Championing Nonprofit Health: A Journey from Harm Prevention to Culture Change


Published by on March 13, 2024

Putting Nonprofit Health on the Agenda

My first paid nonprofit job was as a community educator promoting healthy relationships to prevent sexual violence. That job offered me a crash course in how health promotion = harm prevention, and how promoting health requires culture change. It was a transformative experience and one I took to heart. 

The Vice President’s Perspective: Understanding the Landscape 

A few years later, I accepted the position of vice president at that same nonprofit. In that role, I took seriously my responsibility to build and maintain a healthy work environment for our staff–a lofty goal given that nonprofits are notoriously under-resourced and lacking in administrative funding and capacity. Being a trauma prevention and response organization, vicarious trauma was always a risk. Having gone through significant organizational growth in a short period of time, stabilizing culture and scaling up operations was a challenge. 

All the while, as a nonprofit staff member and leader who genuinely valued health, the struggle was real. There were many challenges within my own organization and structural barriers we came up against. And in the process of leading and caring for the organization and its staff, I developed a chronic illness and burned out. It’s a tale as old as time…and it keeps happening. 

Why is this? 

 Board workshop

Identifying Core Issues in Nonprofit Health 

When it comes down to it, most nonprofits are seeking to promote health in one way or another through external programs and services–even if it’s not explicitly named in the mission, vision, or values. Whether through victim services, legal and economic supports, animal welfare, environmental causes, or youth development, it can be argued that health promotion is the connective tissue of the nonprofit field. 

And while our organizations work to promote health externally, there’s often a flip side of the coin. Internally, through our operations and culture, we frequently sacrifice health and well-being. And we don’t simply view this as a necessary evil. Too often, we treat this self-sacrifice as a badge of honor, a sign of our goodness, and just the way it is and always will be. 

This misalignment between the external and internal is deep-rooted and, of course, systemic. Yet, the mindsets and norms that support this misalignment are frequently internalized in our organizations. 

“Our staff aren’t here for the money.”

“We have to keep administrative costs low.”

“Of course we’re going to meet the need [even if it means overextending our capacity and burning out our staff].”

Statements and beliefs like this speak volumes about the culture of individual organizations and about nonprofit culture as a whole. 

Strategies for Enhancing Your Nonprofit Employees Health and Well-being

Reflecting on my own nonprofit journey, it wasn’t just the responsibility and workload that did me in. Over time, I increasingly came to feel unwelcome in the nonprofit field as someone who values health. Ouch. Having initially come to nonprofit work to promote health, I ultimately experienced not just burnout, but a sense of betrayal. This is what led me to found my business, Culture Work, to support organizations and leaders in building and maintaining healthy work environments. I felt I had to carve out my own space to work in ways that were healthy for me while also doing the work I’d always dreamed of–advancing health at institutional levels. 

Nonprofit work can positively impact our health through connection with likeminded people, deriving meaning from our work, and gaining knowledge that supports health–all things that support mental health at work according to the U.S. Surgeon General. And yet: vicarious trauma, toxic stress, burnout, compassion fatigue, discrimination, inaccessibility, and institutional betrayal are occupational risks that nonprofit organizations and the field as a whole would do well to seriously address—at a systems level. 

How do we do this? It’s no easy task, but here’s some food for thought…and perhaps action. 

Embed health in the foundations of nonprofit work. 

Values alone will not change culture, but they can provide a foundation for collective action and accountability. Last summer, I facilitated a Board workshop titled “Health Begins In-House.” To kick things off, I asked Board members to identify a personal value that motivated them to serve the particular mission of their organization. Many values were identified, but health was mostly absent from the list. 

I then asked: how does health connect to your organization’s mission? 

Posing this question led to a meaningful discussion of the various ways health promotion connected to their mission and services, as well as the barriers–systemic and cultural–to achieving health equity, or the state in which everyone has a fair and just opportunity to attain their highest level of health. 

It’s past time to have real conversations about the inaccessibility of health in the nonprofit field. Naming health as a value can support a more holistic approach to promoting health not just externally, but internally as well.

Embrace a both/and mindset. 

For too long, nonprofit staff’s health and well-being has been positioned as incompatible with fulfilling our missions, but what if the opposite is true? Research indicates that toxic workplaces are costly and detrimental not just to employees, but to organizations themselves, as workplace culture impacts employee health, engagement levels, and turnover rates.

Embracing a both/and mindset allows us to see that we can prioritize our people and our missions, together. Valuing and respecting nonprofit staff helps to remove historic barriers to health and well-being for those working to advance justice, especially in community-led nonprofit and social change work. Prioritizing healthy environments in nonprofits fosters inclusion and belonging, encourages staff retention, protects institutional knowledge, and improves the consistency and quality of work. There are plenty of external forces that devalue nonprofit work and the people who do it. Let’s make sure the call doesn’t come from inside the house. 

Surgeon General framework

Align values and operations. 

I’ve long advocated that operations work is justice work, and that to live our values as organizations is to operationalize our values. Conducting regular organizational self-assessments enables nonprofits to identify and address gaps between values and practices, when conducted in good faith. These culture assessments also model internal self-reflection and growth for other organizations and communities in which we work to make change. Embracing shared leadership models, a topic I recently explored on the Culture Work blog, is another way that some nonprofits are working to model their values and promote healthier, more accessible, and more sustainable ways of working. 

Ensuring a safe environment and prioritizing staff health and well-being doesn’t detract from our goals. It indicates a greater commitment to the underlying values and change we wish to see in the world. 

Building community and capacity to advance change.

In the field of violence prevention and response, we often say that healing doesn’t happen in isolation. Connection and community are essential to healing, but safety must be present in order for healing to occur. Unfortunately, the nonprofit sector is unsafe for many, and it is why we see such high rates of turnover, burnout, and people moving into other fields. We’ve long accepted this as normal, but these trends indicate a collective protest against current norms of the nonprofit field. It’s crucial that we reckon with this reality and prioritize building a safer and healthier nonprofit community. 

And with this, we end back where we started: with the recognition that promoting health is a form of resistance to the status quo, and that culture change is necessary if we are ever going to truly value health. What would happen if we collectively envisioned nonprofit organizations as engines of well-being, externally and internally? Building community around shared values of individual, relational, and environmental health is foundational to much-needed culture change in the nonprofit field and beyond, and we all have a part to play in that change–together. 

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Rebecca is the founder of Culture Work LLC, where she consults with organizations to create healthy environments and improve well-being at work. An experienced speaker, facilitator, and consultant, Rebecca’s professional experience of nearly two decades spans the fields of public education, public policy, public health and nonprofit leadership. She is motivated by collaborations with curious, courageous leaders at all levels who are invested in the challenging but rewarding work of building healthier environments where people can thrive.

Rebecca is the founder of Culture Work LLC, where she consults with organizations to create healthy environments and improve well-being at work. An experienced speaker, facilitator, and consultant, Rebecca’s professional experience of nearly two decades spans the fields of public education, public policy, public health and nonprofit leadership. She is motivated by collaborations with curious, courageous leaders at all levels who are invested in the challenging but rewarding work of building healthier environments where people can thrive.

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