Trust for America’s Health (TFAH) is a health care research organization that advocates for national health care policies and strategies based on the left-progressive philosophy of “health equity” and its criteria of what would ensure “optimal health for every person and community.” ¹

TFAH receives funding from numerous left-of-center grantmakers; as of 2022, its self-admitted list of funders included the California Endowment, the CDC Foundation, the John A. Hartford Foundation, the Dawn Hill Fund, Kaiser Permanente National Community Benefit Fund at East Bay Community Foundation (EBCF), the Robert Wood Johnson Foundation, the Well Being Trust, and the W.K. Kellogg Foundation. ²

Background

Trust for America’s Health studies the causes of poor health, their economic impacts on health care costs in the U.S., and ways to prevent it. Using its lengthy reports on health issues such as pandemics, food safety, public health funding, suicide, alcoholism, and obesity as support for its advocacy, the organization articulates arguments for certain policies, usually of center-left persuasion, to address identified health risks and failures of the U.S. healthcare system. ³

Activities

In March 2007, Trust for America’s Health released an issue report on the economic impact of pandemics (in light of the H5N1 “bird flu”) entitled “Pandemic Flu and the Potential for U.S. Economic Recession.” In the document, TFAH made the prediction that the U.S. and global economy would suffer a major recession if a pandemic arises without a vaccine and recommended “concentrating efforts on wide-scale vaccination” if vaccines for diseases become available even before they turn into pandemics. It also warned that the country could not simply rely on federal, state, and local government to manage the disruptions that a large-scale pandemic would cause, as they would not have the required resources. ⁴

In April 2008, TFAH released a report on “Food Safety” in America, identifying problems with the American food production and distribution process and proposing policies to correct them. It argued that foodborne diseases, which infect 1 in 4 Americans each year and lead to 5,000 annual deaths, could be prevented if the U.S. food system redesigned itself. Some of its proposed corrections included a higher degree of collaboration between and centralization of the federal, state, and local branches of the governmental food-safety system; more stringent regulations against adulterated foods; increased funding and support for the FDA; the realignment and unification under one head of the organization of food regulatory functions at the U.S. Department of Health and Human Services (HHS); a long-term goal of consolidating the different federal food safety agencies; and creating uniform food safety standards across federal, state, and local levels. ⁵

In July 2009, TFAH released a report on obesity in America entitled “F as in Fat,” claiming that obesity levels were harming millions and resulting in billions of dollars in extra costs for Americans, making obesity one of the major drivers of America’s rising healthcare costs. ⁶ To eliminate the “epidemic” of obesity, TFAH listed a number of policy recommendations for the government to adopt such as creating a “dedicated funding stream,” a public health and wellness trust fund, for the purpose of funding community programs that ensure citizens have access to nutritional foods and physical exercise; the creation of universal obesity-related health care benefits that make available to all Americans the most effective practices and information on obesity prevention; and programs to intervene in young populations’ consumption habits to prevent them from being obese when they retire and begin to receive Medicare benefits. These recommendations culminated in TFAH’s call for America’s politicians and government leaders to create a national strategy on combating obesity, with a comprehensive and detailed list of suggested policies and regulations for the federal government, schools, insurance companies, food and beverage companies, and businesses to promote, sustain, and increase TFAH’s recommended consumption and exercise habits. ⁷

In light of the 2020 COVID-19 pandemic, TFAH in March 2021 urged the U.S. government to request an additional $4.5 billion annually to its federal budget in order to strengthen “core public health capabilities.” TFAH detailed that such strengthened capabilities would include a modernized system of data tools, increased surveillance capacities, a bigger and better paid health care workforce, a higher level of “public health emergency preparedness,” more investments in the treatment and prevention of chronic diseases and substance abuse, and an effort “to advance health equity by combating the impacts of racism and addressing the social determinants that lead to poor health.” ⁸

Funding

TFAH’s March 2007 pandemic report was financially supported by a grant from the Pew Charitable Trusts “as part of the U.S. Pandemic Preparedness Initiative.” ⁹ Its April 2008 report on food safety was supported by a grant from the Robert Wood Johnson Foundation (RWJF). ¹⁰

Trust for America’s Health was among the 465 nonprofits to which MacKenzie Scott gave money from June 2021 to March 2022. Scott spent a total of $3,863,125,000 on philanthropic nonprofits during this period; it was not made public how much money TFAH itself received. ¹¹

As of 2022, its self-admitted list of funders included the California Endowment, the CDC Foundation, the John A. Hartford Foundation, the Dawn Hill Fund, Kaiser Permanente National Community Benefit Fund at East Bay Community Foundation (EBCF), the Robert Wood Johnson Foundation, the Well Being Trust, and the W.K. Kellogg Foundation. ¹² The Kellogg Foundation has granted millions of dollars to TFAH over the years, starting at least as early as 2009. ¹³ TFAH claims that it does not receive funding from the government or from private industry. ¹⁴

Leadership

As of June 6, 2022, J. Nadine Gracia was the president and CEO of Trust for America’s Health. Gracia is a “national health equity leader” who had served in the Obama administration as the Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at HHS. She worked and advised on the Affordable Care Act (or “Obamacare”), adolescent health, emergency preparedness, “environmental health” and climate change, global health, the White House Council on Women and Girls, and in the Office of the First Lady developing the “Let’s Move!” initiative regarding childhood obesity. ¹⁵

As of June 6, 2022, Gail Christopher, director of the National Collaborative for Health Equity at George Mason University, was the chair of TFAH’s board of directors. Christopher was previously the senior adviser and vice president of the W.K. Kellogg Foundation and the vice president of the Joint Center for Political and Economic Studies’ Office of Health, Women and Families in Washington, D.C. She also directed the Joint Center Health Policy Institute, an initiative that facilitated discussions on “health equity” and how the health care system allegedly underserves racial and ethnic minorities. ¹⁶ David Fleming, former vice president of Global Health Programs at PATH (formerly known as Program for Appropriate Technology in Health), is the vice chair of the board. ¹⁷

Other board members include Robert T. Harris, senior medical director for General Dynamics Information Technology; Theodore Spencer, formerly of the Natural Resources Defense Council; Stephanie Mayfield, the director of the U.S. COVID-19 Response Initiative for Vital Strategies’ project Resolve to Save Lives; Cynthia M. Harris, associate dean for Public Health and director and professor of the Florida A&M University Institute of Public Health (IPH); David Lakey of the University of Texas System; Octavio N. Martinez, director of the Hogg Foundation for Mental Health at the University of Texas at Austin; John A. Rich, professor at Drexel Dornsife University School of Public Health; Eduardo J. Sanchez, Chief Medical Officer (CMO) for Prevention and the leader of the Target:BP initiative at the American Heart Association (AHA); Umair A. Shah, the Secretary of Health for Washington State; and Vice Ventimiglia, president of Leavitt Partners Collaborative Advocates. ¹⁸

Former board members include Patricia Bauman of the Bauman Foundation and president of the board Lowell Weicker Jr., the former governor of Connecticut. ¹⁹

1. “Staff – Leadership Team.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/staff/
2. “Funders.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/annual-report/.
3.  “Mission and Vision Statements.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/mission-vision-statements/.
4. “Pandemic Flu and the Potential for U.S. Economic Recession, A State-By-State Analysis.” Trust for America’s Health, March 2007. Accessed 6 June 2022. Page 23: https://web.archive.org/web/20070708122547/http://healthyamericans.org/reports/flurecession/FluRecession.pdf.
5. ^[1] “Fixing Food Safety: Protecting America’s Food Supply From Farm-To-Fork.” Trust for America’s Health, April 2008. Accessed 6 June 2022. Pages 1, 20-21: https://web.archive.org/web/20210402035307/https://www.tfah.org/wp-content/uploads/archive/reports/foodsafety08/FoodSafety08.pdf.
6. ^[1] “F as in Fat: How Obesity Policies Are Failing in America.” Trust for America’s Health, July 2009. Accessed 6 June 2022. Pages: 5-6. https://web.archive.org/web/20220111170807/https://collections.nlm.nih.gov/master/borndig/101509792/2009Report-FasinFat.pdf.
7. “F as in Fat: How Obesity Policies Are Failing in America.” Trust for America’s Health, July 2009. Accessed 6 June 2022. Pages: 80-90. https://web.archive.org/web/20220111170807/https://collections.nlm.nih.gov/master/borndig/101509792/2009Report-FasinFat.pdf.
8. “The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021.” Trust for America’s Health, 7 March 2021. Accessed 6 June 2022. https://www.tfah.org/report-details/pandemic-proved-underinvesting-in-public-health-lives-livelihoods-risk/.
9. ^[1] “Pandemic Flu and the Potential for U.S. Economic Recession, A State-By-State Analysis.” Trust for America’s Health, March 2007. Accessed 6 June 2022. Page 2: https://web.archive.org/web/20070708122547/http://healthyamericans.org/reports/flurecession/FluRecession.pdf.
10. ^[1] “Fixing Food Safety: Protecting America’s Food Supply From Farm-To-Fork.” Trust for America’s Health, April 2008. Accessed 6 June 2022. Page 26: https://web.archive.org/web/20210402035307/https://www.tfah.org/wp-content/uploads/archive/reports/foodsafety08/FoodSafety08.pdf.
11. ^[1] Scott, MacKenzie. “Helping Any of Us Can Help Us All.” Medium.com, 23 March 2022. Accessed 28 May 2022. https://mackenzie-scott.medium.com/helping-any-of-us-can-help-us-all-f4c7487818d9.
12. “Funders.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/annual-report/.
13. ^[1] “Search.” W.K. Kellogg Foundation. Accessed 6 June 2022. https://www.wkkf.org/search/site?q=trust+for+america%27s#pp=100&p=1&q=trust%20for%20america’s&at=undefined.
14. “Funders.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/annual-report/.
15.  “Staff – President and CEO J. Nadine Gracia, MD, MSCE.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/people/j-nadine-gracia-md-msce/.
16. “Board of Directors – Chair of the Board Gail C. Christopher, DN.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/people/gail-c-christopher-dn/.
17. ^[1] “Board of Directors.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/board-of-directors/.
18. “Board of Directors.” Trust for America’s Health. Accessed 6 June 2022. https://www.tfah.org/about/board-of-directors/.
19. “Fixing Food Safety: Protecting America’s Food Supply From Farm-To-Fork.” Trust for America’s Health, April 2008. Accessed 6 June 2022. Page 26: https://web.archive.org/web/20210402035307/https://www.tfah.org/wp-content/uploads/archive/reports/foodsafety08/FoodSafety08.pdf.