March 16 2020

Painful lessons hurt, but are worth the pain if we learn from them.

Bear with me for a couple of paragraphs while I contextualize a critically important lesson that COVID-19 is teaching us about the health security of our nation.

Our foundation has just spent a decade and roughly $1 billion investing in the Building Healthy Communities effort.  We are proud of what our grantee-partners have accomplished in policy- and systems-change impact to advance health equity during this time.  But if we could reduce 10 years and dozens of lessons to a bumper sticker, it would be “A + B =C”.  “A” stands for Agency, “B” stands for Belonging, and “C” stands for Change – as in policy and systems change to improve health conditions and wellness.

“Agency” refers to what we know as People Power: the individual and collective assertion of power and voice.

“Belonging” is a multi-faceted theme: it combines spiritual, moral, and strategic meanings.  Spiritually, it suggests that we are connected to one another in our humanity, and that a higher purpose is served in the “we” and the “us.”  The terms social contract or social compact have been utilized to advance this notion. It means a vibrant, participatory democracy.  It means civic engagement.  It means community.  It means Churches, and Synagogues, and Mosques.  It means singing in the choir, and family reunions, and bowling league on Wednesday nights.  It means the free summer night concert in the park.   

Morally, it suggests access to health care and a quality education for all, for example, are rights and not privileges. 

Strategically, the idea of “Belonging” means the smartest and most efficient way to protect the health of the public is for everyone to be included in the system.  So, whether the culprit is COVID-19, or Influenza, or Tuberculosis, or Smallpox – the public’s health is best protected when ALL are welcome and covered in the system.  In other words, a “Health For All” system where no one is left out, co-pays and out-of-pocket costs are either eliminated or at least reasonable, public health programs and systems are adequately funded, and – no more stigmatizing, marginalizing, bigoted, anti-immigrant public policies like the Administration’s “Public Charge” policy – where the utilization of public services counts as a strike against you in the citizenship and naturalization process.

All of a sudden, policy efforts designed to spook immigrants from seeking medical care – for whatever it’s ideological attraction for a certain political constituency – looks just plain felony dumb when a global pandemic is unleashed.  While it’s never a good idea for a human being to hesitate to seek needed preventive or treatment care under any circumstances, it constitutes reckless endangerment for the public’s health during an outbreak.  Welcoming is good.  Fear and intimidation, not good for the health of the public and the community.

COVID-19 is wreaking substantial havoc with the health of our families, friends, and communities.  But when this thing is behind us, maybe – just maybe – our nation will learn a lesson about the power, the centrality, and the importance of Belonging.  “Belonging” is a beautiful thing to see, to watch, and participate in.  But it’s also a really smart public policy. 

Imagine that: Doing the right thing is also doing the smart thing.

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