Isabel Wilkerson, Pulitzer Prize winning author of Caste: The Origins of Our Discontents, shared this message in kicking off this year’s Association for Community Health Improvement’s (ACHI) conference on May 16, 2023.

The American Hospital Association (AHA) runs the conference to share best practices in community health improvement. The AHA Community Health Improvement Network, an affiliate of the AHA, is the premier national association for community health, community benefit, and population health professionals.

The urgent messages that Wilkerson raised—that racism and disempowerment of people of color persist in our health care system, that our inaction leads to increased and unequal sickness and death, and that we need shared accountability for these outcomes across our hospitals and community leaders—carried through the three days of this health equity-focused conference.

But what struck me most was that the solutions presented in conference sessions—while innovative, impactful, and often community-led—often did not match the scale of these challenges. Our workforce diversification programs, community engagement approaches, hospital diversity equity initiatives, and other solutions—while valuable—are often small, underfunded, short-term, and focused on only the publicly insured patient population.

But what also strikes me is that the nation’s growing number of health conversion foundations—now topping 300 nationwide with assets approaching $40 billion—are uniquely suited to advancing the health of their local communities with large, place-based, scalable impact.

Here are five questions I would offer to guide our collective thinking:

  1. Are our community partnerships to scale?
  2. Are we transforming our clinical workforce pipeline? Or just tweaking it?
  3. What is the promise of health data sharing?
  4. What would it take to address the social determinants of MENTAL health?
  5. How do we go beyond an antiracist system and decolonize health?

Read the full article about health systems by Alex Caldwell at FSG.