Want to See Lasting Systemic Change and Transformation to Build Health Equity? Invest in Power Building
Despite a commitment to transformation, equity, and rebalancing the scales of justice, philanthropy often operates in ways that undermine its very purpose. Historically, the philanthropic field has taken a siloed and narrow approach to change, offering investments in short-term funding cycles and attempting to create change from the top down.
Health Philanthropy Impacting the Health and Well-Being of Family Caregivers
More than 53 million Americans—21 percent of the US population—are caregivers for loved ones who are older adults or adults living with chronic, disabling, or serious health conditions. Increasingly, the US health and long-term care systems rely on family caregivers. In 2017, family caregivers in the US provided a staggering 80 percent of long-term care, valued at $470 billion, and in 2021, 38 million family caregivers spent 36 billion hours caring for older adults, amounting to an estimated $600 billion in unpaid caregiving.
As More Americans Gain Health Care Coverage, Advocates Fight for Higher-Quality Insurance
People’s Action and our allies fought hard to win health care for millions through the Affordable Care Act and Medicaid expansion. 91 percent of Americans now have health insurance, even though there is still work to do to ensure everyone can get coverage, particularly immigrants and those living in holdout non-expansion states.
Philanthropy’s Role in Equitable Medi-Cal Expansion
California has more people enrolled in Medicaid than any other state—almost 15 million of 93 million enrollees nationwide, and the state’s efforts to equitably address the enrollment churn make it worth watching. When the pause on Medicaid redeterminations ended in April, up to 3 million Medi-Cal enrollees, California’s program, were at risk of losing coverage. Most at risk are those often eligible but inconsistently enrolled in Medi-Cal—if at all. Many of these individuals are from poorly served communities who often experience longstanding discrimination in accessing health care. They commonly live in extremely rural areas and lack access to the internet and transportation; have unstable housing; are reluctant to enroll due to their immigration status; and have limited English proficiency, live with a physical disability, or have behavioral health needs. If Medi-Cal is to be a true driver for health equity, we need to close the enrollment gap in these communities.
Purpose-Driven Investments: Advancing Equity by Diversifying Foundations’ Asset Managers
In 2020, none of the Health Forward Foundation’s assets were managed by Black, Latina, or Latino managers. Struck by that stark reality, Health Forward began the process of diversifying the asset managers in its investment portfolio as part of a larger strategy to align the Foundation’s capital with its purpose.
Exploring the Impact of Vaccine Equity Grants in Rural Communities of Color
The Rx Foundation launched a rapid response Vaccine Equity grant program in March 2021 as it became clear that communities had unequal access to newly available COVID-19 vaccines. The goal was to fund organizations that were positioned to improve access to vaccines for groups marginalized by or unable to access existing systems and to do outreach and have conversations with people about their vaccine concerns and questions.
New York State Foundations Working Together to Preserve Health Insurance Coverage for Millions of New Yorkers
In March 2020, the United States declared a public health emergency and enacted historic COVID-19 relief legislation. It increased Medicaid funding to states contingent on several conditions, including a “continuous enrollment” requirement that prohibited states from terminating Medicaid enrollees’ coverage until after the public health emergency had ended. How well this worked is a rare silver lining of the pandemic: an estimated 20.2 million people gained coverage since March 2020, and the uninsured rate dropped across the country.
PrEP in Black America: A New Approach to Biomedical HIV Prevention Advocacy
In the U.S., Black communities have been disproportionately impacted by HIV. Between 1981 and 2019, an estimated 2.2 million people have been diagnosed with HIV, an overwhelming number of whom have been Black.
The Reimagining Nursing Initiative: Creating an Equitable Future by Investing in Nurse-Driven Solutions
When you think about improving health care, who do you envision leading the charge for a more equitable future? There are no wrong answers, but perhaps one that does not immediately come to mind—nurses. Representing the largest number of providers and serving as the most-trusted health care professionals (Brenan 2023), nurses’ front-line role in patient care makes them a natural force for expanding access to care and reducing health care disparities.
Let’s Close the Gap on Mental Health for Good in 2023
Before the COVID-19 pandemic, a mental health crisis was growing in America, with 1 in 10 adults reporting symptoms of anxiety or depression. Today, that number is 3 in 10. The recently launched 988 hotline—the mental health equivalent and alternative to 911—is a monumental step forward in changing how we acknowledge and respond to mental health needs nationally. It finally puts mental health on equal ground with physical health—a recognition long overdue—but it is only a first step in addressing the multitude of behavioral health needs.