Recognize the Connections
A DISCUSSION OF
Read Responses From
- Stephanie Ortiz
- Leslie Ruffalo
- Samantha D. Jansen
As someone who grew up in Brown County as a tribal school kid and now works alongside Tribal Nations, culturally specific organizations, grassroots leaders, community health workers, artists, public institutions, and cross-sector partners in rural and urban communities across Wisconsin and beyond, I have spent much of my life moving between worlds that are too often treated as separate
Reading Natalie Bomstad’s “We Created a Survey to Measure Community Well-Being and Activated a ‘Messy Middle’” (Issues, Spring 2026) on Brown County’s journey, I found myself reflecting on a question that extends beyond measurement: What allows communities to not only understand themselves, but to recognize their interconnectedness and collectively shape what comes next?
Community well-being is not only about measuring outcomes or helping people recognize the connections that already exist between them. It is also about helping people recognize that they are connected to one another’s futures
Throughout my life and work, I have witnessed communities come together across differences in race, culture, geography, profession, and lived experience. I have seen tribal leaders sit alongside nonprofit leaders, artists alongside public health practitioners, grassroots organizers alongside institutional decisionmakers. Again and again, what emerges is not simply better information, but a deeper understanding that none of us thrive alone
Community well-being is not only about measuring outcomes or helping people recognize the connections that already exist between them
Too often, we approach community change as a collection of separate challenges to solve. Yet health is connected to housing. Housing is connected to belonging. Belonging is connected to culture. Culture is connected to story. Story shapes what communities believe is possible
This is why I believe the next wave of community well-being work is not simply better measurement. It is strengthening our collective capacity to make meaning together, imagine together, and act together
For generations, many communities with broadly diverse populations have understood that well-being is deeply relational. It is found in our responsibilities to one another, our connection to place, our ability to contribute our gifts, and our commitment to our ancestors and future generations. These ways of knowing have much to offer a society increasingly challenged by isolation, polarization, and fragmentation
The most transformative community spaces I have witnessed are not those where people arrive with answers. They are spaces where people begin to see themselves differently. They recognize that they have wisdom to contribute, relationships to build, and a role to play in creating the future they want to live in. They move from being consumers of systems to co-creators of community
We must remember that people make up systems. Every policy, organization, institution, and network is ultimately an expression of human relationships. If we hope to transform systems, then we must also invest in the cultural and relational conditions that allow people to connect, contribute, and stand in solidarity as a form of love
The Brown County story reminds us that community well-being is not something we achieve once and for all. It is an ongoing practice of relationship, shared responsibility, and collective imagination. At its best, it helps us move beyond asking what kind of community we have and toward asking what kind of community we are willing to create together
Stephanie Ortiz
Weaving Ways
Green Bay, Wisconsin
Natalie Bomstad provides an important reframing of what evaluation and systems change can look like in practice in public health. Rather than positioning measurement as a technical exercise conducted by outside experts, she presents evaluation as a participatory and relational process rooted in trust, inclusion, and shared meaning-making
Too often, community health efforts rely heavily on narrow health or clinical indicators that fail to capture lived experience or translation of the data into meaningful social change. As the article describes, Brown County’s approach acknowledges that well-being is multidimensional, shaped not only by physical health or employment status, but also by belonging, trust, discrimination, social connection, and safety. This framing aligns with growing scholarship in public health and systems science emphasizing that communities thrive when social and relational conditions are nurtured alongside health ones.
Equally compelling, the article emphasizes evaluation adaptation. The county’s survey evolved over time in response to community priorities. This flexibility reflects an important principle of community-engaged work: communities themselves are dynamic, and evaluation systems must remain responsive and nimble rather than static. In many research models, changing survey instruments is viewed as a methodological weakness because it complicates longitudinal comparison. Yet the Brown County example suggests that rigid consistency can also become a liability when emerging realities go unmeasured.
Too often, community health efforts rely heavily on narrow health or clinical indicators that fail to capture lived experience or translation of the data into meaningful social change
My own experience developing a mental health survey of US veterans, done in collaboration with veterans, reinforces this lesson. Our research team initially planned to use a validated mental health instrument, assuming this would provide both rigor and credibility. However, our veteran partners quickly pointed out that several survey items and phrases would not resonate with many veterans and, in some cases, could discourage participation altogether. Rather than dismissing these concerns in the name of methodological consistency, we worked collaboratively to revise the language while maintaining fidelity to the underlying constructs we sought to measure. The process required additional time and discussion, but it ultimately produced a tool that was both scientifically sound and culturally appropriate for the population we hoped to serve. The bottom line is that community-engaged evaluation is not simply about collecting community input; it is about sharing power in the design process.
The article also highlights a tension that deserves deeper discussion: the challenge of moving from shared understanding of data to structural action. Creating spaces for “sensemaking” and collaborative reflection is valuable, but dialogue alone does not necessarily redistribute power or resources. Systems change ultimately requires institutions willing to alter policies, funding streams, and decisionmaking structures. This challenge is hinted at through the author’s description of the “messy middle,” but future discussion could explore more explicitly how communities sustain momentum when competing political and organizational interests emerge.
Bomstad’s mycelium metaphor powerfully captures the interconnected nature of collective well-being and reminds us that resilience emerges through relationships, reciprocity, and shared power and responsibility. I commend this work for recognizing that evaluation itself can become a key strategy in community-building and thus creating the conditions for well-being for all
Leslie Ruffalo
Associate Professor
Director, Center for Healthy Communities and Research
Family and Community Medicine
Medical College of Wisconsin
You can have the best intentions when gathering and analyzing data, but if the human element is missing, it’s impossible to understand the whole picture and allocate resources appropriately. As Natalie Bomstad highlights, the US government’s historical focus on financial measures and health data such as disease rates does not fully capture collective well-being. The “messy middle” coalitions that Bomstad’s organization, Wello, created demonstrate the power of community, at a local level, and could serve as the groundwork for bridging the disconnect between community-led and government-led well-being initiatives.
While politicians campaign on a platform of action, the political system has veered toward performative politics versus everyday politics. As the nation continues to polarize, both ideologically and affectively, there is an illusion of progress but less cohesion across the general population. While we see this at a national level more intensely, it occurs at a local level as well, specifically in cities with more than 50,000 residents, as described in a 2025 report commissioned by the Carnegie Corporation of New York. Perhaps messy middle coalitions are the foundation needed to unite the population and guide government to work on the issues most important to their specific community, versus platforming for ideologies with little progress.
Perhaps messy middle coalitions are the foundation needed to unite the population and guide government to work on the issues most important to their specific community
Bomstad is clear: We need to adjust our systems to meet the needs of our communities. This includes the political system. Politicians should more closely resemble their constituents, intently listen to the diverse experiences and needs of their community, and effectively act. Perhaps this looks like a system where politicians directly and continuously work with their constituents to uncover community-specific needs through community-led qualitative and quantitative measurements, such as those developed by Wello. This could ultimately guide politicians to tangible solutions they can quickly apply, while simultaneously building trust and strengthening relationships among the community and with government.
Although this sounds challenging, it’s not implausible. An example is unfolding in New York City. Mayor Zohran Mamdani’s self-proclaimed “pothole politics” focuses on listening to residents to understand how the city can directly improve their day-to-day lives. He is building Bomstad’s “mycelium networks” via a new Office of Mass Engagement. And it seems to be working. According to a Marist Poll, 74% of New Yorkers believe Mamdani is working hard, and 61% believe he is “working to represent all residents” and “understands the problems facing NYC.” Further, the majority of residents trust him and “believe he’s changing NYC for the better.”
But why is he different? Some observers attribute his mindset to his ineligibility to be president. He is solely focused on being mayor, and his actions are not seemingly swayed by lobbyists or the political system. This is the type of system I believe Bomstad is calling for—where mycelium networks help ground politicians by balancing what influences their decisionmaking and thus help them more effectively fulfill their public fiduciary duty. Networks where everyone is connected, contributing, and uniting in a shared greater purpose: collective well-being.
Samantha D. Jansen
Independent Human Factors Specialist
