intro’d to Steve when Joi posted this on fb (2017):
The fact that more than 70 percent of U.S. adults are overweight or obese is not due to the individual moral failings of 200 million people. It is the result of many different industries, each individually optimizing our engagement for their particular goals, but lacking a coherent value system that prioritizes our overall well-being.
Daniel Lieberman, in his remarkable book, The Story of the Human Body, argues that the human species did not evolve to live in the world we have created.
Lieberman argues that many of the chronic diseases — such as diabetes, cardiovascular disease, back pain and depression — that now plague us in ever growing numbers, are the result of this fundamental mismatch between how we have evolved and the environment in which we live.
To borrow a tag line from Steve Jobs, it’s time to think different. It’s time to reverse the direction of the river.
It would mean creating environments where healthy choices are the easy choices. And not just the easy choices, but the desirable choices, even the defaults. It would mean building a culture where people don’t have to think consciously about being healthy, but rather being healthy is a natural consequence of going about your day..t
Building health into the OS requires that we look at the fundamentals of modern life and challenge the assumption that they are inevitable. We need to stop taking them as givens.
What if someone took on this challenge with the same boldness and urgency that Elon Musk has taken on climate change?
What if lots of us did?
what if 7 bn plus of us did.. everyday.. as the day..
talk feb 2017
3 min – people need everyday behaviors in order to be healthy
health comes from what we do all day – every day..t
we (rwjs) envision a day where every american can be as healthy as they can be
has to be whole world.. or won’t work
5 min – taking enough steps (fitbit et al) should just be a natural consequence of going thru your day
6 min – these devices are beautifully engineered solutions.. but they’re about making the best of a system that in need of fundamental re engineering..t
rather than just focus on health directly.. we could focus on everyday life..t
7 min – tech influences what’s possible.. easy.. ie: cars, washing machines, tv, games, phones.. remote control..
9 min – lawrence lessig: code is law
just as code is law.. tech is health.. how we move thru out our days is not random
10 min – we have opp to invest/invent new techs that will shape our lives differently..
13 min – use hashtag #techishealth
it’s going to take all of us .. making sure our voices are heard..t
so let’s just focus on that.. mech to listen to all the voices.. self-talk as data..everyday.. as the day
convo w dec Joi 2016
rwjf – our mission is to improve health/healthcare for all americans.. the way we approach that .. going after big systemic change..t
vision: a culture of health.. everyone has chance/opp to lead healthiest life they can..t
equity – everyone getting a go everyday
where making good choices are the easy choices..
3 min – what do we mean by health.. and what contributes to it
4 min – if we value health.. we value health of all of us
joi: seems like a lot of our ideas on health come from commercial interests.. incentivized to make you consume more.. rather than more healthy.. how do you expect to change
it’s not easy to be sure.. but we do see change over time.. being able to tap into that value that people have..
6 min – we’re paying for treatment.. not health
joi: i still get back to incentives.. ie: way hospitals get reimbursed.. fighting a financial system that has been created over the years.. getting people to want it.. fiddling w incentives.. easier than getting big entities to change
8 min – if you could start to change things in the environment that would reshape everyday life.. would be better than everyday messages to people or trying to get policy makers to change..
9 min – devices today.. probably aimed more at people that need it less
10 min – ie: fitbit.. suggesting that life is giving you insufficient activity.. in true healthy culture wouldn’t need that.. so ..
how do you use tech to re imagine the patterns of everyday living..t
11 min – joi: how much of the health problem is.. whether you want to be healthy or not.. not an info problem for a lot of people.. ie: hamburger graphs..
13 min – do the degree people say.. this is exciting for me.. i don’t have anything against in indulging in things to be happy.. (ie: go to in/out burger w group of friends on occasion) .. but there are some fundamental patterns in how we live.. led us to lifestyles that are starting to have consequences..
14 min – interested in things that get at those day to day patterns.. ie: electric bikes; pokemon go; blue apron – almost prep’d meals; .. things that make things a little more accessible.. not financially.. but in right direction
16 min – joi: being healthy is expensive.. culture of being healthy among the affluent..t
19 min – rethink city infrastructure..t
20 min – joi: on history of game of monopoly.. rules didn’t change.. just goals did
22 min – changing the goals of our system is a big one
23 min – thinking.. what behavior is this going to illicit.. and how do we feel about that..
24 min – joi: lot of habits start young..t
26 min – you said – mit wanted to do something.. but cross discipline.. not just health
if want to change what build.. change what you think.. and if want to change what you think.. change what you do..t
28 min – joi: at mit.. trying to hack health as a cool thing..
hard to express that value in your work if you’re not living it
31 min – health is about letting you live.. to the fullest..
32 min – joi: i feel like health care is leaving.. just the hospital.. ie: monitor self at some level so whole day gives feedback.. if you could create feed back system that actually is in real time.. rather than ie: end of day.. one of problems.. people don’t think about health until they go to dr’s office
34 min – care between the care is what matters.. our system is designed to be an acute care system.. where big issues are chronic.. it’s not the dr that’s fixing you.. a more continuous care feedback loop makes a lot of sense
35 min – whether quantified self is a skill or a lifestyle.. i don’t want that constant feedback.. just if something is wrong
joi: for me.. just the knowledge that you are in control of your own (health).. ie: only get help if need surgery..
36 min – the built environment.. what a diff that can make.. ie: bike lanes available.. et al
37 min – big part about *people making changes.. big part about re engineering the **environment.. so people can make changes they want..t
joi: bottom up seems to work better on that..
38 min – think about patterns we take for granted in our lives and assume they will always be there.. that can change.. by people who are audacious enough to do that.. that’s the story to tell.. people crazy enough to do this..t
i’d love to hear from people on this.. i think we can do much more and aim higher and deeper into culture.. i’d love to hear how we do that.. how we get more people..t
let’s try this: a nother way.. deep/simple/open enough.. for all of us to leap to
find follow Steve:
on rwjf site..
Steve Downs is the Robert Wood Johnson Foundation’s chief technology and strategy officer. In this role, he focuses on the practice of program strategy and on the alignment of the Foundation’s technology strategy and operations with its organizational directions. RWJF’s pursuit of a Culture of Health requires an approach to strategy that is highly flexible and adaptive. In his current role, Downs works with his colleagues to institutionalize an approach to program strategy that is based on the integration of learning, co-creation, and reflection into the processes of strategy development and ongoing strategy assessment and adaptation.
Since being appointed chief technology and information officer in 2011, Downs’ goal has been to ensure that RWJF staff have the resources they need to practice philanthropy at the highest level. He has emphasized technology directions—namely mobility and social CRM—that encourage informal knowledge-sharing, data-informed decision-making, and peer-to-peer engagement.
Since joining RWJF in 2002, Downs’ career at RWJF has proceeded along two parallel paths: management and programming. Along his management path, he served as the first team leader of the RWJF Pioneer portfolio, helping to shape the portfolio’s direction and initial body of work. From 2007 to 2011, Downs served as the assistant vice president of the Health Group. In this position, he worked with the senior vice president of the Health Group to oversee the Foundation’s strategies and investments in the areas of childhood obesity, public health, tobacco control, and support for vulnerable populations. He also played a key role in helping to shape and articulate the Foundation’s vision for transitioning to a “Web 2.0” philanthropy, one based on values of openness, participation, and decentralization.
Starting as a senior program officer, Downs has focused most of his programming efforts on bringing the benefits of health IT to the mission of improving health and health care. He developed and supported work in public health informatics, including the creation of the Public Health Informatics Institute and the Common Ground program. In recent years, he has focused on how consumer technologies can be leveraged to better engage patients and improve their care. He co-developed Project HealthDesign, a program that challenges conventional notions of personal health records; supported the OpenNotes project, which opens up physicians’ notes to their patients; and has been working on an exploration of how researchers could use self-tracking data to identify health patterns in everyday life.
Over the years, Downs has contributed to numerous blogs. His posts have appeared on RWJF’s blog, The Health Care Blog, the Foundation Center’s Glasspockets blog, Philantopic, and TheHuffington Post.
Before coming to the Foundation, Downs served as director of the Technology Opportunities Program (TOP), a U.S. Department of Commerce, National Telecommunications and Information Administration initiative that promoted the widespread availability and use of digital network technologies in the public and nonprofit sectors to provide better education, health care, public safety, and other social services. During his eight-year tenure with TOP, the agency provided more than 600 matching grants to state, local, and tribal governments; health care providers; schools; libraries; police departments; and community-based nonprofit organizations.
Having begun his career in telecommunications in the private sector, Downs was also a former research fellow of the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. In 2010, he was inducted into the American College of Medical Informatics (ACMI), which serves as the voice of the nation’s top biomedical and health informatics professionals and encourages the use of data, information, and knowledge to improve both human health and delivery of health care services.
Born in New Hampshire, Downs earned an SM in technology and policy from the Massachusetts Institute of Technology and a BS in physics and applied physics from Yale University. He and his wife Janet Estes reside in Princeton and have two children.