What We Can Achieve By Working Together

Jan 13, 2015, 10:49 AM, Posted by

As part of our What’s Next Health series, RWJF regularly talks with leading thinkers about the future of health and health care. Recently, we spoke with Nate Garvis, founder and author of Naked Civics, about entrepreneurial thinking and how it can be applied to building a Culture of Health. RWJF Director Marjorie Paloma reflects on Nate's approach.

What would you be willing to do to learn?

This is just one of many provocative questions Nate Garvis of Naked Civics is asking the Foundation as we look to build a Culture of Health.

Many times, we come across people who seem to have all the answers. But Nate doesn’t pretend to. Instead, he uses questions that help us journey through an issue, guiding us toward a new type of discovery process—one that takes us to uncomfortable places and challenges us to work with unlikely bedfellows.

Traditionally, when the Foundation set its sights on an objective, it is specific and measurable. The very definition of the problem prescribes our approach and whom we need to work with to accomplish our goals. For example, if we want to extend health care coverage to all, our traditional path leads us to work closely with researchers, policymakers, insurers, and other groups within our typical ecosystem, toward a goal that we can measure. This work is hard, long, and at times painstaking, but the path seems straightforward.

But when our goal is more abstract—like building a Culture of Health—the way forward is by definition less certain.

This is why Nate’s approach is so appealing. During his talk, he challenged our thinking regarding where culture comes from (look around, it’s everywhere in the background), and how it can be built (usually not by one person, but by creating together with others).

Headshot of Nate Garvis Nate Garvis

The reality is that the people who will shape a Culture of Health are not necessarily the shapers of the traditional health care system. And if we, as a nation, are going to build a Culture of Health then we must be open to new forms of discovery, flex new muscles, and be willing to find common cause.

So as Nate would ask—“Who are you willing to work with and what can you co-create?

Take business, for example. Under a more traditional approach, we have developed checklists and toolkits to show the important role that businesses can play to promote health. But our vision to build a Culture of Health leads us to contemplate a new and unknown space with business, given its undeniably outsized influence on American culture.

So what can we do with business that would accelerate the building of a Culture of Health?

How can we stimulate the market for healthier products?

How can we make healthy workplaces the norm?

Where can we bring different businesses, foundations, organizations, and government together to advance shared values and goals?

The first thing guiding our actions is our responsibility to ensure that all of our resources—our funds, our people, and our knowledge—are used only for charitable purposes. This is important because, as a private foundation, we may use our resources only to further charitable purposes; any benefit we confer on a private business must be incidental to the charitable purposes served. So the opportunity and the challenge here is to collectively discover ways to work together that advance the Foundation’s charitable mission.

Some might ask, “How can it be charitable to work with a business whose motive is to make more profit?”  Great question. In general, we can’t provide support to a company to fund its usual business operations or provide a company with free services that it could get from other commercial providers. But there are some things we can do. For example, we might convene businesses to develop ways to invest in community infrastructure to promote health. We might work with chambers of commerce on programs that make clear the connection between education, income, jobs, and health. Or bring together businesses, community members, and non-profits to create a roadmap for strategic, coordinated investments in the communities where their employees and customers live and work.

Consider the fast food industry. Some might say there’s no rationale for us to collaborate in this space. It might be tricky, but there are approaches we can take. While it probably would not serve a charitable purpose to advise an individual company on how it might better promote healthy products, we might design an evaluation of a group of fast food companies’ efforts to promote health through their products, and then issue a report card on the results. Or we might issue a challenge to companies to improve their products’ nutrition and recognize those who make the most improvements. Or we could sponsor a contest among chain restaurants to redesign kids’ meals, with parents and kids as the judges—a take-off on the Pillsbury Bake-Off. A prize could be given in the in the winning company’s name to one of the Culture of Health Prize communities.

Who knows what we could achieve by working together?

Stay connected

Marjorie A. Paloma, M.P.H.

Marjorie A. Paloma, M.P.H.

Interim Vice President

If reading this makes you feel a little nervous, then you’re not alone. Frankly, it makes us a little nervous, too. We are just beginning this journey of discovery. We hope it will lead to concrete ideas and actions that allow us to learn and adapt quickly. We also hope that it helps us build a more entrepreneurial mindset, and that we learn a new set of skills. We have a hunch that smart risks can produce big rewards for our nation’s health.

Watch the video below for more on Nate Garvis and view an infographic about an entrepreneurial approach to change. Follow the #whatsnexthealth conversation on Twitter.

Infographice: An Entrepreneurial Approach to Change