Not too long ago, opinion researchers held a focus group experiment in two Colorado towns: Boulder, known for its left-leaning politics, and Colorado Springs, where views typically reflect a more rightward bent. Not surprisingly, the researchers found that when people talked about big, complex issues like climate change or same-sex marriage with others who thought the same way, they didn’t become smarter on the subject; they just became more set in their opinions.
Legal scholar and former White House staffer Cass Sunstein and behavioral scientist Reid Hastie wrote about this in a new book titled Wiser: Getting Beyond Groupthink to Make Groups Smarter, and their example is instructive. If communication is going to effectively move the needle in the understanding of complex issues, inspire action, and promote social change, it needs to encourage leadership that is open to divergent views, eager to co-create solutions, and ready to evolve.
Over the past 40 years, the Robert Wood Johnson Foundation (RWJF) has worked to change American attitudes toward seemingly intractable issues, such as the use of tobacco, end-of-life care, and childhood obesity. Last year, we embarked on our biggest, boldest agenda yet: building a comprehensive culture of health for all. We’re heartened to see so many elements of our strategy reflected in Sunstein and Hastie’s book about smart decision-making, because we know that it will take nimble, systemic leadership and broad-reaching partnerships to change the way we view and value health in the United States.
When we embraced the vision of building a culture of health, we asked ourselves how we could get others to define health as more than simply “not being sick,” and bring about changes in our society that would make health an important part of how we all live, learn, work, and play.
We developed ideas of what a culture like this might look like—where doctors regularly discuss the price and value of treatments with their patients, or write prescriptions for food, heat, or housing for those in need. We pictured cities, towns, and neighborhoods designed to make sure that the health of children is a matter of fact, not a matter of chance. We imagined a future in which businesses could rely on the vitality of workers to stay competitive, military could perform at its highest level to protect us at home and abroad, and the trillions of dollars we spend on health care could go way down.
We knew where we wanted to go, but where on earth would we start in communicating this?
Then we thought of the lessons we learned in our work to end childhood obesity. In all our communication on the subject, we had to sound an alarm about the urgency of the problem, and we had to make it clear that everyone—from parents to policymakers, from corner stores to corporate offices—had a role to play.
To do that, we had to turn the problem of childhood obesity into dinner table conversation. We had to show Americans why it mattered and state it so boldly that they couldn’t ignore it. We pledged $500 million to reverse the childhood obesity epidemic, then backed up our pledge with blunt and powerful messaging: American children could be the first generation in US history to live sicker and die younger than their parents, and that for many inner city kids it is easier to find a gun than a piece of fresh fruit. That got people’s attention. Policymakers responded. Educators responded. Industry responded. Even the White House responded. Fortunately, we are beginning to see signs of progress, especially among children between two and five.
As we look toward our broader goal of building a culture of health, our job now as grantmakers and communicators is to share the vision with others, but not in a way that is set in stone. When we say we are all in this together, we need to mean it and invite partners to help us build the road to our destination, stressing that there is no one route to get there. And we need to listen and really hear how others define a culture of health, and then reflect and amplify what we learn. Our leadership has to be adaptive, collaborative, and flexible. We cannot prescribe our particular vision to others. To them a healthier nation may mean a culture of care, a culture of well-being, or a culture of personal rights and responsibilities. We must have the discipline and courage to allow the direction of this effort to emerge from the input and innovation of others. And we need to continue working collaboratively across disciplines, both inside and outside our foundation, keeping in mind the many complexities inherent to building unprecedented systemic change.
At the end of the day, culture, like the best communication strategy, is always co-created. As the anecdote from Wiser shows, meaningful change cannot happen in an echo chamber of the like-minded, and the best leaders, avoid the “happy talk” of group-think, choosing instead to create conditions for multiple voices to speak up and plot the course toward positive change.
So as we look ahead to 2015, we know that our grantees, leaders in the fields of health and health care, and our philanthropic colleagues can serve as friendly ambassadors for our big idea. But it is important not to listen only to the choir. We must also be prepared to test our message with those who do not know us and have not typically considered themselves part of the health arena: business, the tech sector, educators, and others. Because the true measure of our success will not be the number of traditional allies who embrace our messages, but the number of “unusual suspects” who will find a place for themselves in a culture of health and invite others to join the movement.