We need more than COVID charity; it’s time for systems change

Too many people in our home state of North Carolina 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 uncertain moment. 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 public health crisis and released millions of dollars to address urgent needs in the state, including food scarcity, housing insecurity, and inadequate healthcare supplies.

No matter how quickly we move, however, COVID-19 and the nationwide protests spotlight have amplified 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 have learned that many residents with lower incomes are essential — risking their lives so that 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 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 such a shift look like?

In North Carolina, all residents would have access to quality, affordable health insurance and care — during this health crisis and over the long-term. Residents in rural communities would be able to visit healthcare clinics that offer high-quality primary care and seamless connections, via telehealth, to regional medical centers. Children would 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 would change.

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

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

While we can’t literally join hands as we are social distancing, we can unite for change. Philanthropy and business can incubate and pilot 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 and a commitment to include all voices in the solutions? Absolutely. But experience shows that we can tackle difficult problems together. The moment to do so is now. COVID-19 and residents marching in the streets have taught us that the stakes of inaction and disinvestment are high.

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

Dr. Laura Gerald is president of the Kate B. Reynolds Charitable Trust in Winston-Salem, North Carolina, and Rhett Mabry is president of the Charlotte-based Duke Endowment.