Cara V. James, PhD, President and CEO, Grantmakers In Health
We are nearing the recovery phase of the coronavirus pandemic in the United States. The Centers for Disease Control and Prevention reports that more than 82 million people have received at least one dose of a COVID-19 vaccine, and more than 44 million people have been fully vaccinated. This news comes as over half a million Americans have died after contracting the virus. The road ahead will require continued action and collaboration on complex and challenging issues—and we must apply the lessons of the past year to maximize our chances of building a more just and equitable future:
- Racial and ethnic disparities persist in every facet of our society and achieving health equity will require significant and sustained effort. Blacks and Hispanics continue to have a higher mortality rates from COVID-19, lower vaccine uptake, higher rates of certain chronic conditions, and greater difficulty accessing care. Over the past year, these groups also experienced higher job loss and unemployment rates, as well as greater challenges associated with virtual education. Before the pandemic, Blacks, Hispanics, and other communities of color experienced worse health outcomes and access to care, higher unemployment rates, and lower high school and college graduation rates. These disparities will not disappear as more people get vaccinated.
- Our patchwork health system fosters disparities and leads to only partial solutions. Rebuilding provides an opportunity to rethink our systems and implement creative and innovative solutions. We must strengthen mental and behavioral health services, rebuild our public health infrastructure, and address coverage and payment differences.
- State and local government are critical to addressing problems, but often lack necessary resources. A lack of leadership at the federal level across multiple areas left states and local government struggling to address challenges related to the pandemic, recession, and social unrest. State budgets were strained as more people needed unemployment assistance, food, coverage through Medicaid and education assistance, and other programs supported by taxes. As many have noted, the funding mechanism means that these programs struggle when they are needed most. Earlier this year, Congress allocated funds to help states respond to COVID-19, but funding gaps remain, as does the need for localized programming, such as support for the translation of materials.
- Leadership is critical at every level. Last year presented no shortage of opportunities for leaders across the philanthropic, nonprofit, health, government, and education sectors (and others) to rise to the occasion. Leaders adapted their business models and work cultures to respond to COVID-19, address issues of racial justice, and support staff. We witnessed leadership from people with formal titles, informal titles, and no titles, all of whom stepped in to fill many needs. In some cases, we witnessed a lack of leadership, resulting in delays, confusion, people working at cross purposes, and worse outcomes. Leadership at every level will continue to be important in the months and years ahead. We must develop diverse and inclusive leadership teams and support the training and growth of individuals at every level—from clinics and hospitals to schools and community organizations, as well as local, state and federal government—so that we have more leaders ready to meet the challenges ahead.
- We cannot underestimate the need for clear and accurate information. The horrific events in our nation’s capital in January showcased the real consequences of misinformation. The proliferation of misinformation has increased distrust in traditional sources of information and has hampered our ability to have informed, respectful, and productive conversations. As we move forward, we cannot underestimate the need for consistent and accurate information in multiple languages, nor the role of trusted messengers.
- We are extremely divided but can still come together to help each other. The events of the past year have demonstrated how divided we remain—and yet, there are myriad examples of neighbors, colleagues, and communities joining forces to overcome numerous challenges. We worked together. Unlikely partnerships were formed. We need to build on these relationships and return to a more civil discourse. These partnerships can also be used to strengthen communities and create a more just and equitable future.
As the world changes, health philanthropy continues to adapt and recalibrate. Over the past year, foundations increased funding levels, reevaluated strategic plans and partnerships, and doubled down on mission-related investments. Philanthropy continued to explore the notion of trust-based philanthropy, acknowledging power differentials and working to meaningfully engage with community organizations in identifying problems, co-creating solutions, and sharing power. In the wake of COVID-19, many foundations offered grantees significant flexibility in how they used could use funds, waved or reduced reporting requirements, and reduced the amount of information required for an application.
Foundations and other sectors wrestled with similar questions about how to center equity in decision-making, as the consequences of the pandemic—related to both health outcomes and economic losses—disproportionately affected communities of color. In our 2020 health equity survey, a number of respondents indicated that internal capacity, competing priorities, and lack of support from their trustees were among their biggest barriers to achieving their health equity goals.
The work ahead presents new opportunities and new challenges for our sector. We should expect the recovery to be uneven as it was during the last recession, with rural communities and communities of color lagging behind. But the inspiring work of this sector over the past year indicates that this is philanthropy’s moment.
In the midst of varying crises, GIH spent the past year reflecting on our own role in this moment. The result is our new five-year strategic plan. The philanthropic world was changing prior to COVID-19 in both composition and practice, and in many ways the pandemic helped expedite this work, putting a spotlight on health and social inequities, the gaps in our public health infrastructure, the importance of leadership, and the importance of collaboration. While GIH has a longstanding focus on health equity, the events of last year provided an opportunity to reevaluate and recommit to this work, and to determine how to best support the evolving roles and responsibilities of philanthropy.
As I begin my second year at the helm of GIH, I look forward to finalizing and sharing this strategic plan with the GIH network, building on our equity work and supporting our Funding Partners in their equity journeys, strengthening collaborations to maximize our impact, working with our staff and board of directors in person, and meeting all of you.