Fixes looks at solutions to social problems and why they work.

The benefit of writing a column about solutions is that it provides an alternative lens through which to view the world. The daily news tends to be dominated by daunting challenges (unemployment, climate change, the polarization of Congress) and flashpoint events (the killing of Osama bin Laden, the tsunami in Japan, the Penn State scandal). These stories are vital to cover. However, people often come away from the news with a lot more information about problems than about how society is dealing with them.

One of the premises of Fixes is that society is often self-correcting in ways that go under-reported. We need to be able to envision possibilities before we can act on them. Looking back at some of the stories we’ve covered over the past year or so, I’ve found that a number of groups have made substantial gains even during this tough economic period. These stories also remind me that social change doesn’t always take the form of dramatic, televised events, like the Arab Spring or the Occupy movement. Often it is through gradual, unnoticed, yet steady advancements that new ideas take hold ― like trees spreading roots.



A few examples: In our second column, late last year, I wrote about Root Capital, an organization that supplies credit to small-scale agricultural producers in poor parts of the world. In 2010, the organization disbursed $80 million in loans. This year, it disbursed $120 million: 50 percent more. It now finances farmer-owned businesses that support 220,000 producers, extending benefits to roughly a million people. In April, when I reported on Playworks, an organization that helps public schools create safe and inclusive recess and play periods, it was working in 250 schools in 15 cities. It has since expanded to 318 schools in 23 cities. In a survey of 2,591 educators, close to 90 percent said the program decreased bullying and disciplinary problems and improved students’ focus in class. Text4baby, a free service that provides informative text messages to women who are pregnant or have a baby less than a year old, has, since February, roughly doubled its subscribers to 265,000 (though it still has a way to go to reach its target of a million by the end of 2012).

Root Capital

In July, I covered Health Leads, which mobilizes, trains and places student volunteers in hospitals to address the social causes behind the health problems of low-income patients. They have increased the number of clients they serve annually by more than 50 percent ― from about 5,800 in 2010 to about 8,800 families this year. And the 100,000 Homes Campaign, which has set a goal of placing 100,000 chronically homeless individuals into permanent supportive housing by July 2013, is now working with 107 communities, which have housed 11,345 people. This is up from 64 communities, which had housed 6,816 people when I initially covered them last December.

In addition to growth, a number of organizations have broadened and extended their work. Two Canadian-based organizations that I wrote about have launched their work in the United States: Roots of Empathy ― which brings babies and mothers into classrooms as part of a curriculum to strengthen the development of empathy among children ―is now working in Washington State and has just started in New York City (disclosure: my wife has signed on as a volunteer instructor). And JUMP Math, a curriculum that has demonstrated significantly better results than standard math instruction in controlled studies in Canada, is being adapted to conform to the U.S. Common Core State Standards for grades one through eight. JUMP is currently accepting requests from schools on the East Coast of the United States that wish to test its materials, so that they can be studied by researchers from Johns Hopkins and the University of Texas. (The organization will provide the program free of charge.)

In May, I wrote about First Book, an organization that pioneered an online marketplace to extend access to new, high-quality, heavily discounted books to reading programs that serve only children and youth from low-income backgrounds. First Book is now working to expand its marketplace to include digital content, as well as supplies for art, music, science and math education. It is also getting ready to pilot its work in India in 2012, and evaluating expansion opportunities in Brazil, China, South Africa and Britain. This year, Youth Villages, a Tennessee-based organization that provides a home-based therapeutic model more effective than foster care, expanded into Oregon and Indiana. It’s now in 13 states, as well as the District of Columbia. The Strive partnership in and around Cincinnati released its fourth annual report card, revealing improvements along a broad range of academic measures, including particularly big gains in kindergarten readiness. More than 80 cities have expressed interest in adopting this “cradle to career” shared-accountability model.

In April, my colleague, Tina Rosenberg, reported on Benefit Corporations. These are companies that pursue not only profit, but also seek to do good for employees, their community and their environment. This week, New York became the seventh state to give legal backing to these corporations ― holding them to high standards for social impact and allowing them to pursue a bottom line that includes both financial and social returns. Tina also wrote about the emerging micro-consignment model pioneered by an organization called Soluciones Comunitarias (or Community Enterprise Solutions), which extends economic opportunities that are similar to microcredit without demanding that poor people take on the risks associated with loans. The organization will be piloting its work in Mexico, Peru and the Dominican Republic this year, and will be studying its applicability in Egypt.

While organizational expansion and growth are markers of impact, they aren’t always the most important ones. Many of the problems that these organizations are addressing are the result of systemic failures in public systems or market mechanisms. To achieve major impact, they must find ways to get their “fixes” into the water supply, so to speak.

Some appear to be moving in that direction. In May, Tina wrote a story about the importance of micro-insurance to protect small-scale farmers in Africa. Last month, as a result of the drought in Ethiopia, farmers who purchased weather insurance received their first payouts from an Oxfam America-sponsored program. The World Food Program is now picking up the idea and plans to spread it initially to three other countries. Last November, Tina also reported on Manna Energy Limited, which had a plan to finance solar-powered water purification in Africa by tapping the market for carbon credits, based on projected reductions of carbon emissions. In June, Manna became the first water treatment project certified to do so under the United Nations Clean Water Carbon Credit Program.

In November 2010, I reported on an organization in Mexico City, Antenas Por Los Ninos, which developed a series of animated screen characters that are remarkably effective at communicating with children who have suffered traumatic experiences.

Antenas por los Ninos

Now the tool has been sanctioned and adopted by the district attorney in Mexico’s Federal District as a way of gaining evidence from children in cases of sexual abuse without causing them the trauma of cross-examination.

Another organization making headway into systems is Health Leads. It’s often noted that the United States health care system is really an illness treatment system, with very little emphasis on health promotion. Hospitals regularly discharge patients, especially low-income patients, into the conditions that caused, or contributed to, their illnesses without follow-up. A national survey, sponsored by the Robert Wood Johnson Foundation, found that 85 percent of doctors say that it’s as important to address patients’ social needs (like housing or nutrition) as it is to address their medical conditions. Most doctors (76 percent) want the health system to pay the costs of doing so. But doctors and social workers are already overburdened. Who’s going to do the work?

Health Leads is demonstrating that it can be handled by corps of trained student volunteers (or other lay workers). In some of the centers where the program operates, doctors now regularly inquire about patients’ social problems and request services, a significant change. Close to two-thirds of physicians at the Children’s National Medical Center in Washington, D.C., have prescribed social services through Health Leads via electronic medical records. And at the Harlem Hospital Center, in New York City, patients whose electronic medical records show an elevated B.M.I. (body mass index) are automatically referred to Health Leads volunteers, who help them access community-based services that can help them reduce their health risks. These are initial, but critically important steps in getting preventive care into the DNA of the health system.

Another system change in the making is the Housing Placement Boot Camp developed by the 100,000 Homes Campaign, in partnership with Home for Good L.A., GOOD Magazine, the Veterans Administration and the Corporation for Supportive Housing. The boot camp is an all-day event that brings together high-level representatives from a variety of social service and veterans agencies and housing authorities. Using a game board with magnetic tiles that represent each of the many steps required to get a person housed, participants work together to re-imagine a system that is now terribly uncoordinated and unnecessarily complex, and leads to long delays for people living on the streets, particularly veterans. (A study conducted by the campaign reported that homeless veterans remain homeless almost two years longer than non-veterans.) In New York, the boot camp helped agencies cut 60 days off the housing process for veterans. In Los Angeles, it shaved off 68 days, cutting it almost in half. If a one-day process can spark big improvements in the way cities handle housing, what other government functions could be re-imagined over Chutes and Ladders-like game boards?

Few changes carry more weight than those that modify major federal legislation, like the Social Security Act. That’s what Youth Villages, and a range of other children’s advocates, achieved this September, when their efforts led to the passage of the Child and Family Services Improvement and Innovation Act. One of the things that the law does is give states more flexibility in using federal funds to pay for community and home-based services for youth in the child welfare system. About 60 percent of the funds for these state systems come from the federal government. Previously, much of the money could be used only to pay for foster care and residential placements or services. Under the new law, states can experiment with services that can keep families together wherever this is safely possible. Youth Villages estimates that about half of the 425,000 children in foster care could be successfully reunited with parents, relatives or adoptive parents if they were provided with the right kinds of supports.

Related More From Fixes Read previous contributions to this series.

Governments can supercharge ideas like this. But they can also do great damage. The most disheartening follow-up of the year comes from Bangladesh. In March, I reported on the government’s politically-motivated (and vindictive) actions to oust the Grameen Bank’s founder, Muhammad Yunus. Unfortunately, the government won that battle and now it continues to intimidate the bank’s board members, nine of whom are village women elected by the bank’s borrowers. It also appears to be pursuing a variety of legal strategies searching for a pretext to limit the freedom of nongovernmental organizations, and take control of other Grameen-related companies ― there are 54 ― some of which are quite valuable, particularly Grameen Telecom, which owns a third of Grameen Phone, Bangladesh’s leading telecommunications service company. Governments and foundations that have supported microfinance should be aware that the threat of takeover is very real and could be enormously destructive to these institutions and the people they serve.

Finally, sometimes the biggest changes are those that are hardest to measure. One of the more modest organizations I covered this year (in terms of budget, but not vision) is the Family Independence Initiative, which creates structures in which low-income families come together to help one another solve problems and pursue goals. Earlier this year, in Boston seven of the organization’s members were honored by The Boston Foundation for their contributions to the city as resident leaders. In San Francisco, 30 families came together in lending circles, resurrecting a tradition of mutual assistance. And in New Orleans, a number of families have established community businesses to create jobs for one another and their youth. All these efforts were led by families themselves.

That’s it for the 2011 wrap-up. Now, it’s time to look ahead. So if you’ve come across a creative solution to a social problem that’s worth highlighting, please tell us about it. We’ll need lots of new ideas for next year.

Join Fixes on Facebook and follow updates on twitter.com/nytimesfixes.

David Bornstein is the author of “How to Change the World,” which has been published in 20 languages, and “The Price of a Dream: The Story of the Grameen Bank,” and is co-author of “Social Entrepreneurship: What Everyone Needs to Know.” He is the founder of dowser.org, a media site that reports on social innovation.