Centering Power: The Leading Edge in Health Equity Philanthropy

By Lili Farhang, for the National Committee for Responsive Philanthropy

Milky Way Edge from the GigaGalaxy Zoom project, edited by Stuart Rankin.

“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.” — Aboriginal activists group / Lilla Watson, Queensland, 1970s

Funders that care about health equity have come a long way in the last 20 years. They increasingly emphasize social determinants of health, think intentionally about how to work with communities, and want to make sure those relationships are more authentic and driven by community priorities.

  • In our capacity- and field-building, we’re developing a stronger social justice identity and practice within public health, and building bridges to connect the public health sector to community organizing.
  • In diverse settings we unapologetically advance our perspective, including in government and other institutions that have been complicit in creating inequities.

1. Develop a theory of change that includes how power and oppression constrain—or support — policy, systems and environmental change.

To eliminate health inequities at the root, funders should develop an analysis and understanding of how power is at play — currently and historically — in the issues they care about. Consider housing: Access to affordable, safe housing is unquestionably a determinant of health. But why is housing so unaffordable and of such poor quality in certain neighborhoods?

2. Learn from, ally with and support those who believe in power-building to make headway on the issues you care about (read: work with community organizers).

Mindset shift is essential. Health funders need to see themselves as part of a larger social justice fabric where their health identity aligns explicitly with social movements. This means learning from and supporting foundations and organizations that focus on building power and see themselves as part of the same ecosystem. Health funders could directly support power-building by funding grassroots movements and organizations, to advance solutions to the problems communities identify.

3. Uphold a narrative within health philanthropy that’s about building power to advance health equity, which acknowledges entrenched systems of oppression.

Developing an analysis is not enough. Narrative change within health is daunting but needed. Narratives are values-based stories about how and why the world works as it does, which frame our responses to the problems we see.

4. Create a framework for measuring outcomes and progress. Fund the development of appropriate metrics for organizing and advocacy that advances health equity.

I’m incredibly proud of our progress, but I can’t necessarily tell you how we’ve changed health outcomes yet. I’d love to have health funders’ energy and support in defining success, which includes process metrics about developing transformative relationships, changing the conversation, developing leaders and innovating around strategy.

Bringing the power of public health to campaigns and movements for a just society

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