Backed by a Billionaire, a New York Hospital Takes on Health Disparities
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NewYork-Presbyterian EMS paramedics in Lower Manhattan in May. Leonard Zhukovsky/shutterstock
COVID-19’s disproportionate impact on people of color cast a harsh light on the racial disparities in our health system. Statistics tell the story: During the peak months of the pandemic, Native Americans, Hispanics and Black Americans were twice as likely as whites to contract COVID-19, and Black people were twice as likely to die from the disease.
Such grim statistics helped turn an idea into a reality at New York-Presbyterian Hospital, which has established the Center for Health Justice funded by a $50 million gift from Dalio Philanthropies. The new center will address racial health disparities and help build a more equitable healthcare system.
This is not the first COVID response grant to come from the Dalios, but it’s a unique one in that the new center’s leadership seeks to create structural change and make an impact even outside of the hospital system. In recent years, a growing number of donors, like the Dalios, have been making gifts to support the institution’s work as a potential “change agent,” according to New York-Presbyterian’s development team.
The Dalio Center for Health Justice opened its doors in October, and will be fully staffed by the beginning of 2021. New York-Presbyterian Hospital (NYP) was able to get the project up and running quickly following a meeting of the minds between Ray Dalio, who founded Dalio Philanthropies, Dr. Steven Corwin, NYP’s president and CEO, and Dr. Julia Iyasere, a physician with a long-term commitment to health equity.
Giving Pledge
When it comes to the super-rich, Ray Dalio may not be a household name, but Bridgewater Associates, which he founded, is the world’s largest hedge fund firm; Forbes estimates Dalio’s net worth at $16.9 billion. Dalio and his wife, Barbara, signed the Giving Pledge in 2011, writing at the time: “We found taking our excesses and providing it to others who have extreme shortages has been both a good investment and a great satisfaction.”
Dalio Philanthropies, which the couple created in 2003, funnels a good portion of those excesses to a wide variety of causes that reflect the family’s interests and concerns—including public education, ocean exploration and conservation, financial literacy, and mental health and wellness—with some focus on New York and Connecticut.
The Dalios acted quickly as the pandemic took hold. In February, Dalio Philanthropies and Bridgewater committed $10 million to fight the coronavirus epidemic in China; the foundation later pledged $3 million to support childcare services for hospital workers across the state of Connecticut, and another $1 million for food and nutrition for Connecticut residents in need.
Perfect storm
As a past major donor and trustee at New York-Presbyterian Hospital, Ray Dalio was intrigued when NYP President and CEO Corwin approached him about creating the Center for Health Justice.
The issue of health equity and how the hospital could address it was something that Corwin and Iyasere had been discussing for several years. NYP has a commitment to promoting racial equity—internally, through its RESPECT credo and inclusion and diversity training; and externally, through community programs that address social determinants of health.
But the combination of the pandemic and the rising demands for racial justice following George Floyd’s murder created a perfect storm of factors that pushed the hospital to make an even bigger commitment.
“As COVID occurred, it became obvious that we were dealing with a public health crisis, an economic crisis and a social crisis,” said Corwin, who is also a physician. “Not only with the disparity in mortalities between people of color and white people, but also some of the attendant issues with Black Lives Matter. I felt it was important for us to take the next step. I felt very strongly that a Center for Health Justice was exactly what we needed to do, and I felt that now is the time to do it.”
The idea resonated with Dalio, who says his philanthropy is animated by an ideal of equality he learned as a child. “I was raised in an era with parents who believed in the American Dream and this notion of equality as being the fundamental objective of our society,” he said when the center was announced. “Then, in various ways, I saw the great inequality and inopportunity [in our country]… And I think health and education are fundamental to having a successful life, and equality should start there.”
Moving the needle
Corwin, who has called the Dalio Center for Health Justice “the conscience of our organization,” has made it an institutional priority. “So many people on staff have reached out to me to show support,” says Iyasere, who now heads the center. “I’ve heard from dieticians, physical therapists, lab technicians—everyone is galvanized to get this work done, and that’s helped us hit the ground running.”
Iyasere says the center’s work will be carried out across all 10 of the health system’s hospitals, and will address three principal areas: research, education and clinical and community strategy, and program development. “We want this to be a center for institutional and structural change. We’re at a moment in time that presents a real opportunity to move the needle on disparities in healthcare.”
One of the center’s first projects was a symposium on racial justice. It is also working on a comprehensive patient database that will help identify health disparities. Iyasere anticipates that the center will also play a role in educating patients about the COVID-19 vaccine once one becomes available.
“There is a lot of vaccine hesitancy in our communities—for good reason, because of the long history of bias in the health care system,” she said. “That mistrust has increased over the last year because there is so much misinformation out there. But these are the communities that are most vulnerable, and we need to rebuild that trust. We have to approach this with a unified message, meet people where they are, and make them feel like they are part of the process.”
Iyasere is quick to acknowledge that, while the issue of racial health disparities has received broad public attention since the pandemic, it is not a new concept. Physicians and public health advocates around the country have raised alarms about health inequities for years; they’ve also collected data, conducted research, and developed local and national initiatives to address the issue. Iyasere is hoping that the Center for Health Justice will become a forum that brings experts in the field together.
“That is one of our goals: to support ongoing work that is happening in silos across the country,” she said. “We want to bring people together to share information so their work can be elevated and amplified.”
Iyasere is also aware that there is only so much the center can do about inequities that have nothing to do with healthcare but that contribute to health disparities nonetheless. “If you look at education and housing and food insecurity, and economic insecurity—healthcare makes up only about 20% of what a person needs to achieve optimal health,” she says. “But we are a healthcare system, so that is our mission: to help every patient and every person in our community become healthier. When it comes to the other factors that contribute to an individual’s health, we have to look to partnerships, to strategic collaborations, to get this work done.”
NYP Chief Development Officer Sarah Avins, for one, thinks that philanthropists will continue to be partners in health justice work going forward. “I don’t think it is a passing trend,” she said. “I think this is an area where we are likely to see sustained support. The Center for Health Justice’s work is very aligned with what research shows are key motivators for younger donors, for one thing. Many of these donors have an almost activist approach to giving. Over the last five years, I’ve noticed a change: Many of our major donors are increasingly seeing our hospital as a change agent, and deliberately investing in that piece of our work.”
