Lisa M. Medellin, Director of Programs, Healthcare Georgia Foundation
The beginning of a new year is an opportunity to hit the reset button for a fresh start, with resolutions to spend less, eat healthier, and exercise more. But 2020 has proven to be a year in which we have been forced to stay home, work remotely, and distance ourselves from one another. The pandemic has unveiled the magnitude of health inequities in this country from New York City to Albany, Georgia. COVID-19 has struck with a vengeance, hitting African Americans, older adults, and those with chronic health conditions the hardest. Simultaneously, our nation is experiencing a moment of reckoning, resulting from a long history of racism that has shaped the foundation of this country and thus permeates every system and institution. Collectively, these events have generated more authentic conversations about racial inequities that have contributed to health disparities and poor health outcomes.
Healthcare Georgia Foundation became operational in 2002, and from its inception acknowledged health disparities as a priority. Four impact areas guide our strategic grantmaking: Addressing Health Disparities; Expanding Access to Quality, Affordable and Integrated Health Services; Promoting Health and Preventing Disease; and Strengthening Health Nonprofits, Programs, and Workforce. In 2019, the Foundation adopted a five-year strategic plan that affirmed its mission to enable, improve, and advance the health and well-being for all Georgians, with a vision of health equity in Georgia—where all people attain their fullest potential for health and well-being.
The Foundation’s equity journey has not been a linear process with a finite end, but rather a continuous and evolving learning experience. Our progression toward equity is most evident in the foundations’ board diversity, grantmaking practices, and program investments.
Healthcare Georgia Foundation’s initial Board of Directors resembled many foundations’ boards 20 years ago in that it was largely comprised of older white males. In 2005, the Foundation began expanding recruitment of members across demographics such as race, ethnicity, geography, disability, and expertise. There are currently 15 members of the board; more than 50 percent are female, 40 percent represent communities of color, and members hail from both urban and rural areas in Georgia. We firmly believe that a diverse board allows for broader viewpoints based on lived experience, serves as starting point from which equity can be actualized in the governance structure, can yield better results and demonstrates a commitment to board membership that mirrors the communities served by the Foundation.
As a statewide funder, the Foundation recognizes its responsibility to champion racial equity, partner with stakeholders, and help create conditions in which open and honest conversation is welcome and everyone is offered a seat at the table. In 2002, the Foundation conducted a listening tour across Georgia to hear from residents and providers in order to capture their stories related to health care access quality for the uninsured. These stories were published in a report titled Why We Do What We Do: Georgians Speak About Health and became a roadmap for soliciting community input at the Foundation. While early Foundation grants addressed a wide range of health issues and were designed to change individual behavior, our funding strategy transitioned into population-based programs that focused on fewer health areas, incorporated best-practice approaches, were tailored to reach African American communities most affected by disparities, and were structured to have deeper engagement within communities. This led to developing a Childhood Obesity Prevention Program, a Health In all Policies Initiative and Taking Care of You, a Maternal and Infant Mortality Prevention Program.
The Foundation’s equity journey has also included recognizing the important role that social determinants of health play in achieving healthy equitable communities. In 2017, the Foundation funded its most comprehensive investment to date: the 5-year $8 million place-based rural health program The Two Georgias Initiative, supporting 11 community health coalitions in Georgia with a focus on creating more equitable rural communities. This was the first grantmaking program where the design and purpose of the investment was to explicitly address health equity. In 2018, the Foundation restructured an existing funding program focused on direct services to support approaches that address chronic diseases with consideration for equity and social determinants of health The Foundation has also begun looking at internal grantmaking policies, procedures, and application materials from a diversity, equity, and inclusion lens to eliminate barriers to equitable distribution of resources.
Healthcare Georgia Foundation also supports other activities to advocate for equity. For example, our grantee conference Connections, Community Service Awards, communications vehicles and social media platforms are used to promote equity messages. In 2019, the Foundation established a Health Equity Award recognizing and celebrating the accomplishments of its inaugural recipient, the Partnership for Southern Equity. In the coming years, this biennial award will continue to uplift and recognize organizations that are relentless in their pursuit of health equity for all, inspire leaders for health equity, stimulate public discourse on what improves health, work to end structural and systemic racism, and address the unequal treatment of vulnerable populations.
Over the course of the Foundation’s history our equity journey has been fluid and has encompassed successes, challenges, and numerous lessons learned, including:
- Be Flexible and Adaptable. Equity work is complex, challenging, and will require difficult conversations. Exercise humility, foster a learning culture, and get comfortable with being uncomfortable.
- Transformative vs. Transactional Grantmaking. Build and nurture new relationships with unlikely organizations. Listen to the community and ask for their input. Place-based grantmaking allows for more authentic engagement with communities. Support capacity building and general operating activities. Develop and cultivate leadership within communities.
- Results Matter. Champion and lead efforts to collect data, with an emphasis on disaggregated data. Support evaluation activities that develop equity indicators, incorporate qualitative data, and make use of storytelling. Celebrate and share successes, even if they are small wins.
- Take Risks. Focusing on the social determinants of health will address the root causes of systemic racism and barriers to progress. Forge collaborations with organizations that have the expertise in housing, education, poverty, and transportation. Support policy and advocacy activities that address the political determinants of health.