An Imperative for our Time: Defining and Supporting a Well-Being Agenda for Cities

This is guest post by Tyler Norris, chief executive of Well Being Trust.

Across America, city leaders — not just mayors and other elected leaders, but also philanthropists, business owners and community organization professionals — know that promoting health and well-being is not just about having enough hospitals and doctors. Over the past three decades, research has shown that quality education, a living wage and good jobs, affordable housing, reliable transportation, healthy food, family supports, safe neighborhoods and an experience of civic belonging all deeply impact our health.

In other words, the conditions that shape the long-term well-being of people today —and our children in the future — are mostly produced outside the health care system. From Anchorage, Alaska, to Burlington, Vermont; and from Omaha, Nebraska, to Orange County, California — scores of communities are embracing and acting from this knowledge. They are investing years or even decades bringing together people from all walks of life to take bold steps that advance comprehensive and systemic change to ensure intergenerational well-being for all.

This work is more important than ever, as deaths of despair (from suicide, opioids, alcohol) are projected to double in the next decade. It’s time to address the underlying hopelessness, loneliness and isolation and turn the tide for intergenerational well-being.

Based on learning from communities across the nation, here are four actions all city leaders and partners can take to foster well-being and ensure everyone has the opportunity to realize their fullest potential:

  1. Articulate a positive, long-term vision. America’s cities are places of opportunity and connection. By envisioning the possibility of optimal health for all, rather than using a frame only of problems, a more comprehensive picture takes shape, one of healthy housing, safe drinking water, adequate infrastructure and transportation, quality schools and jobs, and safe neighborhoods and streets. From there, leaders and community members can focus on creating intergenerational well-being by building civic capacity and making the best use of community resources to leave lasting legacies for future generations.

For example, spurred by high obesity rates, Greenville, South Carolina, launched LiveWell Greenville, a network of organizations promoting community change around healthy eating and active living that is lasting and intergenerational — and inclusive of job training and boosting economic mobility, ending homelessness, increasing affordable housing, and bolstering city transportation.

  1. Plan across the lifespan — and for generations. City residents of every age deserve the opportunity to be well. To make that possible, leaders must go beyond short-term health improvement projects that touch people only at particular moments, lacking sufficient reach, intensity and duration to deliver sustained population level impact across the lifespan. Policymakers are wise to plan supports that seamlessly transition from life-stage to life-stage, including healthy pregnancies, births, and post-partum recovery; early childhood education and development and school preparedness; supports for staying in school; mentoring and preparation for jobs and careers; mental and physical health care at all ages; supports for elders; and so on.

The point is to focus on long-term outcomes, not just short-term temporary wins, and thereby create a system of well-being that lasts generations.

For example, for generations, Algoma, Wisconsin, students graduated high school and faced the decision either to leave for opportunities elsewhere or to join the manufacturing labor force. Knowing that so much of the community’s legacy rests in its youth, leaders pursued innovative strategies to change the way the education system and local businesses interacted. Just a few years later, students are empowered to create mentorship programs, spaces and opportunities for residents of all ages to come together to build relationships through conversation and sharing a meal.

  1. Build on what’s already working. A good solution solves many problems. For example, supportive housing not only gives people a home with a roof and a key, it provides stability that enables them to work, routinely get the medication and services they need, and make sure their kids can focus on school.

And, many communities already have the puzzle pieces to create a more holistic system — pieces that, when knitted together, are more effective. For example, New York City’s comprehensive effort to improve the mental health system and promote wellness includes pairing mental health providers with social service nonprofits that work with low-income people. The providers train staff at the nonprofits to administer evidence-based mental health practices in the course of their work.

  1. Lead with humility. In the cities that have forged these exciting paths toward well-being, leadership is not about one person but rather about inclusion and cohesion. Together, community members build a coherent body of work that capitalizes on their community’s strengths and folds new ideas into the holistic efforts already underway.

For example, there is an assumption that in rural counties everyone knows and talks to each other. But, this isn’t the case for Allen County, Kansas, which lacks population density. To handle the sprawl problem, community members seeking change  created initiatives that were intentionally inclusive, county-wide and resident-led. Because physical distance and isolation make it difficult for people in some towns to be involved, the group holds meetings in smaller towns and brings others from around the county. They’ve also shifted the paradigm around community engagement to allow people to be involved on their own terms. For example, if someone volunteers to help build trails, they aren’t immediately asked to do volunteer dental screenings next week.

Sure, there are barriers to taking these steps. City leaders come into office with short time frames to drive change and a myriad of problems to address. And, people working in different sectors may not know how to deepen conversations that could kick-start a new way of working together.

But there is evidence that positive change happens — time and again — when skillful leadership brings diverse voices and experiences together around a shared vision for a healthier future. And, we heard from civic leaders at City Summit how important and vital this work is—and how hard they are working to support a well-being agenda.

Tyler_R (Headshot) About the Author: Tyler Norris is chief executive of Well Being Trust, a national foundation dedicated to advancing the mental, social, and spiritual health of the nation.