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Leveraging the resources of foundations to advance health equity

      Abstract

      Background: Foundations that support health and health care related issues are bell weathers for our nation's most pressing challenges in this area. The new National Academy of Medicine report, The Future of Nursing 2020 to 2030: Charting a Path to Achieve Health Equity has been perfectly timed to provide foundations with the additional research and evidence they need to support health equity efforts through the utilization of the nursing workforce. Many foundations are thinking beyond traditional grant-making to align more of their assets with mission in creative ways. Conclusion: Funders are investing in strategies along a downstream-upstream continuum to promote health equity. This paper is aimed to encourage nurses to approach philanthropy as important partners in their efforts to advance health equity.

      Keywords

      Background

      Foundations that support health and health care-related issues play an instrumental role in efforts to improve health and health care for all people. Large foundations with a national reach generally devote their funding to policy and systems issues and seek to develop the next generation of health leaders. These foundations devote considerable resources to communications efforts to raise the visibility of particular health issues. Smaller local foundations provide programmatic and policy solutions to support the needs of their communities within a designated funding region. Examples might include supporting community organizations that are addressing the opioid epidemic or supporting housing and food programs for affected populations.
      Currently, many health care foundations offer funding opportunities at the national and local levels as part of their efforts to advance health equity. Although funders may have different aims, they largely seek to affect change in policy and systemic solutions that address health inequities in the United States through capacity building, convening, policy research, and agenda setting (

      Easterling, D. and McDuffee, L. “Becoming Strategic: Finding Leverage Over the Social and Economic Determinants of Health.” The Foundation Review, 10, no. 1 2018: 90–112.

      ).
      The purpose of this paper is to encourage nurses to view philanthropy as important partners in their efforts to advance health equity. Foundations offer a wellspring of information around health equity, networking opportunities, and funding. Both the National Academy of Medicine report, The Future of Nursing 2020 to 2030: Charting a Path to Achieve Health Equity and the National Institute of Nursing Research's 2022 to 2026 Strategic Plan underscore the pressing need for more nurses to devote their time, talents, and research to advancing health equity.
      In fact, The Future of Nursing 2020 to 2030: Charting a Path to Achieve Health Equity, (the FON report) has been perfectly timed to provide foundations with the additional research and evidence they need to support health equity efforts through the utilization of the nursing workforce (

      National Academies of Sciences, Engineering, and Medicine (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982. Accessed May 3, 2022.

      ). The FON report calls for foundations to invest in cutting-edge, nurse-led, health equity policies and programs. Investments that expand, strengthen, and diversify the community and public health nursing workforce will go a long way to advance health equity for all.
      This paper will (a) focus on the role of philanthropic investments in achieving health equity, (b) highlight case examples of foundation involvement in the pursuit of health equity, and (c) describe how nurses can take action to employ human and financial philanthropic resources to play a larger role in achieving health equity, consistent with the recommendations from the FON report.

      Philanthropy's Role in Advancing Health Equity

      For too long, the United States has overinvested in treating illness and underinvested in promoting health and well-being and preventing disease. US health disparities are stark: data show that people with higher levels of wealth live longer and those without health insurance are less likely to receive preventive care. Structural racism has contributed to public health crises, such as maternal mortality, that disproportionately impact people of color.
      The COVID-19 pandemic has revealed in the sharpest terms that illness and access to quality health care are unequally distributed across populations and communities. Foundations stand at the ready to meet these challenges, as evidenced by the following:
      Health foundations have contributed to and created community-level rapid response funds, provided general operating support to nonprofits for maximum flexibility, and quickly created new grant opportunities for organizations working on the front lines of the pandemic response.

      Cara James, President, Grant Makers in Health, 2020

      National foundations often seek to address complex problems at the local or regional levels. Health foundations report that they can connect grantees with state and federal decision-makers to help to share their stories and what works in their communities (

      James, C. (2020). Achieving health equity is possible, and philanthropy can help lead the way. Retrieved from https://www.gih.org/from-the-president/achieving-health-equity-is-possible-and-philanthropy-can-help-lead-the-way/on Accessed November 16, 2021.

      ). For example, the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF) collaborated on the Partners Investing in Nursing's Future program from 2006 to 2015. The two organizations supported almost 300 state, regional and local foundations to advance the profession of nursing. The program encouraged local funders to catalyze partnerships with nursing leaders and other community partners to foster grassroots solutions to the challenge of ensuring a competent and experienced nursing workforce. A qualitative evaluation of these partnerships found that the partnerships achieved meaningful gains. Partnership participants underscored the value of engaging foundations and other stakeholders from outside of nursing in the implementation process, the importance of funding for implementation, and the unique leadership and convening role that local and regional foundations can play to help their regions respond to complex challenges for the nursing profession (

      Jellinek, P. S., Reinhardt, R. J., Ladden, M. D., & Salmon, M. E. (2015). Round six of partners investing in nursing's future: Implications for the health sector, policy makers, and foundations.

      ).
      Many of the FON report recommendations will also be carried out at the local and regional levels, and success will be contingent upon engaging interested local and regional funders to assemble and mobilize communities, nurses and other stakeholders to improve health equity. These stakeholders should organize their work around the report's four key messages. The report calls on the systems that educate, pay and employ nurses to (a) permanently remove barriers to allow them to do this work; (b) value their contributions; (c) prepare nurses to tackle and understand health equity, and (d) to diversify the workforce.
      The philanthropic sector already is well-positioned to advance the FON recommendations. The National Academies of Medicine report entitled, Communities in Action, offers promising approaches and partners for promotion of health equity. In particular, it has explained how philanthropy can support communities as they design, implement, and evaluate interventions to promote health equity (
      National Academies of Sciences, Engineering, and Medicine
      Communities in action: Pathways to health equity.
      ).   First, foundations can serve the role of a trusted, neutral host by convening individuals and organizations from different sectors and disciplines. They can bring together people from different fields with diverse opinions for the good of the whole community. Community foundations, in particular, can serve as catalysts for addressing issues facing a community.
      In addition, foundations can address gaps within the non-profit sector by providing leadership and capacity development programming to develop new leaders. Jonas Philanthropies, for example, offers the Jonas Nurse Scholars initiative to improve health care through targeted investments in high-potential doctoral nursing students pursuing PhD, EdD or DNP degrees, whose research and clinical foci specifically address the nation's most pressing health care needs.
      Foundations can support model testing to fund smaller scale, innovative interventions that may not yet have the evidence base to secure other funding sources. The Rita and Alex Hillman Foundation, for example, offers the Hillman Emergent Innovation program, which provides grants to accelerate the development of bold, nursing-driven interventions that will improve the health and health care of marginalized populations.
      Foundations can fund studies and reports that review and synthesize existing knowledge, projects, or data, and create resulting products to support or inspire other work. For example, the FISA Foundation, in partnership with the Heinz Endowments, commissioned Snapshot: Inequities Affecting Black Girls in Pittsburgh and Allegheny County to showcase the gender and racial disparities facing black girls in the Pittsburgh region. Kathi Elliott, DNP, MSW, CRNP, the executive director of Gwen's Girls, an organization to empower girls in the Pittsburgh Region, used the report's findings to organize four workgroups that meet monthly to collaborate on addressing inequities in health and wellness, school pushout and discipline, child welfare, and juvenile justice (

      Kelley, Jaimie. (2019). RWJF interdisciplinary research leader fosters resilience in black girls. Campaign for action blog. Retrieved from https://campaignforaction.org/rwjf-interdisciplinary-research-leader-kathi-elliott-fosters-resilience-in-black-girls/. Accessed May 3, 2022.

      ).
      Foundations also can engage communities in the grant making process to make decision-making community informed. An example of a community-led grant making process is the St. Louis Regional Racial Healing Fund, which was established by Deaconess Foundation, Forward Through Ferguson, and Missouri Foundation for Health. RWJF provided a matching grant. A Community Governance Board, made up of Black St. Louisans and St. Louisans of color, are responsible for managing the fund's grant making process and priorities. The fund supports efforts to develop capacity and infrastructure in the racial justice movement to envision, articulate, and create a transformed St. Louis region through community organizing and healing arts (

      Forward through Ferguson (n.d.). Retrieved from https://forwardthroughferguson.org/healingjustice/on Accessed May 3, 2022.

      ). With their available tools and resources, philanthropy can play a key role as a partner in promoting health equity in communities. By working together across multiple sectors, communities have the power to change the narrative and promote health equity through enduring community-driven interventions (
      National Academies of Sciences, Engineering, and Medicine
      Communities in action: Pathways to health equity.
      ). Below we describe some exemplars of how philanthropy and communities have worked together in the pursuit of health equity.

      Case Examples of Foundation Involvement in the Pursuit of Health Equity

      Foundations can and are using the tools of convening, leadership and capacity development, model testing, topic studies and reports and community engagement to advance health equity. The case examples described below illustrate the work that foundations are doing around each of the key messages from the FON report to advance health equity. The examples highlight the opportunities for practicing nurses, nurse scientists, nursing schools and the broad nursing community to showcase novel strategies to engage in efforts to achieve health equity.
      Highlighted foundations were chosen through a convenience sample based on their commitment to health equity and how they are utilizing nurses in that work. We also aimed for a diverse sample of local and national foundations with geographic diversity as well as diversity in the size of their endowment.

      Permanently Remove Barriers

      The FON report calls on policy-makers to expand scope of practice for advanced practice registered nurses, including nurse practitioners, and registered nurses to improve access to care, particularly in underserved urban and rural areas. Foundations have used their power of convening to lay the groundwork for removing barriers to care. For example, in 2007, RWJF, AARP and the AARP Foundation created the Center to Champion Nursing in America to provide a home for The Future of Nursing: Campaign for Action. The aim of the Campaign is to harness the power of nurses as essential partners in providing care and promoting health equity and well-being so everyone can live longer, healthier lives. The Campaign, with its multitude of partners, has championed lifting restrictions on nurses’ scopes of practice to expand access to care for almost 60 million people. One of the benefits of bringing different types of organizations together is that each one has different skills and capacities. In addition, organizations are also subject to different laws and regulations. For example, while federal tax law prohibits private foundations from lobbying, AARP, as a Section 501(c)(4) social welfare organization, has more flexibility and worked directly with states and communities to help with efforts to gain health care access to communities by advocating for laws and policies aimed at full practice authority for advanced practice registered nurses (). While private foundations may not designate grant funds for lobbying, they can fund other types of advocacy. For example, Foundations can help build social movements by providing support for organizations that use community organizing to address important social issues (
      National Academies of Sciences, Engineering, and Medicine
      Communities in action: Pathways to health equity.
      ).

      Value Nurses’ Contributions

      The current payment systems are not designed to pay for services that address the social determinants of health (SDOH) and advance health equity. These payment systems often do not explicitly value nurses’ contributions to care. One way that foundations can value nurses’ contributions to care is to support their work that addresses the SDOH and advances health equity. A great example is how the Blue Cross Blue Shield of Michigan engaged in model testing and program funding to support a suicide-prevention intervention. In 2020, the Blue Cross Blue Shield of Michigan, the Blue Cross Blue Shield of Michigan Foundation, the Michigan Health Endowment Fund, the Children's Foundation, and the Ethel and James Flinn Foundation collaborated to support the “Suicide Prevention Support for Health Care Clinics Working with Michigan's Health-disparate Populations” program. The funding enabled health care teams, including nurses, to develop evidence-based and sustainable programming to decrease the rate of suicide attempts and deaths. The focus of the programs was the identification of children or adults at risk for attempting suicide and addressing their needs for timely and appropriate medical social and behavioral services.

      Prepare Nurses to Advance Health Equity

      The nursing field needs to do a much better job of educating nursing students so that they are prepared to promote health equity and improve the health and well-being of everyone. There are several examples of foundations that offer leadership and capacity development for nurses to prepare them to promote health equity. The Josiah Macy Jr. Foundation is the only national foundation dedicated solely to improving the education of health professionals. The Foundation's guiding principle is that health professions education has a strong social mission: to serve the public's needs by improving the health of the public. Macy has long focused on both nursing and medical education innovations and innovators to advance health professions education. Many investments have been made in nursing related to health equity, including the Macy Faculty Scholars Program. The Macy Faculty Scholars Program is designed to identify and nurture the careers of promising educational innovators in nursing and medicine. The Macy Foundation believes that the observations and experiences of nurses are fundamental to helping to create equity in their clinical learning environments, and ultimately, equity for their patients.
      The Kresge Foundation's mission is to advance opportunities in America's Cities. Its efforts are community centered and facilitate relationships across sectors to improve health and eliminate inequities by focusing on “upstream approaches to equity” in the areas of food security, housing and the environment. The foundation has prioritized investments that heighten community-led solutions, catalyze institutional investments in community health, and stabilize the community health infrastructure.
      Kresge has begun to support nurses in the Climate Change and Health Equity (CCHE) initiative (https://kresge.org/initiative/climate-change-health-and-equity-cche/) (). The investment in the Alliance of Nurses for a Healthy Environment is building a cadre of nurses who are working with communities most at risk for being impacted due to climate change. The goal of the program is to position nurses as partners with communities to support the local advocacy agendas and to begin shifting institutional practices that foster climate change.

      Diversify the Workforce

      The nursing workforce and leadership do not accurately represent the communities that they serve. Diversifying the nursing workforce and leadership could help to eliminate health disparities and enable all nurses to better provide care with cultural humility. Many foundations offer leadership and capacity development programs to diversify the workforce. The Independence Blue Cross Foundation, for example, is a private, corporate charitable foundation with a mission to lead sustainable solutions that improve the health and well-being of the community. The Foundation serves as a leader to nonprofits in southeastern Pennsylvania, advancing initiatives that address access to care and reduce health disparities. Independence Blue Cross Foundation has supported and led in community capacity building to advance the education and professional development of nurses.
      In the last decade, the Foundation's funding has provided scholarships through schools of nursing to more than 3,000 undergraduate, graduate and doctoral nursing students. These exemplary and trusted nurses are improving quality of care and health outcomes for diverse communities, understanding and addressing social needs, and advocating for their patients through policies and practices. The Foundation is also creating pathways for underrepresented individuals to pursue careers in health care, including nursing. Currently, the Foundation is launching a new educational pipeline program for minority nursing students, to remove the barrier of cost and provide additional academic supports. The Foundation supports organizations like the Black Brain Campaign whose License Educational Program aims to increase the representation of culturally sensitive mental health clinicians of color.
      Foundations can also use their ability to convene and release reports to call attention to and build evidence for diversifying the workforce. The Macy Foundation, for example, launched a conference on Addressing Harmful Bias and Eliminating Discrimination in Clinical Learning Environments. This meeting brought together thought leaders from schools of nursing and medicine, representatives from governing and accrediting bodies, and students and learners across the continuum of both medicine and nursing. Outcomes of the meeting included consensus recommendations, a supplement to Academic Medicine on the topic of mitigating harmful bias and eliminating discrimination in health professions learning environments, a webinar series and podcasts.

      Case Examples of Corporate Foundation Efforts to Advance Health Equity

      Many corporate foundations also support health equity efforts, and they are a potential partner for nurses interested in advancing the FON recommendations. Corporate foundations are philanthropic organizations that are created and financially supported by and legally separate from a corporation. Companies establish corporate foundations and giving programs to have a positive impact on society and to increase their own opportunities for raising the awareness of their brand and enhancing employee engagement (

      Foundation Source. (2021). 10 exciting capabilities of corporate foundations. Retrieved from https://foundationsource.com/landing/capabilities-of-corporate-foundations/on November 16, 2021.

      ). Corporate foundations tend to make grants in fields related to their corporate activities or in communities where the corporation operates or their employees reside. In reviewing websites of some of the major US companies, many are involved in addressing the SDOH and health equity and engaging nursing in this work.
      For example, in 2011, Campbell's Soup Company committed to reducing childhood obesity and hunger by 50 percent in Camden, New Jersey through the Campbell's Healthy Communities Program. This initiative has focused on four strategic areas: ensuring access to affordable and fresh food; increasing physical activity in a safe environment; supporting healthy lifestyles through nutrition education; and partnering with the community to advance positive social change. While this initiative does not specifically call out nursing in the proposal, nurses are embedded in this initiative, and it provides opportunities for nurses to engage with philanthropic initiatives.
      Campbell's Healthy Communities Program also partners with the Camden Coalition, a multidisciplinary, community-based nonprofit working to improve care for people with complex health and social needs in Camden and across the country. The Camden Coalition's Camden Core Model was highlighted in the FON report as an exemplar nurse-led model for optimizing the use of nurses in the community. Camden Coalition partnerships include an interprofessional team of nurses, social workers, and community health workers who visit program participants, helps them to reconcile their medications, accompanies participants to health care visits, and links them to social and legal services. Critical to the model's success is recruiting nurses who are from the local community, capitalizing on their cultural and systems-level knowledge to facilitate and improve access to and utilization of local health and social services.
      In addition, Johnson & Johnson and its foundation, the Johnson & Johnson Foundation, is a corporate leader in providing support for nursing. Johnson & Johnson has had long-term support of the nursing profession by working with partners to advocate for, elevate and empower nurses to drive transformative health care change by strengthening innovation skills, providing skill development and leadership training, supporting well-being, fostering health equity through diversity, and advocating for the profession. As the COVID-19 pandemic emerged, the Johnson & Johnson Family of Companies and the Johnson & Johnson Foundation committed $50 million to support frontline health workers. This commitment expanded upon a $250 million multi-year commitment made earlier in 2020, guided by the Johnson & Johnson Center for Health Worker Innovation aimed at catalyzing efforts to respond to the human resource crisis in global health and build a thriving health workforce. Specifically, this funding will recruit, train, retain and mobilize one million nurses, midwives and community health workers, reaching 100 million people by 2030 ().
      The Johnson & Johnson Foundation aims to foster health equity through championing and supporting greater diversity in the nursing workforce. Programming focused on health equity includes the Race to Health Equity Initiative, diversity scholarships to the Foundation of the National Student Nurses’ Association, Wharton Nursing Leaders Program for nurse directors and executives offered in partnership with the National Black Nurses Association, and the BAND-AID Brand's multi-year commitment with the National Black Nurses Association to provide need-based scholarships for Black nursing students to increase representation in the nursing field and help to achieve health equity in diverse communities. This deep and long-standing commitment by the Johnson & Johnson Foundation to nursing helps elevate and empower nurses to drive transformative health care change and offers many other foundations a roadmap for how to utilize the FON recommendations.

      How Nurses Can Take Action to Employ Philanthropic Resources

      Philanthropic investments can offer resources to support substantive nursing workforce initiatives to address the SDOH and health equity more comprehensively, regardless of practice setting. Nurses can and should seek out foundation support to scale up innovative collaborative partnerships between nurses and affected communities to advance health equity. It is not enough to know that funding opportunities exist, however. Nurses need to think through the type of project for which they are seeking funding, (e.g., research, testing an intervention, direct services, etc.) and the type of funder most likely to support the work and move strategically to attain needed resources. Importantly, nurses must also develop a specific skill set to approach foundations for funding. As nurses take on more leadership roles in their organizations and external boards and committees, knowing how to approach foundations will become an increasingly critical skill. Philanthropies often can be more flexible with funding than public funders and enable nurses to partner in obtaining a wide range of support to best serve their communities Table 1.
      Table 1The Four Key Messages of the FON Report
      1. Permanently Remove Barriers

      Policy makers need to expand scope of practice for advanced practice registered nurses, including nurse practitioners, and registered nurses. Employers need to remove institutional barriers, such as telehealth restrictions and restrictive workplace policies.

      2. Value Nurses’ Contributions

      Public and private payers need to establish sustainable and flexible payment models to support nurses working in health care and public health. This includes school nurses, a group that is consistently undervalued and underutilized

      3. Prepare Nurses to Advance Health Equity

      Preparing nurses should take many forms. Nursing education programs need to strengthen education curricula and expand the environments where nurses train to better prepare nurses to work in and with communities. Federal agencies, employers, nursing schools and other stakeholders need to strengthen the capacity of the nursing workforce to respond to public health emergencies and natural disasters, while also protecting nurses on the frontlines of this work. Employers need to support nurse well-being so nurses can in turn support the well-being of others. They, Along with other stakeholders, should create and implement systems and evidence-based interventions dedicated to fostering nurse well-being.

      4. Diversify the Workforce

      Nursing schools need to intentionally recruit, support, and mentor faculty and students from diverse backgrounds to ensure that the next generation of nurses reflects the communities it serves.

      Nursing accreditors can play a role by requiring standard for student diversity just like other health professions schools.
      Source: Adapted from the future of nursing report,

      National Academies of Sciences, Engineering, and Medicine (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982. Accessed May 3, 2022.

      .
      There are a multitude of resources and websites for nurses to learn about funding opportunities in health equity (See Table 2).
      Table 2Foundation Opportunities in Health Equity: Resources
      There are a multitude of resources and websites for nurses to learn about funding opportunities in health equity. For further information on grant making or to locate foundations in your area
      In addition, nurses might think about exploring Foundation opportunities by utilizing some of the skills listed below, set up as the “10 Required R's of Fundraising” (
      • Hassmiller S.
      How to engage funders and get money.
      with permission from AJN):
      • (a)
        Research: Become familiar with the mission, goals, and programmatic funding areas of the foundations you wish to approach by studying their websites. The closer the alignment between yours and the foundation's goals, the better the opportunities for funding. You will also determine if they are open to solicitations or if they have specific grant programs you might apply to. You can also get a sense of who they fund.
      • (b)
        Relationships: Get to know the foundation professionals who are responsible for making funding decisions. Share your ideas and passions with them as a way of getting to know them and their foundations and as a means of engaging them in your ideas and solutions.
      • (c)
        Relevance: Tailor your funding application to what you believe the foundation is looking for, including feeding back phrases they have in their funding criteria.
      • (d)
        Riveting: Funders want to invest in people and organizations that have a significant “next big” solution to the most intractable societal issues they care about. Convey inspirational stories about the possibilities embedded in your solution.
      • (e)
        Reasonable: Your funding request should be logical, achievable, and supported by facts and evidence. Using a logic model or decision tree, free of jargon, might be useful in laying out your approach.
      • (f)
        Rigor: Funders depend on valid processes that will yield credible and trustworthy results that will further enhance their brand and reputation. Having such results allows foundations the option of scaling the idea/program regionally or even nationally.
      • (g)
        Return: Funders want to be assured that their investment will yield results that will add to the knowledge base of issues of interest to them. Being clear about what your project may yield and your likely audience reach including policy papers, op-eds, books, presentations, or webinars will help to indicate a clear return on investment.
      • (h)
        Reliability: Funders want to work with people and organizations who can deliver an outstanding product or set of products for a reasonable price and in a defined time frame. Have a clear plan that is time bound along with a clear and reasonable budget with on-time deliverables.
      • (i)
        Rapport: Maintain an ongoing relationship with foundations you are interested in or who have funded you. Share products with them emanating from their investment, including inviting them to presentations. If you apply to a foundation and don't get funded, stay in touch with them with short emails apprising them of your work.
      • (j)
        Recognition: Foundations like to achieve results and promote their work. Help them by actively using communications and social media with key audiences to get the word out. Always let foundations know when the work they have funded will somehow be highlighted.
      Nurses were advocating for better care and access for individuals, families, and communities even before COVID-19 illuminated such disparities and exacerbated inequities in the United States. As bridge builders and collaborators, nurses engage and connect with people, communities, and organizations to ensure that people from all backgrounds have what they need to be healthy and well. Nurses are traditionally “boundary spanners” who utilize care coordination and transition management to connect patients across health care and community settings. Boundary spanning includes crossing departments, professions, organizations, sectors, demographics, and/or geographic areas to develop innovative new care strategies and population health models (

      Pittman, P. (2019). Activating nursing to address unmet needs in the 21st century. Retrieved from https://hsrc.himmelfarb.gwu.edu/sphhs_policy_facpubs/963

      ).
      Part of boundary spanning is to connect with foundations. As
      • Maraldo P.
      • Fagan C.
      • Keendan T.
      Nursing and private philanthropy.
      , which is still largely true today,
      Since the passage of the Nurse Training Act of 1964, public financing—federal and state—and not private giving has been the mainstay of nursing education and its ultimate influence on nursing service. If its past record is any evidence, however, philanthropy remains uniquely equipped to make two major contributions. First, it can define nursing issues and related strategies for dealing with them. Second, it can help test and demonstrate actions to implement the strategies proposed (pg 136).
      Many foundations are thinking beyond traditional grant making to align more of their assets with their missions in creative ways. Funders are investing in strategies along a downstream-upstream continuum to promote health equity. The FON report specifically calls on foundations to invest in cutting-edge, nurse-led, health equity policies and programs to advance health equity. Nursing leaders should approach foundations to seek to leverage their many tools including convening; leadership and capacity development; model testing; topic studies and reports; and project and program funding that could be used to advance the FON report recommendations.

      Authors' Contributions

      Susan B. Hassmiller: Conceptualization, Writing - original draft, Ashley Darcy Mahoney: Conceptualization,Writing - review & editing.

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