The Road to Health Equity and Justice is Hard, Worth It, and Best Traversed Together

Even with the best intentions, we have sometimes acted in ways that deepened the very inequities that we seek to undo. Thanks to a new partnership with bold truthtellers and advocates, we are listening, learning, and embracing new ways to do better.

In 2020, we saw organizations and companies publicly grapple with and acknowledge the barriers to living well and living safely for people of color and other historically marginalized groups in our nation. Today, we are witnessing a dangerous swing to a place where the mere mention of diversity or equity can provoke controversy, resistance, and blatant attacks, especially from the highest levels of leadership in this country.

We Are Not Backing Down

Earlier this year, we reaffirmed our commitment to dismantling the biggest barrier to health in America: structural racism. In support of this mission, we’ve been working across the Foundation to transform our work from the inside out to prioritize equity, diversity, and inclusion—including looking inward to learn from our own missteps as an organization and be more accountable to communities, especially those furthest from health. This is our commitment to Truth, Repair and Transformation, and it is critical to fulfilling our mission.

As a health philanthropy, we are part of a broader ecosystem that has both harmed and helped communities. Despite our best intentions and a lot of good work over the past five decades, we have sometimes worked in ways that neglected, excluded, and/or harmed communities most impacted by the health inequities we are committed to undoing. That’s why we’re looking at how we can be more responsive to the most impacted communities and the organizations that serve them, help manage the increasing risks they face on the frontlines of health equity and justice work, more deeply support the influence of these organizations on decision-making that impacts the health of their communities, and over time rebalance resources toward organizations and infrastructure that have been vastly under-resourced, including by RWJF.

It can be uncomfortable and difficult to reckon with our past actions while steering a 50+ year old institution toward new ways of thinking and working. But our past is very much alive in our present, and learning from it is the most effective way to become the strongest partners to organizations paving the way to health equity and justice, especially as they navigate an uncertain and often hostile political and social landscape.

Our Next Step

One important next step in our process is the launch of the Truth, Repair and Transformation Wisdom Council. The 13 members who make up this advisory group are bold truthtellers and advocates who will provide RWJF with expert guidance on institutional truth and repair, and hold us accountable to communities most impacted by health inequities. They possess a critical historical understanding of healthcare, public health, community organizing, and philanthropy, deep experience in equity-driven work, and a shared commitment to communities most affected by structural racism and other barriers to health.

“Philanthropy’s history of wealth generation presents a unique opportunity and responsibility. Intentional or not, all the stats we quote about disparities in our communities happened because of a series of conscious decisions made by very real people,” said Katherine Ponce, Senior Research Manager for Special Projects, National Committee for Responsive Philanthropy and a member of our Wisdom Council. “We cannot talk about wealth in this country without talking about racial injustice. I think if foundation histories were more widely known, it would add context to the power dynamics within the sector and allow for meaningful and radical progress.”

The Wisdom Council will help ensure that truth leads to action—with recommendations to put what we learn into practice and redress harms in a way that is responsive to the needs and input of those who were most affected.

Holding Ourselves Accountable

This work of truth and repair is messy and not linear, but we’re committed to being transparent about what we’re doing and the feedback we’re getting along the way. This serves two purposes: for others to learn alongside us, and to hold ourselves accountable to the voices of our grantees and partners to ensure our transformation is not just about intent, but measurable progress.

We invite you to learn about where we’ve grown and hold us accountable to our commitments in the months and years ahead. Here are some highlights from this work so far:

• Truth, Repair and Transformation (TRT): We continued the process of understanding our history, legacy, impact, and culture as an organization. As our colleague Beth Toner who serves on the Memory and Narrative workgroup for this effort shared, “We are uncovering the stories that haven't been told [about challenges and missteps] that may present us in a less than positive, but also a more complete and authentic light.” For example, some of our grantmaking took a top-down, closed-door approach and focused on individual behavior rather than structural inequities. Internally, we saw evidence of our staff with the least privilege and power taking on the burden of risk and the most labor for making our work more equitable. We look forward to working with the Wisdom Council on analyzing these findings so we can repair and transform how we work.
• Community Partnerships: Last year, we convened an Equity and Social Justice Relationship (ESJR) cohort of 13 organizations working in support of communities impacted by health inequities. We created the cohort to listen to, prioritize, and deepen our accountability to racial and health equity leaders. We recently hosted the second annual ESJR convening to learn more from their work and what’s needed from philanthropy in this moment. We will continue to create spaces for shared learning and solidarity. Read more about what we’re hearing from our ESJR partners on what is needed from philanthropy.
• Equitable Principles and Practices: We will continue to partner with teams across RWJF to fully embody our mission around health equity in our work. For example, in collaboration with our facilities and event services team and Human Resources, we developed protocols to help ensure RWJF-hosted meetings are inclusive and accessible.

We have also started to collect and track data on our own organizational performance on equity, including how deeply our grantmaking addresses health equity and health justice in a transformative way. We aim to see more of our grantmaking moving toward a health justice approach into the future, supporting the infrastructure for people most affected by health inequities to build the power to create and sustain the conditions for health. We’re also working to demonstrate a shift in our trust in and level of flexibility provided to our grantees.

We’ve never been more certain of how important this work is than in this moment, and our commitment to justice and equity has never been stronger. With democracy and civil rights under accelerated attack, it is critical to take the necessary steps to be the best possible partners to racial justice and health equity leaders who are putting themselves on the line to create a more equitable future.  

To our partners—thank you for your vision, fortitude, and leadership in our shared mission and for your partnership, which has pushed us to be a better, bolder philanthropy. Your courage inspires us every day. We invite you to hold us accountable to our commitments to truth, repair and transformation during this process and to join us in making similar commitments at a time where efforts to tell the truth and to repair historical injustices are being challenged or dismantled. Doing so is worth it, as it will bring us closer to a future where health is no longer a privilege, but a right, for everyone.

About the Authors

Fiona Kanagasingam, vice president, Equity and Culture, is co-chair of the RWJF Truth, Repair and Transformation Taskforce.