Review | We need to re-imagine how to address DC’s persistent health inequalities

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Tonia Wellons is the president and CEO of the Greater Washington Community Foundation.

The recently created $ 95 million Health Fund has the power to help DC reshape the way it addresses long-standing health inequalities. According to some, the best investment would be to help organizations that provide direct services to people struggling with diabetes, hypertension, covid-19, maternal and child mortality, HIV / AIDS, homelessness, food security, gun violence and many other disproportionate issues. it affects people of color in our city. These challenges are well worth the attention and funding of our community.

The Greater Washington Community Foundation and the Health Equity Committee, which manages the Health Equity Fund, have decided to focus on the main reasons and early interventions. With 80 percent of DC’s health outcomes affected by social, economic, and other factors, and only 20 percent by clinical care, we plan to expand all of the fund’s resources to projects that ultimately break down more traditional approaches to social change. helping to close unbearable racial health and wealth gaps. In other words, instead of putting a dash on these issues, we should first focus on the reasons why people bleed.

The Health Equity Fund was created last year with the resources of a settlement between the DC Department of Insurance, Securities and Banking; Group Hospitalization and Medical Services Inc. (CareFirst BlueCross BlueShield affiliate); and the DC Appleseed Center for Law and Justice.

One of the largest funds of any kind focused on community-based nonprofit organizations serving DC residents, the fund is also the largest company in The Community Foundation’s nearly 50-year history.

This month, the Community Foundation has applied for the first grant application. Given that health and wealth are inextricably linked, this first round of $ 10 million in grants to 40 organizations will invest boldly in economic mobility and building wealth in communities that have historically invested little in DC. To promote future funding policy, community and multi-sectoral anchor partnerships will focus on hospitals and health systems, and behavioral health and behavioral care systems based on trauma.

If you’re a nonprofit working to address these issues, we’d love to hear from you. In particular, we are embracing disruptive strategies for changing systems that improve the opportunities for blacks, Latinos, or indigenous people of color and other marginalized populations. Let me share some examples of what disruptive system change strategies mean.

Thirty years ago, the approach used by service organizations and governments to combat chronic homelessness – and was accepted by funders – was to prove to homeless residents that they were “ready for housing”. This meant meeting certain conditions, such as simplicity or treatment, as a prerequisite for housing. But these demands often put these homeless people back on the streets. In light of this alarming trend, a nonprofit began to ask homeless residents what to expect. them necessary. Answer: A safe and stable place to live. Thus was born the innovative Housing First model. Compared to the traditional approach, Housing First does not require any treatment or simplicity before moving the client to a permanent care home. Housing First providers offer customers, but do not require customer support, support services tailored to their individual needs and goals, understanding that these services are most effective when they are voluntarily chosen by customers. Housing First has become an accepted standard in our region, across the country, and in other parts of the world, and one that has long been supported by the Community Foundation, including the Homeless End-of-Life Partnership. Housing First’s results speak louder than words: Sustainable housing has a long-term retention rate of 90% compared to the 45% success rate of the old model.

Other examples revolve around us: organizations addressing long-standing inequalities in our food system (historical heritage of slavery, parking, and rooted systemic racism) that encourage local youth to use photography to document differences in their schools and communities. , and local incubators that bring BIPOC (black, indigenous and people of color) risk and philanthropic capital to companies so that they can grow and scale.

Let’s all think about how we all deal with the causes of DC’s enduring health inequalities as we pour our creative juice. They have reminded us that in the last two years, our economic, social and health care system has already benefited people who receive wealth and health care. The time has come – in fact, time has passed – to improve health outcomes all DC neighbors.

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