Health Forward reimagines the future

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Editor’s note: The following is Qiana Thomason’s full keynote address of Health Forward’s virtual, 15-year anniversary celebration. You may also watch her address.

Good morning! Welcome to Health Forward Foundation’s 15th anniversary virtual celebration. We are so pleased you’re sharing your morning with us as we reflect on our past and set our priorities for our future. 

I must begin with a heartfelt thank you to our board chair, Marshaun Butler, for her engaged and thoughtful leadership, and the entire Health Forward Foundation family — our current and past board of directors, Community Advisory Committee, our phenomenal associates who I’m fortunate to lead, and my predecessors Steve Roling and Dr. Bridget McCandless. I also want to thank our partners for working hand-in-hand with us in the fulfillment of our mission. Collectively, you are each invaluable contributors to the richness of Health Forward’s 15-year journey.

It’s hard to believe I’ve already been Health Forward’s president and CEO for eight great – and unpredictable – months. In this time, we have supported our partners’ response to the COVID-19 pandemic by allocating $3.7 million in emergency funding. We led advocacy efforts in partnership with over 75 organizations in Missouri and Kansas to expand collection of COVID-19 data by race, ethnicity, and ZIP code. And, on August 4, Health Forward, the Yes on Two campaign, and over 300 statewide partners successfully drove Missouri Medicaid expansion across the finish line and secured health coverage for more than 230,000 Missourians. 

These shared successes invigorate me and place the wind at our backs as we prepare for what’s next. 

With our focus aimed forward, I know it’s equally important to reflect on where we’ve been. For me, my journey to Health Forward began over 40 years ago. Born at Truman Medical Center and a young patient of then Swope Parkway Health Center, two current Health Forward partners, I stand before you in gratitude as a beneficiary of philanthropic and public investment in human capital. 

Little did I know that such investments, followed by a game-changing opportunity, would carry my mother — an uninsured, struggling – but buoyant – single mother of three — from public assistance lines to the CEO of INROADS Kansas City. In this role, she equipped and positioned a generation of youth of color for corporate and community leadership. 

Those opportunities would also usher me, a little brown girl from 26th and Woodland, from standing in those same public assistance lines alongside my mother to the steward of philanthropic assets, which lift others from whence I’ve come. 

We believe in the possibilities of a greater democracy where all have equal access to power, money, and resources. This fundamental belief undergirds my vision: Health Forward Foundation as a national model for health equity through economic inclusion. 

Anchored by proximity to the communities we serve and having confidence that the collection of my personal and professional experience has led me to this opportunity, I approach this work with immense humility, judicious care, and a resolve for impact. 

In view of our current reality, nothing less than meaningful and measurable positive impact is acceptable:

  • The uninsured in Missouri and Kansas remain uniquely susceptible to the spread of COVID-19 due to income inequality and longstanding underinvestment in public health.
  • Missouri ranks 51st and Kansas ranks 46th in per capita public health spending. And our bi-state region shares a ranking of 38th for income disparity for our uninsured.
  • The health injustices we’ve experienced in COVID-19 mortality among black and brown communities is not new. Health injustices in infant and maternal mortality, higher chronic condition prevalence, and shorter life expectancy have plagued communities of color for centuries. 
  • And in Kansas City, a mere 10 miles significantly influences a 15-year shorter life expectancy, the ultimate health outcome, for those most in need. 

Why is that?

An abundance of evidence affirms that our socioeconomic conditions, like access to healthy and whole foods, safe and affordable housing, quality education, a livable wage, community violence, and the reverberating impact of structural racism are causal to health outcomes.

These root-cause factors are known as the social and political determinants of health. I prefer to say influencers of health because, like my mother, people are resilient. 

When met with asset-building opportunities, the people in our communities — and the communities themselves — experience improved economic well-being and improved health. 

Health Forward’s mission is to provide leadership, advocacy, and resources that eliminate barriers and promote quality health for the uninsured and the underserved in our service area. 

We cannot achieve health care quality or eliminate barriers to health without health equity. And we cannot attain health equity without centering race equity: the condition in which one’s racial identity has absolutely no influence on their ability to thrive.

At this critical moment where the interconnectivity of health, race, and economic inequality are clearer than ever before, Health Forward is reimagining our strategic positioning to accomplish our mission. 

In doing so, we will not allow current and historical social ills to limit our imagination of what’s attainable. We believe in the possibilities of a greater democracy where all have equal access to power, money, and resources. This fundamental belief undergirds my vision: Health Forward Foundation as a national model for health equity through economic inclusion.

Why economic inclusion? I ask why not. We know the shared experience of our target population is poverty. And we know the underpinnings of poverty are income, wealth inequality, and structural racism. 

This understanding compels us to move upstream to address economic inclusion and race equity as mission-critical imperatives. We cannot achieve health care quality or eliminate barriers to health without health equity. And we cannot attain health equity without centering race equity: the condition in which one’s racial identity has absolutely no influence on their ability to thrive. 

Health Forward’s commitment to diversity, equity, and inclusion isn’t just external, it comes from within. We are undergoing a comprehensive equity assessment involving every facet of Health Forward.

As Marshaun noted, prior to the glaring and painful racial injustices of 2020, our board of directors deepened its commitment to diversity, equity, and inclusion by sanctioning the creation of an ad hoc equity committee.

This commitment is particularly noteworthy considering the board’s demonstrated commitment to inclusion. Since inception, half of Health Forward’s board chairs have been people of color. Our current board is composed of 53 percent people of color.

Health Forward’s commitment isn’t just external, it comes from within. We’ve created a culture and inclusion officer position, a new role which will help center equity in our policies, practices, people, and systems in collaboration with our associates and leadership team. We’ve also partnered with the Race Equity Institute to help establish a common understanding among board and staff of the social construct of race and the insidious impact of structural racism. And finally, we are undergoing a comprehensive equity assessment involving every facet of Health Forward.

Through recent examination of our 2019 grantmaking, we found that, of the $20 million awarded, about 18 percent or $3.6 million went to organizations led by and,  in most cases, serving people of color. 

We will examine the ways our norms pose barriers to philanthropic effectiveness. We will look to architect unconventional on ramps for accessing and sustaining funding for organizations focused on people of color.

Why is this relevant? Not only is it important for philanthropy to honor the role that people of color have played in wealth creation in our country, we must also leverage their lived experience and fund their expertise in addressing the conditions that improve health in our communities. They are trusted messengers and best positioned as partners in addressing health injustices.

This commitment to inclusion requires deep introspection within Health Forward on what adjustments are necessary to achieve philanthropic justice. Earlier this month, we convened an intimate and transparent conversation with organizations led by and serving people of color. We needed to understand their strengths and challenges in accessing and growing philanthropic funding. 

This valuable conversation affirmed our belief that we’ve got good bones when it comes to race equity. But they also challenged us with uncomfortable truths. 

They shared that many organizations led by and serving people of color struggle to compete in the arduous application and reporting processes often required by funders. They also spoke of underlying and sometimes unconscious mistrust toward leaders of color and less access to informal, intimate, and trust-based philanthropic networks. These ills pose deep and complex challenges for leaders of color who receive a mere 4 percent of all philanthropic dollars. 

Having heard these powerful truths, we now need to do the work. We will examine the ways our norms pose barriers to philanthropic effectiveness. We will look to architect unconventional on ramps for accessing and sustaining funding for organizations focused on people of color. And we will continue to build authentic and trusting relationships with leaders of all races to build power and assets in black and brown communities. 

We have such a journey ahead in this regard, and we are committed to keeping you abreast of our progress. 

Join us in centering race equity in your sphere of influence. Join us in developing equitable asset-building opportunities with and in communities that improve health and economic well-being.

In looking ahead, we will spend most of 2021 on an internal process of purpose alignment, which is what I call strategic planning. Through this process, we will explore various paths at the nexus of health, economic well-being, and race equity. 

It is clear that we have philanthropic adjustments to make. We expect our grantmaking to evolve, our partnerships to diversify, and our advocacy footprint to broaden. The drivers of health equity and economic inclusion are best addressed via policy and collective impact using metro financing. In other other words: pooling local public, private, and philanthropic funding to improve health.

It will take an incredible amount of innovation, collaboration, and bold action to affect change in this way. And while philanthropy is uniquely positioned to lead, we cannot do this alone. We need your partnership around our shared values and strategies. 

So join us. Join us in centering race equity in your sphere of influence. Join us in developing equitable asset-building opportunities with and in communities that improve health and economic well-being. 

Simply put, asset-building opportunities create and sustain access to power, money, and resources for individuals, families, and communities. It will take time and a continued commitment but together we can move health forward.