Rendez-vous with . . . Steven Schroeder, Past President of the Robert Wood Johnson FoundationAuthor: Philippe Boucher
Rendez-vous with Steven Schroeder Past President of the Robert Wood Johnson Foundation Distinguished Professor of Health and Health Care, Department of Medicine, University of California, San Francisco email@example.com
Thank you Steven for accepting our rendez-vous.
May I ask you to introduce yourself?
Steven Schroeder: I am a physician with training in internal medicine and public health and with a long interest in health policy. For most of my professional life I was in academic positions, first at Harvard, then at George Washington, and from 1976-1990 at the University of California, San Francisco. At UCSF, I was professor of medicine and founding chief of its Division of General Internal Medicine. From July 1990 until December 2002 I served as President of The Robert Wood Johnson Foundation in Princeton, New Jersey. I have now returned to UCSF to direct a new center, about which I will comment later.
Q1. You became President of RWJF in July 1990. During your 12 year tenure (until December 2002) RWJF invested approximately $408 million in tobacco control programs. How did it start? How long can/should it last?
Steven Schroeder: The mission of RWJF, which was established as a national philanthropy in 1972, is "To improve the health and health care of all Americans." When I interviewed for the position of president I told the board of trustees that I thought the foundation had underdeveloped the health part of its mission and was known primarily as a health care foundation. When asked how I would expand health grantmaking, I responded that a good place to start would be with substance abuse, because its burden was so great, so little foundation work was devoted to it, and government action was constrained by political sensitivities about tobacco and alcohol. It was easier to sell involvement in combatting illicit drugs than tobacco and alcohol abuse. Our staff was not very enthusiastic, but eventually they came around. Then it was very difficult for our trustees to accept, mainly because they were concerned about having to do combat with the tobacco industry. Fortunately, the congruence of the tremendous toll that tobacco takes plus the spirit of our mission prevailed. Ultimately, our board became very proud of our work in tobacco control.
We now have a new president, Risa Lavizzo-Mourey, who is using her fresh eyes and ears to reexamine foundation goals and directions--as she should. It is still very early in her tenure, so it is premature to predict whether RWJF will change its emphasis on tobacco. My sense is that she is balancing the realization that tobacco use is still a huge problem with the hope that others will also support programs in this area.
Q2. In the 2001 Foundation annual report you reflected on "looking back at lessons learned." What lessons did you learn as far as tobacco control is concerned?
Steven Schroeder: First I want to express my gratitude to those who have been working in the field all these years. These anti-tobacco veterans are real heroes, who were largely unsung until quite recently. Much of the work that we were able to support was grounded on their earlier efforts. Second, I learned that our strategies should be diverse, rather than relying on a single approach. Thus, we supported state and community coalitions, started leadership programs, sponsored policy research, helped create advocacy groups, and worked on projects that would tell the tobacco story in the media. I hope that the effect of this broad set of efforts was to make working on tobacco safer and more respectable, and to give extra energy to the movement. I also learned how skillful the tobacco industry is in countering anti-tobacco efforts. The industry is relentless, well-funded, and well-connected. Anyone working on tobacco control must understand this and learn how to cope with it.
Q3. RWJF has been a big funder for many years. You have joined forces with a few other voluntary organizations to co-finance projects (like ACS and Legacy) but I still have the impression (maybe wrong) that there are not that many other organizations willing to invest so much in tobacco control. Could they think this is RWJF's special cause so they choose not to get involved?
Steven Schroeder: It is hard to claim that RWJF's efforts in tobacco control crowded out other funders, since there were no private funders before we entered the field. Now ACS and Legacy are major players, and I hope that others will join. It would be a mistake to think of any funder "owning" a field, especially one as important as tobacco control. I think the case for investment is stronger now than it used to be, because we and others have shown that support goes a long way, and the public health relevance is still so profound.
Q4. Can you tell us about your experience with Legacy? How different is it from RWJF? How do you envision its financial future?
Steven Schroeder: The American Legacy Foundation is a unique foundation. It was established as part of the Master Settlement Agreement with 46 Attorneys General, has a public-private board that includes six elected officials (2 governors, 2 attorneys general, and two state legislators) as well as five "private" members with expertise in public health and other related fields. There is specific language under which the foundation much operate. Under the payment formula, it is likely that funds going into the foundation will soon decline precipitously. Thus, the circumstances of its creation and operation differentiate Legacy from all other foundations. During its short life Legacy has been fortunate to have attracted a talented staff, led by its energetic and creative President, Cheryl Healton. It has supported a number of anti-tobacco programs, but is best known for its truth campaign, which is highly regarded and seems to have been an important factor in the recent decline in youth smoking.
Q5. You are back at UCSF. Can you tell us what your new position is about? What are now your priorities and goals?
Steven Schroeder: My position at UCSF is as Distinguished Professor of Health and Health Care, as well as Director of a RWJF-supported Smoking Cessation Leadership Center. The Center is premised on the following: of the 46 million smokers in the US; one third will die of smoking if they don't quit; 70% would like to quit yet most cannot; their chances of quitting are increased if they are encouraged by a health professional; yet most health professionals do not help their patients to quit. We will be working with leaders of the health professions to encourage their constituents to do a better job as cessation advocates. This is an area where even tiny improvement in performance can save thousands of lives.
Q6. Is there anything else you would like to add?
Steven Schroeder: Thank you and others like you for your courageous and important work. There are few fields where the stakes are so high, the potential rewards so great, and the opposition so formidable.
Thank you Steven for taking the time to be with us today.
Editor of Tobacco Control Rendez-Vous and The Tobacco Control Directory