Design for Everyone to Thrive

Evidence suggests this building block is important because diverse leadership and inclusive processes can be associated with positive impacts on well-being and equity considerations in the work, though more research is needed. Evidence-building for equity-centered leadership includes studies of outcomes of diversity and inclusion practices of leadership entities, public participation processes in multiple fields, and community groups that push formal decision-making bodies to center equity. The composition and diversity of organizational leadership and boards illustrates this concept. Nonprofit boards in the US tend to be older, white, and male.¹ While the evidence base connecting the diversity of boards and equity-related outcomes is not robust, studies find board diversity important for a range of outcomes, including board performance and legitimacy with the community.² 

Leaders can center equity via robust community engagement. Reviews of public participation processes in which community members have a say in the policies and programs that impact their lives reveal that there is a wide variety of engagement and decision-making power, ranging from performative engagement to meaningful levels of community power and co-creation. ​​Notably, research also indicates that poorly designed or implemented public participation approaches can negatively impact participants. It is not just participation that is important but meaningful participation in organizational processes that are inclusive, accessible and supportive.³ 

Systematic reviews of the evidence conclude that public health interventions using community engagement positively impact health behaviors, health consequences, community members’ sense of self-efficacy, and perceived social support outcomes.⁴ These reviews also identify factors for successful community engagement, such as having accessible infrastructure in place for connecting and communicating with community members, an open attitude towards and training for community engagement, seeing community members as partners, and community members feeling ownership in the process.^3,5,6 Robust research on models of community engagement for health improvement of marginalized populations show positive impacts on health behaviors, public health planning, health service access, and health literacy. Power-sharing, collaborative partnerships, bidirectional learning, and incorporating voice and agency were key community engagement components for positive health outcomes.⁷ 

Other developmental and planning processes similarly put humans or community members at the center of the planning process and goals. Native nation-building is the foundation for effective regional rural development for both Indigenous and non-Indigenous populations. Successful strategies embrace both tribal sovereignty and relationship building between Native communities and their non-Native neighbors.⁸ In the workforce development field, experts suggest that improving employment opportunities in rural areas requires redesigning workforce development systems and approaches that recognize the challenges and aspirations of rural communities, workers, and jobseekers.^9-11 Expert opinion also suggests that designing community and economic development efforts for rural vitality requires fostering rural leaders through programs that elevate inclusion, resilience, and collaboration¹² (see also, G: Prepare Action-able Leadership). More recently, human-centered design has emerged from the design field and social sector as a way to apply design principles to social issues¹³ and in public health initiatives focused on a specific product or concept.^14,15 

1. Lilly Family School of Philanthropy 2018
2. Azevedo 2021
3. De Weger 2018
4. O’Mara-Eves 2013
5. Pennington 2018
6. Voorberg 2015
7. Cyril 2015
8. Jorgensen & Gutierrez 2021
9. Rosenfeld 2018
10. Pages 2018
11. Dabson 2018
12. Khokhar 2021
13. Brown 2010
14. Vechakul 2015
15. Holeman 2020