SOCIAL SUSTAINABILITY: BUILDING LASTING CHANGE IN OUR EDUCATIONAL, SOCIAL AND HEALTH COMMUNITIES
Pau Gomes, Director, Emotional Well-being Area.
In the current context, where attention is focused on the immediate, with a culture of ephemeral consumption and policies that prioritize the short term over the long term, social sustainability in social, educational and health projects takes on even greater relevance. It is not only a matter of addressing current needs, but also of ensuring well-being and equity for future generations, thus promoting fairer and more sustainable development.
Social sustainability refers to the capacity to maintain a balance between social needs, such as equality, justice, health and education, and the capacity to maintain these conditions over time without compromising the well-being of future generations. It involves promoting inclusion, participation and respect for human rights, as well as equity in access to resources and opportunities. Patrick Barron and colleagues (2023)[1] present a conceptual framework for social sustainability with four components: social cohesion, inclusion, resilience and legitimacy of the process, emphasizing the need for collective action for development that equitably benefits all, fostering resilient and just communities and societies. But how do we achieve this?
Aesop, through his fable “The Farmer and his Children”, taught us the importance of constant work and patience to achieve lasting results. With Aesop’s symbolic permission, I have adapted the story by changing the farmer for the farmeress, for two main reasons, because we are in times of progress and gender equality and because it reminds me of my grandmother, for me, a role model.
A farmer, now an old woman and feeling near her end, wanted to make sure her daughters learned the value of hard work and perseverance. She called them all together and said: “My dear daughters, I have worked all my life in these fields, and now that my end is near, I want to reveal to you the secret of my wealth. In our vineyard lies a buried treasure. Dig and you will find it. Remember, only with work will riches be revealed.”
After her death, the farmer’s daughters took her words to heart. They dug diligently in search of treasure, turning over every inch of the ground. Although they found no hidden treasure, the vineyard was so well tilled that it produced an exceptional harvest. In time, they realized that the real treasure their mother had bequeathed to them was the lesson that hard work and perseverance are the true keys to wealth.
The moral of this fable is that there are no shortcuts to lasting success. Steady, cooperative and consistent work seems slow and less attractive than other supposed “hidden treasures,” solutions or magic formulas. However, constancy, cooperation and consistency is actually the surest and most reliable path to the realization of social sustainability goals. This fable is an example for those of us who pursue systemic and sustainable changes through projects in the social, educational and/or health sector.
In order to address the complex challenges facing our society, it is important to adopt a holistic, comprehensive and sustainable approach. Solutions that merely address immediate emergencies are not enough; these efforts must be part of a long-term strategy. In addition, when we get involved in educational and health projects, we discover that the sustainability of the desired changes has several nuances.
Integral Sustainability seeks to foster relationships between people and the collective use of what is common to us. It integrates economics, respect for the environment and social well-being, focusing on the development of equitable systems and the promotion of social justice, inclusion and quality of life. This implies the maintenance and generation of employment, the reduction of poverty and inequalities, the mitigation of situations of social exclusion, the incorporation of gender perspectives and other diversities, as well as the promotion of people’s health and wellbeing.
In this article, we will leave environmental and economic sustainability for other forums and focus on social sustainability, which we can consider as the integrality of community well-being, equity and resilience, and which can be found in the educational, social and health sectors. This definition implicitly underlies certain key principles and determinants for the design, development and evaluation of social, educational and public health projects considered as the three pillars of our welfare state. In this article we will attempt to answer the following question:
How can the long-term and system-wide effects of interventions be sustained?
To sustain means to support, to hold firm something[2]. It is important to precisely define this “something” so that all those involved know the direction and what we must hold firm over time. To know the what, we must also know the why and what for. In our projects, it is necessary to clearly define the changes we wish to pursue in order to reduce, mitigate or solve a particular problematic situation in our society.
Projects intervene at different levels, both at the intrapersonal and at the interpersonal and organizational levels of the system we are part of. At each level, projects act to a greater or lesser extent, generating profound changes in the system.
The person
When we speak of impact at the intrapersonal level, it is when people have acquired knowledge, applied strategies and actions for their educational development, personal and social growth and health promotion. At this level, achieving sustainability means that these people decide to continue applying these strategies because they consider them useful, positive for them, for their environment and/or for their society. This is why projects must be thought of considering people as rights holders, as people who have a voice and the power to determine their immediate reality. Let us flee from protectionist and paternalistic visions: the people with whom we intervene are not merely passive beneficiaries who receive help, they are active people. When we work with children and adolescents, it is essential to count on their opinion and their active participation in whatever the project wants to address. Save The Children in Finland[3] propose a model for integrating children’s perspectives into the planning, development and evaluation of services, combining principles of service design, children’s rights and a child-centered approach. Here the Child-Centered Design methodology is based on active participation processes with dynamics and games in the generation of ideas for possible solutions to improve services. It offers a set of tools and methods to ensure that services are ethically sustainable and responsive to children’s needs, promoting meaningful and enjoyable development processes for the children involved.
In a world with limited resources and full of adversities, interventions must be designed with an accompanying approach, without creating dependency relationships with the intervention itself. As professionals we are not here forever, we are just passing through. The approach and the guarantee of social sustainability must be present in the accompaniment methodology itself. Therapists, educators, teachers, health professionals accompany during a prolonged but finite period of time, providing knowledge, recommendations, strategies and resources so that the person being accompanied can dispense with the help of all these professionals at the end of that time. It is not easy neither for the one who accompanies nor for the one who is accompanied. Whether in a treatment, a therapy, a training course, a learning process or of any social nature, there is always a moment that comes to an end. There is therefore a change of stage. That is why it is recommended to opt for gradual transitions that go from a greater intensity of intervention to a lesser one, with determination and firmness in each small step that is taken in the change of phase. It is essential that this transition is made with the greatest guarantees for the sustainability of what has been learned and changed during the accompaniment process. It is important to prepare this transition from the beginning of the intervention, with a shared planning, with a frequent check of expectations, considering the needs of each moment and with a clear communication of the necessary information, and with the tools and resources available for each phase.
The community
People are part of communities in which, through our behaviors and interactions, we directly influence the development of the community. In the interpersonal sphere, more communitarian, social, educational or health projects influence and influence all those relationships and ties between people. If the intrapersonal sphere is already a complex area due to the great diversity of personalities, feelings, beliefs, mental schemes and perceptions of people, the area of relationships between people is even more complex. It is in these connections that the major keys to social sustainability lie, so that the effects of our interventions last over time.
A community is formed from a set of networks of relationships that interact with each other, sharing common norms and values. These norms and values enable the creation of a supportive and connected group. In essence, a community is an active and mobilized group whose members collaborate and act together. We can draw inspiration from community social pedagogy, a social and educational approach whose main objective is to improve people’s quality of life and well-being, as well as to promote social cohesion. To achieve these objectives, it is essential to empower individuals and encourage their active participation, which requires socially engaged citizenship.
For social sustainability, at the community level, the lessons and reflections shared by Sascha Haselmayer (2023)[4] through his alternative approach called “The Slow Lane” are promising. He conveys this to us in five principles that focus on transforming the way we approach social change.
The first is to contain the urgency. Haselmayer suggests resisting the pressure to act hastily in situations of high urgency. He stresses the importance of not sacrificing inclusiveness and participation in the rush for immediate results. Instead, he advocates taking the time necessary to ensure that solutions consider all those affected, recognizing that speeding things up will not necessarily get us to our desired destination any faster.
The second is listening. It emphasizes the importance of listening with humility and recognizing the limitations of our own listening skills. This principle values treating others as equal contributors and is fundamental to building the trust needed to change hearts and minds. Authenticity in listening allows new solutions to emerge and keeps people engaged for the long term.
Sharing agency without imposing solutions is the third. It encourages creating environments where even the least prepared people feel comfortable and able to contribute and exercise their power. This principle rejects the imposition of answers and focuses on empowering everyone, practicing patience and taking care that the invitation to participate meets people where they are and remains open to everyone at all times. Later in this article, it will be interesting to connect it to the work of Whitehead who has also analyzed the role of active participation of communities in community-based projects.
The fourth is to encourage curiosity. This principle opposes fixation on a single answer. Curiosity makes the process more inclusive and allows transformative visions to emerge. It motivates us to unlearn preconceptions and be open to new ideas, seeking inspiration beyond our immediate reality. Curiosity also facilitates the flexibility needed to find common ground.
The fifth and last is use technology as an enabler. This principle advocates against the use of technology to dominate others and suggests developing strong human values, principles and behaviors that technology can enable. In this vision, technology is owned by everyone and creative new ways are used to facilitate the best of human relationships.
The knowledge, recommendations, strategies and resources provided by the projects will change the mindsets of each individual, which in turn will change conversations, dynamics and activities that occur between people within the community. In educational, social and health projects, it is key that they are based in the community. When we talk about community, it is important to explain what we are referring to. That is to say, is it a geographical space, a group of people in a more relational sense, which people, an entity or a group of entities or social, educational or health organizations? It is key to identify the commitment of that group of people to that same community.
In terms of Monitoring, Evaluation and Learning (MEL), Hawe (1994)[5] explains how evaluations of community health promotion interventions may underestimate the benefits of an intervention if only individual-level changes in health behavior or attitude are reported, without capturing improvements in a community’s problem-solving capacity and competence to address the problems it faces. Empowerment can be considered an outcome variable in community interventions if capacity building is a core activity of an intervention. Active and interactive strategies should be used to articulate what empowerment really means and to challenge what success of an intervention really means in interactive dialogues with program workers and the community. For those of us who intervene in social, educational and health projects, we are increasingly moving from viewing community as a merely reinforcing scheme to the concept of community as an organization that has the capacity to work toward solutions to its own community-identified problems. Hawe stresses the importance of not designing the evaluation in isolation, but of actively working with program workers and producing the evaluation design in an interactive manner. This reveals the true value that the program places on the role of community and, at times, even for the program workers themselves. This approach challenges evaluations based solely on behavior and argues for a richer and more multifaceted appreciation of the success of community interventions.
The fundamental aspects of a community intervention include strategies such as mobilization of people, self-help and mutual support initiatives, action in a variety of settings such as work, schools, health centers, as well as policies and initiatives at the regulatory and legal level that promote or limit certain practices. This approach also involves the participation of community leaders, social support networks and all kinds of community groups [6] [7] [8].
Whitehead (2002) distinguishes up to seven varieties of community-based projects[9], based on the role of active participation of communities and external agents. Each approach has its own criteria for evaluating success or failure. It is worth mentioning that those programs implemented with balanced and equitable participation between the community and external agents is the most desirable to achieve social sustainability, because it balances the strengths of all parties.
Therefore, it is important to mention the active participation of individuals and the community and the need for community participation processes, with spaces of place and time to reflect, reach consensus and align the agents in a common direction. This requires constant, cooperative and consistent work, as Aesop’s opening fable reminds us.
The effectiveness of alliances
Community health, through its collaborative and sustainable approach, mobilizes resources and establishes partnerships between various sectors such as health, education and social services. This intersectoral approach is fundamental because it can address the social determinants of health. Based on published literature and good practice experiences, Gillies (1998)[10] has evaluated the effectiveness of alliances or partnerships for health promotion in different contexts. The active involvement of the community in setting agendas for action and in the practice of health promotion significantly increases the impact of these initiatives. Volunteer activities, peer-to-peer social projects, and civic activities maximize the benefits of community-based approaches. The creation of durable structures that facilitate planning and decision-making, such as commissions, task forces, committees, and interdepartmental councils, are key to the success of health promotion alliances or partnerships. These structures also support the distribution of power, responsibility, and authority for change, maintaining order and programmatic relevance. The existence and implementation of policies for health promotion activities at national, regional, and local levels is crucial to the sustainability of these initiatives. Gillies proposes social capital as an important framework for organizing our thinking about the broader determinants of health and how to influence them through community-based approaches to reduce inequalities in health and well-being.
Undoubtedly, collaborations and alliances between public, private and/or third sector entities work if they are done properly. These alliances are part of the way to achieve changes that are sustainable in the long term and have the potential to change the system.
In both alliances and long-lasting structures, it is essential to clearly establish expectations and objectives among all participants. This will guide the community to proactively assume their role in the project, thus strengthening their empowerment. Effective communication and unification of governance and responsibilities will foster the commitment, both individual and collective, that is desired during and after the project. Omitting this initial step may force a reconsideration of the project’s viability. This step is key to ensuring the long-term sustainability of the project.
Empowerment
As noted above with Hawe’s analysis, empowerment plays a key role in the sustainability of social, educational and health projects. This concept is defined as the process by which individuals, groups or communities gain control over their circumstances to achieve their goals and improve their quality of life, as described by several authors[11] [12]. Empowerment depends on the ability to shift power and expand it, often through the acquisition of knowledge, skills and resources. It involves enabling people to develop mastery over actions and control over decisions that influence their lives, both through the processes and outcomes of this development. Empowerment can be understood in various contexts, such as psychological empowerment, patient empowerment, and women’s empowerment, each with its specific dimensions and implications[13] [14]. It is a multidimensional concept that can be influenced by factors such as resources, agency, achievement, and the political context in which it is applied.
Christens (2012)[15] argues that empowerment is a desirable outcome for community development projects, as it is associated with higher levels of community participation and has protective effects for mental health. Christens proposes several organizational and community practices and processes to achieve empowerment.
Empowering community environments that enable people to play meaningful roles, provide social support, access to social networks in different organizations and promote community action. These environments contribute to individual psychological development, community development and positive social change.
Unfortunately, there are environments where individuals or groups are in a position of lesser importance or power, i.e. are ignored or relegated to the margins of the social debate. Christens discusses how this marginalization and mental health are interconnected, suggesting that empowerment can play a critical role in improving mental health through reducing inequality and improving the community context. That is why empowerment should be addressed with a transactional approach to community development that involves the interaction between individuals and their contexts. This means that psychological and community empowerment are mutually dependent and must be considered together for effective impact.
Christens advocates including empowerment as an objective outcome in the design, implementation, and evaluation of community development projects. He suggests that this can contribute to programmatic sustainability and promote positive mental health outcomes.
Nikkah and Redzuan (2009)[16] examine the relationship between participation in community development and empowerment, with the ultimate goal of improving the quality of life of communities through empowerment. However, they point out that it is essential to differentiate between types of participation to achieve this goal. Nikkhah and Redzuan distinguish between participation as a means and participation as an end. Participation as a means uses people’s resources to achieve predetermined objectives, while participation as an end involves a process in which people are directly involved in and take control of decisions that affect their lives. Both authors argue that participation as an end is what leads to empowerment.
The authors examine three main approaches: top-down, bottom-up, and partnership. Both conclude that the bottom-up approach, where the community initiates and manages development, is the most effective in achieving empowerment and long-term sustainable development.
Design of projects for sustainability
For the design of sustainable projects with a long-term vision, it is essential to recognize communities as bearers of fundamental rights. Integrating a deep understanding of human rights into social, educational or health projects is key to empowering people and their communities. This fosters the protection and promotion of people’s health, well-being and social inclusion.
In the context of projects with a long-term vision, collective learning and participation are essential to ensure project success and sustainability. The creation of communities of practice within these projects can contribute to innovation and social sustainability, as they allow members to share knowledge, experiences and perspectives, which can lead to the generation of creative ideas and solutions.[17] The three predominant characteristics that can be distinguished in a community of practice are related to the group’s identity, links and work[18] [19] [20].
To ensure the effectiveness and sustainability of educational, social and health projects, it is necessary to implement a multilevel strategy that encompasses the organization and the community in which it intervenes. This includes the integration of all leadership, both formal and informal, within the community. It is essential to allocate spaces and develop various actions to promote the active participation of all organizational levels, as well as to foster greater awareness within the organization. This integrative and multidimensional approach is key to achieving a solid commitment that will support the long-term sustainability of the project.
To ensure the sustainability of the project, it is essential to implement Monitoring, Evaluation and Learning (MEL) systems. It is essential to continuously draw lessons from the project’s achievements and difficulties, which is vital for its development and growth. This process can be facilitated through constant reflection, feedback and participatory evaluations that actively involve the different stakeholders.
Beyond the organization or community where it operates, weaving links and alliances with other entities, institutions or experts of reference will enhance both the impact and the sustainability of the project. This can be achieved through one-off collaborations, shared projects, knowledge-sharing programs and successful practices. Creating these alliances will reinforce long-term change in the ecosystem where we intervene, as well as the broader systemic change we seek.
Returning to the conceptual framework proposed by Barron et al. (2023)[21], they highlight social cohesion, inclusion, resilience and legitimacy in processes as components for social sustainability. The existence of a common purpose, trust and a collaborative attitude within communities and also between different communities and public administrations will enable social cohesion. To achieve social sustainability, it must be ensured that all people are included, first that they have access to services that respond to basic needs, and then that they have the opportunity to actively participate in society. Community resilience ensures that all people, especially those in vulnerable situations, are protected and are able to withstand and overcome adversity, while maintaining and respecting their cultural identity. Process legitimacy focuses on the way in which public decisions are decided and implemented, ensuring that the parties involved consider these decisions as fair and valid. Process legitimacy will be based on the credibility of decision-makers, consistency with agreed rules and social values, perceived benefits, participation and transparency.
Planet Youth[22], which originated in Iceland, is an example of how a well-founded, community-integrated intervention can have a profound effect on public health and the well-being of young people. It is an outstanding initiative for its preventive and community-based approach to adolescent substance use. Developed from the Icelandic Prevention Model, it is based on a participatory methodology and scientific evidence, with more than two decades of proven results in reducing substance use. Planet Youth’s effectiveness is based on several key principles and steps that include the active participation of the entire community: families, schools, peer groups and extracurricular activities. The initiative promotes a comprehensive approach that not only addresses youth, but also the environment around them, working to strengthen protective factors and mitigate risk factors associated with substance use. This approach is flexible and adaptable, allowing for its implementation in diverse communities beyond Iceland. Its evidence-based methodology and focus on community participation make it a replicable and effective model. It also serves as a source of inspiration, demonstrating that systemic change is possible.
The Peaceful Schools[23] program described in the article Twemlow, Fonagy and Sacco (2005)[24] focuses on creating a more peaceful and productive school environment through mindfulness. This approach involves the entire school community, i.e. focusing on relationships within the school social system, rather than isolated individuals. This intervention included positive climate campaigns, classroom management focused on problem solving rather than sanctioning, mediation, peer and teacher mentoring, a physical education program, and reflection times to discuss power dynamics and mindfulness in the classroom. These programs have been in place for 25 years and have helped give students the tools they need to meet the challenges of life and the community.
The Nous Cims Foundation is building its programs to achieve social sustainability of the direct effects of its interventions as well as the empowerment of the communities where they are working. Komtü[25] uses the methodology of reflective practice as an element for the empowerment of people. A process by which the person engages in critical thinking about his or her experiences and in which he or she draws lessons from his or her practices. Through this methodology, we give teachers the opportunity to adopt an emotional wellbeing approach to their students and to themselves. Following the community approach, we see how both Komtü and Domum[26], another program for the oncology patient, work to create structures of people in the community in order to endure and sustain the relational dynamics that allow the community to continue its mission of fostering emotional well-being. Koa[27] also works for the training of the educators who are accompanying the adolescents, providing tools that the educator herself will be able to use with the adolescents and people she accompanies throughout their personal journey. The use of an empowering methodology as part of the intervention, the training and development of professionals, the training of trainers, the accompaniment of people are the strategies chosen by Nous Cims programs, contributing to incorporate the look of emotional well-being in the social, educational and health sectors.
Contextual challenges and potential risks
Challenges also arise that deserve our attention in order to achieve social sustainability. Projects such as those mentioned above pose risks arising from both internal and external factors, influenced by political, social, economic and technological changes. Externally, aspects such as economic fluctuations and changes in government policies can have a direct impact on funding and support for initiatives in these sectors. Existing socioeconomic inequalities in society play a relevant role, affecting to varying degrees the success and changes that the project seeks to implement. It is essential to take into account public policies and legal regulations, as they provide a solid foundation for projects. Changes in these regulations are aspects to which projects must adapt to ensure their continuity and effectiveness.
Dependence on a single source of funding or limited resources can make a project vulnerable to changes in the availability of such funds. For example, a social project funded solely by a government grant may face difficulties if the government decides to cut the budget for such initiatives. It is recommended to diversify the source of funding.
Depending on the sector, there is a constant rotation and movement in the work teams. The frequent loss or change of key team members can affect the continuity and effectiveness of the project. For example, an educational project loses its main coordinator, leading to a disruption in the implementation of the planned curriculum. Projects should consider including multiple people in leadership roles, avoiding concentrating formal leadership in one person. In addition, it is crucial to implement continuous training programs that facilitate the transfer of knowledge and learning. The implementation of programs aimed at staff loyalty and professional development is essential to minimize employee turnover in the teams. Working conditions, which can be precarious in certain sectors, also play a significant role in the high turnover rate.
Over time, the initial enthusiasm and commitment of community agents may diminish, affecting the progress and results of the project. Here it is important to establish mechanisms for feedback and active participation of the community in decision making, as well as to preserve spaces for recognition and celebration of achievements in order to maintain initial motivation and commitment.
Overestimating the community’s capacity to sustain the project without external support can lead to its failure once that support is withdrawn. For example, a community health initiative that fails to take root in the daily practices of the population and ends up being unsustainable on its own. This is why confidence in the community’s own resources and capabilities needs to be considered from the beginning of the project. Periodic monitoring and evaluation of community capacities is key to adjusting support as needed. It is important that withdrawals of support be gradual and respect the empowerment processes as we have seen above. This will minimize the “wind-down” effect that occurs when the effects of an intervention diminish over time. The drop-off is important to consider when assessing the long-term impact of an intervention. We cannot assume that impacts will stand on their own and by themselves over time; instead, the focus should be on empowering, preparing and enabling those involved to take responsibility for the effects and impacts resulting from our and their interventions.
An interdisciplinary workshop described by Kubzansky et al. (2023) explored the potential of psychological well-being interventions to improve population health, while noting the need for future research to address challenges regarding the durability, scalability, and effectiveness of these interventions in diverse populations[28]. It is important to consider effect sizes in psychological well-being interventions, questioning whether the observed effects are large enough to influence long-term health and behavior. The heterogeneity of outcomes and the need to better understand where and with whom these interventions work suggests that even small effects may be valuable if the interventions are easy to implement on a large scale. It can be ensured that the effects of wellness interventions are sustained over time, through habit formation or changes in cognitive perception and processing. It is also important to develop interventions that can be scalable, easily distributed and adopted by the population, considering the use of digital technologies and other means to facilitate large-scale implementation. Again like the authors already cited, Kubzansky et al. recommend adapting and contextualizing interventions for different populations and contexts, recognizing that the effectiveness of interventions may vary significantly across demographic and cultural groups, and suggest further research to optimize interventions for minority and underserved groups.
And to end this article, we will finish as we began, with another complementary Aesop’s fable. It is the fable of the bundle of sticks, again adapted.
An elderly woman was concerned that her daughters were constantly fighting with each other, and feared that their discord would lead to their ruin. Seeking to teach them the value of unity, the woman devised a plan. She called her daughters together and presented them with a bundle of sticks, tied tightly together, and asked them to try to break it.
One by one, each daughter tried to break the bundle of rods. They used all their strength, trying different methods, but none could bend or break the bundle. Frustrated and confused, they finally gave up and returned the bundle of sticks to their mother.
Then the mother untied the bundle and separated the rods, handing each daughter an individual rod. “Now, break your own,” she told them. Effortlessly, each daughter broke her individual rod. The mother used this moment to teach them a valuable lesson: “My daughters, if you stay together and united like the bundle of rods, you will be invincible. But if they divide and face challenges alone, they will be as easy to break as these individual rods.”
The moral of this fable is clear: unity is strength. Through cooperation and unity, obstacles that would seem insurmountable for an individual acting alone can be overcome. To achieve social sustainability of our projects in our educational, social and health communities requires constant work and cooperation. As the moral of this fable, which coincides with the motto on the coat of arms of a great little country in the Pyrenees, says: Unity is strength or Virtue united is stronger.
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[Koa Programme ( 2021, July 13). Nous Cims Private Foundation. Retrieved April 10, 2024, from https://www.nouscims.com/proyecto/koa-programme/
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