Racial Equity and the Role of Foundations

Around 1935, a group of Washington D.C., area workers – many of whom were government employees – had a collective vision for revolutionizing the way they received health care. They wanted preventive, pre-paid, quality health care provided in a racially integrated environment. The Group Health Association (GHA), one of the first health maintenance organizations (HMOs) in the country, was created from their vision. GHA leaders established the Consumer Health Foundation (CHF) in 1997 from the sale of the HMO.

CHF’s mission is to advocate for racial equity and racial justice through programs and investments that advance the health and well-being of low-income communities of color in the Washington, DC region. CHF believes that racial equity and economic justice are essential to achieving health equity.

CHF has long embedded racial equity in its programs, policies, and practices. They developed a racial equity approach, which includes the following elements:

• Grounding its work in history so that it better understands how past social policies led to current conditions affecting low-income communities of color;
• Disaggregating data by race and place to identify groups and places where an intervention is most likely to create the biggest impact;
• Using a racial equity impact assessment tool to develop policy recommendations that would match the scale of challenges born out of decades of systemic racism;
• Organizing communities so that people with lived experience lead the development of solutions;
• Working with elected officials and agency leaders to educate them about solutions they can formulate into policies, programs and systems change to advance racial equity.

The foundation sees the process of operationalizing racial equity as long-term and continuous. In addition to the following activities, CHF continues to align its investment and internal policies and processes with its commitment to racial equity.

Initiatives. CHF has partnered with the Meyer Foundation to launch the DC in Color initiative. The foundations commissioned the Urban Institute to produce an equity report on the District of Columbia—using census and other data–to examine racialized inequities by ward along a number of key indicators (e.g., housing, employment, income, assets and education) and to imagine what it would look like to achieve equity. The report identified policies like redlining, restrictive covenants and segregation which helped shape the realities of communities of color in the District and surrounding region. Data from this research helped inform the work of the foundations, its grantee partners and other nonprofit organizations.

With the help of community organizers, CHF and Meyer organized community conversations in areas of DC with the starkest racial inequities. Community members were able to discuss the challenges they face in their daily lives and possible solutions. The foundations provided support to community members, including stipends, childcare assistance, and interpretation services. These supports were essential to assist community members in their engagement within their communities and with other stakeholders, including decisionmakers.

Grantmaking. CHF issued a request for proposals that required applicants to use the racial equity impact assessment tool. It required organizations to analyze the racialized histories and root causes of the policies they were seeking to disrupt. CHF hosted trainings prior to incorporating the tool in the RFP and organized information sessions that included an exercise on how to use the tool. CHF gathered feedback from the organizations that used the racial equity impact assessment tool and revised it based on the comments.

Capacity building. CHF’s capacity building program focuses on helping community members and advocacy and nonprofit organizations to learn about racial equity and its operationalization. CHF holds workshops (including ones conducted in Spanish), trainings and learning exchanges.

Philanthropic partnerships. CHF is a member of the Washington Regional Association of Grantmakers and its Racial Equity Working Group. WRAG created “Putting Racism on the Table”, a learning series for the philanthropic sector. The working group was formed to continue to learn about structural racism and identified its areas of focus, namely, a vision for a racially equitable region, community engagement, and systems and policy work.

Stakeholder partnerships. CHF is also a member of the DC Initiative on Racial Equity and Local Governments, which is composed of local and national nonprofit organizations, a local government agency, and WRAG. The DC Initiative is seeking to raise awareness about the role of local governments in advancing racial equity in partnership with community members, nonprofit organizations, foundations and businesses. Last year, the Initiative co-sponsored a workshop with the Government Alliance on Race and Equity, a national network of jurisdictions and agencies that are committed to racial equity, on the government’s role in advancing racial equity in their decision-making processes, policies, programs, regulations and budgets.

Even with the above activities, the foundation realizes it still can do more to become truly equitable. CHF envisions a world in which community voice is centered and power is shared and ceded. This vision has led the foundation to put out a call for four Board members who have experience with housing insecurity, low-wage work and underemployment or unemployment within the last five years. The most power resides within the Board of Trustees and so the CHF board is transforming so that those who have the most experience with the issues CHF funds are making the decisions. The foundation is working with consultants to prepare the Board, staff and community members for the transformation.

CHF remains committed to its ongoing learning journey to operationalize racial equity. As the foundation began its work with engaging community members directly, it had to re-examine the multi-racial spaces it creates. During the foundation’s learning days with community members, it became clear that while interpretation was provided (along with translated materials) English was still centered. With the help of interpreters, over time, a truly dual language space was created. The interpreters also became part of the planning meetings so that all content (written and spoken) and the breakout sessions could be designed with two languages in mind.

The foundation still seeks other foundations in a learning exchange to share the challenges and opportunities in advancing racial equity in the philanthropic sector.

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The Consumer Health Foundation (CHF) is a private foundation that envisions a nation in which everyone — regardless of race, ethnicity, immigration status, religion, gender identity, sexual orientation, disability, age, education, or income — lives a healthy and dignified life (CHF, 2016). The foundation advocates for racial equity and racial justice through programs and investments that advance the health and well-being of communities of color that have faced historically rooted structural barriers to health care.