Creating the Framework

After organizing these principles into conceptual clusters, the team created logic models to determine how they would connect, then reviewed them with diverse stakeholders across the country. These clusters became the core structure of the Action Framework:

With these Action Areas in place, the team conducted a systematic literature review and consulted with experts to determine what could drive progress within the Framework. Each Action Area includes several Drivers, providing a set of long-term priorities, both nationally and at the community level.

10 Principles for a Culture of Health

  1. Good health flourishes across geographic, demographic, and social sectors
  2. Attaining the best health possible is valued by our entire society
  3. Individuals and families have the means and the opportunity to make choices that lead to the healthiest lives possible
  4. Business, government, individuals, and organizations work together to build healthy communities and lifestyles
  5. No one is excluded
  6. Everyone has access to affordable, quality health care because it is essential to maintain, or reclaim, health
  7. Health care is efficient and equitable
  8. The economy is less burdened by excessive and unwarranted health care spending
  9. Keeping everyone as healthy as possible guides public and private decision-making
  10. Americans understand that we are all in this together

Measuring Progress

Each Driver is accompanied by a set of national, evidence-based Measures. By design, they are not limited to traditional health indicators—instead, they encourage us to think of health in broader ways, incorporating all aspects of well-being. They are intended to serve as illustrative entry points for dialogue and action toward building a Culture of Health.

The Measures included in the Action Framework were narrowed down from a list of hundreds, using several criteria:

  • Availability of national data
  • Application to entire lifespan & healthspan
  • Broad determinants and upstream drivers
  • Appeal to multiple audiences
  • Focus on equity

Then, the full set of Measures was reviewed for its cohesiveness in broadly increasing health equity, while also addressing major national health challenges. The Measures include protective factors that if increased would improve health; they also include risk factors that if reduced would improve health and well-being. They are intended to be clear and understandable—empowering various fields to make positive changes in health behaviors and policies.