“It’s time to make a shift and recalibrate our choices to make the healthy choice the easy choice, and to make health the choice for a better America,” declared Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, the nation’s largest foundation devoted to health, at the Changing World Speaker Series: Sustainability, Resilience, and Health during the 2015 ULI Fall Meeting in San Francisco. She called on ULI members to intentionally plan, design, and build projects that encourage health: “We need to create a culture in which every person can live in a safe and healthy environment.”

Changing the national agenda begins with the recognition that health is more than not being sick: It’s the bedrock of personal, family, and community stability, she said. “When we open our eyes to all the things that really influence health and well-being, the list keeps getting longer and longer—poverty, violence, economic opportunity, clean air and water, public transportation,” as well as genes, diet, exercise, stress, and spirituality. “When we start thinking about the importance of health in all aspects of life, that’s the ‘health is everything lightbulb moment.’ ”

Lavizzo-Mourey said her own “health is everything lightbulb moment” came one cold winter night when she was training to be a physician at Harvard University. She cared for a homeless woman she called “Patient Ruth” who arrived at a Boston-area hospital wearing slippers, with raw leg ulcers that made walking painful. “We did what we always did: gave her a few hours in a warm bed, some antibiotics, and a decent meal. But the next morning she had to go because, according to the rules, our job was done. So she limped out the door, straight back into the dark tunnel of problems she faced every day: No home. No job. Lousy food, and no family or friends to turn to for help. Our care ended at the front door of the hospital, and that is so shortsighted. What if instead of ushering her back into the cold, we could have asked what she needed to keep from having to come back? And then, what if we linked her to all the things outside the clinic that she needed to get better and stay healthier?

“Zip code may be as important as your genetic code in predicting how well and how long you live,” said Lavizzo-Mourey. In New Orleans after Hurricane Katrina, a person living in the Lakewood neighborhood could expect to live 25 years longer than someone living six miles (9.6 km) away in Iberville, near the French Quarter. Physical health indicators correlated with economic disparities: Compared with wealthier Lakewood, Iberville has an unemployment rate three times higher, a crime rate 60 percent greater, and a high school graduation rate 18 percent lower. Folks in the region are working to close the economic and health gap, she said, but similar disparities exist nationwide.

“All across America, there are neighborhoods where parents are afraid to let their kids go out to play or walk to school. And when they do get to school, the playground is a chewed-up piece of asphalt, littered with broken glass and trash. No monkey bars, no slides, no swings.” In too many neighborhoods, she said, “there are more liquor stores than grocery stores, and it’s easier to buy a gun than to buy fresh fruit.” What if our communities were intentionally designed to encourage and support health, providing children not only with promise but also with a path to upward mobility? she asked.

“Every one of us has the power to make a difference,” she said, citing examples of individuals leading the way. One was Tom Cousins, a developer who in 1995 helped establish the East Lake Foundation in Atlanta, which brought business leaders, residents, philanthropists, and city officials together to create a “purpose-built community.” The foundation tore down a slum and replaced it with mixed-income housing, half of which was market-rate. It also started a charter school, built a YMCA, and revived a professional golf course available for use by everyone who lives in East Lake. These changes have boosted the employment rate and slashed the crime rate. The charter school has one of the best academic records in Georgia, and East Lake kids are going to college in record numbers, some of them on golf scholarships.

The United States annually spends nearly $3 trillion on health care, more than any other developed nation, but annually loses nearly $226 billion in productivity because of personal and family health issues, Lavizzo-Mourey noted. “We are living in a moment of urgency, and our nation cannot continue doing more of the same.” She cited previous success in creating cultural shifts: Before Earth Day in 1970, for example, recycling was not a part of our cultural vocabulary, but “people began demanding change, and now we see recycling bins everywhere.”

Robert Swan, polar explorer and founder of 2041, an organization dedicated to building leadership skills and encouraging sustainability, next addressed the need for urgent action to slow climate change. He recounted his experiences, sometimes in harrowing detail, as the first person in history to walk to both the North Pole and the South Pole, and described his efforts to save Antarctica, “the only place on earth that we all own,” from accelerated global warming. To underscore his message, he showed film footage of huge areas of Antarctica where ice shelves are melting and breaking off.

After his first expedition in 1998 to the South Pole, an unassisted journey of 900 nautical miles in which he pulled a heavy sled, he met with his patron, Jacques Cousteau. The eminent conservationist and filmmaker gave him a 50-year mission: Make sure that Antarctica is preserved for everyone at least until 2041, the year the Antarctica Treaty declaring a moratorium on mining on the continent expires.

Since 2003, Swan has brought his environmental message of “thinking globally, acting locally” to 77 nations through education campaigns to promote recycling, renewable energy, and sustainability to combat the effects of climate change. Swan also had promised Cousteau to “leave Antarctica tidy” of debris left by various scientific and commercial ventures, and has spearheaded extensive cleanup efforts, including an eight-year, $12 million campaign to remove 100,500 tons (91,000 metric tons) of rusting debris left by the Russians. His vision for a sustainable world focuses especially on the next generation, he said. “We need them to inspire them to look up, because they are the future.”