how to work inclusively with those we might not naturally agree with to make progress and improve lives. I see this spectrum of approaches to public health as an asset to the public health workforce, allowing us to solve problems from a variety of perspectives and with a variety of partners. As a result, I believe I can both stretch myself to communicate in all of the moral foundations, while still prioritizing the communities I serve.
What these approaches have in common is that they highlight the necessity of being a good partner in communities and engaging all the people we serve with humility and integrity. I still don’t know exactly where I fit in in the spectrum of these approaches, but asking these big questions about the public health field and workforce helps me imagine more possibilities and paths. When I consider what type of public health career I want to build, I know to look for opportunities that enable me to uphold my deeply held values, communicate in many moral languages, and partner with everyone committed to making a difference for the health of the public.
A majority of the largest U.S. cities now are demonstrating leadership when it comes to adopting policies that improve the health and well-being of their residents, according to the CityHealth initiative’s updated city ratings. But others lag when it comes to smart policymaking. See the ratings at www.cityhealth.org.
CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, offers a close look at whether the nation’s 40 largest cities have nine key policies in place that experts say help residents lead healthier lives and make communities thrive. CityHealth awarded each city a gold, silver, bronze, or no medal, according to their performance in the assessment. The group also awarded nine policy-specific medals to each city, according to the quality and strength of the laws in place, which address affordable housing, safe streets, and food safety, among other issues.
The report is designed to show which cities are leading the way on policies shown to improve people’s health and quality of life. CityHealth found in just one year, cities earned a total of 24 new medals for implementing proven policies to better the lives of the people who live, play, learn, and work in their jurisdictions. These advances meant that 10 cities — a quarter of the nation’s 40 largest cities — improved their overall medal status.
As a result, for the first time, a majority of the cities—25 cities total—earned a gold, silver, or bronze medal. Five cities (Boston, Chicago, New York, Los Angeles, and San Jose) earned a gold medal overall, demonstrating that those cities’ leaders have used powerful policy tools to enhance their city’s health, well-being, and economic vitality. Nine cities earned an overall silver medal, and 11 cities earned an overall bronze medal. Last year, only 19 out of 40 of the largest cities medaled. Each city’s medal status is noted below.
“Policy is a powerful lever for boosting health at the city level,” said Dr. Shelley Hearne, CityHealth’s President. “Many cities are demonstrating significant progress across nine pragmatic polices, which have been proven to help millions of people live longer, better lives. Still, too many cities are not getting to gold. We encourage all cities to show their commitment to building a healthier community that truly thrives, by adopting this set of proven policies. Every unearned gold medal represents an opportunity to take action and to improve people’s quality of life.”
While many cities made positive changes, others remain unchanged: Fifteen cities did not earn an overall medal, meaning they were awarded three or fewer medals across each of the nine policies. And four of the nation’s most populous cities (noted below) did not earn a medal for smoke-free indoor air policies, missing a significant opportunity to protect non-smokers from secondhand smoke and reduce smokers’ use of tobacco – the leading cause of preventable death in the U.S.
CityHealth’s nine evidence-based policies address ways that cities can improve the health of their residents in areas of everyday life – from the workplace and school, to housing and public transportation. Each policy is backed by evidence, supported by experts, and has a track record of bipartisan support. In addition to the medal ratings, CityHealth is available to provide technical assistance and support to cities as they advance these policies.
2018 Overall Medal Results
Overall Gold Medalists – Five Cities (five or more gold medals across each of the nine policies)
Los Angeles, CA
New York, NY
San Jose, CA
Overall Silver Medalists – Nine Cities (five or more gold or silver medals across each of the nine policies)
Kansas City, MO
Long Beach, CA
San Antonio, TX
San Diego, CA
San Francisco, CA
Overall Bronze Medalists – Eleven Cities (four or more gold, silver, or bronze medals across each of the nine policies)
No Overall Medal – Fifteen Cities (for cities receiving three or fewer medals across each of the nine policies)
El Paso, TX
Fort Worth, TX
Las Vegas, NV
Oklahoma City, OK
Virginia Beach, VA
Kaiser Permanente, the nation’s largest integrated health system, is joining forces with the de Beaumont Foundation, a leader in public health philanthropy, to help U.S. cities thrive through the CityHealth initiative.
Created by the de Beaumont Foundation to promote practices that make cities healthier, CityHealth tracks and reports on proven policies, and works with cities to advance policies that achieve community health priorities. Through this new relationship, Kaiser Permanente will leverage its deep expertise in health policy, government relations, and community-based prevention to accelerate cities’ efforts to improve people’s health and quality of life.
CityHealth promotes nine evidence-based policies addressing issues that have a major effect on health, such as affordable housing, education, and clean air. The first steps of this joint effort will be to identify municipal leaders’ community health policy priorities, and to assess the support they may need to help advance those policies.
“CityHealth embodies the de Beaumont Foundation’s core belief that policy is one of the most powerful tools to improve health,” said Brian C. Castrucci, the Foundation’s CEO. “We’re excited to have Kaiser Permanente join us in this effort to transform health in cities across the country.” CityHealth is an example of the Foundation’s focus on building cross-sector partnerships and offering practical tools and data to improve public health.
Bechara Choucair, MD, Senior Vice President and Chief Community Health Officer at Kaiser Permanente, said, “We share the de Beaumont Foundation’s belief that the power of local policy is one of the most promising and effective strategies for transforming health in America, and we are pleased to join them in this important work. The CityHealth initiative provides mayors and other community leaders an opportunity to harness some of that transformational power to improve health, drive down health care costs, and save lives.”
For Kaiser Permanente, this partnership complements the organization’s established approach to community health – bringing together health leaders, clinicians and community partners to help solve the social, economic and environmental health challenges facing its 12.2 million members and the 65 million residents who live in the communities it serves.
Dr. Shelley Hearne, President of CityHealth, said, “We know that where you live has an enormous influence on how healthy you can be. This innovative partnership between two national leaders is a way to catalyze change in city governments so that every resident has the opportunity live a healthy life. Working with city leaders through CityHealth, the de Beaumont Foundation and Kaiser Permanente will bring a pragmatic menu of policy options to create real results in American cities, like better pre-K programs for kids and more public places with cleaner, smoke-free air.”
CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, provides leaders with a package of evidence-based policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities. CityHealth will regularly evaluate cities on the number and strength of their policies.