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Dr. Risa Lavizzo-Mourey
A Healer for the Health Care System
There's no doubt that aspects of the United States' health
care system are ailing. Millions of working people are uninsured,
access to services varies widely, and Medicare is
predicted to reach a crisis in coming years.
No one is better suited to help heal the system than Risa
Lavizzo-Mourey, MD, WG'86. As the president and CEO of
the Robert Wood Johnson Foundation (RWJF) since 2003,
Lavizzo-Mourey applies principles she has learned from her
training in business, medicine, and public policy to guide
strategic investments that redesign systems and improve the
health and health care of all Americans.
From a career as a practicing physician and work in academic
medicine, she moved into the public sphere as an expert
in health care policy, held positions in government, and
played a key role in philanthropy. After earning her medical
degree from Harvard, Lavizzo-Mourey went on to earn her
MBA at Wharton. At the Medical School of the University of
Pennsylvania, she served as a Robert Wood Clinical Scholar,
where she specialized in geriatric medicine. While at Penn she
became the Director of the Institute of Aging and the Sylvan
Eisman Professor of Medicine and Health Care Systems.
While the Foundation's $9 billion in assets makes it the nation's
largest philanthropy dedicated exclusively to health and
health care, its resources are dwarfed by the scope of the need.
Under Lavizzo-Mourey's leadership, the Foundation refocused
its priorities and restructured its grant-making activities into
an "impact framework." This framework brings more integrated
strategies to a highly targeted set of program priorities.
The framework clusters the majority of the Foundation's
grantmaking into four strategic portfolios: Human Capital,
Vulnerable Populations, Pioneer, and Targeted. Like an investment
fund, each portfolio targets specific high-impact
goals, seeks results across different time frames, and assumes
varying levels of risk. Human Capital aims to develop a
diverse workforce of health care leaders and practitioners;
Vulnerable Populations addresses health and health care
problems that intersect with social factors like poverty, race,
education and housing; Pioneer invests in innovative and
cutting-edge programs that often involve high-risk; and
the largest of the four, Targeted, addresses the urgent need
for short-term action with long-term impact in eight areas—health care
coverage, nursing, childhood obesity, health
care quality, disparities in health care, public health, tobacco,
and addiction prevention and treatment.
The problems Lavizzo-Mourey aims to solve are indeed big—bigger
than any single leader or even any private foundation—but
she is able to recognize issues on a system level, understand
the individuals affected, and bring together the people
and organizations needed to make a difference. As committed
to healing individuals as well as society, she still treats patients
at a community health clinic in New Brunswick, NJ.
Lavizzo-Mourey says of herself: "What continues to energize
me is the opportunity to address big problems in the
area of health and health care, to make a difference on a large
scale, and to touch people directly and change their lives."
Why did you change your path to philanthropy?
I grew up as the daughter of two physicians and intended to
have a career as a practicing physician focused on individual
patients and their health care. While I never envisioned a career
in philanthropy, in hindsight it was a natural progression.
My personal connection with philanthropy began as a
Robert Wood Johnson Clinical Scholar at Penn. Certainly, that
initial connection with philanthropy, with the Foundation I am
now privileged to lead, has taken me down paths I could not
have imagined when I arrived in Philadelphia in 1982.
Philanthropy at its best can be transformative—changing
the lives of its beneficiaries as well as changing the trajectory
of entire neighborhoods and communities, changing
entire systems, changing public policy and private action.
My background and experience in various aspects of medicine,
business, academia, and government, give me a unique
perspective and understanding of these different fields. For
example,
the lessons
I learned at
Wharton
help me apply
concepts from
business into
health care. I
can also help
the Foundation
serve as both a
convener and bridge between the different fields and areas we
are working.
It takes a multidisciplinary approach to attack root causes
head-on and transform the health care system and with it,
society as a whole.
Given the unequal access and inferior health care
of racial and ethnic minorities, what steps can be
taken to reduce these disparities?
It's important to recognize that a lot of people don't appreciate
that Americans from different racial and ethnic backgrounds
are not getting the quality of care that they should.
I have been thinking about and writing about this area for a
couple of decades now. In fact, a few years ago I had the opportunity
to co-chair The Institute of Medicine's Committee
on Racial Disparities in Health Care.
The Foundation's strategy is focused on finding and
implementing practical, evidence-based solutions that target
diseases where both the evidence of racial and ethnic gaps
and the recommended standard of care are clear. What we are
realizing is that when you bring those two characteristics together,
you begin to see not only changes in attitude but also
real gains. These gains are not just in reducing disparities, but
in improving the overall quality of care as well.
And that really is the kind of work the Foundation is doing,
working on testable ways of solving the problem. I am
heartened by the fact that there are signs that we are improving
the quality of care and narrowing the disparities gap in
some areas.
Many children in our country are significantly
overweight. What strategies might be effective in
dealing with this epidemic of childhood obesity?
If the trend in childhood obesity continues, we are in danger
of raising the first generation of children who will live sicker
and die younger that their parents. Fortunately, there are a lot
of strategies, and a handful of approaches that I am confident
will help halt the rise in childhood obesity.
Children have to learn healthy lifestyles in their current environment.
Average American lifestyles have become incredibly
sedentary. It is hard for many people to make the
healthy choices that they want to make. It is
hard for them to find healthy
foods and to integrate
physical activity into their lives so that it is not an extra activity
but just something that is done everyday. So what we are
trying to do through a coordinated effort is to improve the
environments for kids so that they think of healthy choices as
normal choices, as the right choices.
RWJF has a four-pronged approach to halting the increase
in childhood obesity. We are building the evidence regarding
what works to promote healthy eating and physical activity
among kids; testing innovative approaches so we can spread
promising models; educating leaders and investing in advocacy
strategies; and working on ways to help health care providers
screen and counsel to prevent and manage childhood obesity.
We are very much committed to building evidence
and testing innovation. For example, RWJF has provided
grant support to the Food Trust of Philadelphia, which
operates a network of community-based farmers markets,
school markets and nutrition education programs to
address diet-related health problems in America's lower-income communities. Its Corner Store Campaign is
teaching children to make healthy choices at corner stores
that are close to schools, and offers an incentive system
to encourage them to buy healthy snacks as opposed to
non-healthy snacks. And that innovation has been shown
to work over the long term.
LDI works to improve public health through multidisciplinary studies
on medicine, economics, and social and ethical issues that influence
health care. The Institute emphasizes research on the efficient allocation
and appropriate use of health care resources and the development
of innovative health care delivery systems.
Penn's Leonard Davis Institute (where Dr. Risa Lavizzo-Mourey is an
adjunct senior fellow) was established in 1967 as a formal cooperative
venture among Wharton and the University of Pennsylvania's schools
of Medicine, Nursing, and Dental Medicine.
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