We keep acting like one fix is going to be the thing that upholds health equity.

A new clinic. A new program. A new policy. And then we’re genuinely baffled when outcomes don’t change.

Public health so often treats system failures as individual gaps instead of systemic misalignment. We over-rely on single solutions and then wonder why the needle doesn’t move.

But what if we thought about health the way we think about Swiss cheese?

You might have seen the Swiss cheese model of self-care floating around: the idea that no one practice can fully protect us from life’s daily stressors. Each layer of cheese has holes. But when you stack imperfect layers together, those non-matching holes create real protection.

Health works the same way.

The Four Layers

When I started mapping this out, I landed on four essential slices that make up the public health ecosystem:

1. Access to responsive care and services. Care that’s timely, culturally responsive, affordable, accessible. This doesn’t come from one health center. It’s the whole ecosystem: insurance, hospital systems, nonprofits, justice organizations. All of it creates that accessibility.

2. An ecosystem of community support and opportunity. This is mutual aid. Social connection. Economic opportunity. It’s where folks are held between their formal interactions with the system. When communities have the resources and time to support each other, to cook for each other, to look after each other. That’s infrastructure.

3. Policies and practices that see and serve us. I was talking to someone recently who runs an incredible organization, and she mentioned that only 18% of families in the U.S. are a nuclear family with two parents and children in a single home. Yet nearly all of our policy is written for that unit. We’re creating policies that don’t reflect the lived realities of the people they’re designed for.

One of the most impactful things I learned in grad school: there’s no such thing as a broken system, because every system gets exactly the outcomes it was designed to get. So when we’re systems makers, it’s on us to create policies and practices that actually meet folks where they are.

4. A healthy, abundant environment. Physical environment. Land. Housing. Transportation. Places to connect, to rest, to move, to belong. It’s not just the environment existing, but our ability to actually spend time in it with the people we love and are in community with.

The Holes Aren’t Failures

The holes in our Swiss Cheese slices are not failures. They’re realities.They’re  what happens when systems meet real life. No organization is meant to be doing everything at once. We need each other. We create this ecosystem together, this wraparound vessel that holds our communities and keeps us safe and healthy.

I think of the rural context where I live. We have incredible mutual aid networks where people really show up for each other. But there’s no institutional power or funding behind it. Meanwhile, there’s excellent clinical care, but getting there is another story when transportation is unreliable and areas are inaccessible.

This is why we need each other. My slice covers where yours has holes. Yours covers mine.

The Wrapper

So if the slices are the layers, what holds them together?

We don’t just put cheese willy-nilly in the fridge. It needs a container. And in this model, story-driven strategy is that wrapper.

If you’ve been around here for a while, you know I don’t mean marketing and testimonials. Story-driven strategy is about how systems listen, how they see patterns, how they decide what matters. It’s that deep listening and then building strategy based on the wisdom from the community about what folks need and want and demand from the systems that serve them.

Story structurally reveals where the holes actually are. It shows how those layers interact in real lives. When we create strategy in response to story we get real policy and real practices that can be enacted with ease and impact.

Without that wrapper?

Programs compete instead of collaborate. Communities get engaged but not centered. We end up fragmented—and frankly, we end up with a smelly fridge.

The Cycle We Actually Want

When we deeply listen to our communities and the folks who work alongside us we create strategy that already has buy-in.

Strategy with buy-in leads to powerful implementation.

Powerful implementation leads to increased impact because folks are coming to programs they spoke a need for. They have ownership in it.

And as we all know, once you have increased impact, funders’ ears perk up. Decision makers love to see it. That gains more attention, and your impact increases even more. And then you continue to deeply listen and iterate, feeding that healthy cycle.

That’s the ecosystem we want. That’s the wrapper holding it all together.

A Question for You

If you were to think about your system in layers—not just the big public health pillars, but your specific system—what might some of those layers be?

Where are the holes?

And more importantly: where can you collaborate instead of duplicate? Where can you find partners whose slice covers what yours can’t?

When we get serious about health and equity and impact, story is not fluff. It’s the true infrastructure. It’s the wrapper of our cheese, holding it all together.

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Okay, let’s get serious about bringing story & strategy into your organization. Below are a few ways we can partner, and, of course, you can reach out if you want to collaborate in a remixed sort of way:

+ Story Lab Sessions: Tailored strategy mapping to chart your organization’s storytelling journey, followed by a comprehensive brief with guidance to implement the findings from our session. These sessions are perfect for organizations ready to take their first steps or needing focused guidance on specific initiatives.

+ Story Hour: Real-time support, guidance, and peer learning through a suite of trainings and regular calls. These group sessions provide ongoing support and practical insights for implementing storytelling initiatives in your organization

+ Customized Collaboration: Long-term, tailored support for comprehensive organizational transformation. We’ll work closely together to integrate storytelling deeply into your existing processes. This is designed for organizations looking for in-depth support designing, implementing, and learning from storytelling initiatives.

+ Intensives & Retreats: Individually designed intensives for your staff retreats and training blocks to engage your staff in a process that centers their experiences and connections to their work through story. Great for organizations looking for a unique, connective experience for their team.

Entangled Health can be in your ears, too! Listen to the show wherever you tune into podcasts.

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