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The Stew BLOG

What Will it Take for Regional Leaders to Reallocate Resources in Ways that Ensure Our Well-Being?

Anna Creegan, Project Director | 02/25/2020

This month, The ReThinkers’ Blog is introducing ReThink Health’s three projects in which we are working with national and regional stewards as they discover what it takes to drive transformative change and produce better health and well-being for all. Today, Anna Creegan describes how we are supporting stewards as they build on their work to be more interdependent and reallocate resources as a means to improving their regional health ecosystem.

Whether you are aware of it or not, the region you live in has a portfolio of investments being made toward the health and well-being of its population. Few of us really think about it that way, however, because it’s not a coordinated set of investments from some kind of single, regional purse. Instead it’s a group of mostly siloed investments that each organization impacting health and well-being is making on its own.

When regional stewards begin to wonder about their potential to bring about the kind of ecosystem their region really needs for health and well-being, it’s worth asking whether the region’s existing portfolio of investments is effective. And, if it isn’t, what’s the path stewards could take to ensure effective resource allocation in the future? ReThink Health’s Portfolio Design for Healthier Regions project is working with stewards as they take on these important questions, to begin to figure out how to answer them.

Getting Started

In 2018, ReThink Health released the Negotiating a Well-Being Portfolio Toolkit, a tool we had been testing with stewards working together in regions across the country for a few years prior. In our tests, we asked every steward in the room to consider where the investments they have some say in are directed, write them on sticky notes, and place them on the wheel.

The wheel has two sides: one for efforts that provide urgent services (the kind anyone under adversity would need to temporarily regain or restore their health and well-being) and one for the efforts that not only have the potential to improve health and well-being but also prevent harm and avert the need for urgent services.

Efforts on this second side of the wheel seek to create vital, systemic conditions that people depend on to be healthy and well. They are usually tackling problems at the system level, whereas urgent services are tackling important problems with solutions that will only address the problem on a temporary, isolated basis. Urgent services will always be needed, but there is a question about how much they’ll be needed as stewards improve their region’s vital conditions. What will it take for stewards to reallocate resources in different ways, over time, to pursue the equitable regional ecosystem they know they need for health and well-being?

Shifting Mindsets

With the region’s current investment portfolio now made more visible, stewards see they are doing great work they can be proud of. And yet when we move to the next part of the exercise, where we ask if that’s their ideal portfolio, stewards begin to have more strategic conversations almost immediately. They begin to consider how investing more in vital conditions could eventually alleviate adversity, avert costly urgent services, and assure more equitable opportunities for everyone to reach their full potential.

They also notice gaps in some urgent service areas and overabundance in others given health needs they currently face (which raises new questions, such as: do current epidemics, such as a mental health or opioid crisis in a region, have enough resources for relevant urgent services?). The sticky note placement also shows stewards where system level changes to bring about vital conditions in a region may be beginning to take shape and where they could expand.

Shifting the stewards’ mindsets in this way is just a start. We’d love to share a fairy tale ending: “and in the end, stewards made a strategy by which the ecosystem that produces well-being in the region could be transformed, and then all the money magically went to the right places to make it happen immediately.” But as with most fairy tales, that would be completely unrealistic. After all, every regional player involved has their own purse and most have vested interests in keeping and growing what’s in it.

Figuring out the Best Ways to Nudge Forward a Shift in Practice

ReThink Health’s Portfolio Design for Healthier Regions project is working with stewards from four regions who have agreed to be our learning partners in figuring out what it would take to begin to shift investment portfolios. They include:

  • 5 Healthy Towns, MI
  • El Paso County, CO
  • Fox Cities, WI
  • Palm Beach County, FL

Each of these partners is recruiting fellow stewards to join the effort, selecting organizations who “hold purse strings” that may significantly impact health and well-being in their respective regions. For example, local governments, philanthropy, corporations, etc. The 12 they’ve identified have “skin in the game,” making them the right partners for ensuring this project can help other stewards interested in pursuing regional portfolios that more effectively cultivate equitable health and well-being over time. (Visit our web page to learn more about the stewards involved in each area.)

Together with these groups, ReThink Health will develop and share tools and processes that will help all interested in stewardship (even those not involved in this project, but interested in exploring resource reallocation in their regions):

  • Each see their own, current contribution to the regional portfolio and use that as the basis for understanding their own role in the regional ecosystem for health and well-being as it exists today.
  • Explore the processes and motivations that enable stewards to connect their own institutional interests and investments with an ecosystem designed to produce vital conditions in addition to meeting urgent needs.
  • Understand the constraints inhibiting stewards from varying types of institutions as they are presented with opportunities to make shifts in their mindsets, their role in an interdependent ecosystem, and their approach to allocation of resources.

My team invites you to explore our project web page and follow us on social media to learn more about this work. We also welcome any ideas and insights: ThinkWithUs@rethinkhealth.org On social media, #ThinkWithUs