October 5, 2022

DC Health Equity Fund targets racial disparities in health care

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A new fund in the District plans to dispense $95 million in grants, starting next month, to address health disparities.

But the Health Equity Fund, managed by the Greater Washington Community Foundation, is not primarily targeting clinical care. Instead, it will fund community-based nonprofits to tackle systemic factors such as income and access to housing — which research has shown drives 80 percent of population health outcomes.

“If we can change the prospects for how our Black and Brown neighbors generate and share wealth, we will ultimately improve the quality of life for everyone who works and raises a family in the city,” said Tonia Wellons, president and CEO of the foundation.

The Health Equity Fund was created last year, after the insurer CareFirst agreed to pay the $95 million to end a 13-year legal battle with the city. The initial round of grants will focus on funding 40 community-based programs that are working to improve people’s economic stability, including through access to food and safe-neighborhood initiatives. The last day for organizations to apply is July 24.

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The remaining $85 million will be distributed in the following three years toward health policy advocacy, partnerships with hospitals and health systems, and behavioral-health and trauma-informed systems of care. Areas of the city with high needs and concentrated poverty, such as Wards 7 and 8, will be prioritized, Wellons said.

People’s most determinant experiences occur outside the health-care system, and interventions that focus only on health behavior cannot fully address health inequities, said Derek Griffith, co-director of the Racial Justice Institute and professor of health systems administration at Georgetown University.

“Whether somebody has equal opportunities as others to get a good education, get a good job, get fair employment opportunities, fair engagement with police and criminal justice, all of those things very much shaped the opportunities they have to be healthy,” Griffith said.

There is a causal relationship between poverty and poor health outcomes, Wellons said. Higher incomes, meanwhile, are linked to better health, and a 2018 D.C. Department of Health report found that the greater the gap that existed between the richest and poorest residents of an area, the greater the differences were in health outcomes.

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In the District, an estimated of 14.4 percent of residents lived at or below $15,000 per year, higher than the national average of 12 percent, in 2015 inflation-adjusted dollars, the same 2018 study found. In 2019, the median D.C. household income for White residents was $149,734, more than three times higher than the $49,652 median income of Black residents, according to the D.C. Council Office of Racial Equity.

And more than two years into the pandemic, its economic stressors have only exacerbated people’s ability to stay healthy, maintain employment and have enough resources for their families, Griffith said. The fund, Wellons said, is not only an economic investment but also an opportunity to create partnerships with organizations that can inform the city about policy barriers that affect health.

The Health Equity Committee — a seven-member group appointed by Mayor Muriel E. Bowser (D) — and the Greater Washington Community Foundation will review and approve proposals and oversee how the funds are invested.

Nonprofit organizations with operating budgets of $750,000 or less are eligible for grants ranging from $50,000 to $100,000 per year. Those above $750,000 are eligible for grants ranging from $150,000 to $200,000 annually.

“We know that our communities of color have been disinvested in for many, many years, for many generations, so part of our ambition is to target these resources toward the communities that need them, require them and deserve them the most,” she said.



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