The latest leader’s guide for Stakeholder Health: Insights from New Systems of Health is available. This guide, written by Gary Gunderson, offers reflections and insights for conversations among the faith community as they explore the book. What follows is the first section.
New Systems of Health and Spirit
By Gary Gunderson
What is a hospital?
What is church, mosque, synagogue or temple?
What does it mean to be an agent—or agency—of healing?
The last half century of both faith and health organizations has been marked by profound and sometimes disturbing change, as both adapted to fundamental shifts in science, technology, finance and culture. The largest number of hospitals in the United States were started by religious groups, often a small gathering in the basement of a church convened, as in Memphis, by a layperson who wondered why their members didn’t have the chance to go to their own hospital. Or it might have been led by a small group of physicians, perhaps Black or Jewish, who were denied the right to practice in the local hospital. Often the hospital was the next logical step of ministry that began as home-based nursing or diaconal care, the usual, and in every case, astonishing Catholic and Lutheran story.
Today the word “hospital” describes vast technical institutions that dwarf the religious networks that conceived them. However, those religious networks raised the thousands of dollars for the institutions’ first bricks, sewed the sheets on their first beds and wiped the sweat and tears from the first patients hoping that the early science would help their struggle for life. While a few systems, such as Wake Forest Baptist Medical Center, receive significant financial support from their birth parent, most hospitals are overwhelmingly dependent—and responsive—to the government and private payers and the calculus of those in far-away financial centers who lend them the money to buy extraordinarily expensive technology.
The churches, mosques and temples have changed, too. For one thing, it is not just “church” any more, especially inside the radical diversity inside a hospital and the unpredictably diverse places where vulnerability is concentrated. New language may help us see the new reality, so let us speak of “communities of spirit” to bring to focus the 300,000 institutions that continue to exist for the purpose of forming and expressing faith. Although many of their buildings are similar—and in some cases the very same ones—most all the other functions, processes, and relationships have adapted to the wild flows of the 21st century culture. No physician would want to practice within the limits of a 1908 hospital; neither would a modern leader of a community of spirit.
This modest piece is an invitation for those of influence within the new systems of health to enter into dialogue with their peers in the new systems of spirit. The invitation is prompted by some years of intense collaborative learning by people working within health organizations, both hospitals, public health and varieties of academic fields. Forty-four of these individuals came together under the convening of Stakeholder Health to describe what we’ve seen emerging, not from the struggles of the past, but let us say the struggles where the future is breaking through. We write of the “insights from new systems of health.” The new is already present on the toughest streets, bearing witness of what is possible everywhere. These new systems are emerging from within and around the old systems, of course, so it is easy to miss the significance of what has already happened and what it tells us about what is possible next.
Ironically, many of the participating health organizations that have contributed to this collaborative learning process were born of faith, but have lost meaningful relationship with those seminal faith networks. The faith that provided the imagination that created us is now nearly out of dialogue range. We want the dialogue very badly, not out of nostalgia, but because of what we’ve learned about the new and the next. Science and technology will continue to accelerate. But the really new part of the “new systems of health” is the profound integration with the full array of community partnerships. A hundred years or so ago, the community invented hospitals. Now we together need to reinvent community, something that demands deep, sustained, faithful dialogue—especially between those most immersed in the networks of health and those of the spirit. This invitation is born of humility, but is marked by confidence that the dialogue will help all of us who care for the future of the neighborhoods we love be deeply accountable for what is possible.
This piece is written for two audiences. The first and most immediate are those faith leaders coming to a meeting at Howard University in September of 2017, a meeting explicitly built around the findings of the Stakeholder Health collaborative learning process, hoping to set off a serious dialogue with our faith partners. But we do not expect the two days at Howard to do anything but start that dialogue. So this piece may be useful for other people in or near faith institutions or networks that want to be partners in the spreading dialogue likely to follow the Howard event. The Stakeholder Health learning is a lot to take in and respond to. This piece hopes to make it more clear why it may be worth the trouble to do so.
It’s fair to ask “Why do you want to talk now?” And, frankly, “Why should we care?” After all, it’s much harder to run a faith organization these days than a hospital. The demographic and financial ecology on which a congregation depends has changed more fundamentally than healthcare economics. The next few pages are intended to answer the question, “Who cares about the relationship between faith and health?” The framework will be to explore the book Stakeholder Health: Insights from New Systems of Health by looking at how each of the 11 chapters suggests some ways in which that relationship is filled with new possibilities that could help both sides thrive in sustained service to the communities we love.
But before we even get to the logic, let us be clear about the fact that the authors of the book live on both sides of the relationship, as do the people of faith. We are not secular health professionals speaking to faith members who are not deeply familiar with the journey of health themselves. We are members, parents, children, neighbors, employees and, in short, grown-ups trying to do the best we can to live with integrity in all those roles. What we learned about the new systems of health piqued our imagination about living with integrity, about how becoming deeply accountable to how our lives could contribute to the health and wellbeing of those we love. Rather than standing passively before changes that seem to tear apart and undermine what we love the most, we have learned that we can act with purpose to build a future for those we love.
The key is finding the deep common ground between those within faith and health networks. Let us take a few pages to explain why we are committed to doing that by walking chapter by chapter through the book. Please understand this as doing you the respect of explaining carefully why we value the dialogue so much, the exact opposite of thinking we have learned so much we can tell you what to do. In fact, we have learned enough to know we need the dialogue with one of the other sectors who love the same community.
You’ll see that this approach toward partnership on the very first pages of the book. The chapters—all ten of them—seek to address these critical questions:
- How should we think differently about and help improve the social conditions in which our most vulnerable neighbors live?
- How do we move toward establishing essential healthcare as a basic human right—something that simply comes with being created by a loving God born into a human community designed to express shalom or wholeness?
- How do we help achieve health and other types of fairness in our communities?
- How do we use our leadership roles and work in health systems—and faith systems—to engage the heart and spirit of our local communities, including those who work within the organizations of health and faith?
- How do we answer these four questions by moving upstream, earlier in the development of negative conditions by working earlier on the positive drivers of health?
It should be obvious that all of these questions point toward deep partnership born of deep dialogue with those in the community focused on faithful imagination—you.