Initiative News, Rural Health

Building a Durable Model for Rural Philanthropy

lisa medellin

By Lisa Medellin, Vice President of Community Engagement

There has been a long history in rural communities of out-of-town experts, having been commissioned by a foundation, funder, or other entity, using their own insights to develop strategies for improving rural challenges, then dictating priorities, determining how money will be invested, and deciding who will benefit. As a consequence of these good intentions, rural communities have found themselves the topic of research, the recipients of big promises, and, too often, abandoned at the conclusion of another revitalization strategy. Many times, the remnants of the latest improvement tactics remain visible in closed storefronts around a town square or faded flyers tacked up on the church bulletin board.

So how can we establish a durable model for rural philanthropy, one that not only makes change but leaves something sustainable behind? I believe that one critical and often overlooked component is authentic community engagement in the design and execution of any interventions or strategies.

The Two Georgias Initiative

Healthcare Georgia Foundation built the Two Georgias Initiative on the concept of community-based philanthropy as not only an approach to addressing the stark health disparities that exist between resource-rich urban areas and economically challenged rural communities, but also as a response to the well-worn dynamic between philanthropy and rural Georgia.

In 2017, Healthcare Georgia Foundation launched the Two Georgias Initiative after dedicating time to learn about and understand the complex issues that contributed to health and wellness inequities in rural communities. Through that learning process, it became apparent that many of Georgia’s rural communities had grown distrustful of institutions from Atlanta and elsewhere that had not taken the time to listen and learn before attempting to take action.

We committed to formulating a thoughtful and robust long-term plan to help create the conditions for sustainable progress in 11 rural Georgia communities over the course of the five-year Initiative and beyond. The first key was to act with patience and to provide true autonomy to each community. Community-based philanthropy takes time. It requires doing the requisite legwork to earn meaningful trust and buy-in at the local level. Especially by those individuals who represent the disproportionate share of health inequities that exist in many rural areas.

Designed to last

The design of the Two Georgias Initiative involved two phases of engagement. In the first phase, each of the 11 community coalitions received a full year of grant support to focus on planning, organizing, and establishing key relationships. This helped forge strong collaborations in which local residents on the ground took the lead in identifying their most pressing community challenges and potential solutions.

To help facilitate the planning and execution, the Foundation assembled a strategic team to provide guidance, troubleshoot issues, and maximize the potential for success. This also served to secure the success of Phase Two-Implementation of the community activities:

Over time, the benefits of laying this extensive groundwork came into clearer focus. Many of the coalitions came to realize they had been operating in silos, and actually had more collective power and resources in their communities than they had previously thought. In partnering with the Foundation team, they could unite and direct those resources to start building incremental change.

A more subtle, but powerful, outcome surfaced through creating space for gathering community members-many of whom had rarely interacted in the past-around the same table. These conversations often yielded powerful and unexpected ideas that would not have otherwise emerged. The camaraderie that developed over time increased individual awareness and understanding of diverse perspectives on solutions to community issues. Trust among organizations enabled traction and continued engagement. Equity moved from a theoretical construct to an action that became visible by the manner in which power was shared among community members.

As the formal funding concluded in 2021, each of the communities created robust and aspirational sustainability plans including impressive lists of what was accomplished. Yet even more powerful were the detailed and inspired visions for how progress can be maintained and accelerated. Visions that came directly from the communities themselves, with full knowledge of the needs and challenges that each would encounter in the future.

Lessons Learned

After reflecting on our experiences with the Two Georgias Initiative, I offer a few key take-aways to philanthropy and anyone attempting to partner with rural communities:

Embrace equity. Lean into equity as a way of thinking and acting that dismantles barriers, policies, and systems that keep all members of a community from having a role in what happens in their community. Recognize that providing training, technical assistance and support for addressing the challenging issues that emerge around health equity is an ongoing process and not a singular event.

Understand that change happens at the speed of trust. Many communities are distrustful of outsider’s intentions. Establishing relationships, having a visible presence in the communities you serve and being responsive to needs are critical.

Build leadership capacity and create a learning community. Community coalitions are largely comprised of volunteers and non-profit representatives who may have very limited experience with leading a community-driven project. This is an opportunity to build leadership capacity which ensures community buy-in and strengthens the individuals and organizations who will maintain the coalition beyond the initial engagement. The value of providing leadership support and technical assistance has been significant for both the communities and the Foundation.

Contribute to best practices in measuring health equity. Health equity-focused evaluations help determine if your program is reaching the underserved population that is experiencing inequities. For further work to continue to have an impact, we must leave behind a road map for those who follow.

When philanthropy can support rural communities to identify and address their own challenges and work toward trust, we CAN be part of positive change for the long-term. By leaning into conversations about health equity and building community leadership we ensure that those changes will be positive, sustainable, and powerful for everyone.

Lisa Medellin is Vice President of Community Engagement at Healthcare Georgia Foundation.