Jan. 17, 2021

Upstream by Dan Heath: why we keep throwing kids in the river (and how to stop)

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New York Times bestselling author Dan Heath examines how to prevent problems before they happen, drawing on insights from hundreds of interviews with unconventional problem solvers.

So often in life, we get stuck in a cycle of response. We put out fires. We deal with emergencies. We stay downstream, handling one problem after another, but we never make our way upstream to fix the systems that caused the problems. Cops chase robbers, and doctors treat patients with chronic diseases, and call-center reps address customer complaints. But crime and chronic disease and customer complaints are preventable! So why do our efforts skew so heavily toward reaction rather than prevention?

Upstream explores the psychological forces that push us downstream—including “problem blindness,” which can leave us oblivious to serious problems in our midst. And Heath introduces us to the thinkers who have overcome these obstacles and scored massive victories by switching to an upstream mindset, including a online travel website prevented 20 million customer service calls every year by making some simple tweaks to its booking system and a European nation that almost eliminated teenage alcohol and drug abuse by deliberately changing the nation’s culture.

About the Author

Dan Heath is the co-author, along with his brother Chip, of four New York Times bestsellers: Made to Stick, Switch, Decisive, and The Power of Moments. The Heaths' books have sold over 3 million copies worldwide and been translated into 33 languages. Heath is a Senior Fellow at Duke University's CASE center, which supports entrepreneurs who are fighting for social good. A graduate of the University of Texas and Harvard Business School, he lives now in Durham, NC.



The book starts with a story about a river; a couple of guys are sat on the river bank doing some fishing, hanging out, and suddenly a child appears in the river in front of them and is struggling. So one of the guys jumps in and pulls the child out.

A few minutes later, another child comes down the river, so they jump back in, pull out the child. And this keeps happening. After a little while, the guys are getting pretty exhausted of pulling these kids out. So one of the guys starts walking up the river. The other guy shouts to him to  ask where he’s going, to which he replies “I'm going to go and find the person who's throwing these kids in the river”.

This is such a perfect analogy that most organisations/ countries are dealing with. We are busy saving the kids in the river without actually going and finding out who on earth is throwing them in in the first place.

But the other problem is the culture part, as it’s the downstream heroes we celebrate. It's those guys pulling the kids out on the river that get the celebration. They get the parade thrown for them. Those are the ones that we celebrate. This is obviously not to say that those working in those front lines, the firefighters, the paramedics, etc, who are reacting to downstream issues, shouldn't be applauded for what they do. But we're probably over relying on that reactive response to situations that could be prevented.

So we see this in our organisations. We see in our lives. We certainly see it in policy and government and public practice. So why don't we do more about it? 


Dan sets out three barriers to upstream thinking. 

The first one is problem blindness; if we can't see the problem or we accept it is the inevitable reality of doing that type of business work in the industry of life. We probably won't try to change it because we are blind to the problem.

The third barrier is tunnelling, which basically comes from overwhelm. We want to feel like we’re moving forward so we make a bad decision, which then creates a chain of problems and bad decisions. For example,  taking a high interest loan to avoid today's problem, but the impact quickly compounds and creates a bigger problem over time.


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Dan sets out the questions we need to ask for better upstream thinking. If I was to summarise all of them, it would be the power of collaboration and finding unity. Some of the most amazing challenges that were overcome in the book came from government agencies actively working together on complex problems, like homelessness or domestic violence, on a person by person basis.

Some of the questions you should be asking are;

  • How will you unite the right people?
  • How would you change the system?
  • Where can you find a point of leverage?
  • How will you get early warning of the problem?
  • How will you know you're succeeding?
  • How will you avoid doing harm?
  • And who will pay for what does not happen?


That last question is really interesting and very relevant, because for some reason it's often hard to justify proactive spending on things that might not happen. Like extra personal protective equipment in case a pandemic breaks out, or training in case of a hurricane off of the Gulf Coast.

The extension of this is that it’s also hard to sometimes prove the link of what did or didn’t happen, with the proactive, upstream, action which took place.

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