Don’t Just Fix the Sh*tty Systems that Broke: A Social Contract for Resilience
Bobby Cochran, Shift Health Accelerator
Jen Lewis Walden, Shift Health Accelerator
Grace Kyung, Shift Health Accelerator
COVID-19 Recovery Represents a Choice
In the wake of the 2008 Great Recession, the federal government acted quickly to shore up banking institutions and to spur consumption. Those actions worked, yeah? Unemployment rebounded to historic lows, stock portfolios grew in value, and home prices boomed in many places across the country.
But that recovery did not create resilience. It didn’t create resilience because it left people behind and furthered inequality. Unemployment in rural areas remains high, even while jobs roared to life in urban centers. Wages remained stagnant and unemployment high for Black, Native American, and Latinx communities. We have not reconciled with the values underpinning our systems and their roots in 400+ years of inequity. The focus on “shovel-ready” projects as part of the 2008 ARRA bill allowed high capacity states and towns to secure low-cost infrastructure money, but yet again, did not invest in the social infrastructure needed for collaborative problem solving or the capacity to help small and low-income towns build their own futures.
So when COVID-19 erupted into a pandemic, the cracks of inequity in our critical systems were magnified — systems that provide us food, work, health, housing, mobility, and access to capital. Essential workers have always been essential, so decisionmakers have a choice, we can rebuild exactly what broke, or we can chart a new path to equitable recovery centered with community.
Community defined: A group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.
Our community
The elements of an updated social contract between communities and their governments reflect input directly from community health leaders. The concepts also draw from A) principles for equitable investment created by Shift Health Accelerator and others, and B) the direct asks of some communities for government in this time of COVID-19 recovery.
Imagine a world where communities maximize their potential for health, well-being and quality of life, and where dignity, hope and self-determination are measures of well-being.
A Social Contract for Recovery between Communities and Their Government
A social contract is an agreement that makes clear the expectations for a relationship between people and their government. Any equitable recovery will require government-community agreements that should consider these principles:
Driven by priorities & needs of the most impacted
Many federal funds are allocated based on formulas (e.g., based on population or income) that don’t match the needs of people most impacted by COVID-19. Early data is showing that black, immigrant, gig worker communities have been hit hardest by COVID-19 and related economic impact. Rural areas are also likely to be hit hard (Propublica, 2020).
Federal investments should be driven by needs and priorities in the most impacted communities, especially in rural places. This means we need to ask and listen to what those priorities are; we need data and data systems that are able to reflect what we know and don’t know about this pandemic; and there are local organizations all over the country who are hearing what their communities need.
Put capital into the hands of community-led coalitions
State and local government are not the only, and not always the best intermediaries between the federal government and communities. There are collaboratives, nonprofits, Community Development Finance Institutions, and other coalitions who specialize in delivering capital to impacted communities. These institutions are not the normal clientele for the Small Business Administration or the Federal Reserve Bank. But we can and should be putting capital investment decisions into the hands of communities wherever possible. For example, the Hawaii Good Food Alliance has set up a Good Food Fund where capital is being invested to connect local farmers and good food directly to the food pantries and other emergency food relief.
Don’t recreate the systems that broke
When the cracks in systems broke open (e.g., access to food, housing, and work), some governments stayed within the boundaries of those broken systems, and others innovated. Moving into recovery, we need to make sure we do not just rebuild the crap that broke, and make permanent some of the experiments that are the beginnings of equitable recovery.
The Supplemental Nutrition Assistance Program provides free breakfast and lunch to school kids, and continues to do that during the COVID-19 pandemic. Some states chose to maintain the requirement that kids be present at school to receive food, and other states recognized that bringing the whole family to school presented an unnecessary public health risk and burden. Working families shouldn’t have to worry about free and reduced school lunch, and we need different ways to access emergency food relief when needed.
The CARES Acts implemented early and temporary versions of paid sick leave, universal basic income, Medicare reimbursement to care for uninsured COVID-19 patients, and student loan payment suspension (Nonprofit Quarterly, 2020). These are the kinds of system changes that should be made normal, and permanent.
Cities rapidly created capacity for additional shelter beds and housing. That speed of mobilization should be recreated to resolve homelessness, remove lead from drinking water pipes, and other acute, immediate threats to public health and wellbeing.
The Small Business Administration loans didn’t work for rural nonprofits with all-volunteer staff, and they didn’t work for immigrant service groups. There are myriad examples of government programs that warrant assessment and as we rebuild, we should ensure that the cracks are fixed.
Invest in social infrastructure, not just construction
We know that past recovery dollars flowed toward bricks and mortar investments and more quickly toward those that were shovel-ready. This didn’t rebuild our communities, our sense of hope and wellbeing, our connections to one another that are the cornerstone of resilience.
But communities with strong community-based collaboratives are already mobilizing quickly, demonstrating that social infrastructure does matter to our decisions today and their impact on the future. In Klamath Falls, Healthy Klamath already had committees that linked healthcare, food, and social services. Leaders from the hospitals, business, city, and schools were already working together. They have been able to quickly coordinate responses.
We know that rebuilding will need to invest in cultivating pathways for community leadership to thrive and that diverse voices, perspectives, and approaches will make us stronger as a society. For example, the Robert Wood Johnson Foundation’s Culture of Health Leaders program is growing health equity leaders in 160 communities. States and regions can also double down on lifting the capacity of leaders.
Invest in projects that match a vision of the future — multi-generational, multi-benefit, and just
We do need near term response, and we also need investments in what tomorrow will look like. Past crises have used an intergenerational lens to increase sovereignty, create social supports, and solve for multiple challenges at once. In a recent conversation in the Northwest, a community leader said that the key to recovery is re-centering indigenous values. Northwest tribes use seven generations as their planning horizon. Decision-makers need to apply that intergenerational lens to every action. For example, office parks can create open spaces that capture floods and keep homes safe, community health workers can be based in schools, and land can be made available for small farmers to grow sustainable, good food for their community.
Toward Tomorrow
At Shift Health Accelerator, we are committed to an equitable future. An equitable future is resilient and healthful. Join us. Share these principles. Incorporate the principles into your recovery and resilience strategies.
Who Shift Health Accelerator Is
Shift Health Accelerator is a group of diverse leaders that hold a vision for a healthy and just society — one with the relationships and power to anticipate and recover from environmental, social, and economic shocks. Shift Health Accelerator teammates all met as part of the Robert Wood Johnson Foundation Culture of Health Leaders, which now connects us to 160 leaders in 47 states working to advance health equity.