What Do We Do Now? Practical Ways to Diagnose and Treat the Systems That Drive Inequity
Bay Love |
We started our recent webinar with a simple invitation: come curious and open. Facilitators Monica Walker, Bay Love, Dwight Smith, and David Foster guided participants from outline to action, offering a disciplined way to see systemic problems clearly and to act with courage and precision.
If you lead teams, advise executives, or organize communities, you know the moment we’re in: progress feels fragile; debates turn inward; pressure mounts to “stay in your lane.” At the Groundwater Institute, our approach offers something steadier. It equips leaders to diagnose root causes and pursue informed treatment through measurable action that aligns your impact with your values.
This blog post offers a ready-to-use roadmap based on that webinar, including three steps any institution can take now, along with examples, quotes, and guiding prompts you can bring to your next strategy meeting.
What We Mean by “Groundwater”: A Metaphor That Changes the Work
Many readers know the fish-and-lake-groundwater story. If one fish goes belly-up, you ask what’s wrong with the fish. If half the fish in a lake are belly-up, ask what’s wrong with the lake. If you see half the fish belly-up across multiple lakes, it’s time to look deeper - to the groundwater.
Groundwater flows beneath lakes and streams, connecting them; most of the world’s fresh water lives there, unseen yet foundational. So do the systems and structures that quietly shape outcomes across health, education, housing, wealth, and safety. Or - within an organization - across the multiple systems, processes, and departments that comprise our work.
As Bay Love put it, the metaphor helps us stop “fixing fish” and start examining the deeper systems, cultures, and other difficult-to-see forces that create persistent dysfunction. When we look at society and analyze national outcome data, the pattern is unmistakable: some groups are 1.4–2.8 times more likely to face bad outcomes across domains—not because anything is “wrong” with those groups, but because of historical and structural factors permeating our groundwater.
- Socioeconomic status: Poorer Americans are significantly more likely to face adverse outcomes.
- Place: Rural residents see worse outcomes than their metropolitan peers.
- Race: Black Americans face higher risk across outcomes.
- Community histories: Immigrant communities reflect distinct migration histories and proximity to war and displacement: only a deeper understanding can make sense of the outcomes people experience today.
The Takeaway: Patterns repeat across systems because the groundwater connects them. This also applies inside organizations. Chronic underperformance rarely lives in a single department; interlocking incentives, norms, and histories create familiar modes of failure.

Beyond Diagnosis: The Full Arc from Insight to Impact in 3 Steps
Groundwater work is not an explanatory exercise. As Dwight Smith stressed, “Diagnosis is critical, but without treatment, it leads nowhere.” Our approach spans the full arc:
- Look deeper. Reinterpret data, histories, and everyday experience through a systems lens.
- See systematically. Shift attention from individuals to structures that shape outcomes.
- Act accordingly. Design and implement interventions at the level of systems so progress sticks.
Even with a new context and lens, acting accordingly is easier said than done. The following are three practical steps any institution can apply now.
Step 1: Define a Rightful Role (Purpose, Power, and Self-Interest)
Leaders often get stuck in unproductive debates: purpose vs. profit; urgency vs. strategy; loud stance vs. quiet execution. Articulating a rightful role, David Foster explains, is how teams move forward without collapsing into those binaries. Think of your rightful role as a strategic identity at the intersection of:
- Your mission and values
- Your unique capabilities and assets
- Your self-interest (what enables you to thrive and what truly matters to you)
- The systemic gaps only a coalition—including you—can close
Your rightful role isn’t just identifying what’s immediate control (and ignoring what feels ‘out of your control’). It’s an honest answer to the question: “Where am I positioned to play a part of changing the system?”
A Real-World Example from Our Webinar
A nonprofit health system with staff and clinics in politically diverse areas decided to pursue system-level change to expand equitable access to care. They revised clinical treatment guidelines, delivered targeted clinician education, and adjusted internal reimbursement practices that were producing uneven patient outcomes.
Through organization-wide Groundwater Institute training, the team built a shared analysis of structural drivers, which reduced internal friction and created a common vocabulary for change. Coaching from the Institute helped leaders articulate a rightful role that linked their mission (healthy communities) with their business imperatives (such as cost, quality, access) and their unique assets. That clarity enabled them to prioritize high-leverage guideline and reimbursement shifts, sequence their work sensibly, and communicate the “why” to frontline staff and community partners.
"A rightful role that brings together purpose and business is both necessary for coalition—and necessary to defend your license to operate in this moment.”
-Bay Love
Try This Now: Draft a one-paragraph “Rightful Role Statement.” Link your purpose, your business imperatives, and your unique capabilities to a system-level aim. Share it with your leadership team and ask: Does it resolve our recurring tensions? Does it clarify where we’ll take risks—and where we won’t?
Step 2: Build Your Team (Start with the Who, Then the What)
Coalitions win systemic change; email blasts do not. The most effective leaders in Fortune 500s, nonprofits, and civic networks “start with the who, then get to the what,” David noted. That means intentional relationship-building across functions, geographies, ideologies, and identities grounded in self-interest—properly understood.
What does that mean, you ask? In the community organizing tradition, self-interest isn’t narrow selfishness. It’s what truly motivates people: a safer school commute, a fairer promotion pathway, a meaningful legacy, healthcare for a loved one. You discover others’ self-interest through one-on-one, listening-first conversations, not by screening for ideological purity or role seniority.
“Our ambitions must be broad enough to include the aspirations and needs of others—for their sakes, and for our own.”
— Cesar Chavez
What Building a Team Is (and Isn’t)
- It Is: A power analysis of your institution: Who actually shapes the outcomes we need to change? (Hint: It’s not always the org chart.)
- It Isn’t: Demanding consensus on worldview.
- It Is: Recruiting beyond the “usual suspects” to create a winning coalition. Find people who can “score” in different rooms because of their credibility, relationships, or lived experience.
- It Isn’t: Arriving with a fully baked plan and asking others to sign on. Lead with relationships and listening; the agenda emerges stronger and more durable.
Try This Now:
- Map power and proximity. List 15 names: decision-makers, trusted skeptics, center-of-gravity influencers, community voices. Mark who can “score” in which arenas.
- Hold three one-on-ones this week with people not already aligned. Ask what they care about most right now. Listen for self-interest; don’t pitch.
- Create a “bench plan.” For each major milestone, pair the messenger to the moment—who carries the right credibility to move that room?
Step 3: Make It Real (Measure the Goal and the Path)
Jim Collins’ warning applies as much to equity as to business strategy: When we confuse dramatic end outcomes with the organic, cumulative processes that produce them, we mistake progress for failure.
In other words, if your only metric for progress is “close the racial wealth gap,” every quarter will look like a loss. But if you also track process measures of power and capacity, you can steer, learn, sustain hope, and accelerate over time.
What to Measure: Beyond End Outcomes:
- Strategic capacity: Do we have the right coalition, with clear roles and the ability to act in concert?
- Credible messengers: Do the people who can achieve the desired outcome reach the rooms that matter?
- Partnership strength: Are cross-sector partners aligned on goal and path? Is trust growing?
- Policy/practice levers: Are we embedding changes to guidelines, incentives, procurement, or evaluation that outlast personnel?
- Internal/external coherence: Do our workplace practices, our work in the market, and our stance in the world reinforce one another—or undermine credibility?
“If we only measure end outcomes, we’ll feel like we’re constantly failing. If we also measure the path, we can see and replicate what’s working.”
— Bay Love
Try This Now:
- Add a Process & Power section to your next quarterly review: coalition health, messenger coverage, policy lever progress, internal-external alignment.
- Run a workplace–work–world audit. Where are we strongest? Where does misalignment erode trust (e.g., bold external claims + fragile internal culture, or vice versa)?
- Set 90-day experiments tied to your rightful role: a pilot guideline change, a cross-department rapid-response team, a procurement shift that favors equitable outcomes. Evaluate both results and replicable practices.
Hope Is a Strategy When You Can Feel the Wins
Many leaders today are managing hope as much as budgets. The Groundwater frame doesn’t ask you to be optimistic; it gives you a way to build hope on evidence. When you track the path—the team you’re assembling, the levers you’re moving, the coherence you’re creating—you can see progress, even while end outcomes take time.
Define your rightful role. Build a team that can win. Make it real by measuring both the goal and the path. Then keep going.
Want a sounding board? Connect with the Groundwater Institute for foundational training, immersive experiences, coaching, and community spaces designed to turn shared analysis into durable action.
