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Opinion | We must reimagine how to address DC’s persistent health inequities

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

A recently established $ 95 million Health Equity Fund has the potential to help reshape the way DC addresses its long-standing health inequities. Some might believe the best investment would be to support organizations providing direct services to people struggling with diabetes, hypertension, covid-19, maternal and infant mortality, HIV / AIDS, homelessness, food insecurity, gun violence, and the many other issues that disproportionately affect people of color in our city. Those challenges absolutely deserve our community’s attention and funding.

The Greater Washington Community Foundation and the Health Equity Committee administering the Health Equity Fund have decided to focus on root causes and early interventions. Because 80 percent of DC’s health outcomes are driven by social, economic and other factors, and only 20 percent by clinical care, we plan to deploy the full resources of the fund to projects that disrupt more traditional approaches to social change with the goal of ultimately helping to close the intolerable racial health and wealth gaps. In other words, instead of putting a Band-Aid on these problems, we are going to focus on the reasons people are bleeding in the first place.

The Health Equity Fund was established last year with resources from a settlement among DC’s Department of Insurance, Securities and Banking; Group Hospitalization and Medical Services Inc. (a 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 nonprofits that serve DC residents, the fund is also the largest undertaking in The Community Foundation’s nearly 50-year history.

This month, The Community Foundation issued its first competitive Request for Proposals for grants. Mindful that health and wealth are inextricably connected, this first round of $ 10 million in grants to 40 organizations will boldly invest in economic mobility and wealth-building in DC’s historically underinvested communities. Future funding will be devoted to policy advocacy, community and multisector anchor partnerships with hospitals and health systems, and behavioral health and trauma-informed systems of care.

If you are a nonprofit working to address these issues, we want to hear from you. We are especially looking to support disruptive systems-changing strategies that improve prospects for Black, Latinx or Indigenous people of color and other marginalized populations. Let me share several examples of what I mean by disruptive systems-changing strategies.

Thirty years ago, the approach used to address chronic homelessness by service organizations and government – and embraced by funders – was to require unhoused residents to prove they were “housing ready.” That meant meeting certain conditions, such as sobriety or treatment, as a prerequisite to housing. But these requirements often thrust those same unhoused people back onto the streets. Recognizing this disturbing trend, one nonprofit began asking the unhoused residents what they needed. The answer: a safe, stable place to live. Thus, the innovative Housing First model was born. In contrast to the traditional approach, Housing First mandates neither treatment nor sobriety before moving clients into permanent supportive housing. Housing First providers offer clients, but do not require clients to accept, supportive services tailored to individual needs and goals, understanding these services are most effective when clients choose them voluntarily. Housing First has become the accepted standard in our region, around the country and in other parts of the world, and one that The Community Foundation has long supported, including through the Partnership to End Homelessness. The results of Housing First speak louder than words: Permanent supportive housing has a long-term retention rate of 90 percent, in contrast to a 45 percent success rate for the old model.

Other examples are around us – from organizations that are addressing long-standing inequities around our food system (the historical legacy of slavery, sharecropping and entrenched systemic racism), to those that encourage local youths to use photography to document disparities in their schools and communities , and local incubators that bring venture and philanthropic capital to BIPOC (Black, Indigenous and people of color) enterprises so they can grow and scale.

Let’s all get our creative juices flowing as we reimagine how to address the root causes of DC’s persistent health inequities. If anything, the past two years have reminded us that our economic, social and health systems favor people who already have access to wealth and health care. The time has come – actually, it’s well past time – to improve the health outcomes of annex DC residents.

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