Diversity can heighten creative tension. As partnerships include stakeholders across diverse disciplines, geographies, cultural identities, perspectives and power bases, there frequently can be tension as various voices seek to express their points of view, interests and expectations. Tension can also exist when professionals from different disciplines struggle to learn each other’s languages, concepts and strengths. Tension is often greatest with efforts to bridge differences across age, race, class and culture. Important aspects of inclusion, such as language justice, dialogue about structural racism or other “isms,” power and other issues of multiculturalism, can—and should—slow down a process. This has the potential to create annoyance among those who may not appreciate the need, who may not feel safe from judgment or who may prioritize values such as predictability or adherence to a funder’s timeline. These forms of tension can be characterized as “creative tension” if expression is in honest pursuit of a shared vision. Partnerships that openly and effectively manage this tension are often better prepared to advance health equity.
Where you stand depends on where you sit. Partners often come to the table with their own priorities, history and experience. Some carry deep mistrust of outsiders or government. Others may have a specific agenda, a very particular skill to offer or the need to check in with a larger group they are representing. Some may have a need for services or seek agency funding. Whatever one’s perspective, it is important to agree on a process for setting group priorities and addressing tension that may exist among partners. Sometimes the process involves setting aside or delaying what an individual or organization would prefer. Sometimes it means providing financial support for an individual or voicing support for an organization’s project. Or it may require taking more time for dialogue and conflict resolution before making decisions. Patience and flexibility are often easier for organizations and individuals with more resources, who are better positioned to benefit, more trusting of or influential over the process, or more strongly focused on the partnership’s overall vision and agenda. It is helpful to be aware of how each partner’s context influences his or her positions and contributions.
Examining who benefits from set priorities provides insight and highlights equity. When partnerships seek to set priorities that are actionable and have a good chance of short-term success, it can be tempting to select goals that are politically easier and avoid addressing the challenge of equity. Some priority-setting temptations can seem quite reasonable, such as aligning with the agendas of more influential partners or selecting goals that already have well-positioned champions like a mayor or council member, or those that do not stimulate the vigorous opposition of powerful interests such as the business community. Choosing more likely winners, avoiding difficult conversations to build positive relationships and quietly trying to build momentum with small wins are useful tactics if they are in service to the partnership’s vision and values. Therefore, it is important for equity-oriented partnerships to determine whether a given choice is bending toward equity and, if so, embrace any tensions that come with it. True inclusion of those most affected helps keep these decisions accountable.
Change is difficult and often resisted by those charged with following through. Even positive change can land as a burden on those responsible for implementation. Policy and systems change often require significant retraining and more effort to build colleagues’ commitment to act according to new rules and standards that challenge traditional ideology and practice. It also requires managers to address disincentives at various levels of an organization. Many of these things can put people outside of their comfort zones, leave them feeling less competent, occur without recognition or additional resources, and meet with mixed results over a prolonged period until a truly different system emerges. No wonder there can be resistance! Buy-in is critical for achieving real impact, and people long to feel understood. For this reason, it is important for advocates to account for the challenges, address them directly where possible and respect the people who face them.
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