Vital Signs: A Health Insurer Looks Upstream with Its Corporate Giving

photo:  EQRoy/shutterstock

photo:  EQRoy/shutterstock

With a new round of grants, the philanthropic arm of Aetna is getting out of doctors’ offices and into the neighborhoods where Americans live, work and play to improve health outcomes. The foundation pledged $2 million in grants to 25 community-based nonprofits to promote active living and increase access to healthy foods.

The grants tackle unequal access to everyday things that make us healthier in the long term, like spaces for exercise and affordable, healthy food in the neighborhoods where we live. Eating healthy and exercising guard against obesity and other chronic and expensive diseases, but those preventative measures only benefit those who have access to them. That group is financially secure and disproportionately white.

“We use the social determinants of health as a lens in our grantmaking strategy, because we know that local conditions have a tremendous impact on a person’s health outcomes,” said Amy Aparicio Clark, a senior program officer at the foundation.

Essentially what it boils down to is that a lot of our health is determined by where we live, much of which is determined by factors outside our control, like race and financial security.

Aetna isn’t the first foundation to identify social determinants of health or try to correct those inequalities, though it's still a cutting-edge idea. The Robert Wood Johnson Foundation is a leader in the space and the Kresge Foundation is another convert. A range of local funders, like the Colorado Health Foundation, are also focusing more grant money upstream. And grantmakers are collaborating with each other and partners across different sectors to achieve greater impact in this work, most notably through the BUILD Health Challenge, which is supporting community-led projects that take on the root causes of health problems in low-income neighborhoods.

Related: Looking Upstream: A Funder Collaborative Goes Local to Address the Roots of Health

Most of the big players in the space are foundations, so it’s interesting to see a corporate funder embrace the upstream approach. It makes total sense. As a healthcare company, Aetna knows how expensive diseases like obesity can be in the long term and has a lot of incentive to get this right. A healthier population means lower costs for insurance providers.

In this round of grants, Aetna is sticking with its emphasis on encouraging healthy eating and exercise in low-income neighborhoods, holdovers from the $2 million in grants the foundation gave out in 2016.

This year, the foundation said it gave about $1 million to improving physical spaces for everyday use—think walking and bike routes, retail spaces and gardens. For example, Phoenix received funding to start a bike-share program for low-income neighborhoods. A nonprofit called It’s Time Texas got money to transform low-use public spaces into spots for fitness classes and walking groups.

As far as the foundation’s focus on nutrition, several groups got funding for classes that teach healthy eating. The Doe Fund received a grant to increase access to healthy food in Brooklyn food deserts. Alachua County got funding to hold healthy lifestyle and gardening workshops for prisoners as part of a work-release program.

Aetna also has a new focus on air quality and exposure to chemicals. African Americans, Latinos and Asians are more likely to live in communities affected by pollution and environmental hazards like a high concentration of pesticides, according to the U.S. Centers for Disease Control and Prevention.

About $300,000 of the $2 million is addressing this inequity, the foundation said. The Migrant Clinicians Network received funding for a program that teaches migrant workers in Virginia how to limit their families’ exposure to pesticides. The Boston Public Health Commission received money for training and tech assistance for nail and hair salons, and auto shops to reduce air pollution and chemical exposure. The Clean Air Council got a grant to improve air quality in a Philadelphia neighborhood.

This list of grant recipients reveals another way the Aetna Foundation is taking a page out of the book of cutting-edge philanthropists—the focus on local partners. It’s a trend we’re seeing a lot lately, not just in health, but other areas, like education.

Partnering with groups already working in these communities is key to the work Aetna is doing, Clark said. To tackle the upstream determinants of health, Aetna needs partners that know the communities and understand their needs.

“Their projects will impact the day-to-day aspects of people’s lives, including the quality of the air they breathe, the availability of safe paths for walking and biking, and the accessibility and affordability of fresh food,” Clark said.  “Their work is contextualized to the needs of the residents they serve, which reflects the foundation’s commitment to build a healthier world, one community at a time.”

With its emphasis on upstream causes and a local orientation, the Aetna Foundation is another example of a corporate funder that's been upping it's game and embracing a more sophisticated approach to philanthropy.