Building an Equitable Future for Health and Well-Being

Debbie Chang, President & CEO, The Blue Shield of California Foundation
Laura Landy, President & CEO, The Rippel Foundation

Complex, uncertain and volatile. These words only begin to describe our world today. The pandemic flipped lives upside down, compromising the physical health of over six million people—disproportionately Black, Indigenous and People of Color—and the mental and emotional health of countless more. The urgent calls for racial justice require all of us reflect on our core values and identify ways we can help dismantle systemic racism.

The truth is there is no relief in sight to the complexity, uncertainty, and volatility we all face. And when you look at the long-term trends, opportunities, and challenges driving change, one thing is certain: if we don’t collectively explore what is on the horizon for health and well-being, we risk locking in—or worsening—existing inequities for generations to come. Foresight, defined as gaining insight by exploring what might happen or be needed in the future, is needed now more than ever. FORESIGHT is also the name for a partnership of 17 philanthropies that is catalyzing a vision for the future of health and well-being centered on two things:

• the game-changing trends, challenges, and opportunities on the horizon; and
• the aspirations of a diversity of communities throughout the U.S.

While FORESIGHT started in 2016, the events of the past six months have reinforced its relevance, and the foundation it laid over the last two years has positioned it as a catalyst for equitable change. When it began, FORESIGHT asked professional futurists to scan the health and well-being horizon and identify trends, opportunities, and challenges with the potential to drive change. Their scan highlighted 75 different trends and emerging possibilities that they combined to form nine “Game Changers.”

FORESIGHT asked upward of 8,000 people around the country, with a focus on people from marginalized communities, about their hopes for the future. Centering diverse community voices in any work fundamentally shifts the focus from doing something to or for others, to doing it with others, bringing grantmakers and communities together as allied change agents. While we are still early in the process, initial themes from these conversations with community residents include a growing discomfort with technology; the need for alternatives to existing economic structures and systems; and the importance of redesigned and local food systems, including community-based agriculture. Fully understanding the findings from residents and the trends identified by the futurists will be critical going forward.

While FORESIGHT is still in progress, several key insights have emerged that have broad implications for philanthropy. These include:

1. Partner with community members to imagine the future. Community members are not often asked by funders to imagine the future even though preparing for the future and harnessing the potential for change can allow us to, collectively, get ahead of it and away from reactive solutions. Understanding both communities’ and futurists’ perspectives on the future will inform efforts to create equity in health and well-being going forward. This transformation requires new partnerships and mindsets, a different allocation of power and resources, and a radical openness to experimentation, all grounded in community. Futurists will tell you that major disruptions rarely emerge out of the blue. Partnering with communities, particularly those that have been most marginalized, and listening to what is on their minds is critical to not only spotting major disruptions early, but also to crafting solutions and understanding the conditions necessary for change. 
2. Support communities to act on their ideas. FORESIGHT, in partnership with Marnita’s Table, has hosted over 700 people in conversations. Many of these conversations end with community members asking, “Now what?” They are eager for change, have solutions in mind, and are ready to act now. We have learned that grantmakers need to be ready to act on the ideas generated through conversations like these. In complex adaptive systems, like those that create health and wellbeing, experimenting with solutions, even around part of a problem, generates action and insights critical for systems change. While residents start in different places, grantmakers are critical partners in ensuring they have the power and resources necessary to experiment and act. 
3. Commit to listening, learning, and doing better. Equitable processes are essential to equitable outcomes, but few among us know what it really takes to be equitable in our work. Only by engaging in authentic dialogue with a diversity of people and responding honestly and transparently to their feedback can we do better. Our FORESIGHT partners have been challenging us to be more equitable in the composition of our team and in our timelines, approaches, and processes. In seeking and responding to feedback, FORESIGHT team members have learned, challenged assumptions, and begun to work more equitably. We know we have so much more to learn about working equitably, and we are committed to listening, learning, and doing better. 
4. Nurture peoples’ ability to imagine the future. Conversations about the future are hard for two key reasons. First, it takes a significant amount of energy to navigate the challenges present in our lives today, much less what is potentially years (or decades) down the road. It is important to acknowledge today’s reality, but, in doing so, there is also an opportunity to identify what needs to change, and how that change might be influenced by both threats and opportunities on the long-term horizon. Second, the part of our brain that imagines the future also recalls memories, so our own biology tries to trap us in the present and the past! FORESIGHT is overcoming this challenge by sharing stories of possible futures, created in collaboration with a diversity of community voices, to help people imagine something different. While it is difficult, exploring the future and preparing for the changes barreling towards us is imperative.

FORESIGHT’s formal engagement activities will wrap up in September. In late October, over 100 people will come together from widely different perspectives, including business, government, community, and philanthropy, to collectively shape an equitable vision for the future of health and well-being—one that blends the insights of futurists with those of a diversity of community members. (To ensure you see the results of this process, please subscribe to FORESIGHT’s mailing list.)

For FORESIGHT and for philanthropy, generating a vision for the future is only a first step. The vision and bold ideas that emerge will require local champions, new, more equitable forms of leadership and a just and fair distribution of power to bring ideas to action. A radically different future is possible with courage, collaboration, community, and foresight.