“There is no power for change greater than a community discovering what it cares about.” — Margaret Wheatley
At a time when Americans are being asked to practice social distancing, this necessary isolation is taking a toll on the well-being of individuals and communities. But even as Covid-19 pandemic underscores the pain of disconnection, it can also inspire a revival of meaningful connection.
As health care professionals working to coordinate care for individuals with complex conditions, we’ve struggled for decades to break down silos and foster cross-sector collaboration to meet the needs of our nation’s most vulnerable populations.
These populations — the 5% of patients who account for more than half of all health care costs — bear the greatest brunt of a broken health care system and are deeply affected by the current pandemic. Behavioral health visits and AA meetings are being cancelled or going virtual, requiring resources that many lack, like smartphones or computers, internet access, and a safe place to make a call. Homeless shelters are shuttering. There’s an untenable wait for meals, routine health care, addiction services, and counseling.
Our approach to helping individuals in these populations starts by strengthening social ecosystems. Rather than one person or one entity trying to address wide-ranging needs like housing and food and employment and health, we build the infrastructure to make creative, effective partnerships possible. We leverage strengths and capacity from myriad, often surprising, sources to develop solutions that simultaneously heal populations and strengthen communities.
Project Restoration in Lake County, California, is one example. It’s a collaborative that includes police, fire, EMS, health care, behavioral health, public health, and numerous other agencies working together to serve their most vulnerable community members. The results are impressive and the infrastructure is now serving the community with a rapid and early response to the challenges of the coronavirus crisis.
We’re seeing the same broad-based community approaches being applied to save lives and serve neighbors during this pandemic all across the country.
In rural Kentucky, where one of us (L.H.) lives, a region with high rates of poverty and lack of access to health and social services, people are coming together on their own to take care of their neighbors. Teenagers are delivering meals to elderly individuals who can’t travel to the store. Young couples who have lost their jobs are supplementing their income by virtually homeschooling children whose parents can work remotely but don’t have childcare.
Rather than approaching the crisis in a spirit of self-preservation, people are taking stock of their collective assets and embracing a kind of Marxist philosophy: “From each according to ability, to each according to need.”
In northern California’s Lake County region — another historically underserved community where one of us (S.T.) lives — similar generosity and cooperation are manifest. These are communities that have been victimized by wildfires, rampant unemployment, and the opioid epidemic, yet these shared experiences leave people not with a mindset of scarcity but of charity.
Examples of connection in a time of distancing are cropping up nationwide. College students are remotely tutoring younger peers. Individuals and companies are making face masks for health care professionals. House concerts are being played to stave off growing loneliness.
The speed and agility of local action highlights the need for investment in building and accelerating community agency. At Adventist Health, where one of us (S.T.) works, in the same time it took to convene system-level meetings with potential external food distribution partners, a local leader had already organized two dozen organizational partners and colleagues to create a sustainable food distribution system that serves meals to 250 seniors, and provided more than 11,000 meals to vulnerable families.
Covid-19 is revealing our interdependence in ways that no event in our lifetimes has done. Just a few weeks ago, we could choose to avoid our neighbors, pretending their lives and livelihoods were of little consequence to our own. Today, we see that the very opposite is true. As Benjeil Edghill, a clinician from Brooklyn, N.Y., remarked in a recent conversation with us about the impact of Covid-19 on communities, “It’s a small world. The health of workers in a fish market in rural China isn’t someone else’s problem. Our health is everyone’s concern.”
Importantly, with an increased awareness of our interconnectedness, we’re seeing the development of practices and infrastructure to facilitate meaningful cross-sector collaboration that can be mobilized in times of need — not just now but in the future.
In his book “Tribe,” Sebastian Junger writes about how crises often reignite our very human wiring for each other, saying they “thrust people back into a more ancient, organic way of relating… allow[ing] individuals to experience an immensely reassuring connection to others… It is a kind of fleeting social utopia.”
To be sure, the U.S. is not a social utopia. Just as crises can bring communities together, they can also highlight and exacerbate inequities. The New York Times and others have reported on the disproportionate impact of Covid-19 on poor communities with limited access to care. And with more calls for sheltering in place, we’re becoming painfully aware of how many Americans are without safe, reliable shelter. Just last month, California’s governor, Gavin Newsom, designated $150 million to provide temporary housing for the homeless in California, and nonprofit health systems around the country are repurposing resources and community investments to strengthen ecosystems that support those most vulnerable.
In this moment of heightened interconnectedness, we are touched by the outpouring of collective goodwill. We’re also hopeful that lessons learned from the crisis don’t go to waste, because there will be more crises in the future. So let’s strengthen the cross-sector partnerships we’re just beginning to develop, reduce barriers to accessing care for vulnerable populations, make temporary housing permanent, and keep visiting our neighbors to share resources. And maybe just enjoy belting out a song with a stranger that says we’re all in this together.
Lauran Hardin is the senior adviser for the Camden Coalition’s National Center for Complex Health and Social Needs. Shelly Trumbo is the vice president of community well-being for Adventist Health System.
