Investing in Systems Changes to Transform Lives

To address health disparities we need to change the systems that shape where we live, learn, work, and play. Oscar and Jose's stories show us how it's possible.   

In the quote above, Steven Teske, a Juvenile Chief Judge in Clayton County, Georgia, is describing the first time he encountered 15-year-old Oscar Mayes as he entered the courtroom in handcuffs. Judge Teske saw something special in Oscar. He saw an extremely bright young man and realized that he had no prior run-ins with the law. Yet Oscar was facing five years in the state’s long term lock up—five years that could have destroyed his potential.

Fortunately, Oscar received a literal second chance. The Clayton County Second Chance initiative gives youth facing prison an opportunity to redeem themselves through intensive supervision, participation in evidence-based treatment programs, and weekly check-ins with the court. Judge Teske and others in his community realized that too many of their students were falling out of school and into the criminal justice system. So, the Juvenile Court partnered with local schools and law enforcement to find better ways of disciplining youth while keeping them “in school, out of court, and onto a positive, healthy future.”

And it's working. Clayton County saw an 83 percent drop in arrests and school attendance has gone up by 86 percent. This is what changing a system can do.

What are systems changes and how is the Robert Wood Johnson Foundation (RWJF) investing in them?

Systems are the policies, practices, and procedures of institutions, corporations, agencies and other organizations that shape the determinants of health. Improving systems—and the way they work together—is our approach to eliminating health disparities.

By taking a hard look at these systems—be they access to quality health care, income, public safety, community environment, employment, housing, education— we can find solutions to improve lives and reduce health disparities. We believe everyone in our country deserves an equal opportunity to live a healthier life which is key to building a Culture of Health.

But it's frustrating to acknowledge the current reality. As RWJF’s own Dwayne Proctor noted, if you’re Black you’re 21 percent more likely to die from heart disease than if you’re white. If you live in the Deep South your life expectancy is an average of three years shorter than if you live in other parts of the country. Health disparities like these don't just harm individuals. They also threaten the prosperity of entire communities. We want to change this.

To do so, we are launching the RWJF Awards for Eliminating Health Disparities to honor and celebrate those who have successfully created systems changes to eliminate health disparities. In doing so, we’re delving deeper into the determinants that impact health—the neighborhoods we live in, the schools our children attend, the jobs we work and the resources inside our communities. And we’re hoping to heighten awareness around the power of systems change.

Jose’s story: From school suspension to college

Last year our colleague Maisha Simmons met Jose, a bright student from Chicago who used art to express love, fear, joy and pain. He spread his art everywhere—on notebooks, text books and eventually the walls and fences of his community. Despite efforts of a relative to channel Jose's passion into a community art program, one day Jose found himself in the principal's office where teachers wrongly accused him of vandalizing school property. Unable to prove his innocence,  the school suspended Jose. He fell behind in his schoolwork which jeopardized his chances of graduating. Since art now reminded Jose of his struggles at school, he stopped pursuing his passion.

But Jose was lucky to live in the city of Chicago with the Safe Schools Consortium, a coalition that offers alternatives to traditional harsh school discipline. A nonprofit partner of Safe Schools—VOYCE—offered Jose a chance to share his story and reconnect with art in a way that uplifted his community. Thanks to this partnership, rather than dropping out of school, Jose is now in college.

Oscar and Jose are just two examples of what's possible when we change systems. We know that systems once pushed people like them toward unhealthy outcomes. But together, we can reimagine these same systems to guide everyone toward healthier and brighter futures and the Culture of Health that we are working toward.