Home
Learn More About CoH
Visit CoH Library
Explore CoH Communities
Contribute to CoH Blog
Get Involved

Archive for June, 2009

Where reform is needed most

Monday, June 22nd, 2009
“If we want to improve health, we’re going to have to reform more than just health care” (“Wealth-Care Reform”, Ezra Klein, The American Prospect, June 18, 2009).
 

While improving “health care” quality and access is essential, our nation will not improve health and reduce costs in a meaningful and sustainable way without considering what is making so many of us sick in the first place. And let’s not expect change to come from a debate among legislators; we need greater collective awareness and participation to make a difference.

 

What needs reform most is the level of consciousness through which we see, think and act. This is the work of Communities of Health.

A great good place

Thursday, June 18th, 2009

“Until a clean and airy ShopRite opened a year ago in Parkside, her low-income west Philadelphia neighborhood, Christine Gilliard used to pay someone to drive her several miles to the closest supermarket so she could avoid a long bus ride. Now she can walk to the new 69,700-square-foot store as often as she likes.” (Read articles in the June 17th NYT and June 18th Philadelphia Daily News.)

This is an amazing story. Not only because it goes beyond individual responsibility (eat better) to begin to address the social determinants of health (affordable access to healthy food). Not simply because it is happening in a neighborhood especially threatened by “food insecurity,” which is a major cause of obesity. And not just because it is a story of overcoming significant obstacles of economics, safety, perception and competing interests.

This story is most amazing because of the way this particular supermarket came to be in this neighborhood. When we first learned about this several months ago, we heard how owner Jeff Brown visited with community leaders, how he listened and got to know what was most important here. And how he collaborated in building what has become a source of nourishment in the broadest sense.

It is what sociologist and author, Ray Oldenburg, calls a “great good place,” in his book by the same name. Like the cathedrals of old Europe, this is a place where community members gather, for fellowship as well as for groceries (which includes foods selected by the community, such as Caribbean and West African specialties, and halal meats, catering to the large Muslim population).

Employees are hired from the neighborhood, including ex-offenders who need a second chance. There are community meeting rooms, and the local activist was invited to set up “shop” here. Some residents make it a point to visit nearly every day, whether or not they need groceries. And while crime is often cited as a barrier in urban neighborhoods, residents here consider themselves the “security guards,” preserving a place they feel part of.

A great good place gives us more than “access;” it allows us to belong.

Is Honesty Possible

Monday, June 15th, 2009

“We won’t be able to rebuild trust in institutions until leaders learn how

to communicate honestly—and create organizations where that’s the

norm.” – from “A Culture of Candor” by James O’Toole and Warren Bennis; Harvard Business Review, 2009

 

The above passage is from a Harvard Business Review reprint distributed as a pre-read to a group of corporate leaders gathering for a two-and-a-half day strategy session. The purpose of the piece below is to analyze the concept of honesty by shining a light on the nature of language.

 

In common usage, when we talk about honesty we mean that a person is giving an accurate account. We say the truth is a correct correspondence of one thing to another – a simple equation. We expect that the words used to express these relationships are stable currency – to the common understanding, honesty probably doesn’t mean much if the words we use one day mean something different the next.

 

I’ve been listening to podcasts of a lecture course on Martin Heidegger’s Being and Time, given by Hubert Dreyfus, a noted Heidegger scholar and philosophy professor at the University of California, Berkeley. What’s struck me are the moments when Dreyfus seems to be struggling, reaching, for an understanding of a text he must be very familiar with. During these moments, he comes upon a passage that doesn’t yield the meaning he had come to expect. How is it possible that someone like Dreyfus could come to passages he’s probably read dozens if not hundreds of times only to struggle, reach, for understanding, as if reading them now is different than all the times before, as if the words themselves are different?

 

Well, this is one of Heidegger’s central concepts: words are not terms. That is, they are not like buckets out of which we scoop meaning. They are rather, “wellsprings that must be found and dug up again and again [my italics]”

 

This seems to suggest that honesty is something other an accurate account, a correct correspondence. Honesty uncommonly understood is this struggle, this reaching for understanding, even of something that just yesterday was clearly understood.

 

I’m concerned that the deliberately open-ended language we use to describe CoH is instantly converted to terminology – tamped down, reigned in, deflated, dried up and withered. “Coming together,” “dialogue-driven,” “what the community most wants for itself,” “a sense of belonging,” etc. There is always the risk with language that we are not equal to its essential nature. Common understanding is what we resort to when we avoid this essential nature. Uncommonly understood honesty again and again finds and digs up the wellspring of, say, belonging. Failing that, we assume a common understanding of belonging, which will always tend to one degree or another to un-belonging.

Letting go

Wednesday, June 10th, 2009

We often think of health in terms of acquisition. We want to get healthy, fill a prescription, buy ourselves a few more years of life. The language of health care consumerism comes to mind. But maybe health is less about adding, and more about uncovering what is already there.

 

I re-connected with a childhood friend, on his birthday, who told me of a recent retreat with his church around the idea of “letting go.” This was a powerful experience, he explained, of returning to the heart of what matters most in his relationships with others, his work, and his self; shedding what’s not essential so that new growth can emerge from here. The practice of pruning wine vines became a useful metaphor. And I’ve found myself thinking since that this practice is akin to the collective healing needed for healthy community.

 

We know that psychosocial experience plays a fundamental role in health. Letting go of self-defeating ideas or trauma, forgiving self and others, is very often the essential first step in deep, sustained health change. In a larger spiritual context, we can see Health as a revealing of Self. And the nature of this revealing is ongoing and collective (i.e., we come to find that the “self” is not separate; it is one manifestation of the whole).

 

Talking with my friend reminded me of this Biblical reference, found here in the context of Otto Scharmer’sTheory U” (change process), which draws on ideas that are also foundational to our Communities of Health work.

 

Individuals or groups on the U journey come to a threshold that requires a “letting go” of everything that is not essential. In many ways, this threshold is like the gate in ancient Jerusalem called “The Needle,” which was so narrow that when a fully loaded camel reached it, the camel driver had to take off all the bundles so the camel could pass through—giving rise to the New Testament saying that “It is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God.”

 

At the same time that we drop the non-essential aspects of the self (“letting go”), we also open ourselves to new aspects of our highest possible future self (“letting come”). The essence of presencing is the experience of the coming in of the new and the transformation of the old. Once a group crosses this threshold, nothing remains the same. Individual members and the group as a whole begin to operate with a heightened level of energy and sense of future possibility. Often they then begin to function as an intentional vehicle for the future that they feel wants to emerge.

Letting go comes when we remember our way back to what’s essential. We do this with and for each other in our gatherings. Separation dissolves, and we begin to see as a collective what it is we most want, and we choose to create this together. The only world we accept is one in which every individual is honored and provided for, and together we remember what it is to belong.

 

For me, last night, letting go came running in the rain-soaked woods; in the path dark-root and emerald, in mistakes made and made visible; in white birch lighting the way, in hope in remembering, and in return; and in the eyes of my wife and children welcoming me back home, where I belong.

Welcome Houston & Michigan!

Wednesday, June 3rd, 2009

One of the ways we hope this website can be useful is in creating more connections among people, organizations and cities coming together to consider the health of their communities.

Welcome to the people of Houston and Benton Harbor/St. Joseph, Michigan, where the latest Communities of Health efforts were launched (highlights and contact information are now posted for each). We invite you to be part of the movement in these and a growing number of other communities — and to share your own stories with us.

Inclusion before conclusion

Tuesday, June 2nd, 2009

The way we’ve chosen to build our cities is making our children fatter and sicker. More specifically, says a report in the June issue of Pediatrics, “A child’s life is affected by the environment in which he or she lives.”

Parks and open space, location of schools, traffic patterns, crime and safety are all part of the “built environment” which affects health in diverse ways, including physical inactivity. This, according to the American Academy of Pediatrics, is at least part of the reason nearly one-third of American children are overweight. “By working with community partners, (we) can participate in establishing communities designed for activity and health.”

Solid evidence and sound advice, right?

And yet… a quick scroll through reader comments at the end of this Houston Chronicle piece says that even a detailed report, from an expert source, with a mountain of research behind it, and a long list of recommendations tied to nothing less than our children’s health, isn’t enough to convince us to re-consider the way we design our communities. Among the comments:

What if we spend billions redesigning infrastructure and people remain fat? Now it is the fault of city planners, builders and architects that we have a bunch of fatsos?

Laws are needed to encourage physical activities. This article lost all credibility with that statement.

How about the evidence that weight has a nearly unmeasurable impact on health within reasonable bounds?

This will never happen. Most people around here are afraid of their own shadow and would never, ever consider letting their kids walk and/or bike to school. It’s way too scary.

The main cause of the decrease in outdoor activity isn’t the lack of parks or the advent of TV and the internet. The cause is the real pandemic, the epidemic of fear that has swept across our planet. It’s not the parks, it’s the people.

More elitism for the good of us commoner morons.

And so when readers push back on the cause or the evidence or the approach, it seems to me that this is not just skepticism. It’s because we want something more than research reports and expert advice.

“This is not the age of information,” writes poet David Whyte, “People are hungry, and one good word is bread for a thousand.” And that, we think, comes only when people participate in discovering for themselves what they really care about.