To What End? Rethinking Equity, Health, and Human Flourishing
As a Commissioner with the National Academy of Medicine, I’m often asked to examine problems through a systems lens — how they work, who they serve, where they break. But no matter the complexity, I find myself returning to one clarifying question: To what end?
It doesn’t ask what we believe — it asks what we’re building. And in a time of cultural division, fractured narratives, and social fatigue, that question is more important than ever.
Shared Goals, Splintered Language
Most of us want the same things: meaningful work, good health, safe neighborhoods. These are not partisan values. They are human ones.
Too often our language works against us. Words like equity, access, diversity can feel divisive. For some, they inspire action. For others, they signal exclusion. Not because the ideas are flawed, but because we’ve stopped meeting in the middle.
We need a smarter message. One that invites, not indicts. One that aligns people around outcomes instead of dividing them with labels.
Health: The Front Door to Productivity
Health is a critical factor in economic strength, community resilience, and long-term prosperity. If people are healthy, they can work. If they can work, they can earn. If they can earn, they can provide, invest, and contribute.
We need to reframe the conversation — with health as the fuel for everything we care about: business vitality, educational attainment, family stability, and national productivity.
Clarity Over Complexity
We don’t need more policy. We need more clarity of purpose. Imagine if every nonprofit, business, government agency, and community group aligned around one measurable outcome: Increase the number of healthy, productive earners.
Not just workers — earners. People who thrive and ripple out impact in their communities. People who are supported, equipped, and positioned to participate in society.
When that’s the goal, everything else finds synergy. Health initiatives become workforce strategies. Education becomes economic development. That clarity builds coalitions, invites unlikely allies, bypasses rhetoric in favor of results.
A Note on Framing — and Courage
None of this means we avoid difficult truths. Equity still matters. Disparities still exist. But if we want lasting progress, we must speak in language that moves people — not just those who agree with us.
Equity should not be a trigger word or a wedge. It should be a tool for alignment — grounded in clarity, framed by purpose.
This isn’t abandoning values. It’s delivering them more effectively. There is power in being the voice that rises above noise to say, “Let’s focus on what we can build together.”
The Invitation
If you’re in business, government, philanthropy, education, or simply care about the future, ask yourself:
- Are we building systems that help people thrive as earners?
- Are we focused on outcomes that bring people together?
- Are we framing our messages to invite collaboration?
Health isn’t just a moral imperative. It’s a strategic one. And equity isn’t just about fairness. It’s about the alignment required to unlock human potential.
Let’s speak wisely. Act boldly. Aim for outcomes that make progress.
Let’s keep asking: To what end?
Originally published in the St. Louis Business Journal’s Ask the Expert section in July of 2025 by Orv Kimbrough, Chairman and CEO at Midwest BankCentre