The foundational economy approach to economic development suggests that the production of goods and services that are critical to human welfare (e.g., water, energy, education and elderly care) should be the central concern for policymaking. This paper examines whether this approach could address three core challenges for regional development: social polarization, interregional inequality and environmental sustainability. It concludes that the foundational economy approach is particularly promising in addressing challenges relating to social polarization, but could benefit from further engagement with alternative theories on innovation, work in political science on policy for improving government quality, and various literatures on environmental sustainability.