Stewards’ Terms


The collective mix of differences and similarities among stewards’ individual and organizational characteristics, values, beliefs, experiences, backgrounds, and behaviors. It encompasses personal and professional histories that frame how stewards see the world and interact with each other. It also encompasses many simultaneous dimensions of human difference including age, sex, color, class, education, sexual orientation, nativity, language, and more.

Equitable Health and Well-Being

Often shortened to “health and well-being,” or simply “health,” this denotes the overall level and distribution of healthiness and quality of life for all people in a given region, including the presence of fair and just opportunities for everyone to reach their full potential. It is not limited only to the healing or strengthening of the body against injury and disease, but instead includes all aspects of health and well-being, including physical and psychological health, security, economic prosperity, connectedness, and more.

Health Ecosystem

A system composed of an extensive collection of distinct variables and organizations that depend on and interact with one another to produce health and well-being in a region.

Integrative Activities

Stewardship roles and leadership functions for governing and managing stewards’ working relationships to achieve a common purpose.


Integrative governance activities hold the balance between stewards’ individual and collective goals, to contribute to the prosperity and viability of the region as well as stewards’ working relationships. Governance activities ensure accountability, transparency, and fairness across stewards.


Among other things, management activities coordinate establishment of basic infrastructure to support stewards’ working relationships, including establishment of workflow structures, equipment, technologies, facilities, and services.

Interdependent Portfolio of Intervention

A balanced and impactful set of policies, programs, and practices that stewards implement to produce equitable health and well-being in their region.


Regional stewards determine their geographic area of focus for their transformation effort, and there isn’t a standard way to do so. Stewards may draw a “regional area” boundary by neighborhood, zip code, county, city, hospital service area, hospital referral region, or other self-defined configurations.


People who live and work in the community who are not professionally involved in regional stewardship, regardless of citizenship or immigration status.


Stewards are people or organizations who take responsibility for working with others to create conditions that all people need to thrive, beginning with those who are struggling and suffering. Stewards may be affiliated with organizations or may act on their own agency, such as a resident. Stewards have (or are interested in developing) an equity orientation in regard to purpose, power, and wealth.


The act of stewards working together across boundaries to create the conditions for equitable health and well-being. This involves efforts to negotiate shared values, establish and enforce norms, resolve conflict, and adapt to circumstances in a constantly changing world.

System Thinking

A holistic approach to analysis and problem solving that focuses on the big picture to see how parts of a system connect as well as how our mindsets and actions shape consequences over time.

Theory of System Change

A comprehensive description of how and why a desired change is expected to happen. A theory of system change articulates the key trends that stakeholders can shift [via policies, programs, or practices (e.g., allocation of resources)] in order to transform the system’s performance over time.

Vital Conditions

Properties of places and institutions that all people depend on to be healthy and well. They include basic needs for health and safety, lifelong learning, meaningful work and wealth, humane housing, a stable natural environment, reliable transportation, as well as belonging and civic muscle (i.e., special capacities of people and institutions that convey to all a sense of belonging and power to influence the policies, practices, and programs that shape our world). These not only have the potential to enhance health and well-being, but also prevent harm and avert the need for costly, often inequitable urgent services.

Working Relationships

The routine pattern of connections among two or more stewards (people or organizations) intended to achieve a common purpose related to health and well-being.

Urgent Services

Services that anyone under adversity may need temporarily to regain or restore health and well-being. They include acute care for illness or injury, addiction treatment and recovery, criminal justice and emergency response, homeless services, environmental clean-up, as well as unemployment and food assistance.