The U.S. Surgeon General Regina Benjamin summed up the purpose of the 2012 National Health Promotion Summit in one sentence: “If we really want to improve health in this country, we need to prevent people from getting sick in the first place – to stop the illness before it starts.”

The purpose of The Kresge Foundation’s Health Program is to stop illness before it starts, particularly by improving conditions in the homes, neighborhoods and communities of vulnerable populations in the United States.

Rip Rapson, president and CEO of The Kresge Foundation, delivered this message as one of four panelists discussing a national health-promotion, disease-prevention strategy at the April 10-11 conference in Washington.

“We know that social, economic and physical conditions associated with where one lives directly affects the health and well-being of that individual and others living nearby,” Rapson said. “Factors determining health are dramatically and operationally embedded in each condition.”

Rapson explained that, traditionally, philanthropy has maintained a “bright dividing line” between health and medical systems on one hand and community development and poverty alleviation on the other. “Increasingly, philanthropy is coming to understand that these two realms are, in fact, not separate and hermetically sealed but instead tightly braided together – exactly what the National Prevention Strategy is all about.”

Rapson represented the philanthropic sector on the panel. Other participants were:

• Professor Rob Moodie of the Nossal Institute for Global Health at the University of Melbourne, Australia
• Dr. Jonathan Woodson, assistant secretary of defense for health affairs
• Valerie Brown, Sonama County supervisor in California.

Dr. Jeff Levi, executive director of the Trust for American’s Health and chair of the advisory group on Prevention, Health Promotion and Integrative and Public Health, served as moderator.

“We have to stop thinking about creating health one person at a time,” Levi said. “It’s inefficient and it’s ineffective. We have to be thinking about creating healthy communities.”

To do this, Rapson suggested that health funders and practitioners get more comfortable working together in a community development framework. He pointed to Kresge’s work in Detroit as an example. There, rather than addressing health care head on, he said the foundation is focusing on the determinants of good health and using grant dollars to bring about positive answers to the following questions:

• How is land used? Are there walkable, livable neighborhoods and access to safe open spaces and parks?
• Have toxins in the soil been remediated?
• What about the availability of fresh foods?
• Is the housing stock safe and toxin-free?
• Do residents have easy access to high-quality, affordable, culturally competent care?

“There are signs the community-development approach to health promotion is growing,” Rapson concluded. “Look at the work of the Convergence Partnership, LISC – Local Initiatives Support Corp., Enterprise Foundation, the California Endowment, and the partnership between the Robert Wood Johnson Foundation and the Federal Reserve. The National Prevention Strategyis dramatically accelerating and strengthening this way of working. I believe this represents a unified and coherent approach for health promotion and disease prevention in America’s towns and cities.”

For more information, visit:

• Health Education Resource Exchange
• Association for Prevention, Teaching and Research
• HealthCare.gov: Take health care into your own hands