Policy Approaches for Thriving Together
Well-being outcomes are influenced by many factors that could be regulated through policy—including social, economic, environmental, and behavioral factors. Policies are binding and enforceable written statements that apply to a geographic area, institution, physical space, and/or group of people. Policies are made by public institutions, for example laws passed by state governments or ordinances adopted by local councils, as well as private entities, for example, policies adopted by a landlord that apply to their properties.
Policy can be an effective, sustainable tool for improving vital community conditions. For example, policies may create standards, requirements, or mandates to assure conditions, or permanently establish funds or programs that promote health and well-being. Over the course of time policy can transform vital community conditions for health and well-being.
But, what policy solutions hold the greatest promise? What policy approaches should stewards pursue?
This article explores three policy approaches for thriving together, highlighting policies that:
- Solve for multiple challenges at once;
- Allow for targeted approaches to universal goals; and
- Create systems solutions that scale
Solving for Multiple Challenges at Once
Policies that address multiple challenges at once can be said to be “multi-solving”. Multi-solving with policy is advantageous in that multiple aims are achieved with a single effort, thereby making efficient use of often-limited resources. For example, policies that increase public transportation services improve reliable transportation in communities, while advancing environmental sustainability and climate change mitigation. Policies that expand access to midwives, doulas, and other community-based maternal and infant care workers improve health outcomes, reduce care costs, and improve care experience while creating high-quality jobs with real purpose.
These examples illustrate how a single policy can impact multiple priority areas and how policies can prioritize improving vital community conditions for all, while focusing on priority populations. Policies that expand public transportation emphasize the needs of people with disabilities, low-income people, and transit-dependent populations, while improving reliable transportation and environmental quality for all. Likewise, expanding community-based maternal and infant care increases access to essential services for all pregnant and perinatal people, and demonstrates particular efficacy in communities of color who face significant disparities in maternal and infant health outcomes.
Targeted Approaches to Universal Goals
Advocates increasingly emphasize a “Targeted Universalism” approach when creating policy. Targeted Universalist policies offer tailored approaches to universal goals based on the needs of different priority populations. Policies that provide food assistance are an example, in that they address food and nutrition needs for different priority population groups differently. WIC, SNAP, and the National School Lunch Program are federal food assistance programs that are tailored to address food insecurity in specific priority populations, including pregnant, recently pregnant, and breastfeeding women, infants and children, and low-income individuals and families.
Health insurance coverage for all is a prime example of a universal goal, which advocates have doggedly pursued for decades. Passed in 2008, the Affordable Care Act provided a federal policy solution to expand health insurance coverage. Among other provisions, the ACA allows states to expand Medicaid health insurance coverage to low-income adults (up to 138% Federal Poverty Level). Medicaid expansion is linked to positive outcomes that include improved insurance coverage, access to health care, and health outcomes, as well as economic benefits to states and providers. As of January 2025, forty-one states (including D.C.) have adopted Medicaid expansion. The remaining ten states can realize population-level health benefits of increasing coverage by adopting and implementing Medicaid expansion.
Systems Solutions that Scale
System-level impact that improves population health and well-being is possible when solutions scale. Policy is a powerful tool for scaling health and well-being efforts because it can embed lasting change across systems, and reach populations and communities.. During the COVID-19 pandemic, creative solutions and innovations emerged to help address COVID-19 testing and vaccination needs. Mobile vaccine clinics, for example, are one such scalable solution to vaccine distribution. We have not yet unlocked the full potential of mobile clinics and other community-based clinical approaches to provide basic preventive health services, especially among rural and migratory communities and other difficult-to-reach populations. They can create systems-level impact by improving vaccine access, strengthening public health infrastructure, and advancing health equity.
Policies that expand diversion programs—programs that minimize people’s involvement with the justice system by providing alternatives to arrest, prosecution, and incarceration—provide a systems-level solution to multiple pressing challenges like mass incarceration and substance use. For people with mental health and substance use conditions, diversion programs offer treatment and recovery services as an alternative to jail time or other penalties. The benefits of these programs are multiple: 1) more appropriate care with better outcomes for people with mental health and substance use conditions; 2) long-term community safety and lower recidivism; and 3) reduced criminal justice system and health care costs.
Policymaking for Thriving Communities
When considering and/or crafting policy, it’s helpful to consider whether proposed policies (1) solve for multiple challenges at once, (2) allow for targeted approaches to universal goals, and (3) create systems solutions that scale. Because all policies influence health and well-being—not just those that target health issues—it's essential to embed health considerations into all policymaking. A “Health in All Policies” approach recognizes that social, economic, environmental, and behavioral factors all shape health outcomes. This approach incorporates health considerations into decision-making across policy areas and sectors. By taking a more holistic approach to policymaking that considers broadly its potential implications, stewards can more confidently advocate for policies to improve health and thriving.
