Help Us Be Part of the Change.

September 20, 2020
By: John Lumpkin, MD, MPH

For North Carolina to be a healthier state, everyone needs a fair opportunity to be as healthy as possible.

Even though it has been 150 years since the Emancipation Proclamation, nearly 60 years since the end of Jim Crow and the passing of the Civil Rights Act, and more than a decade since the election of our first Black President – many would concede that the United States is still anything but united. Racism – and more specifically structural racism – has resulted in significant disparities in power, wealth, property, resources, access, and protection under and by the law – all based solely on the color of one’s skin.

Racism has also unfairly divided opportunity for good health as it is linked to higher rates of illness and chronic disease, poorer quality of care, and leads to conditions in affected communities that keep residents from being healthy and living longer lives.

Individuals and communities of color live at the mercy of a society that is biased and unjust. Achieving better health for all who live in North Carolina will be impossible if we don't first acknowledge this, and then – more importantly – do something about it.

Our Response

In June, the Blue Cross NC Foundation began a process to determine our role, as part of our mission to improve the health and well-being of everyone in North Carolina. We started by allocating $10 million in initial funding to deepen our organization’s focus on dismantling structural racism and creating more equitable opportunities for health.

This has been followed by a process to develop a greater understanding of racism and to identify potential areas for our Foundation to focus. This process is being informed most substantially by external feedback – involving grantees, peer funders, community stakeholders, and subject-matter experts – in order to interject diverse perspectives, experiences, and opinions by those directly impacted by, and working in and around, these issues.

The anchor of this effort has been a series of six focus groups facilitated by Rural Forward, drawing perspectives from our current grantees already working to elevate racial equity as a priority in their communities.

What We Are Hearing

Consistent themes and insights about potential areas of focus for us to consider have emerged from these conversations, including:

On who and what we fund:

  • Center community voice – specifically those who experience the greatest inequities – more directly in power and decision-making structures and processes, including at the local level
  • Intentional focus on public safety and justice reform including policing and school suspensions which disproportionately impact Black people affecting their safety, educational opportunities, and their health
  • Advocacy efforts aimed at accountability of community, city, county, and state institutions, systems, policymakers, and officials, to ensure that communities can access services and supports important to living as healthy as possible
  • Capacity-building and training on diversity, equity, and inclusion (DEI)
  • Support for community-based solutions and strategies that are defined and led by people most proximate to the problem
  • Wealth-building strategies that promote economic mobility
  • A place-based approach to demonstrate the impact of mitigating historic patterns of disinvestment on the health and well-being of communities

On approaches we use to achieve our goals:

  • Utilize our platform to name and dismantle the local and state policies and practices, implemented over centuries, that have created and reinforced inequities we see today
  • Support local and state policy and advocacy agendas that are developed and determined within communities and by those most impacted
  • Advance initiatives and opportunities that cultivate community leadership as a strategy for transformative change
  • Support communities to address interconnected issues, rather than a single problem

On our operational practices:

  • Implement approaches that shift money or decision-making power towards impacted communities
  • Invest in more Black, American Indian, and People of Color led organizations
  • Approve more multi-year grants to organizations that are explicit about addressing racism and racial inequities
  • Employ a mission-focused lens in our investment strategies so that dollars held for future grantmaking are contributing to our goal of a healthier and more equitable North Carolina

Our Ask of You

The need to address structural racism and its impact on health is paramount. However, we fully realize that our resources are limited, which requires focus in our efforts. As such, we are seeking additional input as we look to define where we can most effectively invest our resources to have the greatest impact.

Taking into account what we have outlined above:

  • Where should we prioritize or concentrate our efforts?
  • What’s missing? What is not being considered that should?
  • What else may help us in this important work?

If you have thoughts on any of these questions or would like to provide any additional input, we welcome you to do so utilizing the form below.  We are requesting responses by Wednesday, September 30, 2020.  

What's Next

This external phase is complementing conversations with our board, an ongoing internal equity learning and discovery process, review of our current grant portfolio, and exploration of the policies, cultural representations, and social norms that impact our work.

All told, we anticipate this could result in the creation of a new focus area, while also making equity and social justice more explicit in our existing strategies. We expect to launch aspects of this new work in early 2021 and we will continue to provide updates along the way.



As noted above, responses to our request for comment were collected through September 30th. Thank you. 



About the Author

John Lumpkin is President of the Blue Cross and Blue Shield of North Carolina Foundation and Vice President, Drivers of Health Strategy at Blue Cross and Blue Shield of North Carolina. More about John.