Development and Health Equity

How state foundations are addressing health equity and creating opportunities

of collaboration for Families USA

Part I: Importance of Health Equity in Development.

Part II: Which health equity lenses do state and national foundations focus on?◦ Health care Access, Quality and Outcomes

Part III: Key Health Foundations◦ How do these foundations define Health Equity?◦ What are their priorities in Health Equity?◦ How do these organizations address health equity issues in their

states/ regions? Who and what have they funded?

Part IV: Families USA and Health Equity◦ Where is there room for alignment and collaboration between

Families USA and these organizations

Table of Contents

The people that the United States traditionally leaves behind in all aspects of the social determinants of health will soon make up the majority of the population.

Part I – Importance of Development in Health Equity

Projections of the size and composition of the U.S. population: 2014 – 2060

◦ 2030 – 1 in 5 Americans is projected to be 65+◦ 2044 – More than half of all Americans are projected to belong to a

minority group◦ 2060 – One fifth of the nation’s total population is projected to be

foreign born

◦ These are just a few projections for the most vulnerable populations in the country.

Census Data

Part II – Which Health Equity Lens? Access, Quality, and Outcomes

How are foundations focusing on health equity?

◦Health Equity in terms of health care access?

◦Health Equity in terms of quality of care?

◦Health Equity in terms of health outcomes?

All three?

Which Health Equity Lens?

Vulnerable populations need to be able to gain entry to the health care system.

◦How do we measure access to health care?

◦Barriers to health care access? Social determinants of health.

Disparities in Health Care Access

Quality health care is easily defined as doing the right thing (patients getting the health care services they need), at the right time in the right way, to achieve the best possible results.

◦How do we measure quality of health care?

◦Barriers?

Disparities in Health Care Quality

Health care outcomes defined as: the impact health care activities have on people — on their symptoms, ability to do what they want to do, and ultimately on whether they live or die.

◦Measures of Health care Outcomes

◦Barriers?

Disparities in Health Care Outcomes

Upstream Interventions – Seek to reform the fundamental social and economic structures that distribute wealth, power, opportunities, and decision-making.

Midstream Interventions – Seek to reduce exposure to hazards by improving material, working and living conditions, or to reduce risk by promoting healthy behaviors.

Downstream Interventions - Seek to increase equitable access, at an individual or family level, to health and social services.

Upstream, Midstream and Downstream Interventions

All of those factors need to be taken into consideration when analyzing how each state and national foundation is addressing health disparities.

Part III – State and National Foundations

Our mission is to advance the health of all Georgians and to expand access to affordable, quality health care for underserved individuals and communities.

Healthcare Georgia

Eligibility – Healthcare Georgia Foundation generally supports organizations and projects located in Georgia that directly benefit Georgia residents. National organizations providing services in Georgia are also considered.

Health Equity Funding

◦ The Two Georgias Initiative: Addressing Health Equity in Rural Georgia

◦ Taking Care of You: Infant Mortality Initiative

Grant range: $2000 – $400,000

Previous Families USA Funding: 2010 - grant of $152,000 for planning and delivery of state-specific training, technical assistance and strategic counsel in the implementation of health reform in Georgia

Analysis of Funding

“The Consumer Health Foundation (CHF) seeks to eliminate racial and ethnic inequities in health and health care. Differences in health and life expectancy between whites and people of color — which contribute to thousands of people being ill or dying in our region each year — can be avoided. These health inequities lead to increasing health care costs and loss of productivity. Our region would be much stronger if everyone had an equal opportunity for good health and well-being.”

Consumer Health Foundation

Eligibility - generally they fund state orgs but will also fund national orgs. Doing work in the area. (better if the state organization is the grant applicant in this case)

Health Equity Funding – Consumer Health Foundation’s grant making focuses on advocacy for health reform and economic justice, community wealth building and racial equity.

Grant range: $25,000 to $50,000

Previous Families USA Funding: Yes, we received $40,000 each year from 1999 – 2006, 2008 to fund consumer health assistance and tech. assistance projects in DC.

Analysis of Funding

“…When we think of health equity, we see the beginning that first we must all have a fair shot to take ownership of our health. So while we continue to believe in the importance of eliminating disparities, our immediate focus will be to expand health equity by helping more people gain access to better care especially those who disproportionately lack it now, people of color.”

Connecticut Health Foundation

Health Equity funding – fund projects that facilitate more access to better care, especially for people of color.

Grant Range - $30,000 to $100,000

Previous Families USA Funding – (2007) $100,000 - Families USA provided tech. assistance for SCHIP, and consumer protection in CT.

Analysis of Funding

“In collaboration with the RAND Corporation and with far-reaching expert input, we have developed a Culture of Health Action Framework which sets a national agenda to improve health, well-being, and equity.”

Robert Wood Johnson

Health Equity Funding - They are working to help achieve health equity and expand opportunity to pursue the best health possible, through investments in four broad areas:

1. Healthy Communities2. Healthy Kids, Health Weight3. Health Leadership4. Health Systems

Grant Range - $100,000 to $300,000 range, and run from one to three years.

Funding Example – (2015) $843,115: NCHE – National Index of Health Equity

Analysis of Funding

“We look at health and well-being in the context of community and across the full range of child development. We emphasize the prenatal months to age 8 as the foundation for all healthy development. And we focus on communities with high health disparities. A nation where all children thrive is what we envision. Health equity is our measure.”

W.K. Kellogg Foundation

Health Equity Funding – rewards grants to projects that improve health care outcomes and reduce health disparities for children.

Grant Range - $50,000 – $400,000

Funding Example – (2015) $125,000 - Zuni Public School District 89

◦ Native American Children◦ In school prevention program

Analysis of Funding

“Everyone should have access to resources that support health: things like safe, affordable housing and neighborhoods, fresh food and economic opportunities. We seek to help communities overcome the environmental and social disadvantages that contribute to poor health so that everyone has the chance to enjoy productive, self- determined lives.”

The Kresge Foundation

Health Equity Funding – addresses health disparities in children by Concentrating their resources on early childhood (prenatal to age 8), within the context of families and communities.

Grant Range – $15,000 – $800,000

Funding Example – (2015) $765,000 – The Prevention Institute.◦ Upstream Interventions

Analysis of Funding

“Across eight decades, our mission has been to reduce poverty and injustice, strengthen democratic values, promote international cooperation, and advance human achievement.”

The Ford Foundation*

About a year ago, Ford shifted its grant making to focus entirely on inequality.

Eight Causes: Human rights, freedom of expression, democratic and accountable

government, economic opportunity, sustainable development, sexuality/reproductive health, Social justice.

Not focused directly on health equity per se but a case can be made.

Funding Example – (2015) $350,000: Community CatalystCore support for MergerWatch to advocate for health care reform that meets the needs of women and families, with a special emphasis on ensuring access to comprehensive reproductive health services

Analysis of Funding

Part IV – Families USA, Health Equity, and Development

• Recap• A shift to health equity funding• Significant potential for Families USA

• How exactly does Families USA define health equity and how does our definition align with these potential state and national funders?

• Another question to consider is how far upstream can Families USA realistically go in order to work with certain funders?

• Addressing the social determinants of health?

http://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/nhqdr15/2015nhqdr.pdf

http://nccdh.ca/images/uploads/Moving_Upstream_Final_En.pdf

* more to come obvi…

Citations

Thank you!Questions/ Comments?