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Key Findings

1. Nurse-designed models of care can inform our understanding of the health sector's role in building a Culture of Health.
2. These models focus on all Culture of Health Action Areas, but especially on "strengthening integration of health services and systems."
3. Strong leadership and broad community support are key to the success of these models of care.
4. Identifying a sustainable funding mechanism for community-level programs that address and encourage a Culture of Health is a persistent challenge.
5. Workforce development should emphasize interdisciplinary learning and collaboration, and nurses should be included and take leadership roles in Culture of Health–related initiatives whenever possible.

In the ongoing debate over how to reform the U.S. health care system, there is increasing consensus that the care that people receive is just one of many factors that contribute to health outcomes. Policymakers, providers, and other stakeholders now recognize that a range of complex social factors — income; education; and where people live, learn, work, and play — also have a vital role in the health and wellness of individuals and communities. The Robert Wood Johnson Foundation (RWJF) has proposed that these social determinants of health must become part of our national conversation about health and that we must move toward a more comprehensive and integrated approach to health. To this end, in 2014, RWJF committed to the idea of advancing a national Culture of Health. The broad goal of the Culture of Health initiative is to improve health, well-being, and equity through activities in four different Action Areas: