Jose Franco Garcia, Executive Director, Environmental Health Coalition
Samantha Hamilton, Director of Coalition Building and Community Engagement, Public Health Institute of Western Massachusetts
Chris Kabel, Senior Fellow, Health, The Kresge Foundation
Over the past decade, many health foundations have shifted from funding specific programs to addressing social determinants of health by supporting policy and systems change strategies (Gray-Akpa and Khanna 2018). Abundant research has demonstrated that low-income communities of color face structural barriers to health that more affluent white communities do not, ranging from access to healthy food to stable housing and clean air (Pastor et al. 2022).
These differences in community conditions didn’t happen by accident—they are the result of intentional policy decisions over generations that apportioned resources and opportunities along racial and ethnic lines (Rothstein 2017). All too often, communities of color were excluded from the decisionmaking tables that determined, for example, what types of housing or industry could be built where, who had access to quality schools, and which professions were valued more than others.
Perhaps due in part to the fact that much of institutional philanthropy is the byproduct of extreme concentrations of economic power, many foundation staff and board members have been uncomfortable recognizing the fact that the disparities in resources that contribute to health inequities are the result of disparities in power (Reich 2018). In recent years, that reluctance has receded considerably due to a multitude of factors. Community power is now called out as a necessary pre-condition for change among both individual foundations and funder collaboratives such as the Amplify Fund, Convergence Partnership and Hive Fund for Climate and Gender Justice (Ito et al. 2023).
Investing in community power was one of the core components of The Kresge Foundation’s Climate Change, Health and Equity (CCHE) initiative, launched in 2019. CCHE is comprised of three strategies: influencing health care and public health institutions to reduce their climate impacts and partner equitably with their communities; mobilizing health care and public health practitioners to take climate action; and supporting community-based advocacy to improve climate resilience and health equity (Cook et al. 2023).
The majority of the $22 million in funding has gone to support community-based organizations; this article highlights the work of two of Kresge’s 14 funded community-based partners and how they have built power to achieve community-defined goals. Kresge currently supports both organizations with 45-month, $750,000 general operating support grants.
Community Power in Action
The Live Well Springfield (LWS) coalition, convened by the Public Health Institute of Western Massachusetts, works to build and sustain a culture of health in Springfield, Massachusetts—a city of roughly 155,000 people that suffers from high rates of respiratory illness due to multiple environmental challenges. LWS partners Way Finders, Pioneer Valley Planning Commission, and Arise for Social Justice worked with a wide range of residents and partners to convince their City Council to pass a Community Choice Energy policy. When adopted, CCE will reduce greenhouse gas emissions and improve health equity by enabling the City of Springfield to get up to 100 percent of its electricity from clean, renewable energy such as solar and wind power.
On December 5, 2022, the Springfield City Council unanimously approved a process that granted the city permission to pursue the shift to clean energy sources. While advocates will need to apply sustained pressure to ensure that the city follows through on this commitment, this policy victory demonstrates the result of years of base-building.
The Environmental Health Coalition organizes residents in low-income communities of color in San Diego to protect public health, reduce toxic pollution, and create a just society that fosters a healthy and sustainable quality of life. Multiyear operating support from Kresge has supported several of their advocacy efforts, such as resident-defined “10 Transit Lifelines” to improve transit access and use while preventing displacement. In December 2021, the San Diego Association of Governments (SANDAG) incorporated these 10 priorities into their new Regional Transportation Plan (RTP), representing a major victory.
Setbacks, Patience, and Pivots
The process of building and mobilizing community power is not linear, and funders should not expect to be able to see anything resembling a direct attribution between their funding and specific outcomes. It’s natural for community policy targets to shift as social, economic, and political conditions change; the collective capacity built by such efforts is often not observable and pays dividends over the long term.
Setbacks are to be expected. For example, shortly after convincing SANDAG to incorporate their 10 Transit Lifelines into the RTP, the board stripped the main funding mechanism (a Road User Charge) from the plan. EHC and their partners are now preparing for a 2024 ballot measure to fund these priorities.
Similarly, one of Live Well Springfield’s original priorities was to collaborate with the City Council to require a Racial and Health Equity Impact Assessment (RHEIA) for all city public budgets, policies, and programs. The intent of this policy was to improve accountability and transparency of city government and local business development and create a way to regularly monitor impacts on communities of color. After exploring options with resident advisors and Kresge TA providers, the coalition is now advocating for a Community Benefits Ordinance that will address disparate access to resources for people of color and mitigate the effects of segregation. The coalition believes that the original goals of a RHEIA can be achieved with the proposed Community Benefits Ordinance.
A Call to Action for Health Philanthropy
Most foundations are organized around specific sectors or fields of practice. Funders hire program staff with deep sectoral expertise and develop networks within those sectors. Very few are structured to support multi-issue organizing and power-building in a sector-agnostic way, although some funders such as the JPB Foundation are making this shift (Kavate 2023). Within health philanthropy, The California Endowment has demonstrated the impact of its power-building approach through its 10-year Building Healthy Communities initiative on health and racial equity (Farrow et al. 2023).
The urgency of the moment—whether the focus is on climate change, racial justice, democracy, or many other issues—calls for greater investments that build the collective agency of historically marginalized communities and enable them to exercise their power at decisionmaking tables. Environmental Health Coalition and Live Well Springfield offer two compelling examples of what can be achieved when philanthropy trusts impacted communities to set their own course. Investing in organizations dedicated to mobilizing their community’s inherent power will lead to improved health, well-being, and conditions over the long term (Vaidya et al. 2022).
References
Cook, Cara, Kalpana Ramiah, Melissa Jones, and Erica Browne. Alliance of Nurses for Health Environments, America’s Essential Hospitals, Bay Area Regional Health Initiative, and The Kresge Foundation. “Strengthening a National Field of Practice for Climate, Health, and Equity: Learning What it Takes.” GIH Views from the Field, GIH Bulletin, September 18, 2023.
Farrow, Frank, Hanh Cao Yu, and Robert Ross. “Philanthropic Investment in People Power.” Stanford Social Innovation Review, Winter 2023.
Gray-Akpa, Kristina, and Natasha Khanna, ed. Philanthropy’s Role in Addressing Neighborhood Conditions that Shape Health. Washington, DC: Grantmakers In Health, June 2018.
Ito, Jennifer, Manuel Pastor, and Ashley K. Thomas. “Thinking About the Long Term With Philanthropic Power Building.” Stanford Social Innovation Review, September 5, 2023.
Kavate, Michael. “Transformation” at the JPB Foundation: Eight Questions with Deepak Barghava, President-Elect. Inside Philanthropy, September 18, 2023.
Pastor, Manuel, Paul Speer, Jyoti Gupta, Hahrie Han, and Jennifer Ito. Community Power and Health Equity: Closing the Gap between Scholarship and Practice. Washington, DC: National Academy of Medicine, June 13, 2022.
Reich, Rob. Just Giving: Why Philanthropy is Failing Democracy and How it Can Be Done Better. New York, NY: Princeton University Press, 2018.
Rothstein, Richard. The Color of Law: The Forgotten History of How Our Government Segregated America. New York, NY: Liveright Publishing, 2017.
Vaidya, Aditi, Ai-jen Poo, and LaTosha Brown. Why Community Power Is Fundamental to Advancing Racial and Health Equity. Washington, DC: National Academy of Medicine, June 13, 2022.
This Views from the Field article is part of “Learning What it Takes,” a special series from The Kresge Foundation and Grantmakers In Health that explores the lessons learned from Kresge’s Climate Change, Health & Equity (CCHE) initiative. Click here to learn more.