Earlier today I began to consider why upstream thinking is so damn difficult, and now I’m going to look at three reasons as to why this is the case. Take a look at that before diving in here if you'd like a bit of a background on what I mean by "downstream" "upstream" and the metaphor of the river.
1. Downstream thinking allows us to feel charitable without actually requiring us to change, or consider our place in, the systems that perpetuate these problems.
A few months ago, I saw this video on YouTube entitled “Homeless Lottery Winner”, about a guy named Rahat who gives a homeless man a fake lottery ticket as a way to give him $1000.00. The man, Eric, amazed viewers by generously insisting on sharing his winnings with Rahat. Their hearts were so warmed by Eric, who Rahat identifies as “a nice and respectable guy,” that they donated $44,000.00 to go toward rent and supplies for one year in a house of his own.
I’ll admit that I felt my eyes well up as I watched this video, but, like many others, I found myself asking “What happens at the end of a year?” and “Is helping one of the millions of people facing insecure housing really something to get choked up about?”
On the one hand, these videos are great examples of storytelling – just glimpsing the humanity of a man experiencing homelessness was enough to move millions of viewers to send him funds –but I’d argue that it reveals something more insidious about downstream thinking in general.
This is an example of when, with the click of a button, we can assuage our guilt for another week, month, or year, knowing that we helped someone we deem deserving (I can only assume that “nice” and “respectable” really means “unlikely to spend this money on alcohol or drugs”).
“What happens at the end of a year?” “Is helping one of the millions of people facing insecure housing really something to get choked up about?”
It's not that this type of downstream help is wrong per se, but it is problematic that there is no critique of the systems that created the conditions for Eric to experience homelessness, no call for justice for others in Eric’s situation (especially those that we might piously decide aren’t deserving of help in the first place), and perhaps most obviously, no overt concern for what will happen to Eric when his “lottery” year is up.
I’m a big fan of Housing First, but there is very little evidence that Rahat and his fans know (or care) about the root-causes of Eric’s situation. Are issues like racism, mental health, physical disability, family history, inadequate education, job training, or early childhood development at play? I can only surmise that this downstream act of kindness for Eric seems to have much more to do with his voyeuristic benefactors than anything else.
2. One-off, downstream support allows us to be selective (intentionally or not) about who we rescue from the river.
Much of the public conversation about social change is stuck in downstream thinking. Either we hear “Listen, I totally understand that change is necessary, but we just can’t afford to help all these people” or “People need to help themselves. They got themselves into this mess and they can’t be relying on us to get them out of it.”
Upstream thinking argues that not only are long-term solutions more cost effective in the long-term, but that by addressing root-causes, we can go beyond “lifestyle politics” and create system-wide change. But let's get one thing straight- those types of solutions are going to make it awfully hard to cherry-pick who is going to make it out of the river.
The Onion posted a great piece of satire this summer detailing a new law that requires recipients of social assistance to “submit vials of sweat” in order to “prove that they have exerted themselves past the point of perspiration during their job searches.” The article jokes that politicians are also considering a law requiring food stamp recipients “to send in recordings of their family’s stomachs growling.” If short-term solutions are scarce, they ought to at least go to the most "deserving," so the logic goes.
Thinking upstream is hard because it requires us to abandon moral superiority, to stop asking people to ‘pick themselves up by their boot straps,’ and to invest in the social conditions necessary for all of us to lead healthy lives. But in doing so, we will forfeit control over retrieving only the cutest babies from the river.
This dark humor reminds us of the indignity that so many people suffer when they turn to downstream solutions, as all too often, they are forced to internalize full responsibility for their unmet needs. This public shaming is totally unacceptable, without even getting into a discussion of the amazing resiliency that I’ve witnessed first-hand within these marginalized communities (Is anyone else a bit uncomfortable with the language of “children” and “drowning” in the river story? A more fitting metaphor would be people fervently treading water, helping one another survive against the current).
As Wilkinson and Pickett argue in their book, The Spirit Level, we all benefit from reduced inequality, and equitable societies are healthy societies. Thinking upstream is hard because it requires us to abandon moral superiority, to stop asking people to ‘pick themselves up by their boot straps,’ and to invest in the social conditions necessary for all of us to lead healthy lives. But in doing so, we will forfeit control over retrieving only the cutest babies from the river.
3. We like to see results.
Upstream thinking is a hard sell - with the public, with funders, and even sometimes with myself. The systemic challenges that cause poor health are complex and intersecting, and effective solutions will occur through sustained partnerships over time. Resources are scarce, and in an industry that favours programs and projects with short-term, tangible outcomes, upstream thinking often fails to fit the mold.
(photo by jfh686)
About once a week, as I head home from work past some of Saskatoon’s most under-served neighbourhoods, I ask myself whether what I’m doing will ever really make a difference. We’ve only been at this reframing work for a year, and already I’m pining for results. I want to show that this way of thinking really can produce the kind of change that we need, but I know that it will require perseverance and patience.
We all want to feel useful, we want to know that our dollars are funding important work with measurable results, and if you’re like me, you want to see those results now.
If I’m really honest, I'll admit that my impatience is at least partly residual of a “privileged white savior” mentality (you know, where I get to feel good about myself and my work and still go home and watch Netflix all night), but it’s a constant reminder of why upstream work is especially difficult to mobilize. We all want to feel useful, we want to know that our dollars are funding important work with measurable results, and if you’re like me, you want to see those results now.
I’m not even going to chalk this up to our cultural need for instant gratification; most people, including public representatives and big donors, actually do want to help people. But can’t we do it before the next election, or the next board meeting, or before that next grant application is due? If we’re talking about upstream change, the answer is probably “no.”
Sustaining upstream efforts will require us to loosen our grip on the immediacy that we see downstream.
Sustaining upstream efforts will require us to loosen our grip on the immediacy that we see downstream. It means building infrastructure for broader movements, the prioritization of strategic initiatives and long-term coalition building. And it also means that we need to resource organizations and movements that can’t, by the nature of their purpose, offer us quick results.
So this is my challenge – to myself, and to all of us who are standing at the edge of this river.
1. Be willing to play the long game.
We can’t all head upstream and abandon the babies in the water, but we all have a responsibility to consider the social conditions that allow our health disparities to continue, and even worsen, over time. Recognize that these problems are complex and systemic, and that no amount of ‘lifestyle choices’ will be enough to create a healthy society.
2. Loosen your grip on the control and immediacy of downstream thinking.
Downstream work is inherently reactive – and we need people who are responding quickly and effectively to the symptoms of today’s realities. But long-term change requires changing the way we talk, the way we think, and building the infrastructure to ensure that this is sustained.
3. Give generously, as you are able, to upstream work.
I’ll say it as confidently and unsheepishly as possible, knowing that there are tons of great people working to address the root-causes of well-being around the country who need your support. If this blog, or other exposure you’ve had to upstream thinking compels you, changes the way you think, or just inspires you, show your support tangibly.
I’m not saying stop giving to charities, or stop volunteering at the local shelter. Keep giving to those in need, and encourage your representatives to fund services at every stage of the “river”, as we cannot abandon those who have already slipped through the cracks.
But I hope that this blog has started you thinking about some of the difficulties in bringing upstream thinking to the mainstream. We need not only sustained funding but sustained interest, engagement, and participation in order to build infrastructure for upstream ideas. The challenges to doing so are real, but the opportunities for change are meaningful and truly exciting. Will you join us?
Consider giving monthly to Upstream - even a small amount, such as 5$ a month, goes a long way in bringing these ideas and this language to the public at large. Click here for more information about donating to Upstream.
Call for change at the systems level. With the knowledge that health begins in our work, our homes, and our communities, you’ll see there there are all kinds of opportunities to advocate for a healthy society. Join a campaign, send a letter to your representative, and get informed about the big decisions being made in your community that affect the conditions of well-being. Click here for more information about our current campaign, Poverty Costs.
- Share stories. Bring upstream language into the work that you do, and the conversations you have every day. Take opportunities to reframe the debate around prevention, about addressing root causes rather than just dealing with symptoms. Click here for more information about the Upstream book club, which is a great place to start having these conversations.
Rachel is the Director of Operations for Upstream. She is a photographer, a singer, and an avid Netflix watcher, and can be reached at email@example.com.
To support Rachel's work reframing conversations around the goal of health, consider becoming an Upstream sustainer by making a one-time or monthly donation.