John A. Hartford Foundation

The John A. Hartford Foundation is a private United States philanthropy headquartered in New York City. Established in 1929 by John Augustine Hartford, and later joined by his brother George Ludlum Hartford, the foundation was created by members of the family associated with the Great Atlantic & Pacific Tea Company, commonly known as A&P. Its long-standing guiding purpose has been to pursue “the greatest good for the greatest number.” Unlike a commercial brand, the foundation does not sell products or operate for shareholder return; it uses an endowment and grantmaking partnerships to influence health-care practice, professional education, research, public policy, and community-based services. During much of the twentieth century, the foundation supported research and education in basic and clinical medicine, health-care quality, and health-care costs. It was at one point among the largest philanthropic funders in these areas. Beginning in 1982, the foundation increasingly directed its resources toward the care of older adults, responding to the limited capacity of the United States health system and professional workforce to serve an aging population. In 1994, aging and geriatric care became its central mission. From roughly 1980 through 2012, a major portion of the foundation’s work concentrated on building the workforce and academic infrastructure for geriatrics. Grants supported medical schools, nursing schools, schools of social work, professional associations, research centers, fellowships, curriculum development, and interdisciplinary education. Its medical initiatives included Centers of Excellence in Geriatric Medicine, the Paul Beeson Physician Faculty Scholars in Aging Research Program, and support for geriatric scholarships, residency programs, and curriculum work. In nursing, it helped establish the John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing and supported centers of geriatric nursing excellence. Its Geriatric Social Work Initiative sought to make aging competence a stronger part of social-work education and field training. The foundation has also funded and promoted models intended to improve care delivery. These include Programs of All-Inclusive Care for the Elderly, interdisciplinary team care, Hospital at Home, Acute Care for the Elderly, Nurses Improving Care for Healthsystem Elders, and palliative-care programs. It has supported evidence generation, dissemination, policy discussion, and communication with grantees and other stakeholders. In 2008, it led a group of funders supporting an Institute of Medicine study on the inadequacy of the health-care workforce and outdated care models for older people. Its current grantmaking is organized around three connected priorities: Age-Friendly Health Systems, Family Caregiving, and Serious Illness and End-of-Life Care. The Age-Friendly Health Systems work seeks to spread evidence-based practices throughout hospitals, health systems, homes, and communities. The family-caregiving portfolio addresses the large number of people who provide unpaid care to older relatives and aims to improve identification, assessment, preparation, and support for caregivers. The serious-illness and end-of-life portfolio promotes palliative care, better communication, workforce preparation, dignity, and care that reflects the preferences of older adults and their families. In 2016, the foundation launched the Age-Friendly Health Systems initiative with the Institute for Healthcare Improvement, the American Hospital Association, and the Catholic Health Association of the United States. The foundation does not solicit ordinary new donations as a core operating model and invests undistributed assets to support future grantmaking. It has no stated closure date. Its work has helped make geriatric medicine, nursing, social work, interdisciplinary care, caregiver support, and age-friendly systems more visible in American health policy and professional educ…

The John A. Hartford Foundation was founded in 1929 by John Augustine Hartford in New York City. His brother, George Ludlum Hartford, later joined the foundation. The family was associated with the A&P grocery business, but the foundation developed as an independent private philanthropy rather than as a retail operating company. Its founding principle was to seek the greatest good for the greatest number. In its earlier decades, the foundation made grants across medicine and health care. Its support included basic and clinical medical research as well as work concerning health-care quality and costs. Over time, the foundation became especially important as a source of philanthropic support for academic medicine and professional education. Its activities were not limited to direct services: it also funded institutions, researchers, educators, policy organizations, and demonstrations intended to change how health care was organized. A major strategic shift began in 1982, when the foundation turned toward improving care for older adults. At that time, geriatric medicine and related disciplines had limited institutional capacity in the United States, and older people were often served by systems that were not designed around their needs. In 1994, the care of older adults became the foundation’s principal mission. From the 1980s through the early 2010s, the foundation pursued a broad field-building agenda. In medicine, its Centers of Excellence in Geriatric Medicine, established in 1986, supported academic departments and helped develop physicians, educators, and researchers. The Paul Beeson Physician Faculty Scholars in Aging Research Program, launched in 1994 with other philanthropic partners, created a three-year pathway for physician scholars working in aging research. The foundation also supported medical-student scholarships, residency programs, curriculum development, and efforts to connect geriatrics with internal medicine subspecialties and surgical fields. Nursing became another major area of investment. In 1996, a $5 million grant helped establish the John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing, described as the first United States institute of its kind. The foundation supported nursing organizations, academic curricula, student exposure to aging care, and centers of geriatric nursing excellence. It also invested in social work through the Geriatric Social Work Initiative, which worked with professional educators on curriculum, scholarships, fellowships, and supervised field experience. The foundation’s work expanded from workforce development to care-model innovation. It supported Programs of All-Inclusive Care for the Elderly, which combine health and social services for eligible older adults in community settings. It also helped develop and evaluate interdisciplinary teams, Hospital at Home, Acute Care for the Elderly units, and Nurses Improving Care for Healthsystem Elders. Beginning in 2006, its support for the Center for Palliative Care at Mount Sinai Medical Center became a prominent part of its serious-illness work. The foundation also supported policy seminars, national reports, communication programs, and research into the organization and financing of care. In 2008, the foundation led a consortium of grantmakers that supported an Institute of Medicine study concerning the ill-prepared health-care workforce and outdated models of care for older adults. Around 2013, its grantmaking was organized into portfolios covering interprofessional leadership, links between education and practice, care-model development and dissemination, quality tools and measures, and policy and communications. During 2015 and 2016, the foundation consolidated its strategy around age-friendly health systems, family caregiving, and serious illness and end-of-life care. In 2016, it began the Age-Friendly Health Systems initiative in collaboration with the Institute for Healthcare Improvement, the American Hospital Association, and the Catholic Health Association of the United States. The initiative sought to spread practical, evidence-based approaches across health systems and community settings, with attention to outcomes, avoidable harm, patient goals, and coordination across the continuum of care. The foundation has also issued special grants in response to events including the September 11 terrorist attacks and Hurricanes Katrina and Rita, often emphasizing preparedness and protection for older people living in institutional settings. Since at least 2004, it has communicated with stakeholders through an electronic newsletter, and beginning in 2006 it supported grantee-perception work and developed the Health AGEnda blog. The foundation remains an active private philanthropy with no announced termination date, using its invested assets to sustain grantmaking for older adults, caregivers, and the health-care workforce.

1. 2016Age-Friendly Health Systems initiative launched

   The initiative began with the Institute for Healthcare Improvement, American Hospital Association, and Catholic Health Association of the United States.

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2. 2013Grantmaking reorganized into five portfolios

   The foundation organized its work around leadership, education and practice, care models, quality tools, and policy and communications.

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3. 2008Workforce study consortium supported

   The foundation led grantmakers supporting an Institute of Medicine study on workforce preparedness and care models for older adults.

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4. 2006Palliative-care investment expands

   The foundation began a significant period of support for the Center for Palliative Care at Mount Sinai Medical Center.

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5. 1996Geriatric nursing institute established

   A $5 million grant helped establish the John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing.

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6. 1994Aging becomes the chief mission

   Improving the care of older adults became the foundation’s primary mission.

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7. 1986Centers of Excellence in Geriatric Medicine begin

   The foundation launched a major effort to build academic capacity in geriatric medicine.

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8. 1982Strategic focus shifts toward older adults

   The foundation began concentrating more strongly on improving care for older people.

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9. 1929Foundation established

   John Augustine Hartford established the private foundation in New York City; George Ludlum Hartford later joined it.

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A long-term, field-building health philanthropy that uses grants, research partnerships, professional education, and policy engagement to improve care for older adults and their families.

• 2016Age-Friendly Health Systems

  United States

  A national collaboration designed to help health systems adopt evidence-based practices that improve outcomes and reduce preventable harm for older adults across hospitals, homes, and communities.

  Outcome. The initiative became a central vehicle for spreading age-friendly care models through health-system and community partnerships.

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• 2016Launch of Age-Friendly Health SystemsStrategy

  The foundation sought to move beyond isolated grants and spread evidence-based practices through entire health systems and community networks.

  What changed. It partnered with the Institute for Healthcare Improvement, the American Hospital Association, and the Catholic Health Association of the United States to launch the initiative.

  Aftermath. Age-friendly systems became one of the foundation’s three principal priority areas.

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• 1982Shift toward aging and geriatric careStrategy

  The foundation identified a growing need for philanthropic attention to the care of older adults and the limited capacity of the geriatric workforce.

  What changed. It redirected an increasing share of its grantmaking toward older-adult care, education, and research.

  Aftermath. The shift led to a long-term focus on geriatrics and ultimately made aging the foundation’s chief mission in 1994.

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1. John A. Hartford Foundation
2. John A. Hartford Foundation official website
3. Age-Friendly Health Systems