The American healthcare system was built on a foundation of structural discrimination and oppression that still persists today. Despite hard-fought victories in the struggle for health equality, the system’s practices, procedures, and policies are still deeply coded with disparities that affect patients and medical professionals alike.
In 2020, The Robert Wood Johnson Foundation partnered with IDEO.org to create a space for emergent and existing health equity activists, scholars, and medical practitioners to craft a radical, new vision for health justice and develop prototypes to bring it to life in institutions across the country. The goal was to design an enabling digital environment where changemakers could confidently set new standards of wellness and interrogate systems of oppression through iteration and making.
Over the course of a year, The Collective, 80+ equity leaders gathered together, galvanized by the possibility of a more equitable and just healthcare system.
Embracing plurality to craft a shared vision for wellness
The Collective included people of different ages, races, and disciplines—from medical practitioners and patient advocates to policymakers and restorative justice leaders—who all had a shared goal of seeing health equity realized in their lifetimes. To cultivate a culture of trust and intimacy between strangers, we focused our role on setting the foundation for collaboration and experimentation moving forward. The Collective aligned on a vision of healthcare that values all people equally, recognizes and rectifies historical and ongoing injustice, provides resources according to need, and is representative of all the people it serves. Grounded in diverse expertise on social justice theory, health disparity data, patient-centered care, and political activism, the Collective came up with 14 ways in which it could manifest in the real world, which then became fodder for the prototypes that would be tested within their institutions.
Unlocking creativity and imagination in the quest for justice
In order to create space for changemakers to imagine new futures and opportunities, untethered from day-to-day constraints, we called on artists and activists to guide them on their journey and introduce opportunities to make things tangible. We brought in spoken word poets to awaken vulnerability and connection, activists to ignite the group’s changemaking power, and illustrators to make their visions come alive. Throughout the year, we transformed their insights and ideas into shareable tools and assets that reflected back their work and gave them momentum. These creative spaces helped members of the Collective see their practice from a different lens, let go of perfectionism through scrappy iteration, and bring humanity and lived experience to a space that often dismisses the value of those mindsets.
Using prototyping to plant seeds of liberation
Instead of getting paralyzed by the idea of changing an institution as big and bureaucratic as healthcare, different teams embodied the changes they wanted to see through small-scale prototype demonstrations. Using a human-centered design approach, teams ran six-week prototypes —from designing a reparations calculator to developing a model of dignity-driven data collection and inclusive decision-making within health institutions. These prototypes enabled participants to test their assumptions, experiment with ideas at a low-cost, and invite feedback from patients, community partners, and service providers early on. Together, we designed each experiment to be a learning opportunity for the Collective, as a whole, to take back to their own personal and professional contexts.
Over the course of the year, the Collective built and strengthened connections that reinforced the message that they’re not alone, but are in fact backed by a network of change agents fighting to promote wellness and inclusivity in their work. By collaborating and making together, teams began to realize the immediacy of change—modeling inclusion, anti-racism, and equity in how they teach students, engage with peers, and treat patients today. The prototypes also demonstrated the value that emerges when we transfer power within traditional hierarchies and invite patients and their networks to be agents of their care journey. Over the next year, Robert Wood Johnson Foundation and IDEO.org will run co-design sessions with the Collective to shape a second year of work based on their visions of change within their institutions.
