Local Angle: A Community Foundation Making a Big Push for Health Equity in a Small State

When it comes to health equity, names like Robert Wood Johnson Foundation, Kresge, Kellogg and the California Endowment come quickly to mind. We have reported extensively on the big foundations working in the equity space. But many local foundations are also making their presence known. Smaller health legacy foundations, often working well off the beaten path, have emerged as key players in regional efforts to expand access to care and improve population health. Community foundations are also doing more to advance health equity, leveraging their connections to local institutions and donors.

Take Rhode Island as an example. This small state best known for its beaches and restaurants also has chronically high unemployment and lagging incomes. It also has seen a dramatic increase in immigrants, who comprise the majority of children under five in the state. Although Rhode Island also has one of the highest rates of health insurance coverage in the U.S., health equity has been a challenge.

The Rhode Island Foundation is engaged in a major push in this area, most recently with the recent award of $3.6 million in grants to six nonprofits working to reduce chronic disease and health disparities in the state.

A Deliberate Strategy

This is the latest round of grants through the Fund for a Healthy Rhode Island, established in 2008, when Blue Cross Blue Shield of Rhode Island endowed $20 million for “the provision of quality and affordable healthcare services in Rhode Island.”

The foundation undertook a locally focused process of assessment to determine how best to use these funds. With input from stakeholders and the community, it developed its priorities, emphasizing access to primary care first, “given its importance and relevance to the health of all Rhode Islanders.”

The foundation says it has made steady progress in the past decade to increase primary care access, utilization and quality. Now, it’s turning its attention to other determinants of health—looking upstream, like so many other health funders these days. “Roughly 75 percent of your health status is influenced by social, economic and environmental factors related to where you live. Living a healthy life is more likely when you are part of a community that promotes health and healthy choices,” said Neil D. Steinberg, the foundation’s president and CEO.

The six nonprofit organizations that received funding will work with community partners to reduce disease, promote health equity and address the medical and behavioral health challenges of underserved populations in more than one-third of the state’s cities and towns.

The recipients were selected based on how well they brought together clinical and community-based organizations, engaged residents, proposed measuring outcomes and leveraged other funding or in-kind support. A list of the grantees is available here. This kind of collective impact approach is increasingly common in health equity funding efforts.

Building on An Existing Initiative

Funding from the foundation will support the activities of Health Equity Zones in six communities, including West Warwick, Woonsocket, Providence, Central Falls, Newport and all seven communities in South County. Health Equity Zones (HEZs) are geographic areas where existing opportunities emerge and investments are made to address differences in health outcomes. Through a collaborative, community-led process, each Health Equity Zone conducts a needs assessment and implements a data-driven plan of action to address the unique social, economic and environmental factors that are preventing people from being as healthy as possible. The key idea here is “community-led.”

Creating Sustainability for the Long Run

The Rhode Island Department of Health (RIDOH) is leveraging various federal, state and local sources of prevention, categorical disease, and population health funding to support these place-based HEZs. However, the HEZ initiative is more than a grant. Funding from RIDOH is intended to be an initial seed investment. Communities need sustainable, flexible funding to continue addressing their diverse needs over the long term. The goal is for each HEZ to sustain additional investments that will drive transformative change in their communities. This is exactly the type of funding provided by the Rhode Island Community Foundation.

Philanthropy has always been essential to moving forward health equity initiatives, often in partnership with other sectors. While many counties or towns across the country are embarking on this critical work, Rhode Island as a small, densely populated state is in a unique position to make health equity a reality on statewide level.