OP-ED: Seizing the Opportunity to Build More Equitable Systems of Care

By Julia Wacker

Senior Vice President, North Carolina Healthcare Foundation 


The Boys and Girls Club of North Central North Carolina has been an anchor in its community, providing afterschool enrichment for children, for decades. Then COVID struck, schools closed, and the world changed. Nearly overnight, their platform collapsed as the need skyrocketed. The club quietly recalibrated itself, transitioning their programming to virtual, with socially distanced meal and supply deliveries. Now, every week, volunteers distribute educational kits and K&W Cafeteria dinners to their 200 member families, while conducting quick surveys of other unmet needs.  

I learned about this community staple while reading their application for the North Carolina Healthcare Foundation’s Fill the Gap Response Fund. Launched in April, the fund pools dollars from philanthropy, corporate donors, and individuals to support efforts addressing health disparities worsened by the pandemic 

In reviewing the stack of proposals from across the state, one thing was clear: the pandemic has aggravated every social ill. It has increased the need for assistance, such as stable non-congregate shelter for the homeless, while complicating access to those services. Racial disparities among those in need of services were pronounced in every application I read 

While discouraging, diseases disproportionately impacting one group over another is not new. The trend is reinforced after every major disaster, where the gap increases in severity. Just weeks into COVID-19, mortality data showed that Black and Brown people were dying at more than twice the rate of whites. We now understand that those disparities persist throughout the country, regardless of income or population density.   

For a pandemic of mysterious origins, the undercurrent of disproportionate suffering is well-documented and entirely predictable.  

And yet, theres a twist. Likely inspired by a growing social reckoning with the reality of racism, we are now talking about the disparities. We are beginning to question why they are so stark. We are not settling for the single explanation that people of color had higher rates of underlying illness going into the pandemic, as if that explained – or explained away – their increased rate of serious complications.  

Rather, we are acknowledging that crowded living conditions, the need to work in frontline minimally flexible jobs, and barriers accessing the healthcare system rank among the many contributing factors. We are also acknowledging that we are early into the pandemic, and when we adjust for numerous factors (such as the virus being more common among older Americans, who are disproportionately white), the disparity is likely much greater. 

Crises are converging, and we are paying attention.   

What is more, we are paying attention at a time when the virus’s rage has energized our determination to survive. Because alongside stories of adversity, the Fill the Gap applicants illustrated how North Carolina’s communities are coming together, building unlikely partnerships, and innovating to conquer the unknowns.  

And there lies our opportunity. With vulnerabilities exposed, we can crack open the system fractures that leave people of color disproportionately in need of philanthropic and government support. We can couple what weve known for years with a new desire, and necessity, to be better. We can ask the hard questions and acknowledge the answers.  

The North Carolina Healthcare Foundation accepts the call to do what is needed to rebuild a stronger system of care. We are committed to supporting the people, organizations and communities severely impacted by the pandemic. We are committed to a new path forward, one that profoundly and systematically uproots the racism that deepens health disparities.  

The challenge is to seize the opportunity, and shoulder the responsibility, to do the right thing, and do it now. 

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