population health haidt messaging





By Gary Gunderson

The lean, tall boxer walked with ease, with long arms that looked like he could land a punch from around a corner. And he would probably need only one, according to his reputation across West Africa. In 1996 he was in Atlanta as part of the Olympic team from Burkina Faso, staying as guests of the city of Decatur, which had a longstanding “sister city” bond with the country “of upright people” since a few of us had visited in the 1980s.

But the fighter’s reputation was as irrelevant as blown sand as he weighed in and learned that he had eaten so much celebratory southern cooking in his few days in Atlanta that he had to move a whole weight class up—among bigger guys with even longer arms. His Olympic career lasted about 17 seconds. As Keb’ Mo’ would sing, he was a “victim of comfort.”

Punching below our weight

I have been thinking of this ever since Tyler Norris told the Association of Community Health Improvement (ACHI) that those of us trying to advance community health were punching below our weight. He meant that we were achieving remarkably little given the huge array of apparent tools, techniques, networks and assets we had to work with. You’d think that with the hundreds of millions of dollars poured into all the coalitions with billions of hours of volunteer efforts, you’d see more… health. Maybe a lot of mercy. Maybe even a glimmer of justice. The ACHI gathering was, of course, reeling from the inauguration of a New York glamor developer who chirped and tweeted about pretty much the opposite of every single thing the community health movement has worked on for decades. Felt like a 17-second smack-down.

Maybe we’ve been eating too much.

Fred Smith has long said that it wasn’t that the forces of meanness were bigger or smarter, but that they were certainly better organized. They do seem better connected to some of the very kind of left-behind people you’d think would welcome some friends working on mercy and justice. Coal miners, who are now way outnumbered by solar panel installers. Or North Carolina former textile workers wearing dollar-store t-shirts made in Malaysia. And Montana farmers who are enraged at people they’ve never met from countries they couldn’t find on a map with the help of a bloodhound.

Maybe we’ve been eating too much with each other.

johnathan haidtMessaging below our weight

Once trust is broken, you can’t talk your way back into the relationship. Many are trying to do that, focusing on how to talk when the issue is how to touch. I’m part of a team that has drawn on the work of Jonathan Haidt who wrote a book about “The Conservative’s Advantage.” The team is rooted in public health, led by Gene Matthews who served as the General Counsel of the Centers for Disease Control and Prevention for six directors. Now at University of North Carolina, Gene considers the work of “crafting richer messages” across the vast public chasms as urgent as any public health vaccine. (Read the article in the Journal of Public Health Management and Practice, JPHMP, here.)

Haidt considers himself an evolutionary psychologist looking at how people develop moral positions based on six very basic intuitions: is the position caring, fair, loyal and in line with tradition, authority and sanctity? His point is that we intuit this before we think it through. Liberals (like me) tend to tune and speak in ways that ring the first two—caring and fair—while conservatives tend to play with all six.

I find Haidt more useful than brilliant. Those of us trying to communicate in these troubled times are messaging way below our weight. One reason is that we’ve been punching those to whom now we want to message. The main problem is that Haidt turns our mind toward talking when the issue is touching. If we have not earned the right to speak by the actions that show we care, no words, much less sentences, much less entire “positions” will make any sense at all.

In the JPHMP article we include a story about the utterly unexpected, almost inexplicable relationship emerging in North Carolina where you’d least look for it. This is a ground tortured by all the harsh winds of deindustrialization, now buried in an avalanche of addictive pills. Driven by polarized public religion, now most people (about 75 percent) in this once Bible-belt don’t bother to go anywhere at all to worship. Yet here—here!—a working relationship is emerging between the Moral Monday Baptists (mostly Black) and the Tea Party Baptists (mostly White) focused on how together they share in the work of mercy for those in need in the towns on sandy soil and rocky hills from Ahoskie to Ashe County. It’s not words but touch in ways that matter in real lives. Haidt would say, of course, that the conversation touches on all six, not just two foundations, and he’d be right. But he’d have missed the point that the relationship precedes the talking; that the doing overcomes the talking.

Over time, actions communicate

My wife TC, my brother John, and I recently spent some time with my oldest sister, Judy, who is living a hard part of her life in a nursing home. Although she is cared for by an exquisite staff of hugely decent women, as well as three sons, on many days she is anxious. I am hardly recognizable from the eighth grader she used to care for. While I started to do my normal comfortable pastoral chatter, she grabbed my hand and simply said, “I’m afraid; don’t leave me.” We held hands almost unbroken through a visit to Wendy’s, followed by an apple, a sip of red wine, a long walk, nursing home entertainment, breeze on the gazebo and watching a raised flower bed until she finally headed for a nap. I slipped out while TC slipped her hand in until sleep won out. I’m sure she won’t remember anything any of us said, which could not matter less.

People can’t hear someone they haven’t touched no matter how well-crafted the message. This has practical implications for practice and management. In our hospital, we have a fund to respond to the emergencies that arise in the lives of our lowest wage, most vulnerable employees. And the same people manage another fund for the emergencies in the lives of our fellow-workers who are veterans. We hold interfaith worship raising up the sacred differences that mark the wild diversity of the world God has created in God’s apparently highly diverse image. And we pray to Jesus and eat breakfasts with Baptists (who are more diverse than you might think).

We provide spiritual care to the law enforcement and first responder community with two—soon three—full-time chaplains skilled in the particular challenges of those difficult lives. This includes ICE! And we have FaithHealth staff who speak various dialects of Spanish with some who have documents and some who don’t. Sometimes the web of relationships crosses over the obvious divides and finds words beginning to form and make sense from ICE to the Sanctuaries. We have performed the weddings of the jailers and signed as “next of kin” with a homeless patient known to our ER docs and nurses (that one needed a whole worship service as words alone simply did not suffice). We live across, not chatter across, the lines.

Over time, actions communicate. The testimony of time wears off the distraction of what is spoken and what is lied. The New York Times recently listed in tiny print a whole page of the lies of a certain man who lives in a white house. Nicely crafted message that won’t be heard. Only the skin sorts out what the ears can’t discern. When we act with loyalty, it will be found true. And when people promise health, then steal the money and give it to their rich friends, that will be found, too. Focus on the life, not the line.

When your actions have opened or re-opened a relationship, don’t forget to talk in a way that honors the wholeness. Speak out of loyalty to the whole and to the authority of the institutions that protect us all (public health, courts, humble worship). Speak to the deeply-rooted, dare we say sanctified, decency for the stranger. Name the common arc of history, as did Lincoln and King. And speak of faith in a future with room for us all.

Live into more radical relationships

On September 5th and 6th Tyler and a couple hundred others of us will gather at Howard University seeking the ways—and the words—to live into more radical relationships across all the lines that keep us from the wholeness God sees. It’s called “Faith in Health: Reasons, Risks and Responsibilities. But who care about the words. The point is coming into relationship with each other to that our lives can be about more than those who agree with us; can be in right relationship to the world God so loves.

The meeting is based on a body of collective learning about how to create and live in the relationships that create health. This includes the astonishing new possibilities emerging in the new relationship between mission-driven healthcare, public health and partners in the community. This isn’t about talking in new ways, but relating in new ways. This is the heart of the Stakeholder Health: Insights from the New Systems of Health, the book that captures a couple hundred pages of amazing news.

If you want to be with people who want to do that, please join us. It’s free, of course. And it comes with a free box lunch! But it might cost you your old life. Register here. Faith in Health: Reasons, Risks and Responsibilities.


Books from Stakeholder Press

Books about Transforming Health

Join the Community!

Sign-Up for the Latest News.

1 Comment

  1. Ralph Morales

    Gary, once again your words come at a critical in my work & life. I will read & re-read your words. Then get back to work. ¡Gracias!

    Ralph Morales


Submit a Comment

Your email address will not be published. Required fields are marked *