The status quo doesn’t work for millions of Americans, and the consequences of millions of failures are expensive for everyone else. There has to be a better, fairer, and more cost-effective way of helping people achieve success. That is what this book is all about.
The United States now spends trillions of dollars on chronic disease, incarceration, educational failures, and lost productivity—among the many problems of the current system.
Instead, this book argues for better, more targeted spending that could guarantee an opportunity-rich childhood for all.
The “guardrails” of the title are the aspects of a well-functioning neighborhood that help children become thriving adults: good schools, well-funded libraries, safe streets and public spaces, quality health care, churches and other spiritual homes, and transportation and other public services.
“Airbags” are timely interventions at the individual level that help avert lasting damage from bad events. Examples include drug treatment or psychological counseling for troubled young people.
The United States can afford both better guardrails and airbags for kids to help them become healthy and productive adults who will be effective parents for the next generation.
This book advocates a smarter social safety net that will catch kids heading in the wrong direction before they are harmed, and society will pay for those upstream investments and reap the benefits of healthier and more productive generations to come.
David Erickson is senior vice president at the Federal Reserve Bank of New York. He has convened thousands of experts to be speakers at conferences and authors in a series of books on how community development finance can work with other social investors to create more opportunities in low-income communities. Key to this strategy is to create new alliances with sectors that previously did not work with anti-poverty activists: health, climate adaptation, household financial wellbeing, art and artists, faith communities, and others. Throughout, he has focused on how quasi-markets can be tools to create better social outcomes—the subject of his first book, Housing Policy Revolution: Networks and Neighborhoods. Erickson has a PhD in history from the University of California, Berkeley and a BA from Dartmouth College.
Introduction: Better Policies and Improved Neighborhoods Can Secure the Fifth Freedom—an Opportunity-Rich Childhood for All
1 Evolution of the Welfare State: 150 Years of Efforts to Assist Low-Income Communities and Individuals
2 Guardrails and Airbags: Better Strategies to Improve Neighborhoods and Support Families Are the Basis for a Smarter Social Safety Net
3 Financing Guardrails and Airbags: Creating a Market That Values Health
4 Hawaii Case Study: How an Island State Can Point the Way
5 Conclusion and Next Steps
David Erickson’s new book is a must-read for anyone interested in health and social welfare. He takes square aim at the ‘know-do’ gap that has plagued efforts to improve our social safety net. Drawing upon his decades of experience, the book offers a lucid diagnosis of the problem as well as practical solutions that would advance health and social equity for millions of people.
Whether serving as a family physician for patients experiencing homelessness, as Chicago’s public health commissioner deploying policies to improve health, or as Kaiser Permanente’s Chief Health Officer implementing upstream interventions to optimize conditions for health, I know just how important reliable and sustainable investments are to the health of our communities. In The Fifth Freedom, Erickson deftly connects the dots between how strategic investment decisions – whether from private industry, the nation’s health care system, or from all levels of government—can create the conditions for health and equity we all need to truly thrive.
With empathy, precision, and deeply informed historical analysis, David Erickson issues a clarion call for America to fundamentally rethink how it serves its citizens and enables the next generation to flourish. The Fifth Freedom shows that it is possible—and necessary—to think big, to spend well, and restore hope and economic security to all people and places. An essential read for policymakers and citizens alike.
David Erickson’s provocative new book leads off with a bold premise: what if, as a society, we decided to truly invest in children’s health and well-being, ensuring that no child grows up in poverty? Drawing on a rich mix of history, social theory, evidence-based research, and promising strategies from the field, this book builds a compelling case that this premise is achievable if we’re willing to re-think our existing approaches to health and social policy.