A discussion paper from the National Academy of Medicine, co-authored by AAMC Center for Health Justice founding director Philip M. Alberti, PhD, outlines a vision for reorienting health systems around individual and community-defined goals and identifies actions to strengthen alignment, trust, and shared accountability across sectors.
Across health care, public health, and the health science enterprise, decisions are often driven by institutional priorities, financial incentives, and narrow definitions of health rather than by the goals and priorities of individuals and communities. As a result, individuals and communities are often treated as passive recipients rather than active partners. This misalignment contributes to ineffective interventions, persistent inequities, rising costs, and declining trust. In order to achieve optimal outcomes, the authors recommend that health systems align actions, investments, and accountability with what matters most to people.