Big vision requires big bets

Written by: Anthony Iton

Date: February 03, 2017

Recent national events have raised fundamental questions about who we are as Americans. The answers to these questions may threaten the health, safety and well-being of many of our neighbors, friends and colleagues, and ultimately each and every one of us. For foundations, how we respond in this moment will say everything about who we are as organizations.

The California Endowment (TCE) is just over halfway into our 10-year, $1-billion Building Healthy Communities initiative, a holistic attempt to improve health status by harnessing the latent power and potential of residents to rebuild California’s social compact and reweave the fraying fabric of low-income communities.

The initiative aims for community transformation through building power (social, political and economic), implementing proven health protective policy, and changing the narrative about what produces health (beyond health insurance and individual behavior). The efforts and outcomes to date offer insight into how to continue the march toward health and justice for all, even in this moment.

Over the past seven years, California has seen unprecedented expansion of opportunities for boys and men of color, the undocumented, formerly incarcerated and other highly stigmatized populations. We have seen millions enroll in health insurance – including undocumented children – school discipline radically transformed, school funding become more equitable, people with low-level felonies get a second chance through reclassification, over 100 local health-protective policy changes in some of our most under resourced communities and so many other health-protective policies in areas like climate change and immigrant rights.

However, many of these wins are highly dependent on an enabling federal environment. We are now readying ourselves and our partners to help protect and defend these gains – not by shifting course, but by doubling down on what works.

Moments like these are fraught with opportunity. That’s why we created our “Fight4All Initiative.” TCE has laid out four interlocking strategies that will guide investments over the course of the initiative’s three-year duration.

1. Defend federal-level gains

Protecting access to health care is foundational. However, assaults on health care are part of a larger federal level effort to erode our already threadbare American Social Compact. Access to supplemental nutrition programs, children’s health insurance and other programs designed to offer a foothold to struggling American households under assault.

Additionally, there are wins in other policy domains that support health that will need defending: wage and overtime laws, immigration and criminal justice reforms, subsidized housing programs, local control in education.

These gains help confer a measure of dignity to some of the most marginalized populations across the country. And human dignity should not be negotiable.

Foundations must move quickly to support organizations that are standing squarely with historically marginalized populations. For health care foundations, this means reaching beyond investments in health care access defense efforts. We must also support efforts that span issues and contribute to building a coalition strong enough to advocate on the multiple and converging fronts undermining the health and safety of most U.S. residents.

2. Protect vulnerable populations 

The rhetoric of the presidential campaign stoked racial anxiety and posed direct threats to the well-being of certain populations. California is home to large concentrations of many of these targeted populations. To guard against harm, communities are putting in place rapid response strategies and networks. These efforts not only save lives, they are a tremendous organizing opportunity.

Our commitment is to direct funds to these efforts, and when possible, directly to organizations led by the people most vulnerable to attack. And as is the case at any time, but heightened at this time, we must not pit populations against each other or deem some sub-groups, such as those with criminal convictions, as undeserving of protection. We cannot fight bigotry while employing its underlying logic.

3. Strengthen state-based strategic advocacy

Neither California nor any other state can go it alone. Each state needs a civic engagement strategy that articulates to a national strategy. These strategies require building a shared sense of solidarity across many different populations that are feeling dispossessed of the American Dream, including low income whites.

We will deepen our statewide efforts to strengthen and network rural and urban populations with the goal of building stronger and broader coalitions across the state.

4. Grow the movement:

People across the country are coalescing around common vision and clarity of purpose. The common thread weaving so many different voices together is not simply identity or issued based. It is much deeper and more formidable; it is values-based. Intersectionality. Equity. Health. Safety. Inclusion. These are the rallying cries joining together transgender people fighting for basic access to restrooms with mothers fighting for health care with Black activists fighting for an end to mass incarceration with Native Americans fighting for the planet and their fundamental rights.

This moment in time is a once-in-a-generation opportunity to build an even more powerful movement for change across cities, regions, states and the nation. The requires deep and long-term support for community organizing across many issue areas and geographies so that the roots of the movement are strong; so that key leaders and organizations have the resources and space they need to weave together their priorities and power in more meaningful ways. It also means building out a new narrative about what progress, fairness, safety and health look like in America. We must support efforts to build a values-driven, inclusive narrative that can serve as an umbrella for the many agendas coming together in this movement.

In closing, I offer a story from my experience, alongside my youngest daughter and wife, at Oakland’s Women’s March. We rushed to arrive on time, with our newly minted posters, only to stand motionless for what seemed like hours. Just as I was starting to get frustrated, I learned that there were so many people in front of us, there was not yet space for our steps. I was part of a line so long and so strong it spanned from the march’s starting to end point and then some. In this moment, I became filled with hope for the future of health and justice.

When we stand together, we are the most powerful force the country has ever seen. Our collective vision of a new, inclusive social compact for the 21st Century, one that reflects our highest values as a nation, may actually be in reach.

Anthony Iton, M.D., J.D., MPH, is senior vice president of healthy communities at The California Endowment.

Photo provided by The California Endowment. 

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