In the month since I started at GIH, the world as we know it has drastically changed. Across the globe, nearly 2.5 million people have tested positive for COVID-19 and over 166,000 have died, including roughly 40,000 Americans. In this new reality, we have been asked to stay at home, and to cover our faces in public. Those of us who are fortunate are working from home. Children are adjusting to distance learning, while the class of 2020 prepares for a virtual graduation. Businesses along Main Streets in the largest cities and smallest towns are closed, some permanently.
And yet, much is familiar. Health care providers are caring for the sick, neighbors and loved ones are coming together to support one another, and philanthropic institutions are providing funding and flexibility to tackle the direct and indirect impacts of COVID-19. But not all familiar things are positive. The pandemic has underscored long-standing racial and ethnic and geographic disparities across many areas of our health system. Numerous articles have documented racial and ethnic disparities in COVID-19 hospitalizations and mortality that are rooted in long-standing inequities in health care coverage and access, income, education, and employment, as well as structural discrimination. (I find it interesting that this data has emerged during National Minority Health Month, a time when many of us reflect on the racial and ethnic disparities that persist in our country.) We still do not know the full extent of the disparities for a variety of reasons, including missing and incomplete data. Moreover, parts of the country have yet to reach their peak.
Focusing on Health Equity During the Recovery
In many ways, the nation has mobilized to address this crisis. Factories have switched from stitching clothing to stitching masks, breweries are making hand sanitizer, and restaurant staff are supporting food banks that are struggling to find volunteers because of stay-at-home orders. Philanthropy has also stepped up. Health foundations have contributed to and created community-level rapid response funds, provided general operating support to nonprofits for maximum flexibility, and quickly created new grant opportunities for organizations working on the front lines of the pandemic response.
As we move forward, it is essential for achieving equity to be a goal of our recovery plan. The effects of COVID-19 are being felt in every sector of society, and inequities in multiple areas—from health care to education, transportation, employment, and agriculture—have contributed to the disparities we’re seeing during this pandemic. As we move to recovery:
- Reducing disparities and achieving health equity should be identified as explicit goals. Making equity central to our recovery strategy will ensure we are intentional about our efforts and remind us that a “one size fits all” approach will not work. Setting these goals will also increase the likelihood of monitoring in these areas.
- Communities impacted by health disparities must be included in the planning, implementation, and evaluation of our plans. Far too often, plans for addressing problems are developed without the input of those most effected by them. This can lead to resources not reaching those most in need, and solutions that don’t work because they failed to account for certain barriers or the unique needs of a community.
- Collecting, analyzing, and reporting data on disparities is critical to achieving success. In order to achieve health equity, we need to know where we are and how far we are from our goal. Collecting data and developing metrics specific to disparities and their underlying causes will allow us to track progress, identify issues, and hold ourselves accountable.
Making health equity a goal of recovery can help prevent disparities from being further exacerbated by the crisis.
How Can Philanthropy Help to Achieve Health Equity?
Philanthropy has a critical role to play in ensuring that health disparities are acknowledged and addressed during this crisis and throughout the recovery process. Health foundations are uniquely positioned to respond to COVID-19 and can deploy a wide range of resources in their communities. They can center equity in their decisionmaking processes and their grantmaking to support and strengthen organizations serving those most at risk. Foundations can also play a crucial role in advocating for public policies and programs that promote equity. Health funders can leverage their reputational capital and access to policymakers, nonprofit and business leaders, and others in positions of power to advance more equitable and inclusive response and recovery efforts. Foundations can also illuminate programs that have been effective at reducing disparities for policymakers and include an equity lens in their grant evaluations. Finally, health funders can connect grantees with state and federal decisionmakers to help them tell their story and share what works in their community.
The health disparities that have surfaced during the response to COVID-19 have highlighted long-standing problems and galvanized numerous stakeholders to demand action. The window to reduce disparities and advance health equity is open, but in order to have a lasting impact health equity must be a goal of any recovery plan, along with data to track progress. Rebuilding offers the opportunity to achieve health equity, and philanthropy can help lead the way.