Across the country, and increasingly around the world, I work with mayors, governors, funders and health systems confronting what policy experts often call wicked problems: workforce disconnection, housing instability, mental health crises and cycles of violence that refuse to yield to simple solutions. These challenges are deeply interconnected and shaped by history, policy and power. One lesson is consistent everywhere I go: we cannot spend our way out of wicked problems without changing the conditions that create them.
Health equity is often misunderstood as a public health issue or a collection of programs layered onto broken systems. In reality, it is a leadership issue. It reflects whose voices are centered, how decisions are made, how power is shared, and whether people experience dignity and belonging when they engage city systems.
That is why the lens must shift, from treating social determinants as a checklist to governing through Vital Conditions as developed by a partnership including The Rippel Foundation and The National Association of Community Health Centers.
Vital Conditions ask a more honest question: Do people have what they need to live with stability, opportunity, safety and belonging? These conditions; housing, transportation, education, employment, safety, access to care and social connection, are not abstract. They are shaped every day by city budgets, land-use decisions, procurement practices and who is invited into decision-making spaces.
Allentown knows this reality well. Recent indicators tell a sobering story: a school district under significant strain, affordable housing increasingly unattainable for working families, a visible and growing mental health crisis and gun violence numbers that many hoped were declining beginning to creep back up. These are not isolated challenges. They are signals of stressed systems and unmet conditions.
This is why Allentown’s selection for the federal Recompete Pilot Program is such a critical moment. Recompete recognizes that communities struggling with low prime-age employment are also grappling with child care access, transportation barriers, skills gaps and economic exclusion. In other words, it treats workforce development as an upstream health equity strategy.
But money alone will not solve these challenges.
We cannot simply throw funding at wicked problems and expect different outcomes. New ideas must be generated by the residents most impacted by the disparities themselves. People navigating low wages, unstable housing, under-resourced schools, untreated trauma and neighborhood violence are not passive recipients of policy. They are experts in systems that have not worked. If Recompete is to become a true model for transformation, those closest to the pain must help lead its design, implementation and accountability.
That requires more than listening sessions. It requires a different posture of leadership.
It also requires honesty about governance. Recent public tension between the mayor’s office and City Council over budget decisions may feel like political noise, but moments like these matter. Budgets are value statements. They reveal priorities more clearly than any speech or strategy document. When conflict becomes public without meaningful community engagement, it risks deepening cynicism, especially among residents who already feel excluded from power.
This is precisely the moment when participatory budgeting and shared decision-making are not optional, they are essential. When residents help decide how resources are allocated, trust grows. When trust grows, participation changes. And when participation changes, outcomes improve.
In my work with mayors nationally and globally, I often say: when people feel welcomed, they show up differently. Welcome is not symbolic. It is rooted in trust, voice and a willingness to relinquish power. Without those elements, even well-funded initiatives will struggle to reach the people they are meant to serve.
Vital Conditions offer Allentown a path forward. They allow the city to see workforce development as health, housing as prevention, education as economic strategy and community safety as a shared responsibility, not merely enforcement. They help align departments, reduce fragmentation and measure success by lived experience, not just outputs.
Allentown has an opportunity, right now, to lead nationally by demonstrating what health equity looks like when community wisdom is centered, when budgets align with values and when leadership chooses courage over control.
The question before us is not whether we can implement Recompete.
The question is whether we will use it to transform conditions, or simply manage disparities more efficiently.
Our residents, and history, will know the difference.
This is a contributed opinion column. Hasshan Batts is the founder and president of the Prison Survivor Network, a Fulbright specialist, and the co-founder of the Watson-Batts School of Construction. The views expressed in this piece are those of its individual author and should not be interpreted as reflecting the views of this publication. Do you have a perspective to share? Learn more about how we handle guest opinion submissions at themorningcall.com/opinions.