Case Studies

Future of Detroit’s Safety Net – Detroit Wayne County Health Authority

Future & Stakeholder Dialogues | Strategy & Scenario Planning


Detroit Wayne County Health Authority


In the 1950s, Detroit was a global powerhouse. By 2008, it was a city of decline and division. Chrysler was filing for bankruptcy. China had just surpassed the US as the largest auto market. And the social toll was high, with soaring unemployment rates (25%), rising poverty and inequality, and over 150,000 people lacking health coverage.

The Detroit Wayne County Health Authority (“the Health Authority”) saw opportunity within crisis. They decided the timing was right to bring the diverse and often divided “safety net” community together to proactively and collaboratively address these huge challenges.


Over a period of six months, the Health Authority convened two two-day stakeholder dialogues designed and facilitated by Adaptive Edge. Participants included diverse organizations and personalities, from healthcare providers, municipal leaders and community activists to large corporate employers. To meet the unique needs of this group, we combined and customized a variety of methods, including: scenario thinking, preferred futuring, visualization techniques, and stakeholder dialogues.


  • The output included four scenarios and a shared future vision of a healthy, revitalized Detroit Wayne County community.
  • This experience created new social capital amongst the participants, overcoming some mistrust and territorialism.
  • Three areas for collaboration were identified, the most important being a unified approach to improving healthcare reform and lobbying for federal resources (namely, FQHCS).
  • This work shaped the Health Authority’s strategy and planning process.
  • After our engagement ended, the Health Authority continued to lead the implementation process over the following year.

These outcomes helped to reverse the deeply rooted factors that had contributed to Detroit’s inability to adapt to change over the past decades. And the initiative is already triggering a broader cycle of renewal in the county—a signal that with the power of inspired collective leadership, Detroit’s decline is anything but inevitable.

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