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Trends in Health Philanthropy: Leveraging Policy Change

March 2019

As I wrote in January, over the next several months my letters will describe trends in health philanthropy that we are observing and contributing to at GIH.

I will begin with policy and advocacy, two areas in which health funders have slowly but surely demonstrated stronger interest and engagement. Lauren LeRoy, GIH’s previous President and CEO, was a strong believer in bringing the worlds of philanthropy and policy closer together, and our initial programming on policy and advocacy began with her. Through webinars, meetings, and presentations, she introduced funders to the policy community and illustrated the ways foundation dollars could leverage policy change. In those early years, the focus was primarily on policies related to health care delivery.

Today, we see robust funder interest in health policy, within a broader frame of reference.

  • Health policy is playing a key role in influencing some funders’ priorities, with policy debates at the national, state, and local levels shaping philanthropy’s investment strategies.

  • Both push and pull factors are at work. On the one hand, funders are drawn to policy topics that have political saliency, such as Medicare for All or defending the ACA. On the other hand, they are also attracted to playing a leadership role by advancing policy options that will generate increased attention from policymakers.

  • Meanwhile, the health policy landscape has become increasingly complex as funders focus on all levels of government (federal, state, and local) and across multiple policy domains. Funders’ policy interests now cover a broad range, from traditional issues like health care financing and coverage expansion, to the components of the social determinants of health, such as economic development, education, housing, immigration, and criminal justice reform.

  • The hyper-partisan atmosphere surrounding most policy debates is challenging funders to think critically and carefully about their role. Most want to avoid being seen as partisan, yet they must operate in an environment where nearly every issue is sharply divided along partisan lines.

  • Funders with an interest in policy have embraced a wide range of policy change strategies. We are seeing a growing focus on proactive policy change strategies, with an emphasis on building advocacy capacity and strengthening civic engagement.

  • However, while supporting advocacy is becoming more common, some funders still face apprehension and uncertainty when pursuing this strategy, and express concern about crossing the line into lobbying—either in reality or as perceived by watchful legislators.

Over the years, GIH has developed considerable programming to help funders learn from one another about effective policy change strategies, to increase awareness of what is legally possible, and to decrease anxiety about emerging strategies. This work will continue, with upcoming products and programs that help funders inform reform on a wide variety of topics, including access to quality health care, equity, health across the life course, and prevention and wellness.

Look for discussions of these and other policy-related issues in upcoming webinars, publications, the 2019 annual conference, stand-alone GIH meetings, and the 2019 Fall Forum. Because some policy topics have controversial elements, I encourage you to be mindful that GIH does not advocate for specific policy positions. Rather, our role is to be aware of developments that affect people’s wellness and to share information about how funders and others are addressing those issues, always with the goal of better health through better philanthropy.