When the Episcopal Health Foundation (EHF) funded a study to determine why Black and Hispanic Texans were being infected by, hospitalized for, and dying from COVID-19 at higher rates than white residents, they found that the reasons weren’t strictly medical. Systemic conditions and disparities were driving factors: these populations are more likely to have front-line jobs, have preexisting medical conditions, and lack medical insurance. As EHF President and CEO Elena Marks said in a press release: “The human and economic costs of health disparities continue to grow during the pandemic, and we’re learning why we can’t address them through medicine alone.”

In short, context is everything. And EHF has always taken a holistic approach to improve health outcomes for Texans. Here, EHF Chief of Staff Eusebio Diaz talks with Marks about how EHF uses its grantmaking to drive equity by creating systems-level change.

Diaz: What does systems change mean to you and how do you go about doing that through the foundation’s grantmaking?

Marks: We see systems change as helping to develop and build health systems infrastructure that improves the health of communities. It also means shifting from filling gaps in the health system to addressing systemic problems that cause and perpetuate those gaps.  In some communities, health systems are high-functioning, and in others, systems don’t exist, are incomplete, or are underperforming. We see great opportunity in supporting the development of networks and ways to pay for and sustain strong health systems. One way we do this is by providing grants and other support to community clinics to help them strengthen their capacity to address community health issues, factors that extend beyond the clinic walls. We are also funding collaborative efforts that look at strengthening care and service networks to address social issues and create sustainable financial support to address these issues. Our goal is to increase investment in the social, economic, and behavioral drivers of health, not just medical care, to achieve better health outcomes.

Read the full article about systems change work in healthcare by Eusebio Diaz at PEAK Grantmaking.