Filling the Vacuum: A Health Insurance Funder Steps Up to Fight the Opioid Crisis



Over the last couple years, we have continued to ask why more funders haven’t responded to the nationwide opioid crisis. Drug overdoses, mostly from opioids, claimed the lives of 64,000 Americans in 2016, and some forecasts suggest that 500,000 people could die from opioids in the next decade. These shocking numbers, though, don't capture the full scope of the crisis, with some 2 million Americans addicted to pain relievers and their struggles reverberating through families and communities in devastating ways.  

Still, the nation’s top foundations have largely stayed silent so far. Even the Robert Wood Johnson Foundation, the leading U.S. grantmaker on health, has remained on the sidelines; it ended work on substance abuse a decade ago. Nor have most big regional health funders moved in a major way to combat the opioid crisis. 

As we've often reported, the hottest trend in health philanthropy right now—led by RWJF—is looking upstream to address the social determinants of health and improve population health. Meanwhile, back downstream—in cities and towns across the U.S. but especially in economically hard-hit rural areas—the worst public health crisis in recent memory has gathered steam and inflicted death on a staggering scale. This feels like another example of philanthropy becoming so focused on long-term, sophisticated funding strategies to achieve systemic change that funders end up ignoring widespread, preventable human suffering occurring right now.

There are a few bright spots in an otherwise lackluster response to the opioid crisis by foundations. The Conrad N. Hilton Foundation, which has a robust substance abuse program, has been funding work on opioids for years, now. The General Electric Foundation is an important newcomer to the field, with significant commitments around Boston. And, as public alarm about opioids has risen in the past year, we've reported on a number of local funding efforts, such as by the Independence Blue Cross Foundation, which is tackling addiction in Southeastern Pennsylvania. 

Today’s story takes us to North Carolina, where opioid addiction is a major problem, as well.

The Aetna Foundation recently announced a new $6 million commitment to fighting the opioid crisis on the local level, and the fight begins in North Carolina. An initial $1 million of this total amount is going to the North Carolina Harm Reduction Coalition (NCHRC) for a project targeted at overdose prevention in rural areas. What’s interesting about this particular grant is the emphasis on addressing the crisis in different ways in different communities.

“While this is a national health crisis, there is no single solution that can be applied across the country,” said Harold L. Paz, M.D., M.S., a member of the Aetna Foundation’s board of directors. “These grants will provide important resources to empower local communities to address the unique characteristics of the opioid-related problems they are facing.”

Opioid addition looks different in rural areas than it does in big cities and suburban areas, and Aetna's effort is guided by that insight. Thanks to better research and data, it's now more feasible to target opioid programs in a strategic way based on geography and local culture.

North Carolina has been hit especially hard by the opioid crisis. According to the North Carolina State Center for Health Statistics, an average of four people died each day from drug overdoses in North Carolina in 2016. The Aetna Foundation is a national funder, and it doesn’t focus its grantmaking specifically on the Southeast. But this region has stood out lately in terms of opioid-related deaths, and has a strong need for addiction and prevention services.

The new Aetna grant will provide community-level risk education in the rural North Carolina counties of Brunswick, Cumberland, Haywood, Johnston and Vance. The money is also going toward distributing naloxone overdose-reversal kits to rural, high-risk opioid users. As part of this rural initiative, there will also be a push to help healthcare and law enforcement professionals adopt a system for best practices for overdose prevention. This is the first program of its kind to address opioid use in these rural parts of North Carolina.

However, North Carolina isn’t the only place in the country that the Aetna Foundation has its eye on. We’re expecting to hear news in the coming months about additional Aetna Foundation grants in other states that are part of this $6 million commitment, as well. What likely drew Aetna to this particular North Carolina grantee is its innovative work in forgotten communities that are struggling disproportionately with a nationwide issue. This approach reminds us of the Independence Blue Cross Foundation in Pennsylvania, which has also been testing local strategies for nationwide progress in the fight against opioid addiction.

The Aetna Foundation's commitment is part of its Building Healthy Communities mission, which is all about supporting locally based programs and models that can spark progress in other places, too. As we've reported, Aetna is yet another health grantmaker that's been moving upstream in its focus. Clearly, though, it's also attuned to what's happening downstream—perhaps because, as the philanthropic arm of an insurance company, it's more sensitive to the health costs of the opioid crisis and the public's rising demands for action.