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Fatima Angeles Reflects on Five Years of Advancing Wellness
When Cal Wellness embarked on a decade-long grant making strategy in 2014 called Advancing Wellness, our goal was to promote a holistic and intersectional understanding of health and wellness. And we dedicated ourselves to championing and funding health equity in our state. By health equity, we mean that every person has the opportunity to achieve good health and experience wellness regardless of their race, ethnicity, education level, gender identity, sexual orientation, employment, neighborhood or disability.
Late last year, we reached the midpoint of our strategy: five years completed and five more years to go. We decided to work with Informing Change, a social change strategy firm, to review our impact. You can read their findings in our Midpoint Assessment report.
In this interview, Fatima Angeles, our vice president of programs, reflects on the first five years of Advancing Wellness, what we’ve learned from the midpoint assessment, how the events of 2020 have impacted our work, and what the future holds for Cal Wellness and the movement for health equity in California.
Advancing Wellness is our 10-year grantmaking strategy. Can you remind our readers what its goals and values are?
Fatima Angeles: At Cal Wellness, we’ve always believed that health is more than just the absence of disease. We want to make sure every resident of California is able to enjoy good health and experience wellness. Health is affected by things outside of your own personal behavior and biology. Your race, your income, where you live and work, how much money you make, the water you drink—your circumstances—have a greater impact on your health outcomes and your well-being than anything else. This concept is often called the “social determinants” of health. With Advancing Wellness, we set out to champion health equity by addressing key social determinants of health. We wanted every Californian to have the chances to live a healthy life and be well.
Advancing Wellness has four portfolios, but the issues and strategies in the portfolios are interconnected. Can you tell us more about the portfolios?
FA: Advancing Wellness shows our commitment to reaching all parts of our state, urban and rural. Additionally, we focus our support on communities of color and fund both direct services and policy advocacy. We want to champion health equity in California by addressing key social determinants of health. Our Equity in Access portfolio focuses on access to quality and affordable healthcare. Through it, we support universal coverage and access to care, transformation of our health care system and our most vulnerable communities — in particular, immigrants, communities of color, low-income communities, and women of color. Our Economic Security & Dignity portfolio addresses your ability to get a good education, master skills, earn good wages and create wealth for yourself, your family and your community. We focus on economic mobility and wealth creation, post-secondary education and training, and access to the economic safety net. We believe that economic outcomes are health outcomes.
Your surroundings influence and affect your health and well-being. That’s why we have the Community Well-being portfolio, which focuses on the health, safety and resilience of communities of color, especially those that have been disproportionately affected by unhealthy environments and community violence. We focus on community violence prevention, and in particular gun violence prevention, because we know that guns kill disproportionately people of color, Black and Brown men in particular. And we focus on unhealthy environments because believe it or not, in this country of such wealth, we have communities that don't have access to necessities, such as safe and affordable drinking water.
Lastly, our fourth portfolio is focused on Leading for Power & Change. We believe that part of achieving health equity is fighting for it. In this portfolio, we are supporting efforts that give voice and priority to the concerns and needs of marginalized communities, mostly communities of color. Because changemaking needs leaders, we’re supporting civic engagement, community organizing and leadership development. We're focused on strengthening and championing leaders of color and organizations led by people of color that are serving people of color.
It’s been five years and we have five more years to go. Why do a midpoint assessment? What were you looking to learn and understand?
FA: Ten years is a long time to commit to something. But we also know that change takes time. At Cal Wellness, we’re deeply committed to our 10-year strategic plan, but we know that our world is dynamic. We know that issues change and organizations change.
With the midpoint assessment, we wanted to make sure that our strategies made sense for how California is faring today. Remember, when we launched Advancing Wellness, our president was Barack Obama and he was a champion for the Affordable Care Act and equitable access to healthcare. Then, two years later, the administration changed and so did our entire world. And now, in 2020, there is so much at stake. We are fighting the COVID-19 pandemic. We are seeing new priorities emerge via the racial justice movement. We’re seeing another contentious election and a potential shift in national leadership. So we want to make sure that our strategy is long-term and durable.
Ultimately, we chose to conduct this assessment because we wanted to make sure that we were still on the right track. We wanted to know what we were doing well and what we were not doing so well, so we could course-correct. We asked ourselves: Five years in, are these still the most important issues that we need to pay attention to? What did we miss? What should we pay more attention to given the changes in the environment? We see our strategy as focused but adaptable, and it enables us to respond to changes in the environment that impact health and wellness.
In light of the midpoint assessment report, what are your top insights from the last five years of Advancing Wellness?
FA: Our portfolios continue to make sense for us and serve us well as we contribute to health equity and justice in California. Health equity remains our north star. And given what we've been learning from our grantees and what we've observed in the environment, we've had opportunities to further refine our strategies and tactics. But, Advancing Wellness is serving us well as a framework.
- We realized that we needed to pay more attention to immigration policy and advocacy. We have always prioritized immigrant communities in the work that we do, whether it's access to affordable healthcare, environmental health and justice work, or leadership development. However, we hadn't really looked at immigration and policy related to immigration. Because of the actions the new administration was taking, we felt we needed to focus our attention on immigration reform and the needs of immigration advocates. That's a shift for us. After all, California is a border state. More immigrants call California home than any other part of the country.
- Another area we wanted to strengthen was integrated civic engagement. We had supported power-building in the past but after the 2016 elections, we realized that we needed to be even more committed to civic engagement if we wanted see change happen. Supporting integrated civic engagement means engaging Californians into the democratic process all year round. Because, regardless of your status, you can participate in a range of civic engagement activities. Voting is not the only way to participate in our democracy.
- Finally, our investments in leadership development, civic engagement and community organizing are making a difference. It’s beautiful to see California communities mobilizing to express discontent with oppressive systems and oppressive laws and to express solidarity with other social justice efforts happening across the state and across the country. The killing of George Floyd was a rallying point, yet the murders of black people in the hands of police have continued. Civic engagement and community power building is a counter to that.
What do you think will be different in the next five years of Advancing Wellness? Do you see any opportunities ahead?
FA: Our grantees have had to do a lot of defense work in the last four years, protecting their hard-won policy victories. At the same time, they’ve had to defend and protect the most vulnerable among us like undocumented individuals, people who are homeless and people of color.
Nevertheless, I really feel that the nonprofit sector—the social justice community—has become stronger over the last four years. There’s incredible momentum.
We have our grantees to thank for this. As a result of their powerful community organizing and civic engagement, so many people who have felt marginalized in the past have claimed their voice and found avenues to channel their rage, but also channel their optimism for change.
We're constantly learning what makes our communities healthier. We have centered racial justice in each of the refined portfolios. It’s true that the assessment found that Cal Wellness leads our philanthropic peers in some ways on racial equity. We have great diversity of staff and board, we direct most of our grants to organizations led by and working for communities of color. Advancing Wellness is structured to help increase the diversity of the health care professions. But we know we still have work to do. So we will continue to set targets for ourselves to push further on racial equity, because we see opportunities to strengthen our focus on how race and racism affect health and well-being.
We're increasing our understanding about how wealth and asset building can help improve health outcomes and economic outcomes. And we’re focusing significant amount of our energy and grants on policy change – from gun violence prevention to juvenile justice reform to improving access to quality education and jobs.
Looking forward, what are you most excited about?
FA: I'm excited about learning. We are a learning organization. And we've learned a lot in the last couple of years about how to do our work better, including not just understanding the issues better, responding better to the needs of our communities, but also how to be a better grantmaker. As part of the midpoint assessment, our grantees told us that they really value their engagement with and direct access to our staff. That's one of the reasons why we've increased staff capacity. We now have program officers — in addition to our longtime program directors — for each portfolio.
Finally, I’m excited about working in partnership with nonprofits, other funders, universities, local and state government, and civic and business leaders. I think there's been really effective and authentic collaboration and coordination in our field over the last five years. And I want to see more of that because we’re not doing enough. I know that the arc of the moral universe is long, but it bends toward justice. If we work together, I know we can both shorten the arc and bend it sooner.