Archives

  • Economic Inequality, Social Mobility, and Institutionalized Racism
    Vol. 7 (2021)

    Dear Reader,

    Income inequality in the United States has steadily worsened since the 1970s.[1] We have experienced a 39% increase in income inequality in under four decades—and it comes as a result of an increase in inequality each decade.[2] Furthermore, with the growth in income inequality in the United States, it is decreasingly plausible that someone born into a lower-income household will achieve a higher income as an adult. A 2012 study by The Pew Charitable Trusts showed that 43% of those born into the bottom fifth of households are stuck there, and with social mobility declining since the 1970s, matters are only worsening.[3]

    People from around the world come to the United States for the promise of the “American Dream,” the notion that a person born into the bottom economic rung can rise to the top. The same Pew study showed that just 4% born into the lowest-earning 20% of United States families rise to the top 20%.[4] We need to face the reality that the American Dream is more suitably titled the “American Myth.” Or, in the words of Ta-Nehisi Coates, “The American Dream is a lie.”[5]

    The situation only becomes more pressing when we consider how income inequality affects Black, Indigenous, and Hispanic and Latino Americans. While the United States has seen massive strides in civil rights, education, and history-making achievement for Black Americans since 1970, median Black household income as a percentage of white household income has only increased 5%—from 56% to 61%—with Latinx Americans earning only slightly more.[6] In terms of social mobility, things are more challenging for people of color, too. Over half of Black Americans born into the bottom fifth of households remain there as adults, while this number drops to 33% for white Americans.[7] It is also more likely that Black Americans will experience downward mobility than white Americans.[8]

    Given the magnitude and enduring nature of these issues, we need more than just solutions. We need innovative solutions that address the underlying institutional, systematic, and societal barriers that collectively—both intentionally and unintentionally—reinforce economic disparities. Articulating these solutions will push us all to think more creatively and act more decisively.

    This edition of The Social Innovations Journal will do just that. We aim to provide insight into the problems of income inequality, social mobility, and the role of institutional and social racism. Moreover, we hope to share solutions and shed light on bright spots where organizations and individuals are overcoming society’s limitations. We also will share policy suggestions and case studies, to encourage lobbyists and policymakers to enact broad changes to make it easier for all people in the United States to achieve the dream we have been promised.

     

    April Kaplowitz, Guest Edition Curator and Editor

    Nicholas Torres, Co-Founder, Social Innovations Journal

     

    [1] U.S. Census Bureau, “Income and Poverty in the United States,” U.S. Census Bureau, 2018, Table A-4.

    [2] Juliana Horowitz, Ruth Igielnik, and Rakesh Kochhar, “Most Americans Say There Is Too Much Economic Inequality in the U.S., but Fewer Than Half Call It a Top Priority,” Pew Research Center, 2020, https://www.pewresearch.org/social-trends/2020/01/09/trends-in-income-and-wealth-inequality.

    [3] The Pew Charitable Trusts, “Pursuing the American Dream: Economic Mobility across Generations,” The Pew Charitable Trusts, 2012, https://www.pewtrusts.org/~/media/legacy/uploadedfiles/wwwpewtrustsorg/reports/economic_mobility/pursuingamericandreampdf.pdf; Kathrine Bradbury, “Trends in U.S. Family Income Mobility, 1969 – 2006,” Federal Reserve Bank of Boston, 2011, https://www.bostonfed.org/publications/research-department-working-paper/2011/trends-in-us-family-income-mobility-1969-2006.aspx.

    [4] The Pew Charitable Trusts, “Pursuing the American Dream.”

    [5] Ta-Nehisi Coates, Between the World and Me. (New York City: Spiegel & Grau, 2015), 52.

    [6] Kathrine Schaeffer, “6 Facts about Economic Inequality in the U.S.,” Pew Research Center, February 7, 2020, https://www.pewresearch.org/fact-tank/2020/02/07/6-facts-about-economic-inequality-in-the-u-s.

    [7] The Pew Charitable Trusts, “Pursuing the American Dream.”

    [8] The Pew Charitable Trusts, “Pursuing the American Dream.”

  • A Healthcare Workforce Cadre That Meets A Country’s Needs
    Vol. 8 (2021)

    We live in a global healthcare workforce crisis. The World Health Organization’s Global Strategy on Human Resources for Health: Workforce 2030 (”GSHRH”) emphasizes the importance of dynamic and effective health practitioner regulation to the achievement of SDG3: Good Health and Wellbeing.  In recent years, regulatory mechanisms and resources across WHO Member States have experienced substantial stress due to the increasing volume and privatization of health professional education, rising importance of previously unregulated occupations; emergence of new occupations; emergencies and humanitarian crisis; accelerating international mobility; new modes and cross border service delivery (e.g. use of digital technology); increasing focus on team-based and integrated networks for service delivery; as well as increasing consumer demand, expectation and knowledge.  A synthesis paper was published in February 2015 to inform the beginning of a Global Strategy which is of tremendous value to all relevant stakeholders in the health workforce area, including public and private sector employers, professional associations, education and training institutions, labour unions, bilateral and multilateral development partners, international organizations, and civil society.

    Driven by a moral compact to mend the fabric of our communities upon which health depends, The Social Innovations Journal has partnered with The Network: Toward Unity For Health (TUFH), Physician Assistants for Global Health (PAGH), International Academy of PA Educators (IAPAE), International PA Organization (IPAO), Global Association for Clinical Officers (GACOPA), and the International Federation of Physician Assistants/Physician Associates and Clinical Officer/Clinical Associate/Comparable Student Federation (IFPACS), the Beyond Flexner Alliance, and AFREHealth to strengthen knowledge networks in order to share experience and best practices in health practitioner frameworks and their evolution across countries. We believe that strengthening knowledge networks will lead toward the adoption and implementation of global policy recommendations locally.

    The World Health Organization (WHO) in 2008 advocated for “Treat, Train, Retain” which refers to the implementation of task-shifting in attempt to meet the unmet burden of disease.  Task shifting/sharing refers to healthcare workers with less training and qualifications performing tasks and activities that meet the country’s needs.  There isn’t any set structure on how to implement task shifting; however, there is an abundance of literature describing the need for task-shifting and task sharing.  The Beyond Flexner Alliance launched The Health Workforce Diversity Tracker to promote greater racial and ethnic parity in the health workforce through measurement and accountability.  The issue of highest concern, in terms of inequalities in healthcare is deepening the diversity of the workforce as an optimal strategy to address racial disparities. But this goal remains elusive without accurate data on the composition of the workforce, the pipeline, and clear benchmarks for organizations to strive toward.  The Health Workforce Diversity Tracker is dedicated to addressing under-representation among healthcare workers by analyzing data on the diversity of the health workforce and the educational pipeline across thirty health occupations, from front-line workers to physicians.

    Combining the reality of task-shifting within the promotion of racial and ethnic parity in the health workforce, this edition of the Social Innovations Journal titled: A Healthcare Cadre That Meets A Country’s Needs provides practical tools and solutions to support local change networks to address the global health workforce crisis. Included in this edition, to serve as a guide for other healthcare workforce cadres, is a database of articles as a medical anthropological approach by a non-physician clinician for 31 countries for non-physician clinicians. This data has not been previously described in the literature by NPCs themselves and we hope this concentration of country-by-country case studies serves as a window of one workforce cadre to fulfill the healthcare workforce gap. 

     

    Mary Showstark, Guest Edition Curator and Editor

    Nicholas Torres, Co-Founder, Social Innovations Journal

  • Innovations in Community-Based and Center Based Services
    Vol. 6 (2021)

    Dear Reader, 

    Since the advent of key pieces of federal legislation, including the Community Mental Health Act of 1963, the Americans with Disabilities Act in 1990, and the Olmstead Decision of 1999, the trend has remained consistent towards locating services in the community and in the home for children and adults with all kinds of disabilities, including mental health challenges, intellectual disabilities, autism, physical disabilities, and others. In the Olmstead Decision, the Supreme Court held that community-based services should be provided to persons with disabilities when (1) such services are appropriate; (2) the affected persons do not oppose community-based treatment; and (3) community-based services can be reasonably accommodated, taking into account the resources available to the public entity and the needs of others who are receiving disability services from the entity.   

    When state psychiatric institutions were closed rapidly in the 1950s and subsequent decades when community-based services were not yet widely available, followed by legislation in the 1980s that drastically reduced spending on mental health services, there was a dramatic increase in homelessness of persons with mental health conditions that persists to the present day. Recent events in which people with mental health issues have had disastrous encounters with law enforcement have further illustrated the scope of unmet needs of individuals with mental health conditions.  

    Clearly the majority of people can be successful receiving services in the home or community, while a small number require a higher level of care and more intensive services. But thoughtful consideration must be given to creative and innovative ways to ensure that programs and services are actually available for people who require them, allowing for maximum choice on their part – especially those with complex needs.  And these services should offer the greatest level of independence and safety for all community members. 

    This edition of the Social Innovations Journal focuses on the progress made in developing community-based services where once there were few or none, as well as policy implications surrounding services and systems which remain fragmented, and best practices and models.  This edition explores a broad range of themes which address far-reaching topics relating to innovations in policy on how we will address the dire workforce crisis that touches nearly every corner of the human services sector, innovations in the use of data, and systems integration and models that exemplify innovative solutions to providing services in community-based settings.  

    Tine Hansen-Turton, Woods Services, Guest Edition Curator and Editor

    Nicholas Torres, Co-Founder, Social Innovations Journal

  • Innovative Practices for Systems Transformations
    Vol. 5 (2021)

    Dear Reader,

    This edition titled, Innovative Practices for Systems Transformations, of the Social Innovations Journal is sponsored by the Transformations Community, a generative space and catalyzing force for sustainability research and practice. This global community of transformation “pracademics” (both practitioner and researcher) is responding to a growing recognition that we need new approaches to address climate change and other existential threats to social-ecological systems.

    In the spirit of the community’s pracademic identity, this edition lies between the formalistic rigor of scholarly peer-reviewed scientific articles and the advice and case histories and practical wisdom that are the lifeblood of communities of practice. This edition captures and shares what Aristotle called “phronesis”, or the practical wisdom of our members that is situated in specific time and place and requires deliberation, judgment, and choice, and above all, experience. This edition is divided into four sections, each with its own style, perspective on practice, and relationship between the authors and practitioner communities.

    The first section, Social Innovation In a Time of Disruption, contains five articles that Guest Editor Bruce Goldstein wrote that consider how social innovation organizations can maintain the enabling conditions for productivity, commitment, creativity, and purpose in a time of disruption. These papers emerged from his three-year partnership with a group of highly experienced and effective “netweavers” who shared what they had learned about how to pursue social justice and ecological and economic well-being while working remotely within collaborative learning networks. The core of these articles are the verbatim words of the netweavers themselves, which he organized and accompanied with enough commentary to make them coherent and cohesive. These articles are very timely as we emerge into a world transformed by the Covid-19 pandemic and poised to move beyond the reactionary Trump years. They get to the heart of how to lead our organizations to address seemingly intractable problems (such as systemic racism and climate change), adapt to changing conditions and new contexts, scale innovation, and respond rapidly to crisis.

    The second section, Transformation Workshop Papers, contains three articles written by Transformations Community members who facilitated interactive community online workshops. These papers provide guidance on how to organize and facilitate participatory visioning exercises to help diverse communities identify desirable social-ecological transformation pathways. They include a participatory food systems sustainability assessment framework from Europe, a method for people to reflect on their own social-ecological agency developed in a transformation laboratory in Mexico, and a scenario-building process that was developed in southern Africa for grappling with complex social-ecological issues and envisioning desirable futures. These approaches exemplify the focus of the transformative community on empowering diverse people to engage in knowledge co-production to enhance their ability to foster systems change.

    The third section contains four articles that capture the diversity and richness of the work undertaken by members of the Transformations Community. The first considers how visioning and project evaluation imported from the developed north to the global south are an expression of colonization, and can be improved by taking a more systemic perspective grounded in local culture and context. The second considers how a systems approach to evaluation can address the field’s fixation on projects, short timeframes, quantitative solutions, and accountability. The third article describes a way to visualize governance transformations across a regional transect, in order to understand how government, civil society and market forces can create positive momentum to respond to ecosystem change. The final article considers how a whole person learning approach can enhance individual capacities for social innovation, and describes how the Wolf Willow Institute for Systems Learning is teaching social innovators about systems change

    The final section, includes four contributions that complement the perspectives of the Transformations Community of Practice and suggest possibilities for collaboration and mutual learning. These four articles address the self-advocacy skills required of legal services clients in low-income communities, examine the work of the Philadelphia Higher Education Network for Neighborhood Development (PHENND), propose how social innovation networks can advance the practice of social innovation diplomacy, and consider how online social enterprise directories can address diverse stakeholder needs by overcoming common challenges in the social enterprise sector.

    Considered as a whole, the articles in this special issue provide a fascinating cross-section of the highly participatory and action-oriented work of the Transformations Community of Practice.

    We conclude by offering special thanks to Lisa Smith, the production editor of this special issue and Tica Lubin, who created the Transformations Community website and Netweaver Network website that hosts the workshops and netweaver dialogue series.

     

    Bruce Goldstein, University of Colorado Boulder, Guest Edition Curator and Editor

    Nicholas Torres, Co-Founder, Social Innovations Journal

  • Social Accountability and Accreditation; Interprofessional Education and Team Based Care; and Population Health Approaches to Global Health Access and Equitable Health
    Vol. 3 (2020)

    Dear Reader,

    This edition of the Social Innovations Journal was curated by The Network: Toward Unity for Health (TUFH), an official non state actor of the World Health Organization (WHO). TUFH is driven by a moral compact to mend the fabric of our communities upon which health depends. The Network: Toward Unity For Health is committed to drive communal interests by supporting local change agents work toward the adoption and implementation of global policy recommendations. TUFH concentrates its efforts on practical tools and solutions that can achieve action by local change networks.

    TUFH does its work by bringing the "Partnership Pentagram" to life by supporting local change agents and Networks. TUFH’s "Partnership Pentagram" is framed within the sustainable development goals and social determinants of health emphasizing that creating a health system based upon people’s needs must not only involve the five key players in the change process, but must also do so within the context of where people live and work. TUFH engages policymakers, academic institutions, health professionals, and communities to collectively address the underlying barriers to healthy individuals and communities.

    This edition highlights three policy action papers on social accountability and accreditation, interprofessional education and team-based care, and population health which were driven by TUFH’s policy fellows and guided by global thought leaders through TUFH’s Taskforces. Each policy action paper provides concrete policy recommendations and action steps for ministries of health, academic institutions, and health systems to adopt and implement. This edition also highlights best practices around the globe on the adoption and implementation of social accountability and accreditation, interprofessional education and team-based care, and population health.

    Around the world, global health policy leaders and associations are convening global leaders, publishing research and policy articles, and releasing “call to action” initiatives for political leaders and health system institutions to adopt and implement. Many of these recommendations are framed within the United Nations Sustainable Development Goals, indirectly correlated with the social determinants of health, indicating that health is much broader than clinical interventions. Today, we witness hospitals and health systems being more like “repair shops,” trying to correct the damage of causes collectively denoted “social determinants of health.” The global fabric of our communities upon which health depends is torn and we must heal this fabric through communal interests.

    We hope this edition is a first step toward healing the fabric of our communities.

    Sincerely,

    Nicholas Torres

    Co-Founder

  • Women, Migrant and Refugee, and Remote and Rural Health Care Best Practices
    Vol. 4 (2020)

    Dear Reader,

     

    This edition of the Social Innovations Journal is curated by The Network: Toward Unity for Health (TUFH), an official non-state actor of the World Health Organization. TUFH is driven by a moral compact to mend the fabric of our communities upon which health depends. The Network: Toward Unity For Health is committed to driving communal interests by supporting local change agents toward the adoption and implementation of global policy recommendations. TUFH concentrates its efforts on practical tools and solutions that achieve action by local change networks.

    TUFH does its work by bringing the “Partnership Pentagram” to life by supporting local change agents and networks. TUFH’s “Partnership Pentagram” is framed within the sustainable development goals and social determinants of health, emphasizing that creating a health system based upon people’s needs must not only involve the five key players in the change process, but must do so within the context of where people live and work. TUFH engages policymakers, academic institutions, health professionals, and communities to collectively address the underlying barriers to healthy individuals and communities.

    This edition highlights three policy action papers on women, migrant and refugee populations, and aging society health which were driven by TUFH’s policy fellows and guided by global thought leaders through TUFH’s taskforces. Each policy action paper provides concrete policy recommendations and actions steps for ministries of health, academic institutions, and health systems to adopt and implement. This edition also highlights best practices around the globe on the adoption and implementation of best practices in women, migrant and refugee, remote and rural, and aging society health.

    Around the world, global health policy leaders and associations are convening global leaders, publishing research and policy articles, and releasing “call to action” initiatives for political leaders and health system institutions to adopt and implement. Many of these recommendations are framed within the United Nations Sustainable Development Goals, indirectly correlated with the social determinants of health, indicating that health is much broader than clinical interventions. Today, we witness hospitals and health systems being more like “repair shops,” trying to correct the damage of causes collectively denoted “social determinants of health.” The global fabric of our communities upon which health depends is torn and we must heal this fabric through communal interests.

    We hope this edition is a first step toward healing this fabric.

     

    Sincerely,

    Nicholas Torres

    Co-Founder

     

  • Social Mobility: Inspiring and Building the Capacity of Local Change Agents to Impact Poverty
    Vol. 2 (2020)

    Dear Reader,

    For more than 10 years; The Social Innovations Journal has connected and inspired local change agents through the sharing of knowledge, best practices, and research to reduce poverty. Concrete impact and change require more than education and engagement -- it requires strategic action. This edition of the Social Innovations Journal highlights the strategies of key actors within the Philadelphia ecosystem who are collectively moving the needle on poverty.  To ensure we always have an international flavor, we have also included three articles related to initiatives in Venezuela as related to Social Mobility.

    To provide context, nearly one in four Philadelphians is living at or below the federal poverty line. Philadelphia's poverty rate is the highest among the 10 largest cities in the United States; and is more than double the national average. There are numerous city-run programs as well as 384 nonprofit organizations with the word "poverty" included in their missions that provide assistance to the residents of Philadelphia. Philadelphia City Council released its Poverty Action Plan focused on three strategies: Social Safety Net, Housing, and Jobs and Education.

    Legislators, government, not-for-profits, academic institutions, and to some extent private companies are all tackling poverty. Despite these efforts, agreed upon strategies, and an ongoing call to action, limited change has occurred for the simple reason that poverty is complex. What is needed is an agreed upon shared measurements and evaluation system that can assess the collective efforts and impact for all organizations. A shared measurement and a system-wide evaluation system would accomplish three things:

    • Measure the collective impact of all organizations working on poverty in the region, with the understanding that poverty can be reduced if the collective is aligned on what is important to assess.
    • Transparency in reporting that will provide organizations, and the collective, the opportunity to adjust their strategies/initiatives if the agreed upon measurements are not being achieved.
    • Data gathering from the collective that can be used to influence local, state, and national anti-poverty policies.

    Generally, local change is either driven by local change agents defined as individuals or institutions that are in a position to influence system behavior at their level OR policy change agents defined as governmental policymakers, regulators, or legislators who are advocating, organizing, and supporting change in a sustainable manner. Rather than local change agents working independently and often in isolation of each other, sustainable change will occur when change agents align their efforts towards collective impact through shared measurement goals.

    At the Social Innovations Journal, we believe that if we create platforms for the fostering of dialogue, learning, new knowledge, and the creation of communities of practice then we will inspire local change and policy agents to take action locally through adopting and implementing policy and strategy recommendations.

    We hope this edition inspires greater collaboration that results in collective action and impact to holistically address poverty in Greater Philadelphia as well as other ecosystems to ultimately help move individuals up the social mobility ladder to a living wage to reduce economic disparities. 

     

    Sincerely,

    Nicholas Torres, Edition Curator

  • An Insight Into Social Innovations Within the Human Services System and Population Health
    Vol. 1 (2020)

    An Insight into Social Innovations Within the Human Services System and Population Health highlights the beginning of a shift of human service organizations to a population health strategy. The relevance and applicability of population health to the human services is often overlooked as it is predominantly associated with the health care industry. However, health and human service leaders are shedding the old ways of doing business in favor of new approaches that are innovative, efficient, effective, and responsive to the needs and demands of focus populations.  

    In this issue, health and human services leaders, innovators, and entrepreneurs share ideas on meaningful and inclusive strategic planning practices that disrupt the status quo; effective change processes that result in successful and sustainable changes at both the micro (organizational) and macro (state-wide systems) levels; technological innovations that engage people in the healing process; and much more.

    Readers will gain a greater sense of the promise that the intersectionality of social innovation, population health, and change initiatives hold across the spectrum of the human services system.