Cara V. James, PhD, President and CEO, Grantmakers In Health
Events over the last year put a spotlight on the significant health, economic, and social disparities in our country. In the few days that have elapsed in 2021, that spotlight has focused in on the division our country faces, fueled by mistrust. According to the latest World Values Survey, only 37 percent of Americans say that most people can be trusted, with rates slightly lower for rural Americans (34 percent), and much lower for Black Americans (17 percent) (Haerpfer et al 2020). Mistrust is significantly hampering our ability to respond to so many of the health and social issues affecting our country, chiefly the COVID-19 pandemic. As a result, many people are needlessly suffering and dying.
It appears that we are setting unfortunate records for COVID-19 every day. More than 24 million Americans have tested positive for the disease, almost 400,000 people have died, and countless more have survived but are dealing with long-term effects of the disease. Health systems continue to be severely strained, health care providers are overworked and overstressed, our public health system is struggling to conduct the testing and contact tracing needed to contain the spread, and there are growing mental and behavioral health issues associated with the disease and long-term social distancing. Meanwhile, mistrust has led to attacks on public health workers and civil servants responding to the virus at the local, state, and federal level—and an inability for us to agree on the precautions necessary to prevent the spread of the disease or the steps necessary to address the pandemic.
Mistrust in our electoral system led to violence in the nation’s capital in the first week of the year, during which five people were killed, and numerous more were injured or needlessly infected with COVID-19. It has also resulted in a lack of confidence in our scientific institutions and contributed to nearly a third of Americans saying they will definitely not or probably not get the vaccine, with higher rates for rural and Black Americans (KFF 2020). This mistrust has also left people confused and unsure of where to turn for information about the virus, the vaccine, and other health concerns. This, combined with fear from the violent images on television and divisive rhetoric on social media, has also impacted Americans’ mental health and well-being.
Finally, our nation’s legislative body has been crippled by mistrust, making it extremely difficult to pass laws related to Medicare, Medicaid, the Indian Health Service, the Veterans Health Administration, public health, and federally qualified community health centers, as well as education, food and housing —which would improve the health of millions. The division and mistrust of late has been so severe that government shutdowns—or even the threat of one, once almost unheard of—are now commonplace.
Like many of the disparities our country experiences, this division and distrust are the result of longstanding structural and systemic issues. The proliferation of unchecked information on the Internet and lack of accountability of false and misleading information have led to a decline in our ability to distinguish news from opinion, and increased levels of mistrust and social division. So, too, has the feeling that many of our systems are not helping those most in need, compounded by a sense that changes in our society are leaving some people behind. Like other disparities, addressing these issues will not be easy. Doing so will require us to address the root causes and to change the systems and policies that are enabling distrust and division.
We cannot solve the problems we face if we cannot come together. No side can force its will on another in our political system, because that leads to a game of ping-pong, with the public caught in the middle as power moves from one group to the next. In this hyper-partisan environment, working together seems like a herculean task, but I’m an optimist at heart and believe there is a path forward.
- We must bridge the divide and find ways to build trust in each other and in critical institutions at the local, state, and federal level. Philanthropy has traditionally played a role as a convener and should continue to ensure that different perspectives are represented in conversations about problems, solutions, and funding; look for ways to foster collaboration and power sharing; and insist on breaking down silos and help bridge the gap between networks and communities.
- We need to increase our reliance on accurate information by calling out false and misleading information and educating people on how to tell the difference. Building stronger communication networks, particularly with underserved and isolated communities, as well as rebuilding credibility in trusted sources of information can minimize the ability of inaccurate information to take hold.
- The philanthropic sector needs to continue its examination of its own policies and practices, addressing the inherent power imbalances between foundations and nonprofits, ceding power and control toward a more equitable way of operating, and adopting a more trust-based approach.
- We need to fix the systems that are failing those most in need, and work to eliminate economic and racial inequities. Addressing inequities in health, education, employment, and justice will promote a sense of fairness in our programs and policies. Philanthropy is well-positioned to work across sectors to improve the systems that are not providing adequate resources to those in need, and to foster stronger connections between those systems and the communities they serve.
- Finally, and importantly, we need to remember the golden rule and do unto others as we would have done to us. Increasing the level of decency and civility in our discourse and in our treatment of each other will help to build trust and increase our ability to solve the critical issues before us.
Building trust takes time. But I am convinced that these steps will help us move in the right direction and increase the likelihood that we will be able to address the problems we face, big and small. The new year presents an opportunity for us to change direction and work together towards a more just, civil, and equitable society.
Haerpfer, C., Inglehart, R., Moreno, A., Welzel, C., Kizilova, K., Diez-Medrano J., M. Lagos, P. Norris, E. Ponarin & B. Puranen et al. (eds.). 2020. World Values Survey: Round Seven – Country-Pooled Datafile. Madrid, Spain & Vienna, Austria: JD Systems Institute & WVSA Secretariat. doi.org/10.14281/18241.1.
KFF COVID-19 Vaccine Monitor (KFF Health Tracking Poll Nov. 30 – Dec. 8, 2020).