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Dr. Laura Gerald and Rhett Mabry: We need more than COVID charity; it’s time for systems change

Dr. Laura Gerald and Rhett Mabry: We need more than COVID charity; it’s time for systems change

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Too many North Carolinians are struggling to survive as COVID-19 wreaks havoc on their health, financial stability, schools and communities. As the pandemic rages on, we also see thousands of residents protesting George Floyd’s murder and the injustices and racism that have permeated all aspects of our society for far too long. Charity is not enough to make a long-term difference.

We must begin laying the groundwork for what comes after this profound time. We have the opportunity to reinvent what we want our state to look like and reform the systems that have failed many of our most vulnerable residents — communities of color, rural residents, elders, children and families with low incomes.

Like many foundations in our state and around the country, The Duke Endowment and the Kate B. Reynolds Charitable Trust moved quickly in the early months of the health crisis to release millions of dollars to respond to urgent challenges, including food scarcity, housing insecurity and inadequate health care supplies.

No matter how hard we work, COVID-19 and the nationwide protests spotlight and amplify inequities that existed long before today.

According to the Centers for Disease Control and Prevention, people of color are disproportionately impacted by this virus. They’re more likely to be hospitalized or die from the disease. Latinos are almost three times as likely to be uninsured; African Americans are twice as likely to lack insurance.

We also know many residents with lower incomes are our essential workers — risking their lives so others can ride the bus, buy groceries or visit the doctor. A lack of access to affordable housing, reliable transportation and personal protective equipment puts vulnerable residents in jeopardy.

As philanthropic leaders, we are calling on other foundations, government and business leaders to think about how we, collectively, can change the path forward.

The public and private sectors came together to respond to urgent needs in North Carolina by investing millions when the COVID-19 crisis hit. If we continue to work together, we can make systemic changes that will help our state thrive well beyond this moment.

What might this shift look like?

All North Carolinians will have access to quality, affordable health insurance and care — during this health crisis and for the long-term. Residents in rural communities will visit health care clinics that offer high quality primary care and seamless connections, via telehealth, to regional medical centers. Children will have access to and thrive in quality early childhood programs, where teachers are supported and appropriately compensated. Law enforcement policies that negatively impact communities of color will change.

How can we collectively make this happen? We — government, nonprofits, foundations and businesses — will each do our part to ensure coordinated access to health care and mental health services. We will address the factors outside of medicine that impact health by investing in affordable housing, transportation, economic supports and access to healthy food. We will increase access to technology and high-speed internet so students and families can stay connected in a time when virtual learning is imperative. We will invest in innovation centers as our state transitions to value-based care to ensure that this new model of health care, one that encourages providers to treat the whole person, produces equitable health outcomes for all. And we will strengthen our state’s public health system so that local communities are better prepared to address the next health crisis head on. These are a few ideas, and working together with our communities, we’ll develop more.

If we don’t seize this moment, we will revisit these same issues — entrenched poverty, racial bias, high uninsured rates, children left behind in school, a shaky public health system — over and over again.

While we can’t join hands and keep our physical distance, we can still be united for change. Philanthropy and business can test and incubate innovative ideas and approaches, and our local, state and federal governments can bring those successful ideas and innovations to scale.

Will this take a significant investment of time and resources to include all voices in the solutions? Absolutely. But experience shows us we can tackle difficult problems together, and the moment is now. COVID-19 and residents marching in the streets have taught us the stakes of inaction and disinvestment are equally high.

By investing in bold ways to help our most vulnerable communities, North Carolina has an opportunity to build a future where we are stronger than we were before, with an equitable system that supports all residents.

Gerald is president of the Kate B. Reynolds Charitable Trust. Mabry is president of The Duke Endowment.


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