Are you putting band-aids on a wound that needs surgery? Kansas ranks seventh in the nation for volunteerism, and yet our state has fallen further than any other in the national health rankings. What if all that good-hearted, charitable energy could be redirected — not away from helping people in need, but one step further upstream, toward preventing the need in the first place?
This episode explores the first of nine mindsets from the book: the upstream mindset. We unpack the difference between charity (which treats symptoms) and change (which addresses root causes), and why people in positions of authority tend to default to downstream efforts — even when they genuinely care about the health gap. The classic "babies in the river" story anchors the conversation, and we're joined once again by Teresa Lovelady, CEO of HealthCore Clinic, who brings powerful real-world examples of how one organization works both ends of the stream simultaneously. From cancer screenings and social drivers of health, to giving kids books during their annual checkups, Teresa paints a vivid picture of what upstream work looks like in practice — and issues a challenge to all of us: take just one step upstream.
HighlightsKansas ranks 7th in volunteerism nationally — a strength that also reinforces our tendency to stay downstreamCharity treats symptoms; upstream work addresses root causes — and we need both, but the balance is offThe "babies in the river" parable: someone has to stop pulling babies out of the river long enough to find out who's throwing them inCharity can actually weaken the urgency to change the conditions that create the need for charity in the first placeHealthCore Clinic (a federally qualified health center in northeast Wichita) operates simultaneously upstream and downstream — with a food pantry, gym, walking path, pharmacy, transportation, and education classes all under one roofEarly detection example: screening patients at the pre-diabetic stage — or even earlier — is a concrete upstream health interventionHealthCore screens for social drivers of health (housing, food insecurity, violence, substance abuse) and intervenes in real timeEarly literacy is directly linked to long-term health outcomes — HealthCore gives every child an age-appropriate book at their annual visitGoing upstream is disruptive, and you may be accused of "neglecting the babies in the river" — expect pushbackThe incentive structures in our society push leaders toward downstream action; value-based care is beginning to change that in healthcare, but it's a long way offTeresa's practical challenge: take one step upstream — whatever your role, just move one step in that directionTextron Aviation's model: on-site healthcare access and a "one-stop shop" to help people upskill for jobs — upstream workforce investment instead of complaining about workforce qualityStorytime Village: a new early literacy program in Wichita that integrates a clinic, bookstore, and community convening space — upstream collaboration in actionThe call to action: audit your charitable giving from the last several months and mark whether each contribution was upstream or downstream
Chapters
0:00 – The 'Upstream' Mindset1:34 – Charity vs. Change: Why Band-Aids Aren't Enough2:50 – The 'Babies in the River' Story: What Upstream Really Means4:52 – Real-World Upstream Examples: Foster Care & Workplace Wellness6:22 – Guest Joins: Teresa Lovelady Returns to Talk Practice, Not Theory7:19 – Inside HealthCore Clinic: Serving Needs Today While Preventing Tomorrow7:57 – Prevention in Action: Population Health, Pre-Diabetes & Early Detection12:06 – Beyond Healthcare: Literacy, Community Factors & Everyone's Role14:02 – Why We Default to Downstream: Ease, Feel-Good Charity & the Health Gap16:26 – Beyond Charity: Take One Step Upstream17:14 – Why Upstream Work Feels Disruptive (and Gets Criticized)18:23 – Downstream Is Tempting: Human Nature & Quick 'Feel-Good' Wins20:00 – What It Takes to Swim Upstream: Org Pushback, Boards, and Incentives21:48 – Upstream Healthcare in Action: Screening Social Drivers & Real-Time Support26:18 – Influence Beyond the Field: Bankers, Electeds, Advocacy, and Collaboration Spaces29:16 – Examples on the Table: Boardroom Questions, CEO Budgets, and Textron's Model32:21 – Call to Action & Wrap-Up: Audit Your Giving and Shift Upstream
Resources Mentioned
HealthCore Clinic — federally qualified health center in northeast Wichita, KS; offers medical, dental, behavioral health, substance abuse services, pharmacy, food pantry, gym, walking path, and transportation for patientsAmerica's Health Rankings — the national health rankings that measure state health outcomes, including volunteerism as a sub-measureTextron Aviation (Wichita, KS) — cited as an example of upstream workplace wellness and workforce developmentWichita State University — mentioned as a resource for scholarship opportunities available to low-income patients at HealthCoreStorytime Village — a new early literacy program in Wichita integrating a clinic, bookstore, and community convening space
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