“Regardless of whether you are a health funder or education funder or housing funder, you are also a funder of shared prosperity. I am seeing a really encouraging move from siloed to more holistic approaches to funding.”
– Marc Allen, Director of Shared Prosperity, Camber Collective
The final day of the 2024 GIH Annual Conference on Health Philanthropy doubled down on a theme we’ve seen throughout our time in Portland. Even if you fund a specific program or issue area, your philanthropy has broader and more profound impacts. Throughout the conference, attendees were encouraged to approach their philanthropy in innovative and new ways. We are excited to hear about your courageous steps to widen your viewpoints, advocacy, and philanthropy in the weeks and months ahead. Let’s discuss your bold results when we convene again at the 2024 Fall Forum on November 11-13 in Washington, DC and the 2025 GIH Annual Conference on Health Philanthropy.
Read all about the final day of the conference—from breakout sessions to plenaries that gave funders important actions to take in this critical year.
What Happened to the War on Poverty?
The final day of the conference launched with a big question: What Happened to the War on Poverty? Ray Boshara, Legislative Fellow in the Office of U.S. Senator Bob Casey, Marc Allen, Director of the Shared Prosperity at Camber Collective, and GIH President and CEO, Cara James, worked to answer this question with a dynamic conversation about the War on Poverty’s legacy and the interventions needed today to make the economy work for all.
During a burgeoning Civil Rights Movement, President Lyndon B. Johnson signed the Poverty Bill, also known as the Economic Opportunity Act of 1964 (EOA), which expanded the federal government’s role in education and health care. Head Start, the Food Stamp Act, Social Security amendments such as Medicare and Medicaid, and the Elementary and Secondary Education Act emerged from the EOA as poverty reduction strategies.
While these strategies were initially effective, Americans now experience more episodic poverty than in the 1960s. A majority of Americans will experience poverty at some point in their lifetime. To paint an even starker picture, today most Americans could not absorb an unexpected $400 expense without going into some form of debt. When the War on Poverty was declared, 90 percent of conference attendees would have access to upward mobility and more financial security than their parents. That number has dropped to less than 50 percent.
“We have won the war on poverty, but we’ve lost the war to make the economy work for everyone,” Boshara emphasized. One challenge is the catchall term of poverty, which is narrowly focused and individualistic. New frameworks can shift our understanding of the economic insecurity impacting the lives of so many Americans. Boshara mentioned the American Dream scholarship, conversations about wealth, and new terminology like financial security and well-being as more comprehensive and indicative of the complex realities of our economic situation. He also emphasized that over 80 percent of the wealth gap comes from structural racism and the ongoing impacts of race-based slavery in our country. These forces require their own reckoning: “We need to shift away from an emphasis on making better choices to having better choices to make.”
With so much at stake this year, James asked, “How do we get out of this quagmire?” While the EOA provided a helpful foundation for many of the public benefit programs we have today, it fell short in addressing the toxic narratives that do not make space for the solutions we need. Allen argued that long-term bipartisan support will come when we tackle narratives like “pulling yourself up by your bootstraps” and move away from silver bullet solutions. “Absolutism is a big challenge in narrative change space,” Allen shared. We need narratives that leave space for individuals while also elevating our collective commitments to one another.
Both panelists agreed we also need a fundamental shift in voter engagement. If there is funding and effort to educate and mobilize voters, we can start to enable an environment of pressure on both primary political parties to address this crisis of economic insecurity and poverty. The panelists stressed the uniqueness of this moment with an unprecedented amount of funding available, and the significant role philanthropy can play in giving space for communities to decide what they need. We can draw from lessons learned in the 1960s and the effectiveness of community action groups. “Don’t miss the low hanging fruit” like community engagement as you work on systemic changes, Allen encouraged.
Closing Plenary: Health and the 2024 Elections
Apprehensive. Hopeful. Excited. Anxious. These are just a few words that emerged at the start of the closing plenary, Health and the 2024 Elections. Dean Rosen, Partner at Mehlman Consulting and an expert on America’s complex health care system, joined President and CEO of Grantmakers In Health, Cara V. James, for a substantive conversation on the general election and implications for America’s health and health care.
The 2020 election was decided by only 42,000 votes in three states out of the over 150 million votes cast. With the 2024 election, we can expect similar margins and outcomes. Many people will be unhappy with the results or outright reject them. Rosen shared that lacking “trusted referees,” we must be prepared for disruption, deeper partisan lines, and inevitable impacts on health care.
Notably, health care and the future of health polled high in previous election cycles, but current polls indicate that health care is a lower priority for voters. People are more concerned about the economy, crime, and individual financial situations. Yet, if we look below the surface, health care does show up in two ways for 2024 voters: economic insecurity and reproductive rights. Voters are concerned about their ability to pay for health expenses and remain wary of a post-Dobbs United States.
Throughout the conference, attendees used Mentimeter to take real-time mini surveys. For the closing plenary, attendees were asked about the top two election issues in 2024. The room overwhelmingly selected “abortion rights” and “jobs and the economy” as major drivers of the election result. Attendees strongly agreed that abortion, affordability of health care, and mental and behavioral health should be top health priorities this election cycle. Rosen also suggested that climate change is a critical health issue that will likely be a topic of heavy debate in this election.
With foundations increasingly entering the policy space, funders can take what we know about health priorities this election cycle and parlay them into deeper conversations with policymakers. Rosen shared that funders are particularly interested in climate, reproductive rights, abortion access post-Dobbs, health equity, racial and ethnic disparities, rural access to care, and maternal and child health. Funders can influence policy by funding direct advocacy and providing substantive expertise and education. Rosen explained that there needs to be more nonpartisan factual information about grantmaking outcomes and community impacts for policymakers.
So, he continued, do not hesitate to share your work early and regularly with legislators so you become the trusted source of information. Understand what they need to know now and what bipartisan issue areas are open to incremental change. There’s great bipartisan interest in social drivers of care and maternal and child health. And most importantly, members of both parties are keenly aware of how complicated the current health care system is—such as the costs and complexity of navigating mental and behavioral health care—and are looking for solutions. As we inch closer to a consequential election, philanthropy can drive conversations and change around health care, regardless of the outcome in November.
“To achieve better health for all and advance health equity, we must address the root causes of the challenges we face, including the systems that are contributing to the poor outcomes and/or poorly designed to serve the populations they are intended to help. Doing this requires us to stop doing business as usual and it requires consistent courageous actions by everyday people committed to the long game.”
– Cara V. James, President and CEO, Grantmakers In Health
Unapologetically Rural: How Three Foundations are Changing the Game
Krystal Grimes, Chief Strategist/Founder of HEAL Alliance, AMMA Empowerment Services, facilitated a fireside chat that explored three models of rural community engagement and empowerment in support of health equity and social justice goals. Each foundation shared practical tips about what works when fostering relationships with rural communities.
REACH Healthcare Foundation serves three counties in Kansas and Missouri. Carla Gibson, Vice President of Programs, shared, “[Communities] come up with solutions, we don’t.” The foundation learned early on that funding needs to happen differently in rural communities, and innovation is vital. Sarah Moody, Director of Community Relationships at Missouri Foundation for Health, offered one particularly innovative model they champion. The community liaison model ensures staff are solely focused on relationship-building and are embedded in the communities they serve. Abena Asante, Senior Program Officer at St. David’s Foundation, has seen meaningful impact through a network weaving model of community engagement in central Texas. Since the foundation’s first cohort of Network Weavers in 2019, over 2,000 individuals in 10 of their communities have been connected to their work.
Following an overview of each model, panelists shared a few key learnings from engaging with rural communities:
- Get out of your office and into the community. Flip the percentage of time you are in your foundation versus meeting people where they are.
- Check your assumptions at the door, and don’t go in with a deficit framework.
- Hold your board meetings in the communities where you work and have rural representation on your board.
- Approach grantees as trusted thought partners.
- Reckon with historic power dynamics between foundations and rural communities.
“Be mindful of how you show up. Have a whole lot of humility, a curious mindset, ask open ended questions, listen to learn and listen to understand,” Abena emphasized.
This session was designed by St. David’s Foundation and The Strategy Group.
Who Are the Experts Advancing Equity? Racial Justice-Centered Research Spurs Empowerment and Impact
New Hampshire is becoming increasingly racially and ethnically diverse, especially among children. Over 10 percent of the state’s population identifies as BIPOC (Black, Indigenous, and People of Color). This session detailed how Endowment for Health, in collaboration with national research firm Child Trends, took a more equitable approach to racial and ethnic research, leading to more considerable impacts for and understanding of New Hampshire’s families of color with young children.
The research was conducted in three phases: Partner + Learning with the Community; Share Lessons Learned + Reflect Together; and Make Changes Based on Lessons Learned. Instead of a research project, they called the work a movement to indicate forward momentum and real impact. To ensure equity in the research, the movement took the following approach:
- Power Sharing: Co-design, co-implement, co-analyze with the community.
- Investing in Community: Training co-researchers and community leaders in research techniques.
- Learning from the Community: Understanding cultural backgrounds, the location, and the historical context before starting research.
- Meeting Communities Where They Are: Adapting procedures and processes to meet the real needs of families.
From the research, they learned that coordinated, funded initiatives help families navigate complicated systems, and community connections and relationships really matter. Families also face challenges like discrimination and social services that feel out of reach or inconsistent. With these findings, the team has started hosting meetings with community members and providers, translating materials to help showcase the research, and exploring partnerships that help build power and grow the movement.
Sandra Pratt and Wanda Castillo, community leaders deeply involved in the work, were fueled by their passion for early childhood development and desire to see research put into action. Not only do they want their voices heard, but they also want to share stories directly with the community. They shared tips for funders who wish to engage in this work:
- Do not come with the prescription in mind.
- What works for one community may not work for others.
- Take what you hear and put it into action in communities.
Castillo reiterated that “People from minorities get tired of getting called and then being left hanging and not receiving any feedback. We know and understand it is not always possible to create a specific program for a need, but at least inform us of your intentions. Tell us your plans and findings. We want to know what you are doing with the research.”
Equity-centered research requires foundations to work differently. Kim Firth, Program Director at the Endowment for Health, shared that foundations must listen to and follow communities. While internal and external systems at foundations may make working in community challenging, Firth shared, “If we truly embrace equity, the only way to make sustainable change is to work in this way.” That may mean taking extra steps and building a bigger budget, but the results are meaningful, equitable, and truly impactful.
This session was designed by the Endowment for Health.
“I loved the session Making the Case for Funding Capacity Building of Community-Based Organizations. I now feel equipped to bring an equity lens to the work I am doing to build capacity at food pantries. The session was really valuable, especially the worksheet with guiding questions that I can take back to my organization on Monday.”
– Megan Hinchy, Program Manager, Ann & Robert H. Lurie Children’s Hospital of Chicago
Fun fact: Portland’s Forest Park is one of the largest urban forests in the United States.
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