Cara V. James, President & CEO, Grantmakers In Health
This month, Grantmakers In Health (GIH) President and CEO Cara V. James sat down with Jill Shumann, GIH’s new Vice President for Programming, to learn more about Jill’s long career in health and how her experience applies to GIH’s mission of advancing better health for all through better philanthropy. Jill discussed her formative years as a Peace Corps Volunteer, her work on international public health in Africa, and her recent tenure at the National Alliance on Mental Illness. We invite Funding Partners to introduce themselves to Jill at the upcoming Grantmakers In Health Annual Conference on Health Philanthropy on June 7 – 9 in Minneapolis, Minnesota.
How did your work in international public health and mental health in the US prepare you for your role at GIH?
All my previous jobs have prepared me for my current role at GIH! First, international public health taught me to be a public health generalist. For each international role, I needed to quickly learn the health profile of the country or countries I covered. I needed to ask basic epidemiological questions like —who is at risk, why, and where? What interventions are successful and who is being reached or not? Secondly, because I started with an international career—and also lived overseas as a child—I combined public health with my love of different cultures and languages. This curiosity allowed me to dig into how culture plays a role in public health—knowing that culture can promote or hinder healthy behaviors.
My experience at the National Alliance on Mental Illness (NAMI) allowed me to ask the same questions with a focus on youth and young adults and diverse communities accessing mental health services. At GIH, it’s important to be a public health generalist so I can ask the right questions about the multiple health areas we cover. Plus, GIH’s emphasis on the social determinants of health means that culture is an important topic for us.
In what ways did your service as a Peace Corps Volunteer in Guinea, West Africa influence your interest in public health?
I didn’t know what public health was when I entered the Peace Corps. My assignment was as an English teacher in a small town in Guinea, but volunteers were also required to have secondary projects. I participated in a training held by the CDC on the use of Oral Rehydration Solution (ORS) for the prevention of dehydration from diarrhea. Because mortality from diarrhea comes from dehydration, and diarrheal diseases are a leading cause of death in children under five in Sub-Saharan Africa, I set up an ORS corner in my town’s health center. After meeting with a health worker, every mother who brought her child to the health center due to diarrhea was directed to the ORS corner. I showed moms how to mix the sugar, salt, and water solution and they started giving it to their kids. It was amazing to see lethargic kids spring back to life after drinking ORS. After that, I was hooked on public health. I loved talking to moms, giving them information, and seeing their faces turn from worried to happy. Now we have packets of Oral Rehydration Therapy and Pedialyte, but simple ORS still works and was truly a revolution when it was introduced.
How do public health challenges in the United States mirror those that you observed in Africa?
Unfortunately, the US faces many of the same challenges as Africa. Universal Health Coverage is a serious challenge in both places and is the focus of the third United Nations Sustainable Development Goal. A more specific example is maternal mortality. According to UNICEF, sub-Saharan Africa’s maternal mortality rate in 2020 was 545 per 100,000 live births. CDC data show that the overall maternal mortality rate in the US in 2020 was 23.8 deaths per 100,000 live births, but the rate for non-Hispanic Black women was 55.3—almost three times the rate of non-Hispanic White women. Interestingly, maternal mortality rates in Africa have been declining over time, while the reverse is true for the US, making GIH’s work in birth equity and health equity generally so critical and timely.
There are other shared challenges such as weak public health infrastructure, health systems that prioritize treatment over prevention, and the need to focus on the social determinants of health. Of course, the social determinants of health are different in sub-Saharan Africa. For example, girls often drop out of school due to poverty, child marriage, or the need to contribute at home or work in the informal sector. This leads to many negative consequences, including increased risk for infant, child, and maternal mortality. More broadly, societies miss out on the potential of these girls and women.
The real question isn’t how the United States can have better health outcomes than Africa, but how all countries can improve the health of all their people. If COVID-19 taught us anything, it is that health is a global issue.
Most recently before joining GIH, you served as National Director in the Office of Strategy and Impact at the National Alliance on Mental Illness (NAMI). What are some opportunities for improvements in mental health that funders should consider supporting?
There are so many opportunities to improve mental health in the US right now! As a public health practitioner and a mom, I know that our young people are struggling. An important part of addressing the youth mental health crisis is to involve youth themselves, especially at high school and college ages. Helping teenagers tell their stories safely both in-person and through social media is a powerful way to reach other youth and to normalize the conversation about getting help. In fact, many NAMI “peers” say that telling their stories helps them in their mental health journey as much as it helps others.
Speaking of accessing mental health services, we won’t solve mental health workforce issues by focusing solely on training more psychiatrists and psychologists—although we do need more and especially people of color. All communities have assets that are already playing important roles in mental health. For example, NAMI works with faith leaders because they are often the first port of call for people who are struggling with mental health issues. Barbers and hairstylists are another community asset, especially in African American communities, because they have privileged one-on-one relationships with their clients often over long periods of time. Ensuring these “trusted voices” have the information they need about mental health, how to talk about it, recognize danger signs, and access relevant local resources is an important step.
Finally, 988 is the new number for the suicide and crisis lifeline. It’s a critical step in ensuring that people experiencing a mental health crisis receive a mental health response instead of a law enforcement one. However, 988 as designated by Congress in 2020 is just a phone number. It is up to states and localities to create the services needed for a robust response, including trained counselors to answer the calls, mobile crisis intervention teams with trained behavioral health professionals, and crisis stabilization programs that link to longer-term care. States and localities are in varying stages of developing their crisis response system. Building the full spectrum of services will take all of us—government, philanthropy, and community members—to make sure it serves, and is trusted by, everyone in the community.
What about the 2023 GIH Annual Conference in Minneapolis are you most excited to experience?
I’m most excited about meeting GIH’s Funding Partners in-person and then continuing these relationships back on Zoom. I’m also excited to learn how our Funding Partners are addressing critical public health issues through their grantmaking. Since philanthropy is a new world for me, I’m grateful that I get to experience the annual conference so early in my GIH career.
Please share something about you that’s not in your published bio.
I’ve met the Queen of England, Princess Anne, Tony Blair, Bill Clinton, and Nelson Mandela’s widow Graça Machel.