“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” – Archbishop Desmond Tutu
In 1963 Jean Nidetch invited some friends to meet weekly at her house in Queens, New York, to talk about how they could lose weight. They had all variously tried pills, hypnosis and a myriad different diets, but the collaborative sharing of ideas, group accountability and peer recognition appeared to make all the difference for those involved, and thus, the concept of WeightWatchers was born.
Slimming World was formed six years later, and over subsequent decades, many more organisations and initiatives have built their own track-records of helping people to lose weight and keep it off. And yet, over that time, the average level of obesity within the populations in which all those interventions operate, has risen inexorably.
It’s not that those interventions don’t work; they do – WeightWatchers for example, has a comprehensive evidence base to prove it. But the obesity challenge they are facing is more complex, more widespread, and growing far faster than individual interventions can hope to match. Which is why, in local authority areas where weight loss programmes are socially prescribed, it’s perfectly possible for goals to be hit, and for hundreds of people to collectively shed thousands of excess kilos of weight, while the local level of overall obesity continues to climb.
If the five and a half decades of weight-watching experience in every major economy in the world has shown us anything, it’s that the population-level problem of obesity will not be solved by individual interventions however robustly proven they may be. The problem at a societal level is fundamentally different to the problem at an individual level, and the solutions must be too.
Across the charity sector, there are plenty of similar examples. Many non-profits do sterling work helping marginalised and disadvantaged groups get into employment. Some have robust evidence proving their interventions and even those that don’t, have no shortage of stories of success. And yet, in the decades they’ve all been working on it, most of the population-level indicators, like the percentage of disabled people in full time employment for example, have hardly changed at all.
It’s clear that any charity whose vision is one of population-level change (“The end of…”; “A world where…”; etc.) needs to start taking these insights seriously.
It might not be an issue for WeightWatchers, in that the ongoing obesity epidemic will continue to provide them with many more new recruits, but for mission-led charities, at some point, one needs to step back from constantly pulling beneficiaries out of the metaphorical rivers of unemployment, addiction, prison, depression and so forth, and look upstream to ask why our beneficiaries are the ones who are disproportionately falling in, and how we can change things to stop it happening.
Invariably these situations are created by many interrelated factors: from policy and legislation to social attitudes and local behavioural norms, alongside a multitude of practical and environmental issues. These factors combine to create highly complex “systems”, from which emerge the problems with which local services then have to deal. Changing the systems to prevent the issues arising in the first place is a mammoth task, and not one that a single charity or agency can resolve alone, which is why we are seeing a surge in place-based initiatives, where national and local, public, private and third sector organisations are coming together, trying to take a much more collaborative and holistic approach to sustainable change.
This is a good thing, but for most of the participants, it’s fair to say that these collaborations are still a very small part of their operation – a footnote in the annual reach and impact report; their strategic goals primarily focused on their own interventions – of how many people they’ve pulled out of the water. And that’s understandable. We like to set achievable goals, so we set them around the things we can control, that are in our gift and not reliant on big, complex unproven ambitions in which we are merely one of many players. But as long as that’s the case, these collaborations, these attempts to shift the system, to prevent beneficiaries falling into the river in the first place, will always be an add-on.
The change that needs to happen, for these collaborations to move from the periphery to the core of non-profit strategies, is to start setting goals for those system-level changes; goals that the charity knows full well that it can’t achieve on its own; goals that create the immediate necessity for collaboration and innovation if they’re to have a hope of being realised. I’m just coming to the end of an engagement with a major charity where we’ve developed the outline of a ten year strategy based on exactly that principle, and I was delighted to see that the British Red Cross appear to be doing exactly the same with theirs. It’s a brave move, but one that’s prerequisite for achieving any genuine population-level goal.
Those women in Jean Nidetch’s house back in the 1960’s came together for ideas, accountability, mutual support and recognition, precisely because they had set goals that they knew, from years of experience, that they couldn’t achieve alone. Necessity may be the mother of invention, but she also had a second child, and she named it collaboration.