STAFF & GUEST BLOG

A Time Machine for America’s Most Vulnerable

April 1st, 2011, byJANE ISAACS LOWE

This post was previously published on March 21, 2011 at Spotlight on Poverty and Opportunity.

Marist College recently conducted a survey to determine what superpower Americans would most like to have. More than a quarter of Americans said they would want the power to travel through time, which tied with mind-reading as the most popular choice.

At the Robert Wood Johnson Foundation, we often wish we had the power to travel through time. We wish we could anticipate and adequately prepare for the challenges that lie ahead, especially to improve the health and well-being of the most vulnerable among us.

Fortunately, we got a taste of that superpower with the expertise of the Institute for Alternative Futures. While time travel may be the stuff of fantasy, we can look into the future — or rather, many possible futures — with the aid of scenario planning. This approach is helping us to understand how our society and the vulnerable populations within it could change over the next two decades.

Being healthy has as much, if not more, to do with our social circumstances — where we live, learn, work, and play — than our access to medical care. And if you’re vulnerable, it often means you don’t have the same kinds of opportunities to make healthy decisions as others. What opportunities you do have may be undermined by poor education, inadequate housing, low income, stress, or violence.

Recognizing the importance of such social influences on health, the scenarios we analyzed looked at a range of factors ranging from education and technology to food, cultural shifts, and crime.

Not surprisingly, two drivers of vulnerability loomed larger than the others: what happens to the economy and jobs, and how the government responds. Even a strong economy does not guarantee a drop in the ranks of the vulnerable. Likewise, there are ways we can respond to economic hardship that would ultimately improve their prospects.

The following is a quick overview of the four scenarios we considered:

SCENARIO 1: COMEBACK?
The economy rebounds after the Great Recession. Education improves and benefits most families. But automation and offshoring prevent many jobs from ever coming back. Governments are constrained by their debts. Despite some improvements, the ranks of the vulnerable expand.

SCENARIO 2: DARK DECADES
The double‐dip recession is followed by peak oil in 2016. Prices for energy and food rise rapidly while low‐ and middle‐income jobs continue to disappear. Government services and payments are cut severely, while vulnerability rises significantly.

SCENARIO 3: EQUITABLE ECONOMY
A depression follows the Great Recession. Massive unemployment and hardship prompt a shift in values that leads to an economy that is fair and works for all. Governments are forced to be effective and education advances opportunity across populations. Vulnerability is reduced.

SCENARIO 4: CREATIVE COMMUNITIES
The economy recovers. High debt levels limit what federal and state governments can do. Families and communities become more self‐reliant and entrepreneurial. Technology yields low‐cost energy and food. Communities develop local currencies, barter services, and support innovation. Vulnerability is reduced.

These scenarios allow us to anticipate what might be, to imagine, to check assumptions, to leave less to chance, and to act in smarter ways to enhance the impact of our efforts and resources. The optimal response is to develop strategies that will work across a range of different conditions. For example, finding cost-effective solutions to vulnerability that can be deployed locally, but also scaled nationally, makes sense in any of the scenarios. All the more so if those solutions address interconnected factors — such as health, education, employment, and housing — at the same time.

This is a particularly challenging time for vulnerable populations and for the country as a whole. We still face high unemployment and deep, long-term deficits with budget cuts that imperil safety net programs, education, and health care. And signs that policy leaders will reach consensus on effective solutions to entrenched challenges continue to be elusive.

But just as Americans are largely in agreement about what superpowers they wish they had, we are confident that there are many innovative and practical strategies that could improve the health and well-being of our most vulnerable populations and that the majority of Americans could embrace.

The time to start identifying those solutions is now, guided by thoughtful, provocative tools that help us take that leap forward in time.

Jane Isaacs Lowe is Team Director and Senior Program Officer for the Vulnerable Populations Portfolio of the Robert Wood Johnson Foundation.

  • Esmeralda

    It saddens and worries me that we are as a nation in a vulnerable situation on many social fronts. I believe the American public is lacking information about the dire circumstances of so many people. My neighbors on the right and left side of my home are unemployed. Someone in my own home has not found a jobs in over two years. All 3 homes are living the truth of the economy and few media outlets are reporting it. We ask each other; why? A daily vulnerability we face is not having the money for medical attention because in a one income household medical attention has now become a luxury.

Last modified: May 4, 2011 at 9:23 pm