LAUSR

In September 2016, Bloomberg Philanthropies made a $300 million gift to the Johns Hopkins Bloomberg School of Public Health on the occasion of the school’s 100th anniversary. The gift’s purpose was to improve health in the United States by focusing on 5 areas: addiction and overdose, violence, obesity and the food system, environmental challenges, and risks to adolescent health. All 5 areas of focus are serious health problems facing the nation, with deep connections to economic and social factors; none have quick fixes. In making this gift, Bloomberg Philanthropies sought to stimulate broader and more effective public health responses to these problems. It is no coincidence that the gift arrived at a time of dispiriting headlines about the state of health in the United States. Despite enormous progress during the last century, with major declines in infectious disease, noncommunicable diseases, and injuries, as well as a dramatic increase in life expectancy at birth, progress is stalling. Life expectancy has stopped growing; indeed, it declined for 2 consecutive years. The opioid epidemic is claiming more than 40 000 lives per year, suicide rates are rising, and obesity rates among adults are increasing. These and other issues are complicated by unfortunate shifts in health disparities and by deteriorating physical infrastructure in both urban and rural areas. How can a school of public health support the field of public health in addressing these complex health and social problems? This question is at the heart of the Bloomberg American Health Initiative (hereinafter, the Initiative), the program launched with the new funds. During its first 2 years, the Initiative has convened partners from across the country, both inside and outside of academia, to identify key issues and opportunities for making meaningful progress on each of the 5 targeted public health challenges. Many of these issues and opportunities are captured in the detailed articles included in this supplemental issue of Public Health Reports. Initial areas identified for action included: stigma that impedes treatment seeking and shapes societal beliefs about appropriate community responses to the opioid epidemic; underappreciated connections among intimate partner violence, suicide, and community violence; systems approaches to the obesity epidemic; changes to infrastructure and community design that enhance environmental health; and programs and policies to prevent high-risk young people from becoming disconnected from school and work. Faculty engaged in the Initiative have also identified cross-cutting themes that are critical to success. One theme is the need for relevant evidence to drive policy. However, the kind of evidence produced through academic research and the way that evidence is packaged and communicated do not always meet the needs of policy makers and practitioners. In addition, critical analyses are often limited by inadequate, poorly integrated longitudinal data and lack of useful evaluation of policies and programs. The Initiative is seeking opportunities to develop stronger collaborations between schools and programs of public health and policy makers to coproduce research that will lead to evidence that is accessible, applicable, and impactful. A second theme is that the field of public health alone cannot succeed in addressing problems that reflect deep inequities in our society. This theme is a central insight of the Robert Wood Johnson Foundation’s Culture of Health action framework, in which “health become[s] a national priority, valued and advanced by collaborators among many sectors of society.” A focus on equity, community engagement, and leadership is necessary to address the role of what have been described as “the social, political, and economic foundations that determine population health.” Public Health 3.0, an initiative launched by the US Department of Health and Human Services in 2016, calls for health