Achieving Equity Through Grantmaking: The Importance of Intention and Accountability

March 1, 2022
By: John Lumpkin & Shelia Reich

We just turned the page on another Black History Month when, as a nation, we recognize the meaningful contributions and sacrifices of Black leaders, pioneers, and every day Americans in shaping our country. One of the ways we can continue to honor the considerable legacy of Black Americans is by working to create a society where being Black in America does not limit one’s ability to be healthy.

To achieve good health, a person must first have a fair and just opportunity to be as healthy as possible, also known as health equity. But for many people living in North Carolina, this opportunity has been limited.

Geography, gender, veteran status, and socio-economic status – these all create health inequities that exist in our state. When you factor in race and racism – the result of generations of public policies, institutional practices, and social norms reinforcing inequities among people of color – poor health outcomes are compounded.

“The American health care system is beset with inequalities that have a disproportionate impact on people of color and other marginalized groups. These inequalities contribute to gaps in health insurance coverage, uneven access to services, and poorer health outcomes among certain populations. African Americans bear the brunt of these health care challenges… They still experience illness and infirmity at extremely high rates and have lower life expectancy than other racial and ethnic groups while also being one of the most economically disadvantaged demographics in this country.”

The Century Foundation

Beginning in 2020, we worked to develop a greater understanding of the ways in which racism drives inequities in the areas of our work and determined the best ways to address the issues. This resulted in a formal commitment to prioritize racial equity as a critical dimension of supporting health equity. In short, racial equity is achieved when racial identity no longer predicts, in a statistical sense, how one fares in life.

While this commitment takes many forms, a core tenet will be achieving equity through our grantmaking – or to put it more bluntly, putting our money where our mouth is. As a foundation, our grantmaking is one of the most significant means by which we can impact racial equity, both in who and in what we fund - from racial equity-focused grants and initiatives to grants specifically supporting leaders of color and people of color-led organizations.

As we approached our goal of achieving equity in grantmaking it was essential that we be intentional about a high level of self-interrogation; using data to assess where we are with our funding, where we are making progress, and where we can grow and improve.

A key component of this was a Grantee Demographics Survey which was designed to help us better understand grantee and partner demographics at the board, head(s) of organization, leadership, and staff levels, as well as gather baseline data on their diversity, equity, and inclusion (DEI) work. If we were going to advance racial equity through our grantmaking, we first must know from where we were starting.

Ultimately, though, good intentions must be grounded in deliberate actions and mechanisms for transparency and accountability. Setting targets, and being accountable to those targets, is essential in reaching broader objectives.

To that end, the goals we established are as follows:

By 2024, at least 60 percent of our grant funding will prioritize racial equity.

By 2026, at least 60 percent of our grant funding will support people of color-led entities.

To achieve these goals we intend to increase both the number of grants and the dollar amount of grants in these categories. The dollar amount is equally as important as organizations receiving more grant opportunities in order for them to have more substantial means of accomplishing the goals they hope to achieve for their communities.

In addition, in establishing our racial equity goals, we are striving for equitable funding, which is substantively different than equal funding. Recognizing that people of color are disproportionately impacted by poor health outcomes, we are setting targets that reflect the need for intentional, equitable investments that address the size and scale of the issues that impact those communities.

Connected to our goals for increasing investments in people of color-led organizations, there is great value in supporting organizations and leaders who are most proximate to the issues, who reflect the lived experience, and who can lift and center community voice in addressing the social problems we are all aiming to solve. We want to do more than a set a numerical target; embedded in our goal is a commitment to help build the capacity of organizations that may not have been able to get grants in the past.

These goals will have a substantial impact on our grantmaking strategy and programmatic approach going forward. We are now tracking demographics for all applicants and monitoring data in real time. Transparency is also key, and we plan to share data so that it might help others to improve racial equity in their own practices and processes.

We understand there are risks involved with being so transparent; however, we think showing both our progress and our shortcomings is an important part of the process. We hope this will spark important conversations and encourage other philanthropic organizations to examine their approaches to supporting racial equity, how they award grants, and who receives them going forward.

It is paramount that grantees across all spectrums are represented and supported as they work to build better communities. For North Carolina to be a healthier state, all communities need to be healthier, and for those communities that have been marginalized and disinvested in, health is much harder to attain. That is why this work is so important to us.

Our belief is simple, everyone in North Carolina deserves the opportunity to be as healthy as possible. Realizing this will take many things. For us, that includes striving to achieve equity through our grantmaking and fulfilling our broader commitment to supporting racial equity.



About the Authors

John Lumpkin, MD, MPH

John is the President of the Blue Cross and Blue Shield of North Carolina Foundation. Learn more about John.








Shelia Reich

Shelia is the Director of Racial Equity and Healthy Communities for the Blue Cross and Blue Shield of North Carolina Foundation. Learn more about Shelia.