Public interest in health policy has intensified dramatically in recent years, as concerns about the nation's health and the health care system have grown. Compared with other industrialized nations, the United States continues to perform poorly on numerous indicators of health status. And though health care expenditures continue to rise, an increasing proportion of Americans are either uninsured or under-insured. Further, health care delivery systems are reorganizing and consolidating in response to competitive pressures in the marketplace. Efforts to reform health care financing and delivery at national and state levels pose serious challenges in terms of policy formulation and implementation. Moreover, problems with deep economic, political and social roots — such as substance abuse, AIDS, depression, racial and ethnic disparities in care, some infectious diseases, and conditions associated with unhealthy lifestyles — continue to burden the health care system and public health agencies with challenges that lie beyond their traditional missions.

Today, as our nation struggles with ways to promote the health of its people and how best to improve access to health care, as well as its quality, equity and efficiency, the field of health policy research offers exciting challenges and opportunities. Clearly, any sector of the economy that consumes almost one-sixth of the gross domestic product deserves the attention of the most gifted scholars. As the health sector has grown in size and complexity over the past three decades, so too has the need for research and analysis to guide development of health policy at the national, state and local levels.

The social science disciplines of economics, political science and sociology have made important contributions to health policy research, providing useful and insightful frameworks for understanding and analyzing the health sector and its problems. In the current environment, marked by growing market forces, an aging population, the increased prevalence of chronic illness and of conditions associated with culture and lifestyle, a public health system in disarray, and a health care system in organizational flux, social scientists who will apply their disciplinary perspectives to the study of complex policy questions are badly needed. Some examples from each field follow.

Economists may inform the discussion by:

• Studying the economic burden of disease on different populations caused by disparities in access to care.
• Analyzing the effects of organizational changes on the cost and quality of care and on the willingness of competing organizations to serve diverse population groups.
• Assessing the effects of continued growth in health spending on federal and state budgets, as well as on other sectors of the nation's economy.
• Analyzing the implications and effects of different tax policies on the health and well-being of populations and of individuals.
• Evaluating the impact of hospital workforce policy changes on patients' health outcomes.

Political scientists may furnish fresh insights into such areas as:

• The ways in which legislative battles are strategically framed and fought.
• The role of public opinion in shaping policy formulation.
• The balance of power among major players that may shift as a result of changing policies.
• The influence that interest groups exert over health policy decisions.
• The forces that empower and mobilize communities to address health problems.

Sociologists may contribute to the policy analysis and debate by:

• Increasing our understanding of the effects of changes in the structure and organization of the health care delivery system.
• Assessing the impact of the changing roles and functions of health care providers.
• Providing a framework for understanding how social movements affect the nation's health.
• Expanding our knowledge of the socioeconomic and cultural determinants of health.

The interplay among all three disciplines, when brought to bear on any single issue, results in a rich, multidisciplinary perspective that enhances problem definition and resolution. To ensure that health policy research continues to benefit from these disciplinary perspectives — and from the interaction among them — the Foundation established the Robert Wood Johnson Foundation Scholars in Health Policy Research Program in 1992. It is part of the Foundation's rich history of programs and projects in our Human Capital Portfolio that seek to build and maintain a strong and diverse leadership and workforce in health and health care, as well as to help develop specific fields.