Amplifying Stewardship Together
There is a growing group of people and organizations who understand the need for action that is grounded in what we are calling stewardship—action that enables all people to prosper and reach their full potential. We call these people and organizations stewards.
Every steward has an area of focus as it relates to improving well-being. Each of us has carved out our role in these respective areas, making up part of an ecosystem. Rippel’s is health. Other stewards focus on democracy, equity, the environment, placemaking, the economy, education, or some combination.
We’ve done a lot of hard work, and we’ve had many breakthroughs. Yet despite our significant investments in time and money, we haven’t made enough progress
toward well-being in the United States. A lot of us have been reflecting and many are asking: what can we do differently?
Stewards are people or organizations that are developing their ability to:
- Take responsibility for forming working relationships with others to transform well-being across a region.
- Serve as natural boundary spanners because they are informed by place-based, interdisciplinary, multisector, and multicultural perspectives.
- Understand that purpose must be larger than oneself and one’s organization, power must be built and distributed with others, and wealth must be invested to create long-term value as well as address short-term urgent needs.
The BIG Questions
How can we acknowledge our limitations, amplify our strengths, and expand our horizons?
Could we better achieve our goals if we work more cohesively and with a greater level of accountability to one another?
They open us up to other important questions, which we are also working to clarify through the project:
- How can we avoid pursuing narrow solutions when we know that barriers to well-being are complex and often can’t be “solved” by one sector or organization alone?
- How do we resist “quick fix” temptations when we know success depends on taking a long-term approach to problem-solving?
- How do we collaborate in ways that include all the people, organizations, and ideas that would strengthen our practice? In ways that recognize we can humbly learn from some marginalized cultures that have been encouraging us to work more cooperatively all along?
- How do we recognize one another’s strengths and see the potential of what we could do with greater alignment instead of magnifying our differences?
- How do we stop writing off those who might one day be effective stewards by wrongly assuming their intentions?
Amplifying Stewardship Together is about working as a group to openly learn from our independent and collective successes and failures, and seeing our differences as assets, so we can adapt our thinking and practices for a more inclusive, cohesive, and effective future. Because we work in such a complex and massive ecosystem that makes up well-being in the United States, we don’t assume it’s possible, or helpful, to create a giant infrastructure and set of processes to help us all work together. But we can lift up shared principles and practices to use as we each go about our own area of focus.
When we amplify these shared principles and practices in our daily work, we will naturally set the conditions that steward well-being across the country. Through this commitment we will create a shared identity and thus the opportunity to claim broader scope and power as part of a visible movement that is stewarding equitable ecosystems for well-being.
ReThink Health is working with leaders who act as stewards.
- A mix of local and national leaders
- Working in different domains affecting regional well-being: health, economy, environment, democracy, placemaking, education, and more
- Well-networked individuals working in well-networked organizations
- Successful for different reasons, so they can learn from one another’s strengths
- Diverse in race, ethnicity, gender, and age
Since our work is interdependent (whether or not we recognize it as such), we must show up in the world with greater context and understanding about what “stewardship” is today—who we are, what we are doing individually and together, what is at stake, and for whom.
Our activities in Amplifying Stewardship Together will focus on learning, adapting, and amplifying stewardship principles and practices so we can strengthen the foundation from which leaders can continue their efforts to steward well-being.
Our efforts must be grounded in reality (as opposed to our hunches) about what amplifies and weakens stewardship of well-being. We’ll conduct two nationwide studies to (1) examine long-term, nationwide trends that affect stewardship, and (2) learn the extent to which stewardship mindsets and practices have spread and are aligned in regions across the United States.
We must adapt based on what we learn together. We’ll convene to deepen our stewardship practice by understanding and confronting the dominant patterns of thinking and sticky issues that hold us back in our efforts.
We must amplify stewardship principles and practices. Together we’ll shine a light on the broad scope of stewardship and the power we can have when each of us approaches our work with a shared set of principles and practices. We’ll share this common identity with other leaders—via their conferences, advisory groups, publications, and beyond—to invite them to work more cohesively and with greater levels of accountability to others who share their goals.
Meet Our Project Team
“It’s an exciting time to be part of the movement to transform health and well-being—new approaches to multisector collaboration are emerging, stewards are sharing ideas, and many are beginning to unify around a shared purpose for their regions.”—Jane Erickson, Project Director
Joined Rippel: 2013
Current Roles: Jane is project director of the ReThink Health initiative’s Amplifying Stewardship Together team. She also leads Rippel’s Organizational Learning and Evaluation team.
Career: Jane has worked with national philanthropies to advance social change for over a decade. Jane oversaw strategy and implementation of Rippel’s ReThink Health Ventures project (2016-2018), a large-scale project that advanced multisector stewardship approaches for health transformation. She also led numerous nation-wide research efforts to transform health, including the ReThink Health Pulse Check and research published in Health Affairs. Before that, Jane led Rippel’s communications and special projects with the executive team.
Prior to joining Rippel, she established and ran the grants department at the Clinton Health Access Initiative. Jane has also conducted research and led efforts to build civic engagement across communities in the US and internationally, including as a Fulbright Scholar in Indonesia and with the Center for Information and Research on Civic Learning and Engagement. She is currently a member of the Board of Trustees at Hobart and William Smith Colleges, her undergraduate alma mater.
More about Jane: Jane played varsity lacrosse in college, which brought her out east from her home state of Colorado. One of her favorite guilty pleasures is watching science fiction television shows, especially Battlestar Galactica.
Education: Syracuse University (MPA, MAIR), Hobart and William Smith Colleges (BA)
“Working with Rippel has been an opportunity to challenge business-as-usual and to create equitable opportunities for everyone to reach their potential for health and well-being.”—Tami Gouveia, Senior Project Consultant
Joined Rippel: 2016
Current Roles: Tami manages the ReThink Health initiative’s contributions to Well Being Legacies (a Well Being Trust project to connect and learn from leaders who are creatively reshaping well-being in their regions), and contributes as a thought partner to other ReThink Health projects.
Career: Tami led Rippel’s efforts to integrate equity, diversity, and inclusion into its organizational culture and its work with partners. She contributed to Rippel’s ReThink Health Ventures project and Rippel’s work with the California Accountable Communities for Health Initiative (CACHI). Before joining Rippel, she launched several nonprofit initiatives in substance abuse prevention and youth development. Tami was executive director of Tobacco Free Mass and the Massachusetts Prevention and Wellness Fund.
More about Tami: In 2018, Tami was elected State Representative of the 14th Middlesex District of Massachusetts.
Education: Boston University (doctoral candidate, MSW, MPH), Mt. Holyoke College (BA)
“ReThinking is the most practical thing any of us can do to change the future. It helps us see where we fit in a common system and shifts our own roles as change agents within a dynamic and democratic world.”—Bobby Milstein, Director of System Strategy
Joined Rippel: 2011
Current Roles: Bobby directs Rippel’s work on System Strategy, is a member of Rippel’s Strategy and Management Team, and is a Visiting Scientist at the MIT Sloan School of Management. Bobby is a principal contributor to the ReThink Health initiative’s projects Portfolio Design for Healthier Regions and Amplifying Stewardship Together. He also leads a suite of nationwide influence activities and coordinates ongoing development of the ReThink Health Dynamics Model, the Well-Being Portfolio Design Calculator , and other simulation tools that let leaders play out the consequences of their scenarios for change. In 2018, Bobby and four co-authors wrote the official brief that defines “health and well-being” as the central focus for the Healthy People 2030 Framework for the United States.
Career: Before joining Rippel, Bobby spent 20 years planning and evaluating system-oriented initiatives at the Centers for Disease Control and Prevention (CDC), where he was the principal architect of CDC’s framework for program evaluation. He received CDC’s Honor Award for Excellence in Innovation, the Applications Award from the System Dynamics Society, and Article of the Year awards for papers published in Health Affairs and Health Promotion Practice.
More about Bobby: Bobby once was a documentary filmmaker whose work was used by PBS to spotlight challenges of racism on college campuses. He also contributed storylines for The West Wing on how to get beyond zero-sum thinking when setting health priorities.
Education: Union Institute and University (PhD), Emory University (MPH), University of Michigan (BA)
“After many years in international work, I find Rippel brings me to focus on the local issues around health and well-being, for a better future for all humanity—locally and internationally.”—Sarah Rial, Program Coordinator
Joined Rippel: 2017
Career: Sarah was previously program director for the nonprofit My Sister’s Keeper and served as senior executive assistant at Management Sciences for Health. Sarah is founder and president of Global Partnership for Peace in South Sudan, which engages South Sudanese communities across the globe in working collectively for peace and social justice.
More about Sarah: Sarah has received numerous awards for her work as a community organizer, activist, and advocate, including the 2010 Eleanor Roosevelt Award for Human Rights. Her activist colleagues have described her as, “A warrior sister with a quiet wisdom.”
Education: The American University in Cairo (MA); University of Massachusetts (GradCert), University of Juba (BS)
“I believe that the health of communities is ultimately shaped by who is and isn’t at ‘the table.’ I’m excited to be part of a team that is boldly imagining a more equitable future while also developing tangible steps to take towards that future.”—Iueh Castro Soh, Project Manager
Joined Rippel: 2019
Career: Iueh cares about building healthy communities and developing leaders. He was previously a management consultant at Oliver Wyman where he advised C-suite executives in the provider, payer, and life science space. He focused primarily on helping health systems develop and pursue a population health strategy amid shifting competitive and reimbursement pressures. In 2018, he worked in the Boston Mayor’s Office of New Urban Mechanics, a civic innovation team. There, he pioneered Rebuilding Together, an ongoing meeting group and advisory council that aims to develop returning citizen (formerly incarcerated) leaders and reshape their image in Boston. Iueh has also served as a volunteer community organizer on racial and economic justice campaigns in Oakland and Boston. At Rethink Health, he is currently authoring a report investigating the role of community organizing on shaping the role of local healthcare systems.
More about Iueh: Iueh loves to hunt for tasty street foods—especially tacos. You can often find him at a park playing pick-up basketball to decompress and get to know his neighbors.
Education: Haas School of Business, University of California Berkeley (BS), Harvard University Kennedy School of Government (MPP)
Stewardship and Public Service: A Discussion Paper
From the Field
This discussion paper prepared for the Public Service Commission of Canada presents stewardship as a bridge between purely market-based approaches and broader public sector responsibilities. While market-based reforms have shown many possible outcomes, they are not robust enough to embrace the full range of public sector activities, such as governance and guarding the public interest.
The Concept of Stewardship in Health Policy
From the Field
This World Health Organization Bulletin traces the history of stewardship and explores its potential as an avenue for public policy to effectively and efficiently improve health and well-being.
The World Health Report 2000: Health Systems: Improving Performance
From the Field
This report from the World Health Organization dives deep into resource allocation and performance quality in the health care system circa the year 2000. It’s notable for its emphasis on stewardship as a critical part of improving that system.
Health Stewardship: The Responsible Path to a Healthier Nation
From the Field
The Aspen Institute published this paper explaining the value of health stewardship and making a case for its importance for successfully navigating the challenges facing the system that produces health and well-being.
What Help is a Steward? Stewardship, Political Theory, and Public Health Law and Ethics
From the Field
As part of The Northern Ireland Legal Quarterly journal’s special issue on ‘super-stewardship’ and the related work of Roger Brownsword, this paper critically examines stewardship in public health.
Achieving Accountability for Health and Health Care Minneapolis, MN
From the Field
This article in Minnesota Medicine proposes Accountable Health Communities (AHCs) as a way to establish health system stewardship. They would to review local data against the Triple Aim, create shared goals and investments, and involve citizens in reform and stewardship.
Stewardship: Choosing Service Over Self-Interest
From the Field
In this book, Peter Block asserts that a fundamental shift in how we distribute power, privilege, and the control of money—away from self-interest and toward stewardship—can transform every part of an organization for the better, and he examines the nitty-gritty of implementing these reforms.
An Introduction to Network Weaving
From the Field
Building effective networks is one of the key tasks for a steward. This practical guide by June Holley teaches basic skills for doing just that.
The Three Horizons: The Patterning of Hope
From the Field
Bill Sharpe wrote this introduction to the Three Horizon’s framework, which can offer stewards a way to manage innovation and transformational change along the short, medium, and long term.
Core Attributes of Stewardship; Foundation of Sound Health System
From the Field
This International Journal of Health Policy and Management Perspective offers one way to look at stewardship, positing that it has five core attributes: responsible management, political will, a “normative dimension” (equity), balanced interventions, and components of good governance.
Promoting Population Health Through Financial Stewardship
From the Field
This Perspective in the New England Journal of Medicine argues that physicians have an ethical responsibility to act as stewards to promote their patients’ health and well-being.
2016 Pulse Check Survey Findings
These results shaped the development of ReThink Health’s Pathway and Essential Practices by illuminating the characteristics of regional multisector partnerships. The survey explored the following questions: What is the nature of the work stewards do in these partnerships? How does stewards’ multisector partnership work develop over time? How do they advance their work? What barriers to advancement do they face? How do stewards finance their multisector partnership work?
Public Involvement and Health Research System Governance: a Qualitative Study
From the Field
This article in Health Research Policy and Systems describes an exploratory, qualitative study of specific active stewardship efforts in two countries: England and Canada. It illustrates some of the benefits of stewardship while identifying three sets of common issues across both locations.
Regional Stewards: Nudging Systems Toward Health and Well-Being
Stacy Becker, Vice President, Programs
Stewards can’t control outcomes in a complex adaptive system, but they can nudge them in the right direction. Using the ReThink Health Pathway, stewards can contribute to shifting mental models away from health care alone and toward the full range of factors that produce health and well-being.
World Health Organization: Stewardship Resources
From the Field
The World Health Organization has collected resources related to stewardship, with an emphasis on the health care sector.