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Appendix A

Survey Results Comparing Populations by City Size

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Appendix B

Survey Results Comparing Urban and Rural Populations

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Research Questions

  1. Do people in the U.S. appreciate that health is influenced by social and physical factors?
  2. Do people value and prioritize both individual and community well-being investments?
  3. Do people take action to promote both personal and community health and well-being?
  4. Do people understand and value action to improve health equity?
  5. What factors contribute to the experience of better health care system integration?

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led a pioneering effort to advance a Culture of Health that "enables all in our diverse society to lead healthier lives, now and for generations to come." As part of the work to track progress toward this goal, RAND researchers worked with RWJF to design and field the National Survey of Health Attitudes to provide insight and perspective on how people in the United States think about, value, and prioritize health and consider issues of health equity. The survey was first fielded in 2015, and an updated version was fielded in 2018. This report describes the survey development and provides the text of the 2018 survey and summary statistics of the data.

The foundation undertook this survey to measure key constructs that could not be measured in other data sources, primarily addressing the action area making health a shared value. The questions in this survey sought to measure various constructs, including those that are linked to the building of shared health values including whether respondents (1) recognized the influence of social and physical factors on health, (2) valued investment in community health, and (3) had a sense of community or community connection. Results from the survey indicate that 37 percent of U.S. adults recognized a strong or very strong influence of social and physical factors on health, 28 percent did not consider investment in community health a top priority, 11 percent reported a strong sense of membership in their community, and 19 percent reported a strong emotional connection to their community.

Key Findings

2018 National Survey of Health Attitudes

  • 37 percent of U.S. adults recognized a strong or very strong influence of social and physical factors on health.
  • 28 percent did not consider investment in community health a top priority.
  • 64 percent felt it was harder for low-income Americans to get health care, 58 percent felt it was harder for those living in rural communities; 35 percent felt it was harder for African Americans, and 37 percent felt it was harder for Latinos.
  • 11 percent reported a strong sense of membership in their community.
  • 19 percent reported a strong emotional connection to their community.
  • 38 percent reported their community could mostly or completely work together to improve its health.
  • 21 percent reported advocating for a health-related issue in their community.

Table of Contents

  • Chapter One

    Introduction to Culture of Health

  • Chapter Two

    Survey Overview

  • Chapter Three

    Top-Line Summary Data

Research conducted by

This research was sponsored by the Robert Wood Johnson Foundation and by the Community Health and Environmental Policy Program within RAND Social and Economic Well-Being.

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