In January 2020, Faith Mitchell, PhD, joined researchers in the Urban Institute’s Center on Nonprofits and Philanthropy and Health Policy Center, adding Urban to a distinguished career that has bridged research, philanthropy, and social and health policy.

Mitchell is the former CEO of Grantmakers In Health (GIH), a professional association for foundations and corporate giving programs and the nation’s largest association of health funders. She has expertise in the issues that shape Americans’ health and health care and the central challenge of inequality.

At Urban, Mitchell will lead the development of the American Transformation Project (ATP), which will highlight America’s racial and ethnic evolution and the implications and possibilities for multiple sectors, including health and health care. The project—along with Mitchell’s broader work on health philanthropy—aims to demonstrate how innovation in the social sciences can help further Americans’ well-being, even as their communities change.

Mitchell recently spoke with me about her plans to elevate the debate on America’s increasing diversity and creating a fairer, healthier society.

What about the American Transformation Project most excites you?

Mitchell: Several things about this project excite me! I am most excited to have an opportunity to focus my attention on the future of the United States, with an eye to both the challenges and opportunities presented by the increasing diversity of the American population.

The project asks the fundamental question, “What kind of country do we want?” It will reflect my optimism that it’s not too late for policymakers to constructively tackle racial and ethnic and income divisions—even though those divisions are stagnant in some cases or widening in others.

For example, for decades, there have been significant racial and ethnic gaps in health. As a result, on most measures of health status and outcomes, people of color—especially blacks, American Indians, and Alaska Natives—consistently fare worse than white Americans. This means that children of color—tomorrow’s parents and workers—may start life with health disadvantages that have lifelong consequences.

Can you share an experience from Grantmakers In Health that may shape your work at Urban?

Mitchell:  My experience at GIH shaped my perspectives on how research data can advance health equity, an important aspect of the American Transformation Project, as well as my broader work at Urban.

For example, research data on the health implications of demographic change in the United States will inform ATP and help identify current gaps in research and social policy.

Another example occurs when university-based researchers collect data related to health equity, but practitioners, including health funders, need guidance to apply findings to their grantmaking strategies. This is where Urban’s Center on Nonprofits and Philanthropy can provide technical assistance in the development of strategic grantmaking that responds to community needs.

Your work at Urban will explore strategies at the intersection of health policy and other key social issues such as housing and equity. Can you give current strategies of this nature?

Mitchell: As health funders have learned more about the factors that affect health, their interest in addressing them has increased. “Upstream strategies” are the result. A few examples include the following:

• funding preschool settings to improve food programs and educate parents and caregivers about healthy eating
• working with public schools to improve the nutritional value of school lunch programs
• financing housing that includes health services
• partnering with community development financial institutions to construct child care centers
• reducing exposure to toxic chemicals in public housing
• supporting research and advocacy for health-related policy change

As these examples illustrate, upstream strategies involve sectors outside of traditional health care, such as education and housing. For place-based funders—who constitute a large percentage of health philanthropy—these strategies can be an effective way to invest broadly in health at the community level. Because place-based funders’ work focuses on specific localities (which could be cities, counties, or states), they have an inherent interest in strengthening all of the sectors that ultimately affect health.

Social determinants of health have become a central focus of research. Will you apply this lens to your work?

Mitchell: The social determinants of health help us understand the many factors that impact our health. For instance, the more we learn about housing, the more it is evident that housing is a fundamental aspect of health. Among health funders, some of the early work on the intersection of health and housing involved reducing people’s exposure to lead paint in low-income communities.

In the context of housing’s role as a social determinant of health, research has expanded to include mold, dust, and other irritants that result in high asthma rates for poor children and contribute to school absences and poor educational performance.

Now there is strong interest in supportive housing to reduce homelessness among people with chronic behavioral health issues and in building public housing that includes health services to reduce access barriers.

Health funders have also raised awareness of how where people live is connected to health, in other words, “your zip code determines your health.”

For the American Transformation Project, this raises the question of long-term implications for America’s children, many of whom are growing up in communities characterized by poor health. Social science has the potential to reduce the determinative impact of residence and alleviate health inequities. We just need to determine how.