In order to improve the health and well-being of those we serve, we will be challenged to take a broader view of what is needed. Whether it is the different components of an illness, or the social determinants that impact the barriers to receiving care, taking a more systemic approach is required.
Using system capital is process of looking at an issue from multiple different dimensions and using different sector resources to solve a given problem. Healthcare has historically not used this model to solve for health issues. The healthcare industry has been charged with designing solutions and it has not focused on how other sectors of our overall social system could be of great support. Unfortunately, this model has woefully underperformed. We need to broaden our scope of both activities and the network of contributing organizations.
Taking this approach will require different sectors of our social and economic institutions to come together in ways that we have only seen in small areas. We have done this type of work at the micro level, but we need to think about it from the macro sphere. The literature has shown that communities that focus on using system capital have made improvements in the health and well-being of their communities.
Multi-sector engagement is needed to create the system capital that will be required. One of the major barriers to such an engagement strategy is the simple issue of who owns this work. Should it be public policy, or should it be driven through the private sector? Do not-for-profits take the lead as social institutions, or does the for-profit sector take the lead due to the value health and well-being has on productivity? I do not believe it is an either/or scenario. Regardless of the initiation point, the systems needed to create a positive impact must rally around the concept and work to be done.
Multi-factorial, non-health sectors have been found to impact overall health when looked at together. These include, just to name a few, fire protection, K-12 education, corrections, housing and community development, and libraries. Expenditures in these non-health sectors would have a positive impact. Unfortunately, is difficult to tease out which has the greatest impact, so increasing one to the determent of another may create a situation where we see no improvement. Further research will be needed to tease out these nuances.
For example, our libraries have historically been places people go to borrow books and read, and are visited 1.5 billion times each year. Those who use libraries tend to be more diverse, of lower socioeconomic standing, and are in need of services. What if we expanded their focus to include health and well-being? We would be leveraging an infrastructure that already exists, serves the population at greatest risk, and is already a public policy.
There is no single right answer. If there were, we would already have implemented such a solution. Only thinking about health and well-being from the larger perspective will allow us to use the system capital that is required. No one owns this alone, and all must work together.