2020 was arguably one of the most difficult years in American history, challenging our resilience and surfacing enduring and systemic challenges to our collective health and well-being. As we continue to measure the pandemic's impact on short- and long-term health, as well as other social and economic indicators, it is useful to note where we stood pre-pandemic. Understanding the conditions and trends that shaped our health before COVID-19 helps us assess whether the systems now being tested to respond to COVID-19 are robust.

Last year, the Robert Wood Johnson Foundation (RWJF), along with the RAND Corporation, shared an update on the national set of measures that we have been using to track our journey toward a culture where every person has a fair and just opportunity to live the healthiest life possible. The goal of the Culture of Health measures is to offer signals of change with a focus on broader social and economic drivers of health, well-being, and equity, as well as the role all sectors play in influencing health outcomes. Developing a clearer picture of what is changing (or not) via the Culture of Health measures is useful for directing investments and identifying where, as a nation, we need to make progress.

In 2019, when we updated the measures, we reported small, positive changes in appreciation for social determinants of health and the need for broader community health investments. However, we also found slow progress on education, housing, and other systemic factors that influence health, well-being, and equity. Now, COVID-19 has added stress to many of those systems.

In our 2020 update, we again had some notable improvements in areas likely susceptible to pandemic impacts (e.g., mental health, health care). Still, progress on social and economic drivers that influence health remained slow. Here is what we found.

Read the full article about health culture before the pandemic by Anita Chandra at RAND Corporation.