Leveling the Playing Field in the U.S. Health System

Solutions Journalism Network

"Pull yourself up by your bootstraps" is an expression used to the point of cliche in American political discourse, especially when referencing the allocation of funding to social service programs. But, as writer John Swansburg pointed out in a piece called "The Self-Made Man": 

To "pull yourself up by your bootstraps" is to succeed by dint of your own efforts. But that’s a modern corruption of the phrase’s original meaning. It used to describe a quixotic attempt to achieve an impossibility, not a feat of self-reliance. You can’t pull yourself up by your bootstraps, anymore than you can by your shoelaces. (Try it.) The phrase’s first known usage comes from a sarcastic 1834 account of a crackpot inventor’s attempt to build a perpetual motion machine.

Misplaced though it may be, the phrase and its underlying concept persist – and, as a result, hinder progress in providing equitable living conditions for all. The stories in this collection spotlight a handful of responses that rightfully complicate that narrative and provide a path toward a more level playing field. As evident by the reporting in this collection, that path is characterized by two assets in particular:   

  • Expanding Access: Health care is not easy to obtain in the U.S., and for those experiencing homelessness, it's even more challenging. Law @ the Margins reported on a model of care that expands access to low-income communities and unhoused community members by combining medical and social services. In another example of measuring the success of an initiative by how it has expanded access to care, the Milwaukee Journal Sentinel investigated how the discontinuation of a practice that forced ambulances to go elsewhere if a hospital was too busy forced hospitals to develop strategies to improve patient flow. 
  • Eliminating Barriers: For those facing food insecurity, it can be time-consuming and difficult to locate resources, so LA Progressive approached the issue by reporting on initiatives – like urban farming and integrated service chains – that help to reduce these obstacles. In another example of investigating how barriers can be eliminated, The Salt Lake Tribune reported on how a pilot program that teaches teenagers coping skills is used to address the lack of existing mental health resources available in the community.