Robert Wood Johnson Foundation: A Legacy Of Transforming Lives In Enduring Ways

Monday, August 2, 2010 - 00:00

The Editor interviews Katherine Hatton, General Counsel of the Robert Wood Johnson Foundation, about the foundation, her work and Playworks, the innovative recess program RWJF is currently funding.

Editor: Please tell us about your professional background and how you came to the nonprofit world.

Hatton: I moved to New Jersey two days after I graduated from law school, back in 1980. For my first 24 years as a lawyer, I worked in Philadelphia. Because of my interest in the news media (I was a reporter before I went to law school), I worked for a Philadelphia law firm that represented a number of newspapers, magazines and television stations. Eventually, one of my clients - the company that published The Philadelphia Inquirer and Philadelphia Daily News - asked me to join them as general counsel. I did that for a dozen years, then was lucky enough to come to the Robert Wood Johnson Foundation. When I joined RWJF in 2004, I was doubly privileged: I joined an outstanding organization dedicated to improving people's lives, and I began working in New Jersey for the first time.

Many people think it must have been a difficult transition from newspapers to philanthropy. It's true that the legal issues are very different. But the people in the fields of philanthropy and reporting share many great traits: in both groups you find really smart people who are passionate about changing the world and making it a better place. It's terrific to work here, where I'm surrounded by committed people with a mission to make a difference in the lives of all Americans.

Editor: Would you give us some history about RWJF?Hatton: RWJF was established through a bequest from the estate of Robert Wood Johnson, who helped build the Johnson & Johnson company and whose personal philanthropy during his life focused on improving health services to people in need. He was the man behind the Band-Aid - the legendary president of Johnson & Johnson who died in 1968, leaving the bulk of his estate to the foundation that bears his name - and continues his work.

For us, philanthropy is much more than writing checks. The philanthropy we practice seeks to be transformative - to change society and the lives of all Americans for the better. It is philanthropy that can alter the trajectory of families, neighborhoods and communities, prompt new public policies, trigger new private actions, change current systems - even invent entire new ones. Some examples of our past efforts are illustrative:

9-1-1 - Today, every schoolchild in America knows to dial 9-1-1 in an emergency. That wasn't the case more than 35 years ago, when we first helped to create and spread what has become today's modern emergency medical response system. Now emergency medicine is a professional discipline and most hospitals, towns and cities have integrated emergency systems.

Tobacco - The changes in public behavior and attitudes toward tobacco use are staggering and represent a tremendous public health success story. Fifteen years ago, we introduced new approaches for research, prevention and treatment of tobacco use that have achieved extraordinary results, improving the public's health and saving millions of lives. Joel Fleishman, a professor at Duke University who has studied foundations extensively, said that RWJF, along with partners like the American Cancer Society, "blazed a trail that many others have followed" when describing our work in tobacco cessation.

End-of-Life Care - We were instrumental in helping establish and legitimize the field of end-of-life care, developing guidelines for what constitutes good palliative care; training and mobilizing health professionals, consumers, families, and elected and appointed officials to change both policy and practice for the better; and promoting the adoption of palliative care programs into hundreds of hospitals across the U.S. What was once an issue that was ignored or swept under the rug is now an integral, recognized feature of high-quality health care.

As we continue to address the difficult health and health care issues our country faces - like reversing the rise in childhood obesity; improving the quality of care and reducing disparities; raising the visibility, effectiveness and readiness of the public health systems; and ensuring that everyone in America has stable, affordable health care coverage - we hope, and expect, to have similar impact.

Editor: The Robert Wood Johnson Foundation has an extremely good reputation among philanthropic foundations in general. To what would you attribute this?

Hatton: We have an incredible privilege in philanthropy. We're guided by the principle that we are stewards of private resources that must be used for the public good, and we need to be accountable for how, and how well, those resources are deployed. Achieving a measurable impact is the best way to hold ourselves accountable for progress toward our mission.

Here at the Foundation, we are connected by a sense of purpose, mission and common cause. That's not surprising when you consider that RWJF has been at this for the better part of four decades. We care deeply about the pressing health and health care issues that this country faces. When issues of national magnitude - like covering the uninsured, improving the care of chronic illnesses, developing the next generation of leaders, improving the health of the most vulnerable among us, revamping our public health system - need leadership, the Robert Wood Johnson Foundation has traditionally stepped forward.

The reason isn't simply that significant issues need significant resources. For 35 years, we've brought not just our financial assets, but our deep experience, commitment and a rigorous, balanced approach to the problems that affect both the health care and the health of all those we serve.

We focus on issues that demand attention. We work with a diverse group of people whose dedication, expertise and perspectives lead to sound, new solutions. We do not shy away from difficult or controversial questions. And we have the staying power to stick with problems until solutions become clear, momentum has been established, and progress has been made.

It's daunting, sure, and we don't always succeed as planned, but nothing could be more rewarding than to be a catalyst - to change our world as we know it - for the better.

Editor: I understand RWJF has seven program area funding priorities. How did you arrive at these?

Hatton: To ensure that our programs are effective, we have implemented an Impact Framework that reflects our different grantmaking practices and areas of focus. The framework is a way of thinking explicitly about our efforts as a whole. It recognizes that we do several different kinds of grantmaking and that improving the ways these grants work together can enhance the measurable progress we make toward our overall mission. The framework groups most of our grantmaking into four clusters we call Portfolios: Targeted (which addresses four issues), Human Capital (creating and supporting a diverse and innovative group of people to transform our health care system), Vulnerable Populations (investing in health where it starts - in homes, schools and jobs) and Pioneer (investing in innovators and cutting edge solutions). These last three portfolios represent our commitment to stick with a set of issues over time.

But as we address America's critical health and health care issues, the need for prompt action and impact also is evident. Within the Targeted Portfolio, we have chosen a group of critical issues to address head-on by setting specific time-limited objectives, benchmarks, a plan of action, and a budget to accomplish the objective. The issues addressed in the Targeted Portfolio are Childhood Obesity (goal: reduce the childhood obesity epidemic by 2015), Health Insurance Coverage (goal: ensure that all Americans have stable, affordable health care coverage), Public Health (goal: ensure all Americans have quality public health services and policies), and Quality/Equality (goal: improve the quality of health care for all Americans).

For more information on our programming, check out our Web site,

Editor: How does Playworks fit into the mission of RWJF?

Hatton: Play matters. Research shows that play is essential to child development. And quality playtime at recess also helps children return to the classroom more focused and ready to learn. Unfortunately, in too many schools (especially in low-income communities), recess is chaotic and unsafe. And when kids don't have an outlet for healthy play, problems from the playground spill over into the classroom.

That's where Playworks comes in - by sending trained coaches to low-income, urban schools to rescue recess and to lead classroom games. Having a trained adult on the playground transforms chaos at recess into a positive experience that can improve the learning environment.

The Playworks model is the perfect example of how we can tap an underutilized resource - in this case recess - and leverage it for a much larger impact on children's health and education. And one of the great things about something like recess is that it's fairly universal. We looked at the numbers and it turns out that you can reach more kids in the U.S. through recess than phys ed or after-school activities. And yet, traditionally it's been the most overlooked time in the school day.

As I said, our mission is to improve the health and health care of all Americans. That means we focus on improving the availability and quality of health care, but also on what makes us healthy or unhealthy to begin with. Health really begins where we live, work, learn and play. So programs like Playworks that make the connection between play and health are incredibly important to our mission.

In short, Playworks is the model of what we look for in our Vulnerable Populations portfolio: an innovative and effective program that produces multiple health benefits and can be taken to scale.

Editor: How have you funded the program?

Hatton: RWJF is currently providing $19 million to expand this program to 650 schools in 27 cities throughout the country. We've also invested an additional $5 million to evaluate the program, so that other funders and educators can be confident that the approach works. We're funding a randomized trial in conjunction with the Stanford University School of Education that will evaluate outcomes of Playworks. The evaluation will assess any improvements in school climate, physical activity, health, academic outcomes, and instruction time that teachers may regain because classroom management is easier. The multi-year study focuses on six schools in California's Silicon Valley, all of which began using Playworks at the time the evaluation began. The research has been in the field for one year, and there will be some preliminary results available this fall.

In addition to this, we've invested in building the knowledge base on the importance of play to the school day, in terms of the value that principals and teachers place on it. The recent report, "The State of Play," summarizes an RWJF-funded Gallup survey of principals on this topic.

Editor: Has the program been successful?

Hatton: If you visit a school where Playworks is in action, you'll see how it transforms a school environment. Two years ago, I visited a school in Oakland where Playworks was operating. The children told us they were happy to have organized playground activities and that they'd learned to get along with each other better as a result. In fact, I learned to play "Rock, Paper, Scissors" while I was there - that's the method the children used to use to settle recess disputes. And they said they carried that lesson back into their classrooms.

Clearly the program gets high marks from school administrators: we know that even in these difficult times, school principals are willing to put $25,000 of their own increasingly small budgets to bring the program back every year. But we also believe that's it's important to conduct a more rigorous evaluation, which is why we've made such a significant investment in the Stanford study.

Editor: How will you work with Playworks going forward?

Hatton: It's really too early to say. Our current investment takes us through 2012, and at that point we'll take a look at where they are, and whether there are specific, additional kinds of opportunities for us to work together.

Editor: How can corporations make a difference?

Hatton: Over the last year or two, Playworks has begun to establish partnerships with the business community. Those partnerships are still young, but Playworks is working with the NFL and several local professional sports teams and 24-hour Fitness, among others. We think there are many other businesses out there whose interest in helping kids thrive should align well with Playworks, and we look forward to helping them develop those partnerships, whether they lead to funding, board leadership, volunteer service or publicity.

I could envision a local company, a law firm, or a group of law firms, bringing Playworks to a school in Newark, Elizabeth, Paterson, Bloomfield, Camden or other community in New Jersey. The cost is manageable, and the benefit is great. And just watching the students play four-square, use hula hoops, or play ball - it's priceless.

For more information on Playworks, visit