Learning Lessons on a Journey Toward Health Equity

One of our core beliefs is that improving the health care system in California for the benefit of all Californians requires diverse partnerships. The health care system is complex. So, too, are the experiences and needs of the population. Health care leaders need to be able to engage a diversity of perspectives in healthy and respectful dialogue in order to achieve meaningful progress.

Last week, we made the decision to withdraw funding for the California Birth Equity Collaborative, a project of the California Maternal Quality Care Collaborative, because we had indications that those values were not being upheld. What makes this decision difficult is that the project has been making progress in the content of the work. Keeping in mind the many different organizations and individuals who are involved with this project, CHCF is working carefully on a transition plan to minimize any unnecessary disruption to programs.

The California Birth Equity Collaborative was created to address the fact that Black women in California are three to four times more likely to die because of complications related to pregnancy and childbirth than are their white counterparts. The data show that factors like health status, education, and income cannot account for this disparity. There is a growing body of research to suggest that the central driver of this risk is racial bias in the health care system. This conclusion is consistent with what we heard in the recent Listening to Mothers in California survey (PDF), where 1 in 10 surveyed Black women reported experiencing discrimination in childbirth. This longstanding pattern of racism has led many in the Black community to deeply mistrust the health care system.

Because of that reality, and the fact that the vast majority of births happen in hospitals, the California Birth Equity Collaborative sought to bridge the perspectives and knowledge of the Black community directly with health care system experts and leaders. We recognized from the outset that this would not be easy. We remain convinced that such collaboration will be necessary to reverse a deadly health outcome with roots in racism.

This experience has been a learning process for CHCF. We will apply these lessons as we continue our work and grantmaking to advance birth equity. Our resolve to make a difference in addressing racial inequities in our health care system remains undeterred.

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