Advancing Health Equity Today Requires Accountability

One year ago, I stepped into my role as President and CEO of the Northern Virginia Health Foundation (NVHF) with a clear goal: to advance the Foundation’s mission of improving the health of residents of Northern Virginia, particularly those who have low incomes and are uninsured or underinsured. In this time, I have met extraordinary people – community leaders, health care providers and advocates – who are working every day to make that mission a reality. I have witnessed their dedication, their resilience, and the relentless challenges they face as they strive to provide care and support to those who need it most.

Over the years, we have seen moments when health equity has taken center stage in national conversations—perhaps most notably in the summer of 2020, when the COVID-19 pandemic and the killing of George Floyd forced America to confront long-standing racial disparities, including those in health. That moment inspired statements, commitments, and actions from institutions across the country—useful first steps, to say the least. But, as we’ve learned, sustained action is essential to create change. The communities that were struggling then are still struggling now, because systemic inequities don’t resolve themselves simply because society moves on to the next crisis.

Today, these challenges are compounded by growing uncertainty in the health care landscape. Shifts in Medicaid enrollment, provider shortages, and policy changes are creating instability for families who rely on safety net services. Many providers are struggling to keep their doors open, and patients are facing new barriers to accessing care. These disruptions disproportionately impact communities already experiencing health inequities.

In Northern Virginia, it is easy to assume that these problems do not exist. Our region is often associated with wealth and opportunity, but beneath that affluence are communities facing significant barriers to health. Research that we’ve commissioned before and after the pandemic showed that health outcomes vary drastically depending on race, income, and ZIP code. Today, there remain “islands of disadvantage,” places where families experience poorer health outcomes simply because of where they live. 

That is why NVHF is deepening our commitment to accountability. We do not provide direct services, but we do have the power to influence change through our grantmaking, research, and partnerships. For nearly 20 years, we have worked to strengthen Northern Virginia’s health care safety net and equip decision-makers with the data and resources they need to direct investments where they are needed most. Now, we are taking this further.

We are expanding our evaluation process to ensure the dollars we allocate and the strategies we pursue contribute to tangible improvements in health outcomes. To date, we have shifted our evaluation practices to focus on longer-term investments, which is to say, we’re examining how the decisions we make today will shape the health and well-being of communities over the next three years. 

We are also asking our grantees to share how they engage with the communities they serve, ensuring their work truly meets people’s needs to be and stay healthy, and advances health equity.

Accountability has to be a shared value in this work because Northern Virginia’s progress depends on all of us – funders, policymakers, health care providers, and community leaders – being intentional and responsible for advancing health equity.

As we move forward, we are committed to expanding our impact, amplifying the work of our partners, and investing in solutions that improve health and well-being for all. Health equity is not just a goal—it’s the foundation for a thriving community.