Thursday, October 18, 2012

Fixable

"Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning." — Albert Einstein 

THE ONLY UPSIDE of occasional bouts of insomnia is that I end up reading things that I might otherwise miss. Below is an intriguing article by David Bornstein, who writes an online column called Fixes for the New York Times

Opinionator - A Gathering of Opinion From Around the Web

FIXES 
October 17, 2012
Social Change’s Age of Enlightenment
By David Bornstein

One of the benefits of writing a column about solutions is that it offers an alternative lens through which to view the world. This week is the second anniversary of Fixes. Much of my time over the past few years has been spent talking to people about the creative responses to social problems that are emerging across the country and around the globe. It turns out there’s no shortage of these stories. I’m often struck by how much ingenuity is out there and being directed to repair the world, and how little we hear about it.

As a result, I often find myself out of step with friends whose views are shaped by the big news stories — money-driven politics, unemployment, war and violence, seemingly irreparable education and health systems. After looking at hundreds of examples of social change efforts, I see a side of reality that goes unreported: namely, that we’re getting smarter about the way we’re addressing social problems. In fact, I would go so far as to say we’re on the verge of a breakthrough — maybe even a new Enlightenment.

If that sounds like an overstatement, consider the comparison. The Enlightenment was a period in history when fanciful thinking gave way to a more rational understanding of cause and effect. It promoted the scientific method, challenged ideas grounded in tradition, faith or superstition, and advocated the restructuring of governments and social institutions based on reason. (It was not always so enlightened, however. While Enlightenment thinkers sought to advance the public good — producing documents like The Bill of Rights — they also used reason to justify colonialism and slavery.)

Today’s Enlightenment stems from new understandings and practices that have taken hold in the social sector and are producing better and measurable results against a range of problems.

In Fixes, for example, we have asked questions like: Is it possible to systematically increase empathy and cooperation in children? Is there a way to teach math so virtually all children become proficient? Can we prevent thousands of cases of child abuse without removing children from their parents? Can we dramatically reduce — or come close to eliminating — chronic homelessness from every city in the United States?

What’s surprising is that the answer to these and many similar questions is yes. This is not wishful thinking. We know how to do these things; in fact, we’re currently doing them at significant scale (although nowhere near the scale of the problems). We’re accustomed to hearing that our problems are intractable, that social programs inevitably disappoint. So what’s different today?
Looking across many initiatives, I’ve found several patterns — strategic insights — that jump out. (In my previous career, I was a systems analyst, and I remain a wonk.) In the months ahead, I plan to explore some of them in depth. For now, here are three themes to ponder.

We are not econs 
It may sound strange, but we are increasingly addressing social problems with the recognition that human beings don’t behave rationally much of the time, or even most of the time. Recent research from behavioral psychology and neuroscience has shed light on the different ways that emotions, unconscious drives, group identities, and situational cues guide human behavior. (My colleague Tina Rosenberg has written extensively about this.) In short, we’re learning more about how people really work — and we’re applying the knowledge to solve problems.

And it makes a difference. We’ve seen, for instance, that if we want to mobilize people to protect the environment, it’s probably less effective to issue dire warnings than to organize campaigns that tap people’s sense of pride in their heritage. We’ve seen that we can increase desirable behaviors — recycling or hand-washing in hospitals, for example — by changing the context so the behaviors become more reflexive or culturally reinforced. In schools, organizations like Playworks are showing that, if you want to reduce bullying, increase students’ readiness to learn and give teachers more time to teach, one of the most sensible strategies is to improve recess — so that it becomes a period in which children learn, through play, how to control their impulses and get along with others. In vocational training programs, we see that one of the best ways to increase the odds of career success is to teach the so-called “soft” relational skills alongside “hard” job skills.

In these and other areas, groups are increasingly applying knowledge about how humans work. Like Enlightenment thinkers, they are being more rational about cause and effect.

Just the facts 
Alongside these behavioral insights, we are increasingly using data, well-conducted studies, and evidence-based decision making to evaluate and sharpen the effectiveness of social interventions. This, of course, is nothing new. Some 150 years ago, Florence Nightingale revolutionized medical care in England the same way. We think of Nightingale as a kind lady with a lamp, but she was closer to a data analyst. She wrote: “To understand God’s thoughts we must study statistics.” And she used data to force changes that substantially cut death rates in hospitals and military barracks and led to the formalization of nursing.

Today, the social sector remains far from evidence-based. For example, much of the math and writing instruction in American schools is not supported by evidence of what works. Even in medicine, the evidence-based movement is only two decades old. (It was only in the 1960s that the U.S. government began requiring pharmaceutical companies to demonstrate “substantial evidence of effectiveness” for new drugs.) Since the 1970s, a few standout groups like MDRC have pushed for more rigorous testing of social programs. But until recently, if you ran an after-school or Head Start-type program, or a program that claimed to reduce juvenile crime or prevent teen pregnancy, you could keep turning the crank for years without having to furnish proof that you were achieving results.

That is still possible, but it’s getting tougher. Private and public funders, as well as groups like M.I.T.’s Poverty Action Lab, the Cochrane and Campbell Collaborations, the Coalition for Evidence-Based Policy, the Washington State Institute for Public Policy, the Institute for Health Metrics and Evaluation, are increasing demands for more, and better, evidence.

The upshot is that we’re now in a better position to recognize what works and what doesn’t in a variety of areas — like which methods to reduce child abuse and prevent unwanted teen pregnancies appear most effective, or what studies tell us about how to improve the teaching of math or writing, or which police tactics are most effective at reducing crime. In both the Bush and Obama administrations, we’ve seen early efforts to incorporate evidence in policy making at the national level. People with good intentions have long worked on social problems in the dark; increasingly they are being asked to prove that they are getting somewhere. This is a departure from the past. And like the scientific revolution, if the movement grows, it should foster considerable innovation.

The Integration of Labor 
For the past century, society has grown ever more specialized and balkanized. Today, we’re getting smarter about bringing people back together to build comprehensive solutions. This is a shift away from a trend that can be traced back to Adam Smith, who wrote in the very first sentence of “The Wealth of Nations” that the greatest gains in productive power come from the “division of labor.”

Smith famously showed that a pin factory could multiply its productivity many fold if each worker specialized on one narrow aspect of pin making. Henry Ford adopted the principle and invented the assembly line. Modern society is full of “pin factories” — inward looking agencies and organizations that operate in silos and bounce people back and forth like pinballs.

The problem is that social issues are multi-dimensional. If you want to fix the health problems in a low-income community, you have to fix the housing problems and the access to healthy choices. If you want young people to graduate from college, it’s best to get started when they are in preschool, or better, in utero.

And that’s how more people are beginning to think about problems. In a number of areas, we’re witnessing the sewing together, or integration, of social functions that have for decades been handled in piecemeal fashion. One of the best examples of this is the strategy that has come to be called “collective impact,” through which scores or hundreds of organizations in a city agree to coordinate their work, aligning behind an agreed set of measurable goals. In education, cities are building end-to-end “cradle to career” pathways.

Groups like Health Leads, staffed by volunteers, are working in hospitals, side by side with health care providers, to address the social determinants of health — malnutrition, housing, poverty — that underlie or directly cause many medical emergencies. The 100,000 Homes Campaign, directed by Community Solutions, has developed a model that assembles all the players in a city who, collectively, redesign the housing placement process. Cities soon discover they are able to multiply the number of people they house and cut the time it takes by 70 percent or more. (To date, the campaign reports that close to 21,000 people have been housed.)

More and more, people are taking up the challenge of connecting the dots. In doing so, they find they can address problems in more sensible ways — and achieve results.

In future columns, I’ll explore other ways that we’re getting smarter. Here’s a preview of three more:
— We’re recognizing that a key to social change is to turn great ideas into great institutions. And one way to do that is to begin by identifying and supporting talented entrepreneurs who are driven to build social change organizations (just like we do in business).

— We are beginning to finance social change more rationally, moving away from capricious, fragmented, short-term funding towards financing that is tied to success and, like in the private sector, allows top performers to grow rapidly.

— We are harnessing the power of everyone. Bill Joy, the co-founder of Sun Microsystems observed: “No matter who you are, most of the smartest people work for someone else.” Recognizing that fact, we are increasingly using open innovation models to identify powerful ideas wherever they may be found.

Most of these changes are still in their early stages. To be sure, they are far from standard practice. But even as scattered examples, the innovations show what’s possible, raising expectations and creating pressure for others to respond. This is not to say that issues like education and health care will become depoliticized or ‘rational’ anytime soon. However, the more society becomes aware of the remarkable potential we have in our hands — the more we hear about post-Enlightenment programs that are achieving their goals — the more we can make sense of why they are working — the less legitimate it will be for those with vested interests to defend the status quo.

It won’t happen overnight. It took two centuries after Copernicus for the world to acknowledge that the earth was not the center of the universe. But, as they say, the truth will out.

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