We Can Design the Future of Health
“We cannot talk about our future without thinking about our past and all that it holds. We must overcome some of it and carry other parts forward. It is both scary and hopeful.”
My colleagues and I heard sentiments like this over and over last fall as we listened to hundreds of people, across the United States, for a futuring project called FORESIGHT. People are asking for a new conversation about health and a better future for their families. They know this will require an orientation towards the future and a focus on reframing, redesigning, and regenerating the system we want: a system that is built around new ideas of health and well-being. Now with COVID-19, the need for change is ever more critical.
COVID-19 casts a new light on existing health inequities
Health inequities in the United States are not new but COVID-19 casts them in a more urgent light. According to a recent report from the Kaiser Family Foundation, Black people account for a higher share of confirmed cases and deaths compared to their share of the total population in most states. These disparities were particularly large in Wisconsin and Kansas, where they made up 39% and 33% of deaths respectively but only 6% of the population. In Arkansas, Illinois, Indiana, Michigan, and Missouri, the share of deaths among Black people was at least twice as high as their share of the total population.
The financial and social ramifications of COVID-19 also hit some much harder than others. These include people who live in poverty or do not have adequate savings to weather tough times. According to a recent Pew Research Poll, less than half of Americans have enough savings to survive for even three months of an economic downturn. The reason why is simple: math. As former Treasury Secretary Hank Paulson noted, many workers in the hospitality sector have an annual average income of $20,000. How can anyone save money in that situation?
Some people face more complicated layers of challenge. Immigrants who don’t speak English as a first language often have difficulty accessing accurate information. Undocumented workers who lose their jobs cannot access unemployment benefits. As the USC Center for Health Journalism Collaborative recently highlighted, day laborers are forced to choose between maintaining their health or working under the threat of virus. Survivors of domestic abuse are confronted with untenable situations and people experiencing homelessness are dealing with another layer of stress and potential outbreaks.
A new system for health that includes everyone
We must do better. Addressing our great health inequities starts with a radical rethinking of what it means to be healthy and how we can truly achieve well-being for all people in the U.S. — not just those with money and privilege. We need to design a bold, new system for health that centers around a diversity of voices and honors our interconnectedness.
That’s why 17 philanthropies from across the U.S. came together to launch FORESIGHT. It is a collaborative effort — uniting business, philanthropy, and thousands of people — to equitably envision and create a new future for health and well-being. This is a bold experiment that asks:
What if we look at the big forces that will shape health in the future; listen to thousands of people about their health hopes, dreams, and fears; and then bring all of those insights together to re-imagine what health could look like?
Nine game changers that could alter the future of health
We kicked off this initiative last year by working with a team of futurists who identified nine “Game Changers” that could alter the future of health, including the infusion of machines into all aspects of life, the simultaneous rises of authoritarianism and citizen-led movements, and the breakdown of our environment due to climate change. The global spread of COVID-19 has evidenced why this kind of analysis matters in policymaking and in everyday life.
The FORESIGHT team — working with more than 50 health leaders, tech gurus, community activists, and more — have used these Game Changers to develop a set of four scenarios of possible futures. Starting later this spring, we will ask thousands of people from all parts of the country to learn about the scenarios and react to them, telling us what excites and concerns them. The scenarios are provocative — designed to help people imagine radical possibilities.
A new vision for health that brings people together
We will collect many diverse perspectives, prioritizing groups that have traditionally been excluded from conversations about the future of health. That includes communities of color and Indigenous people, immigrants, and people with disabilities or experiencing homelessness.
We expect this process to unearth a new vision for health that brings people across the country together — because they will see themselves in it. We will get all the possible ideas onto the table and think about what we can build with them. We want communities across the country to grab hold of that vision and test out these ideas to see what takes root. How could communities make that vision come alive?
This will require everyone — corporations, policy leaders, community organizers, and more — to forge new partnerships and mindsets, a different allocation of resources, and a radical openness to experimentation. We all need to work together to create a country and a future where health equity can reign. As we heard early on, it is both hopeful and scary.
Over the next couple of months, we will publish a series of pieces that explores how some communities are already thinking about the future and factoring Game Changers into their work. We’ll hear how they are using technology and data to improve health, creating the vital conditions that support health in communities, and closely monitoring change so that everyone in their communities can enjoy healthier lives.
We also want to hear from you. FORESIGHT should involve as many people as possible. Will you be part of this game-changing effort to envision a new future for health? Share this article with your networks or visit our website to join the conversation.
