This article is written by Karabi Acharya, Senior Director, Global Ideas for U.S. Solutions, Robert Wood Johnson Foundation.

  • The problem: How can understanding global trends help us advance global health equity so that everyone — no matter where they live — can live their fullest possible lives?
  • Why it matters: We all want to live long and healthy lives, but around the world, health inequities are glaring and persistent.
  • The solution: We can learn a lot about improving health equity by exploring powerful global trends that are reshaping our everyday lives — and that means learning with and from colleagues and communities in countries all over the world.

What can policymakers in England or the United States learn from Zimbabwe about how to address serious shortages of mental health professionals, especially in communities that have been left behind?

Quite a lot, as it turns out. A new report, Global Trend Sensing for Health Equity, from the Robert Wood Johnson Foundation and Dalberg Advisors, describes how Zimbabwe’s outdoor Friendship Benches, staffed by volunteer ‘grandmothers’, are helping improve people’s lives.

The report delves into multiple, powerful global trends that are reshaping our everyday lives — from the rise of AI in healthcare to the growing demand for healthy public spaces to the health information boom — and explores how communities around the world are responding in ways that improve health and wellbeing.

It’s complicated, because not only do these trends intersect and interact with each other, but they are also constantly in flux. Fortunately, we can all learn from each other — and from millions of others who are working to make the world a healthier place for everyone to live.

The unique strength of this report is that it spotlights global solutions in two ways.

Bold Policy Actions for Addressing Global Challenges

First, the report describes creative policy solutions from around the world. For example, what policies are countries investing in to support caregiving work, which is disproportionately carried out by women for little or no pay? As populations age, how are governments promoting the health of older adults?

Many countries are taking bold steps to address these kinds of questions. For example, Uruguay has passed transformative legislation to ensure free care for all children, people with disabilities and elderly people. Not only does the state provide free care services, but it also provides training and regulations to guarantee quality care while recognising the right of caregivers to decent working conditions, in response to the global trend of increasing demands for equitable care work.

To address the needs of an ageing population, Japan is building a “longevity economy” that prioritises employment opportunities for older adults. The goal is to ensure healthy employment until age 70 and provide opportunities for people to stay engaged in the workforce after that age.

And, in one of the world’s most ambitious regulatory efforts to tackle childhood obesity through marketing, Chile has banned TV junk food ads targeted to children, created warning labels for unhealthy foods and barred their sale in schools. Since 2016, when the policies took effect, purchased sugar has declined by 10.2%, saturated fat by 3.9% and purchased sodium content by 4.7%.

Local Communities Driving Local Solutions

The second unique aspect of this report is how it opens a window into what’s happening in communities. To solve community problems, the communities themselves need to be involved — using their voices, expressing their priorities and leading and designing solutions. When communities are in the driver’s seat, their solutions for improving health and well-being often centre on non-medical factors that have major impacts on health, like social connectedness and access to safe and affordable housing, healthy foods and reliable transportation.

💬 Let the author know which local project inspires you the most and why by leaving a comment below

Zimbabwe’s Friendship Benches programme trains community volunteers, or ‘grandmothers’, to counsel patients suffering from common mental illnesses outdoors on park benches. The project came about after Dixon Chibanda, a young Zimbabwean psychiatrist, confronted the extreme shortage of mental health professionals in his country. He discovered an amazing resource — grandmothers: respected and knowledgeable community members who were eager to help. An inaugural group of grandmothers helped Chibanda design the program, even suggesting the name to reduce stigma and shame. Many of the patients who benefit live in low-income areas where there is less access to care. And participating grandmothers have seen improvements in their own health. Seven countries, including Kenya, Malawi, Tanzania and the United States have implemented Friendship Benches.

Another example comes from Bogotá, Colombia, where marginalised populations have been forced to the city outskirts, often without access to mass transit. Intense social mobilisation and community advocacy finally led the government to prioritise a new public transportation project for Bogotá. Community leaders and members helped guide the research that laid the groundwork for the TransmiCable cable car project. Today, the TransmiCable cable car line not only cuts workers’ commutes from two hours to less than 20 minutes but also provides easier access to healthcare and social services, bicycle pickups, community gardens and more.

After a disastrous earthquake and tsunami struck Japan in 2011, older people wanted to help their communities — leading to the first Ibasho project, an elder-run café and community centre in Ōfunato. At the Ibasho House, visitors across generations connect over meals in the café or ramen noodle shop, participate in communal gardening, use community-based daycare and celebrate special events. Not only does this project address the trend of growing demand for healthy public spaces, but it also helps fill climate change needs by serving as an evacuation centre and hosts disaster preparedness training. Nepal and the Philippines have both replicated the Ibasho project, following natural disasters in those countries.

It's important to note that solutions to community problems — even those driven by global forces like climate change and ageing — often lie in the communities themselves. They are their own experts, and they need to co-create solutions with their partners.

Cross-Cutting Forces that Create Opportunities for ‘Multisolving’

The report also identifies two driving forces that are important to consider across all trends: accelerating climate change and the rise of artificial intelligence (AI). By considering how climate change and AI will continue to shift social systems around the globe, we can address multiple issues by ‘multisolving’, as climate change expert Elizabeth Swain calls it.

Take climate change. The map below compares U.S. climate zones with climate zones around the world and shows how the U.S. could learn from what other countries are doing to address climate change in conjunction with food insecurity, housing shortages and social isolation. Given that almost half the global population lives in areas that are highly vulnerable to climate change, I can imagine other countries creating similar maps to help them identify potential solutions to their climate challenges.

The rise of AI affords opportunities to multi-solve as well. How, for example, might we use AI to identify areas of food waste and optimise food production and supply chains, which would help solve the global trend of rising food insecurity? What could AI do to support older adults with daily tasks such as grocery shopping and medication management? The report elevates AI’s potential impacts across global trends with an eye to opportunities for advancing health equity, as well as its potential risks.

Unleashing Our Imaginations

Learnings from global trends are meant to spark inspiration: to share new ideas, choices and ways of thinking, not offer prescriptive solutions. They encourage us to think expansively about how ideas from other places could be adapted to improve health equity where we live — because what works in India may not work exactly ‘as is’ in South Africa; it might require tweaking and adjustment for cultural, social, political and other differences.

To me, the best part about global learning is how it gives free rein to our imaginations — to picture how we might create a better world for everyone by taking junk food ads off TV, enlisting ‘grandmothers’ to counsel people on park benches or banishing mass transit ‘deserts’ with the leadership and involvement of those most affected by them.

So, I invite you to read the report and let your imagination fly.

Done reading? Make sure to share your own thoughts about global trends you would like to see implemented in your country by leaving a comment below ⬇️

(Image credit: Unsplash)