This week, our Board of Directors at The California Endowment is announcing our vision and strategy for the next decade of our work as California’s largest health foundation.

This is the final year of our 10-year campaign called Building Healthy Communities, or “BHC” for short. We are very enthused about what our community partners, grantees, and advocates achieved in this 2010-2020 timeframe, including key statewide policy changes in health coverage expansions, changes to school discipline and suspension policies, and juvenile justice reform. At the local and regional level, moreover, we catalogued more than 1,000 policy or system change wins in support of healthier communities between our 14 BHC sites. We could not be more pleased with what our grantees and funding partners have achieved over this time.

So, it will not surprise you to learn that we are building the next decade of work on the shoulders and lessons of BHC. You won’t see any sharp right or left turns from us as a foundation. What you can expect from us will be foundational and similar to the previous decade of work:

• We remain wholly dedicated and committed to confronting the social determinants of health – the roles that race, power, privilege, place, poverty, economic exclusion, and public education all play in shaping health and wellness. The savage inequities unmasked by the COVID-19 pandemic have served as the grimmest possible reminder that health inequality in our nation is profoundly systemic and structural in orientation.
• The “theory of change” that forms the basis for our work and investments in grantee-partners is about people power and voice. BHC has taught us a powerful but simple lesson in addressing the complex matter of the social determinants of health. We call this lesson “A + B = C” – where “A” stands for individual and collective Agency, “B” stands for Belonging and the spirit and ethos of full inclusion, and these together lead to “C,” which is structural and systemic Change.
• Place matters, and we remain conscious of the roles that place and geography play. “Place” represents the social and political construct where health inequality and inequity reveal themselves; at the same time, however, “place” is where leaders and ideas for meaningful change are incubated among those most directly affected by structural inequality. It remains our view that philanthropy must be proximate to the pain and injustice of structural inequality and that those who are closest to this pain and injustice harbor the best ideas and solutions to promote progress.

In the coming decade, this is what you can expect from us that will be different or done with greater emphasis:

• An even greater level of focus and intentionality on California’s “power building ecosystem” to drive transformational change. USC Professor Jennifer Ito’s groundbreaking research in mapping California’s ecosystem of organizers and activists tells us that there is a powerful force of change agents – many of them operating at the grassroots level – who are working diligently to address structural inequality, health injustice, and racial injustice in California. We will begin to turn our attention to the leadership and alliance-building infrastructure needs of these leaders and their organizations.
• While “place” as defined above remains important, we are shifting from the geographically targeted focus of the 14 BHC sites to a more regional emphasis. There are important reasons underlying this (subtle) shift, but the bottom line is that structural and systemic change to advance wellness and health requires regional strategies and policy changes that are tied to place. The four regions we will focus on most intently are LA/Southern California, the Inland Empire, the Central Valley, and the Bay Area. But we will also be more intentional about “power building” grantmaking in both Native American and frontier rural communities.
• We will heed the advice and exhortations of our grantee-partners and offer a greater proportion of multi-year general operating support grants. This decision is about showing trust in our grantees and partners.
• Finally, we must address the matter of race, racial injustice, and structural racism in America. Structural racism generally, and anti-Black racism, must be bravely and courageously confronted in order to achieve the vision of health for all. We learned this through our partners in BHC, but the events of 2020 have affirmed this lesson in triplicate. Our Board is committed to applying a racial equity and racial justice lens to our work in the decade ahead.

Our “Beyond 2020” strategy focuses on the achievement of three bold ideas for California: a robust “power building” infrastructure; health-promoting systems transformation in justice, school, and community development; and a transformed system of health for all across our state. We aspire to achieve the vision of a Beloved Community for our great state, which would be a community with full belonging and inclusion. And we must endeavor to be an even better partner – which to me means being a bolder partner, but also a more humble one at the same time. Our investment strategy for the coming decade is built on the inspiring evidence of the ability of people power to achieve social and health justice. We need no more evidence than that.