Amplifying Stewardship Together
Tracking Poll for Stewards of Well-Being
Explore findings from our recently concluded bi-monthly poll that surfaced perspectives from a diverse circle of stewards about navigating system change during the COVID-19 pandemic.
There is a growing group of people and organizations who understand the need for action that is grounded in what we are calling stewardship—action that enables all people to prosper and reach their full potential. We call these people and organizations stewards.
Every steward has an area of focus as it relates to improving well-being. Each of us has carved out our role in these respective areas, making up part of an ecosystem. Rippel’s is health. Other stewards focus on democracy, equity, the environment, placemaking, the economy, education, or some combination.
We’ve done a lot of hard work, and we’ve had many breakthroughs. Yet despite our significant investments in time and money, we haven’t made enough progress
toward well-being in the United States. A lot of us have been reflecting and many are asking: what can we do differently?
Stewards are people or organizations that are developing their abilities to:
- Take responsibility for forming working relationships with others to transform well-being across a region.
- Serve as natural boundary spanners because they are informed by place-based, interdisciplinary, multisector, and multicultural perspectives.
- Understand that purpose must be larger than oneself and one’s organization, power must be built and distributed with others, and wealth must be invested to create long-term value as well as address short-term urgent needs.
The BIG Questions
How can we acknowledge our limitations, amplify our strengths, and expand our horizons?
Could we better achieve our goals if we work more cohesively and with a greater level of accountability to one another?
They open us up to other important questions, which we are also working to clarify through the project:
- How can we avoid pursuing narrow solutions when we know that barriers to well-being are complex and often can’t be “solved” by one sector or organization alone?
- How do we resist “quick fix” temptations when we know success depends on taking a long-term approach to problem-solving?
- How do we collaborate in ways that include all the people, organizations, and ideas that would strengthen our practice? In ways that recognize we can humbly learn from some marginalized cultures that have been encouraging us to work more cooperatively all along?
- How do we recognize one another’s strengths and see the potential of what we could do with greater alignment instead of magnifying our differences?
- How do we stop writing off those who might one day be effective stewards by wrongly assuming their intentions?
Amplifying Stewardship Together is about working as a group to openly learn from our independent and collective successes and failures, and seeing our differences as assets, so we can adapt our thinking and practices for a more inclusive, cohesive, and effective future. Because we work in such a complex and massive ecosystem that makes up well-being in the United States, we don’t assume it’s possible, or helpful, to create a giant infrastructure and set of processes to help us all work together. But we can lift up shared principles and practices to use as we each go about our own area of focus.
When we amplify these shared principles and practices in our daily work, we will naturally set the conditions that steward well-being across the country. Through this commitment we will create a shared identity and thus the opportunity to claim broader scope and power as part of a visible movement that is stewarding equitable ecosystems for well-being.
ReThink Health is working with leaders who act as stewards.
- A mix of local and national leaders
- Working in different domains affecting regional well-being: health, economy, environment, democracy, placemaking, education, and more
- Well-networked individuals working in well-networked organizations
- Successful for different reasons, so they can learn from one another’s strengths
- Diverse in race, ethnicity, gender, and age
Since our work is interdependent (whether or not we recognize it as such), we must show up in the world with greater context and understanding about what “stewardship” is today—who we are, what we are doing individually and together, what is at stake, and for whom.
Our activities in Amplifying Stewardship Together will focus on learning, adapting, and amplifying stewardship principles and practices so we can strengthen the foundation from which leaders can continue their efforts to steward well-being.
Our efforts must be grounded in reality (as opposed to our hunches) about what amplifies and weakens stewardship of well-being. We’ll conduct two nationwide studies to (1) examine long-term, nationwide trends that affect stewardship, and (2) learn the extent to which stewardship mindsets and practices have spread and are aligned in regions across the United States.
We must adapt based on what we learn together. We’ll convene to deepen our stewardship practice by understanding and confronting the dominant patterns of thinking and sticky issues that hold us back in our efforts.
We must amplify stewardship principles and practices. Together we’ll shine a light on the broad scope of stewardship and the power we can have when each of us approaches our work with a shared set of principles and practices. We’ll share this common identity with other leaders—via their conferences, advisory groups, publications, and beyond—to invite them to work more cohesively and with greater levels of accountability to others who share their goals.
Meet Our Project Team
“It’s an exciting time to be part of the movement to transform health and well-being—new approaches to multisector collaboration are emerging, stewards are sharing ideas, and many are beginning to unify around a shared purpose for their regions.”—Jane Erickson, Director of Learning and Impact
Joined Rippel: 2013
Current Roles: Jane is project director of the ReThink Health initiative’s Amplifying Stewardship Together team. She also leads Rippel’s Learning and Impact team.
Career: Jane leads Rippel’s Learning and Impact team and directs the ReThink Health initiative’s Amplifying Stewardship Together project. Jane has worked with national philanthropies to advance social change for over a decade. She has led numerous nation-wide research efforts to build a shared understanding of the landscape of multisector collaboration to improve community health, including the ReThink Health Pulse Check. Previously, Jane oversaw strategy and implementation of the ReThink Health Ventures project (2016-2018), a large-scale project that advanced multisector approaches for health transformation. Jane has also worked to foster civic engagement across communities in the US and internationally, including as a Fulbright Scholar in Indonesia and with the Center for Information and Research on Civic Learning and Engagement. In 2020, Jane was named a Terrance Keenan Institute fellow by Grantmakers in Health.
More about Jane: Jane played varsity lacrosse in college, which brought her out east from her home state of Colorado. One of her favorite guilty pleasures is watching science fiction television shows, especially Battlestar Galactica.
Education: Syracuse University (MPA, MAIR), Hobart and William Smith Colleges (BA)
“ReThinking is the most practical thing any of us can do to change the future. It helps us see where we fit in a common system and shifts our own roles as change agents within a dynamic and democratic world.”—Bobby Milstein, Director of System Strategy
Joined Rippel: 2011
Current Roles: Bobby directs Rippel’s work on System Strategy, is a member of Rippel’s Strategy and Management Team, and is a Visiting Scientist at the MIT Sloan School of Management. Bobby is a principal contributor to the ReThink Health initiative’s projects Portfolio Design for Healthier Regions and Amplifying Stewardship Together. He also leads a suite of nationwide influence activities and coordinates ongoing development of the ReThink Health Dynamics Model, the Well-Being Portfolio Design Calculator , and other simulation tools that let leaders play out the consequences of their scenarios for change. In 2018, Bobby and four co-authors wrote the official brief that defines “health and well-being” as the central focus for the Healthy People 2030 Framework for the United States.
Career: Before joining Rippel, Bobby spent 20 years planning and evaluating system-oriented initiatives at the Centers for Disease Control and Prevention (CDC), where he was the principal architect of CDC’s framework for program evaluation. He received CDC’s Honor Award for Excellence in Innovation, the Applications Award from the System Dynamics Society, and Article of the Year awards for papers published in Health Affairs and Health Promotion Practice.
More about Bobby: Bobby once was a documentary filmmaker whose work was used by PBS to spotlight challenges of racism on college campuses. He also contributed storylines for The West Wing on how to get beyond zero-sum thinking when setting health priorities.
Education: Union Institute and University (PhD), Emory University (MPH), University of Michigan (BA)
“The Rippel Foundation’s commitment to health equity and health innovation is amazing to be a part of—it influences the work I do in both my personal and professional life.”—Bethlihem Gebremedhin, Program Coordinator
Joined Rippel: 2019
Current Roles: Bethlihem provides high level support to two Rippel directors as well as managing the Cambridge office. She also helps to support the Portfolio Design for Healthier Regions team and the Learning and Impact team.
Career: Bethlihem previously worked as an administrative/project specialist for the Department of Population Medicine at Harvard Medical School. She supported over five faculty members within the Therapeutics Research and Infectious Disease Epidemiology (TIDE) group, and provided administrative support for multiple project submissions. As an undergraduate, she majored in public health with a minor in afro-american studies. She is currently pursuing her masters in public health with a concentration in health services management and policy.
More about Bethlihem: Bethlihem loves to read, and a few of her favorite authors include Toni Morrison, Chimamanda Ngozi Adichie, and Bell Hooks. She is extremely passionate about holistic health, traveling, and learning about different cultures. Her dream vacation destination is Bali, Indonesia.
Education: University of Massachusetts Amherst (BS), Tufts University (MPH candidate)
“After many years in international work, I find Rippel brings me to focus on the local issues around health and well-being, for a better future for all humanity—locally and internationally.”—Sarah Rial, Program Coordinator
Joined Rippel: 2017
Career: Sarah was previously program director for the nonprofit My Sister’s Keeper and served as senior executive assistant at Management Sciences for Health. Sarah is founder and president of Global Partnership for Peace in South Sudan, which engages South Sudanese communities across the globe in working collectively for peace and social justice.
More about Sarah: Sarah has received numerous awards for her work as a community organizer, activist, and advocate, including the 2010 Eleanor Roosevelt Award for Human Rights. Her activist colleagues have described her as, “A warrior sister with a quiet wisdom.”
Education: The American University in Cairo (MA); University of Massachusetts (GradCert), University of Juba (BS)
“I believe that the health of communities is ultimately shaped by who is and isn’t at ‘the table.’ I’m excited to be part of a team that is boldly imagining a more equitable future while also developing tangible steps to take towards that future.”—Iueh Castro Soh, Associate Director, Stewardship Practice
Joined Rippel: 2019
Career: Iueh cares about building healthy communities and developing leaders. He was previously a management consultant at Oliver Wyman where he advised C-suite executives in the provider, payer, and life science space. He focused primarily on helping health systems develop and pursue a population health strategy amid shifting competitive and reimbursement pressures. In 2018, he worked in the Boston Mayor’s Office of New Urban Mechanics, a civic innovation team. There, he pioneered Rebuilding Together, an ongoing meeting group and advisory council that aims to develop returning citizen (formerly incarcerated) leaders and reshape their image in Boston. Iueh has also served as a volunteer community organizer on racial and economic justice campaigns in Oakland and Boston. At Rethink Health, he is currently authoring a report investigating the role of community organizing on shaping the role of local healthcare systems.
More about Iueh: Iueh loves to hunt for tasty street foods—especially tacos. You can often find him at a park playing pick-up basketball to decompress and get to know his neighbors.
Education: Haas School of Business, University of California Berkeley (BS), Harvard University Kennedy School of Government (MPP)
Stewardship and Public Service: A Discussion Paper
From the Field
This discussion paper prepared for the Public Service Commission of Canada presents stewardship as a bridge between purely market-based approaches and broader public sector responsibilities. While market-based reforms have shown many possible outcomes, they are not robust enough to embrace the full range of public sector activities, such as governance and guarding the public interest.
The Concept of Stewardship in Health Policy
From the Field
This World Health Organization Bulletin traces the history of stewardship and explores its potential as an avenue for public policy to effectively and efficiently improve health and well-being.
The World Health Report 2000: Health Systems: Improving Performance
From the Field
This report from the World Health Organization dives deep into resource allocation and performance quality in the health care system circa the year 2000. It’s notable for its emphasis on stewardship as a critical part of improving that system.
Health Stewardship: The Responsible Path to a Healthier Nation
From the Field
The Aspen Institute published this paper explaining the value of health stewardship and making a case for its importance for successfully navigating the challenges facing the system that produces health and well-being.
What Help is a Steward? Stewardship, Political Theory, and Public Health Law and Ethics
From the Field
As part of The Northern Ireland Legal Quarterly journal’s special issue on ‘super-stewardship’ and the related work of Roger Brownsword, this paper critically examines stewardship in public health.
Achieving Accountability for Health and Health Care Minneapolis, MN
From the Field
This article in Minnesota Medicine proposes Accountable Health Communities (AHCs) as a way to establish health system stewardship. They would to review local data against the Triple Aim, create shared goals and investments, and involve citizens in reform and stewardship.
Stewardship: Choosing Service Over Self-Interest
From the Field
In this book, Peter Block asserts that a fundamental shift in how we distribute power, privilege, and the control of money—away from self-interest and toward stewardship—can transform every part of an organization for the better, and he examines the nitty-gritty of implementing these reforms.
An Introduction to Network Weaving
From the Field
Building effective networks is one of the key tasks for a steward. This practical guide by June Holley teaches basic skills for doing just that.
The Three Horizons: The Patterning of Hope
From the Field
Bill Sharpe wrote this introduction to the Three Horizon’s framework, which can offer stewards a way to manage innovation and transformational change along the short, medium, and long term.
Core Attributes of Stewardship; Foundation of Sound Health System
From the Field
This International Journal of Health Policy and Management Perspective offers one way to look at stewardship, positing that it has five core attributes: responsible management, political will, a “normative dimension” (equity), balanced interventions, and components of good governance.
Promoting Population Health Through Financial Stewardship
From the Field
This Perspective in the New England Journal of Medicine argues that physicians have an ethical responsibility to act as stewards to promote their patients’ health and well-being.
2016 Pulse Check Survey Findings
These results shaped the development of ReThink Health’s Pathway and Essential Practices by illuminating the characteristics of regional multisector partnerships. The survey explored the following questions: What is the nature of the work stewards do in these partnerships? How does stewards’ multisector partnership work develop over time? How do they advance their work? What barriers to advancement do they face? How do stewards finance their multisector partnership work?
Public Involvement and Health Research System Governance: a Qualitative Study
From the Field
This article in Health Research Policy and Systems describes an exploratory, qualitative study of specific active stewardship efforts in two countries: England and Canada. It illustrates some of the benefits of stewardship while identifying three sets of common issues across both locations.
Regional Stewards: Nudging Systems Toward Health and Well-Being
Stacy Becker, Vice President, Programs
Stewards can’t control outcomes in a complex adaptive system, but they can nudge them in the right direction. Using the ReThink Health Pathway, stewards can contribute to shifting mental models away from health care alone and toward the full range of factors that produce health and well-being.
World Health Organization: Stewardship Resources
From the Field
The World Health Organization has collected resources related to stewardship, with an emphasis on the health care sector.
What Could Stewards Achieve if We Acknowledged our Limitations, Amplified our Strengths, and Expanded our Horizons?
Jane Erickson, Project Director
Every steward has an area of focus as it relates to improving well-being. Each of us has carved out our role in these respective areas, making up part of an ecosystem. Rippel’s is health.
To Catalyze System Change, Become a Better Casemaker
Tiffany Manuel, President & CEO, The CaseMade and Bobby Milstein, Director, System Strategy
Perhaps more than ever before in our nation’s history, there is an enormous opportunity to build the groundswell of support that we need to advance equitable system change and improve our collective well-being.
Stewards are Hopeful as the Case for Systems Change is Increasingly Seen and Understood
Jane Erickson, Project Director
We are experiencing multiple systemic crises at once—including Covid-19, racially-motivated violence and injustice, and an economic recession—and one result is that more and more people see and understand that our lives and livelihoods depend on each other and on a system that is poorly designed for equitable outcomes.
Amplifying Stewardship: Characteristics and Trends Stewards Consider When Expanding Equitable Well-Being
This report profiles characteristics of people who are not only impressive stewards, but also are helping to grow the entire field of system stewardship for well-being. Read the Report here.
Stewards are Leveraging Relationships to Help Communities Thrive
Iueh Soh, Associate Director, Stewardship Practice and Jane Erickson, Project Director
From city council chambers to neighborhood revitalization partnerships around the country, stewards are leveraging relationships to support their communities in the midst of the Covid-19 pandemic, ongoing protests against racial injustice, and economic recession.
In the Midst of National Crises, Stewards are Taking Action Inside Their Own Institutions
Iueh Soh, Associate Director, Stewardship Practice and Bobby Milstein, Director, System Strategy
Our institutions are in transition. From hospitals navigating new financial realities during the pandemic to schools re-working their curricula, the established ways are changing. Across the country, stewards are taking advantage of these transitionary times and encouraging our institutions to also advance well-being and equity.
Insight Spotlight Series: Amplifying Stewardship Together Project
Jane Erickson, Project Director and Bobby Milstein, Director, System Strategy
This month, ReThink Health is sharing what we are learning across our projects through an Insight Spotlight series. This week, the spotlight is on the Amplifying Stewardship Together (AST) project, which is clarifying stewardship mindsets and practices and helping them develop into widespread norms across the country.
Stewards Continue to Seek Lasting Systems Change
Iueh Soh, Associate Director, Stewardship Practice
Stewards End the Year with Rising Determination to Make Progress on Systemic Issues
Bethlihem Gebremedhin, Program Coordinator and Iueh Soh, Associate Director, Stewardship Practice
Fatigue. Optimism. Frustration. Persistence. These are the varied emotions and mixed signals ReThink Health encountered in response to our December Tracking Poll for Stewards of Well-Being. This was our final bi-monthly survey, which was designed to find out how stewards are navigating systems change in the midst of Covid-19, racial injustice, economic recession, divisive electoral politics, and ecological catastrophes. Read more about these findings in our latest blog post.
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