Former Health Program Managing Director David Fukuzawa shares his hope for the future

In September 2020, David D. Fukuzawa retired as managing director of The Kresge Foundation’s Health Program and transitioned to a new role as special advisor to the president. In the conversation below, he shares his reflections on his career, thoughts on the field of philanthropy and his hope for the future.

How has your approach to philanthropy changed over time?

I think the biggest difference may be the framework for how we frame challenges and their solutions. I think that philanthropy, when I started, was very much focused on funding specific projects that were usually designed around a specific testable intervention to solve a specific problem. Or it was focused on demonstrating the effectiveness of certain policies and practices aimed at addressing a specific need or problem. The ultimate goal, in many cases, was to build support, especially via government funding, for widespread replication or scaling up of the program.

While these kinds of projects are still important, have their place and certainly haven’t disappeared, we now realize that problems are ultimately rooted in systems, especially institutional and structural racism. Therefore, solutions need to be aimed at systems change.

Think about housing segregation, for example, or environmental justice. These are examples where policies and land use either deprived communities of opportunities or exposed them to serious health risks. To me, that’s the key difference is that we look both further upstream and deeper into history to design solutions.

What do you enjoy most about your work?

The thing that is most gratifying about my work is seeing all the wonderful things that people are doing on the ground in communities all across the country that are really making a difference in the lives of communities. That they are really fighting the good fight, or as John Lewis said, they are seeking good trouble in communities all across the country.

It is these hundreds and thousands of examples of community-based nonprofits that are really carrying the torch towards justice and equity and well-being all over. And to me, I have always thought that that is the great untold story. Despite all the problems that people think about or read about in the newspaper or hear on the news, there is a lot of really good things happening.

How have you seen philanthropy change?

I don’t know if I could make a neat characterization of all of this, but I do have a few observations.

First, I think that the question of who is doing philanthropy has changed. While foundations still have a long way to go, you certainly see more program officers of color, if not a few more executives and CEOs of color. We’re still far from moving past the long tradition of an elitist, white-controlled sector, but it has changed.

Second, I also think that society has changed too, especially with the internet and technology, and that how we think about our problems also has shifted. There is this new wave of folks who often come from a high-tech entrepreneurial background. A lot of that philanthropic money is focused on impact and trying to tackle very big problems.

Often, these newer philanthropies have a social impact investing mindset. And this is the third change I’ve seen. These new philanthropists seek a double or triple bottom line – do good for people and planet, but also do well, in terms of financial return.  Of course, Kresge’s been a part of that whole movement too, and our Health Program also supported several big social investments early on. But this is something that is continuing to grow, and it is influencing how we think about philanthropy.

Within health philanthropy, the emergence of conversion foundations over the past couple of decades has really expanded the number of foundations focused on health. And they’ve been heavily influenced by the larger push towards health equity, which is really looking at the social determinants of health. So that has I think changed a lot from what health philanthropy used to look like.

What issues do you think deserve more attention?

The big issue that is getting a lot of attention from foundations is racial justice and structural racism. Several foundations have made multimillion-dollar commitments to supporting Black led movements. I think this is long overdue, but there is still a long way to go.

There is not only the question of support for the racial justice movement, there is also the question of internal foundation practice and culture. Foundations continue to be largely institutions that reflect the dominant—and white—society and culture. Where philanthropy needs to change is not only where it directs its dollars, but how it makes the decisions about those dollars, and whose voice counts. Historically, academia, big policy and research institutions and the consultant industry have been the chief source of advice and guidance for philanthropy. But a growing number of people, including foundation executives and boards, are challenging the field to pay more heed to the lived experience and expertise of people closest to the problem.

In many ways, one of the biggest challenges is that philanthropy is still organized around specific fields or topics, such as health, education, arts and so forth, but the problems we have traditionally tried to solve for have deeper roots in racism. In health, for example, we speak about the social determinants of health, but in many instances, these can be traced back historically to racialized policies which privileged some populations, and marginalized others. So solutions will have to be both designed to undo the immediate harm and also open the door to a longer term effort to restore and repair.

Solutions also need to be multi-sector. We cannot achieve healthy communities through health care and public health alone. What are the community structures that are going to allow health to really engage in this bigger solution? I think we’re still figuring that out.

Another area that needs more investment and investigation is around social and economic mobility and the intersection between health equity, racial equity and social economic mobility.

I also think that we need to understand better how to invest in communities.  A great part of this is our commitment over the long term since repair and restoration doesn’t happen overnight. So, what are the near term and what are the longer-term investments? What is a more systematic way of reinvesting in communities?

We need to look at urban communities in a different way. Not seeing them as places of deficits and pathologies, as concentrations of poverty and crime, but more as histories and stories that need to be told, and assets and wisdom that can be leveraged.

How would you like to see philanthropy continue to change in the future?

One of the big changes that I would like to see is that philanthropy begins to precisely understand this position of advantage and power that it has. What philanthropy must be about is not just doing good, but also undoing the harm that has been done. Rather than just fixing a problem, it is about thinking about what it is upstream that are leading to these different problems we have?

Almost every dysfunction we have in society, every bad outcome we could think about, whether it’s bad health or bad educational outcomes or poverty, ultimately go back to similar roots. And it’s just simply how they unwind in people’s lives that really matter. And a lot of that has to do with situations that people are born into through no control of their own. What can philanthropy do to help undo a lot of that injustice and inequity?

That means thinking about supporting communities in a different way. We can’t undo half a century or more of redlining, but what we can do is help communities be a part of reimaging how we live in those communities and what those communities need to have in order to thrive.

The process may not be a smooth one, but I think society is at a stage where there are more people receptive to different ways of solving problems.

What advice would you give to someone just starting out in the field of philanthropy?

Listen and be humble. Because whether you want it or not, you’re in a position of considerable power and influence and how you begin to understand that in a way that allows you to be effective without being arrogant or being elitist or being superior, is a temptation that probably anyone who has been in philanthropy understands. So how to listen and be humble, I think is always to me, the best advice, in the very beginning, when coming in.

What gives you hope?

I’m always hopeful about how things can change. I’ve been in philanthropy alone for over 30 years—and in Detroit for 40– but despite the multiple crises we’re that we’re experiencing in this country, I continue to see that moral arc in the universe and it is moving towards something.

Despite all the obstacles and the steps and challenges, the defeats and setbacks, we are seeing, I believe, one of those generational moments of change.

Younger people who are carrying forth the work in a way that is inspiring to me. So many of these movements are being led not by older people, but by kids. That to me is remarkable. It gives me hope.

Editor’s note: Fukuzawa will be retiring as special advisor to the president at Kresge in January 2020.