Well-financed advocacy groups resist upstream change, frustrating health equity efforts

By Dennis Archambault

Special interests have always financed advocacy efforts. But the recent article, “How the Koch Brothers Are Killing Public Transit Projects around the County” (https://www.nytimes.com/2018/06/19/climate/koch-brothers-public-transit.html) offers a perspective on how difficult it is to make “upstream” systemic change to influence the social determinants of health.

Publicity about workers spending hours on bus rides to work – or walking in all kinds of weather — have raised awareness as to how difficult it is to get to (and hold) a job in this region. But the sobering reality is that there are oppressive financial forces, such as Americans for Prosperity, that provide financing to oppose progressive, social programs like regional transportation. Americans for Prosperity is the advocacy group funded by the Koch brothers, known for financing countless Republican campaigns. Paid activists, using a sophisticated data service, identify voters inclined to be of a more conservative orientation, then appeal to their interests.

Recently, civic leadership in Nashville supported a $5.4 billion transit plan. Americans for Prosperity made 42,000 phone calls and knocked on 6,000 doors to engineer defeat of the measure. “This is why grassroots works,” said the Tennessee state director for the organization. Their mantra: Public transit goes against what some Americans define as “liberties.” If someone has the freedom to go where they want, do what they want, they’re not going to choose public transit. They’re probably not going to be inclined to support other measures that remove social determinants of health – because the fear of governmental encroachment.

Reportedly, Americans for Prosperity have set up shop in Southeast Michigan to combat this year’s regional transportation campaign.
It’s difficult enough to convince people to spend money for the common good, much less when well-financed opposition is at work. Someone is going to have to come forth to defend these initiatives, and it’s unlikely that the government will, unfortunately.

Dennis Archambault is vice president for Public Affairs at Authority Health.