A seventeen-year-old African American woman is pregnant. She has no health insurance. She doesn’t know how to access proper obstetric care for herself or her baby and doesn’t know where to go to find out. She is sporadically semi-homeless. She has a substance abuse problem, as does her mother, and is without anyone around her encouraging her to get help. She smokes and eats poorly. She doesn’t know how to shop for healthy food or how to cook. She doesn’t have a permanent home in which to cook. The availability of healthy food within a convenient distance for regular shopping is non-existent. She lives in Indianapolis where the public transportation system is dismal, where sidewalks are in disrepair and are not cleared of snow in winter, so she can’t walk or find public transportation to her obstetrician visits. Her boyfriend is abusive. The public schools into which she would put her child are under-funded. The educational approach in the schools in her nation is built for the 20th century. The baby’s father is in prison for the second time, soon to get out, which will cause conflict with her abusive boyfriend. There’s a lack of economic opportunity in the city. While a large convention center has just been built, it has only succeeded at bringing in mostly minimum wage jobs cleaning hotel rooms and waiting on tables.
Our dream plan won’t come to fruition for twenty years. By then all hope will be lost for her. It pretty much already is.
But what about her child?
Think about the village that needs to be brought together to bear—in a coordinated way—for her child to be successful, and the number of issues it implicates. It is mind-boggling.
The entire transportation infrastructure needs to be re-thought and rebuilt so she can get to her doctor’s visits. That means money. That means tax increases and applications for state and federal funding. Tax increases mean the need for political leaders willing to design and advocate and win the tax increases. Tax policy for the public schools needs to change so that the schools the child will enter will be adequately funded.
That probably means a PTA on steroids to make the case to the public, not once, but consistently. Our entire approach to education needs to change so that the child will get training for 21st century economic opportunity. That means a serious navigation of all the disparate expert opinions on education reform, buy-in from the teachers’ unions, and implementation of such a plan in a coordinated way from kindergarten through high school. It means we need leadership to stay there long enough to see it all through, but turnover as it currently stands is high, so that sub-issue needs to be addressed. The economic opportunity this new training is designed to take advantage of needs to be built before there’s an exodus from the city. Prison rehabilitation programs are needed. Local healthy food stores need to be brought in. However, they don’t want to come in because of crime in the neighborhood. So, the police department needs a strategic plan to combat that, but they’re dealing with issues of internal racism and abuse for which they need funding, which puts them in competition with the schools, as they perceive it. The mother needs emotional support and mentoring. She needs the help of a recovery clinic. She needs health insurance. She needs health—but the hospital system’s revenue model pays the hospitals when people are sick, not healthy, so a very difficult systemic and fundamental discussion about healthcare incentives needs to happen. She needs housing. She needs a job.
Now multiply that times tens of thousands or more people in various scenarios of need. Now we start to grasp the beginning of the level of complexity required to get to a whole person, with no one left out, within twenty years. We want the solution map to look like a neat little ten-point diagram, when in fact it looks like the circuit board for a super computer—microscopic lines crisscrossing one another at a million points of contact. The human mind can’t grasp it or map it and certainly can’t store it—only a coordinating entity can. Yet individual human minds and an occasional white board are all we ever bring to the task. And breakfasts leave out even the white board.”