The racial dimension of health equity has long preoccupied top funders in the healthcare space and it's not hard to see why. Spend five minutes looking at health data for the United States and you'll be blown away by the scope of racial disparities in all aspects of health, including how long people live, the chronic conditions they face and whether they have health insurance.
In turn, it's not hard to trace these inequities back to larger social and economic disparities by race, not to mention gross inequities in who has power in American society. As we report often, national health funders like RWJF and Kresge operate very much with this larger context in mind, and aren't afraid of getting into some edgy advocacy work.
Lately, more state-level health care funders have been getting with the same program—and, in some cases, taking things even further. Just the other day, we wrote about how the Missouri Foundation for Health is making a $6 million push to address racial equity issues raised in the wake of the police shooting in Ferguson. We've also written about the huge investments by California funders to improve the health, and broader well-being, of that state's Latino population.
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Then there's the Connecticut Health Foundation, which made a shift in 2013 to focus its grantmaking laser-like on the non-white residents of this New England state.
It was the Affordable Care Act that prompted the $100 million foundation to make a strategic turn from its original mission, improving the health of the people of Connecticut, toward getting more people—specifically those of color—access to better care.
Connecticut has long struggled with a major health equity problem. People of color, roughly 30 percent of the population, were shut out of the healthcare system before the ACA. Poverty and a lack of communication served as barriers.
Like many other state health funders, the Connecticut Health Foundation made a big push to ensure that the ACA succeeded. It committed resources to the Obamacare enrollment period, supporting grassroots organizations that were active in the underserved communities of African-Americans, Hispanics, African-Caribbeans and people of mixed races. The foundation is proud of the results: The insured rate for Connecticut rose to 97 percent after a health insurance marketplace opened, which simplified the enrollment process and costs of coverage.
But getting people covered, it turns out, is only part of the challenge. The other part is ensuring this coverage actually works for people.
“It is now critical to help the newly insured understand how to use their coverage and the health care system to achieve the promise of the Affordable Care Act,” the Connecticut Health Foundation says, and that's what it's doing that through its grantmaking, with a focus on those who still struggle the most with health systems: underserved people of color.
Notably, the foundation isn't afraid to push into contested terrain—and the hallways of power—in pursuit of this mandate. Like another state funder we keep a close eye on, the Colorado Health Foundation, it has a keen eye on whose voices are getting heard in healthcare debates. It believes that people of color lack a say in policymaking, so—most recently—the foundation is putting up as much as $200,000 to recruit leaders of color who can engage in health issues at this level, either by pushing for better data or through policy analysis. The deeper idea here, the foundation says in an RFP, is that “that the inclusion of the voices of consumers of color in health reform will ensure that the needs, values, and preferences of consumers who experience health inequities will be represented and reflected in opportunities to change the healthcare system."
This is the third round of grants offered through the foundation's Diverse Advocacy program.
The foundation’s spokeswoman, Elizabeth Krause, told us a bit more about the thinking here. “What we noticed in Connecticut is that there is not a lot of diversity among the organizations that have a presence not only at the legislature when it’s in session, but also around other policy tables where important decisions are being made or debated.”
State-based nonprofits that advocate for the African-American, Latino, Caribbean and mixed race communities have an opportunity to gain a seat at the big table. Grassroots leaders in the cities of Bridgeport, Hartford and New Haven—all over 100,000 population with sizable black and Latino neighborhoods—are invited to partner with Connecticut Health and network with other consumer-engagement groups that specialize in health reform for the state’s 3.6 million people.
Connecticut Health anticipates funding two to four grants, ranging from $25,000 to $50,000, and will assist those grantees with training and any technical assistance they need.
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