The well being and well-being of persons are intimately tied to the circumstances of life of their communities—circumstances that construction alternatives and pathways for lifelong and even inter-generational well-being. Philanthropic efforts to enhance group well being should attend to the numerous techniques that form life circumstances by focusing not solely on whom, what, or the place to fund, however equally importantly, on how to fund.
The Urban Institute’s latest complete evaluation of health-focused community development investments made by the Robert Wood Johnson Foundation between 2013 and 2019 yielded a variety of insights about how philanthropic investments can drive enduring techniques change wanted to enhance group well being, well-being, and fairness throughout the nation.
Drawing on dozens of interviews with grantees and companions, group growth intermediaries, and philanthropic leaders; analysis on collective influence and social accountability; and City’s personal experience, we recognized three key suggestions (amongst others) which are particularly essential to funders searching for long-lasting impacts on group well being and well-being:
- Goal the foundation causes of group well being inequities in the US by dismantling systemic racism, centering group energy and accountability, and investing in youngsters and households;
- Incentivize and strain the well being care sector to redirect important assets towards group well being and growth, the place so many nonmedical drivers of well being and well-being are embedded;
- Direct a number of types of philanthropic energy and affect towards true techniques change—that means, everlasting imprints on coverage and apply—in order that energy and management are shifted to the folks and locations most in want.
Three Key Suggestions
The primary requires a basic dedication to countering the numerous techniques producing circumstances of inequality and well being inequities, particularly systemic racism and its attendant injustices; empowering—by way of self-determination and management of wanted assets—the folks and locations most affected by marginalization and exclusion; and investing within the earliest ages and phases of life to permit for the compounding advantages of health-promoting components over the life course.
Mid-point variations to the Strong, Prosperous, and Resilient Communities Challenge (SPARCC)—a multisite initiative involving native efforts in six areas to construct wholesome communities—included acknowledging racial equity as a main driver of group well being outcomes, and guaranteeing that group growth capital methods mirror approaches which are group pushed. And whereas it is likely to be tempting to focus solely on the folks and locations which have borne the brunt of systemic marginalization—they’re definitely the perfect positioned to name out the way it works and with which pernicious results—it’s important that we additionally study and hold accountable these with extra power and privilege, as a result of they typically have essentially the most decision-making management, even on the hyper local level.
A second suggestion stems from the truth that at nearly 18 percent of gross domestic product (GDP) and rising, the well being care sector is consuming a disproportionately excessive share of the nation’s assets. Cross-national proof persistently exhibits that the United States spends more on health care (by far) than different high-income international locations and but has among the many worst well being and survival outcomes. This huge and rising “U.S. health disadvantage” spans many a long time and is discovered in any respect ages, for each sexes, and amongst all racial and socioeconomic teams.
The nation shouldn’t be spending its well being care {dollars} properly, with redistributions wanted throughout the well being care system, and equally essential, a redirection of a few of these {dollars} out of well being care and into different sectors. These embody conventional community development areas like housing and the constructed setting, but in addition schooling, employment, and youth growth. The Democracy Collaborative, for instance, is working with well being care system leaders in an effort to proactively deal with financial and racial inequities in group circumstances that create poor well being. You will need to acknowledge, nonetheless, that the redirection of well being care {dollars} (at scale and in sustainable methods) into communities won’t come with out problems or resistance, and philanthropic well being funders have a robust position to play on this shift.
Lastly, the numerous techniques which are producing the nation’s giant and rising types of inequality—be it well being inequality, revenue inequality, or wealth inequality—are typically working as designed. It follows that the options should even be targeted on techniques, and particularly, the way in which they’re designed to function, distribute assets, and confer energy.
If we consider techniques change by way of “everlasting imprints” on coverage and apply, then philanthropic funders ought to be excited about how they’re contributing to sturdy shifts in energy towards the folks and locations which have been topic to long-term disinvestment and marginalization. Historically, philanthropy has deployed its monetary assets by way of grant making. Nevertheless, as a big heart of energy itself, philanthropy must wield all of the resources at its disposal, together with its social, ethical, mental, and reputational capital.
Philanthropy’s Essential Function
The alternatives for philanthropy, particularly well being philanthropy, to enhance group well being, well-being, and fairness are large and nonetheless largely untapped. Many efforts throughout the nation are working towards extra equitable insurance policies and practices—some are simply beginning, and others have lengthy and wealthy histories of their communities.
Nevertheless it takes energy to shift energy, and to take action in methods which are each efficient and enduring. Well being philanthropy generally is a main power and accelerator in these efforts, and alongside grantees and different companions, might help shift techniques and useful resource flows in ways in which optimize well being in underinvested communities throughout the nation. The nation deserves no much less.
