Examining the Groundwater: Understanding History As Context For Upstream Structural Interventions To Advance Health Equity

HealthBegins May 25 Webinar (Twitter)


Federal and state policymakers have introduced new health equity standards and requirements for health plans and systems. Teams across health care are now working to meet these new standards and, we hope, to stretch beyond minimum requirements and move upstream to substantially transform health inequity for whole populations. In order to do that well, healthcare leaders and teams need to understand the groundwater in which we stand: the historical and structural roots of current health and healthcare inequities.


A deep grasp of this context is essential to drive the necessary transformation through which our healthcare institutions (and community partners) will not only meet equity requirements but also meet the broader challenge of this moment. So vanguard leaders are helping stakeholders to do just that—to deeply internalize the reality that we live in a racially structured society and understand how we got here.


In this webinar, we joined forces with the Groundwater Institute to share the groundwater metaphor, shone a light on the historical roots of racism, and spelled out how the effects permeate both health and the work of health care today. With this history as our guide, we identified solutions to advance equity across multiple domains, from healthcare delivery to the power of healthcare institutions in society.



  • Rishi Manchanda, MD, MPH, CEO, HealthBegins (host)
  • Monica Walker, Partner, Groundwater Institute
  • Bay Love, Partner, Groundwater Institute
  • Jen Goldsmith, Consultant, Groundwater Institute
  • Sadena Thevarajah, JD, Managing Director, HealthBegins


Webinar Objectives:

By the end of the webinar, attendees will be able to:

  • Describe the groundwater metaphor and its three core observations about structural racism.

  • Explain implications of this metaphor for current healthcare and social sector efforts to improve health equity and social drivers of health.

  • Identify strategies to deepen understanding of structural racism and develop structural interventions to improve outcomes and opportunities for patients and communities harmed by societal practices.


Watch webinar

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