September 27, 2016
It seems to me that the world of health care is changing faster that many of us realize, and in ways that many of us don’t fully understand, including me. My hope, however, is that we are truly at the start of a transformational shift from treating the individual to a focus on the community’s well-being. This will involve nontraditional partnerships and collective action – what I see as the promise of Accountable Communities for Health (ACH) in Vermont: bringing together people, institutions and programs that impact the social determinants of health and holding ourselves collectively accountable for the health and well-being of a whole community. This is a complex undertaking, and the recipe for success requires a commitment to step outside our comfort zone.
As CEO of the Vermont Foodbank, hunger is my “lane.” Forty years ago food banks thought we could end hunger by capturing all the wasted food we saw and delivering it to people who couldn’t afford enough for themselves and their families, usually through existing community groups and faith-based organizations. However, the community need outpaced the food banks’ capacity to access and distribute more food, and we struggled to understand why we weren’t making sustained progress. With experience and more sophisticated understanding of systems, we’ve realized that hunger can’t be solved without understanding and addressing the complex interconnections of our neighbor’s lives.
Yet we still struggle to understand the interconnectedness and interdependence of the social/political systems we have constructed over the years – a hodgepodge of stovepipes you might say. Access to health care, food, housing and meaningful work is essential to family stability and health, and many of our neighbors can’t fulfill those needs on their own. Programs designed to help often separate these interdependent needs into “program” areas that create another stovepipe. We’ve designed systems that don’t do what we really want them to do – help families achieve stability.
The systems need to change, but before that can happen we need to understand why the systems don’t work. Accountable Communities for Health are an opportunity to take some steps forward along that path. Inviting nontraditional partners (like the Vermont Foodbank) to the table is a first step. It takes courage. You may not think the community housing agency or the regional planning commission understands the work you do. And you’re probably right. Spending the time to understand each other takes patience and persistence. Building a trusting relationship with your partners and maintaining it takes resilience. But with the right people around the table you can start understanding those complex interconnections and interdependencies that stand in our way. You’ll need everyone’s commitment to the shared ACH goal of community health and well-being.
This work is beginning to happen around the country. We’re excited to be part of a pilot right here in Vermont, funded by Feeding America (http://www.feedingamerica.org/hunger-in-america/news-and-updates/hunger-blog/finding-real-hunger-soluntions.html) that is ground testing the theory. It also happens to be an ACH that is part of the work we are all doing together. You can learn more about the work we’re doing at https://www.vtfoodbank.org/nurture-people/collective-impact
Bring your resources, learning and perspective to the table – and leave your organizational ego at home. Discover how our social and political systems interconnect. Recreate adaptive systems that understand those connections. Be willing to change what you do to help the whole community reach its shared goal. You will see lots of barriers at first (regulations, policies, “the way we’ve always done it,” other partners’ stubbornness) but don’t give up. I can’t solve hunger without you, and we can’t create community health and well-being without each other.