In the United States, the convergence of the 2020 social justice movement and the COVID-19 pandemic prompted philanthropic organizations to explicitly center social justice and equity within their grantmaking practices. However, shifts in the sociopolitical landscape in 2025 altered the trajectory of progress on health equity. Early in the year, a federal executive order reversed several equity-focused initiatives, placing federal support for health equity research and programs at risk. As federal funding retreats, philanthropic organizations are being looked to as critical players in sustaining health equity efforts. However, one cannot overlook philanthropy's ties to wealth, privilege, and its history of philanthropic redlining. This tension highlights the role of communication scholarship, which extends beyond understanding and explaining; it is also tasked with critiquing and intervening to bring about change. The socio-political context shapes the focus of this dissertation, interrogating how health philanthropies operate, how they integrate lived experiences, and how they are navigating the anti-equity backlash while maintaining their commitment to health equity. The study employs an integrated conceptual framework that combines the socio-ecological model (SEM), community-based participatory research (CBPR), and the culture-centered approach (CCA) to examine communication processes across health philanthropy. Methodologically, this dissertation used a two-phase design. Phase 1 examined developments in health philanthropy at a macro-level using computational methods. Phase 2 draws on in-depth interviews with 30 program staff across health philanthropic organizations to explore how equity is communicated and operationalized. Health philanthropy and public health are not immune to politics, as both are deeply embedded in cultural and structural contexts. This dissertation shows that communication is a constitutive process through which philanthropic practices are made possible, whether in storytelling, relationship building, narrative change, or resistance. The findings demonstrate that health philanthropies are increasingly treating lived experience as an asset, although it is not uniform across foundations. Finally, foundations reported experiencing anti-equity backlash; this dissertation offers a responsive framework as a blueprint for how health philanthropy can exercise agency in the face of opposition. Ultimately, this dissertation has sought to open the “black-box” of health philanthropy by showing us that the pursuit of equity is not only material but also discursive.
Arpita Jindani (Thu,) studied this question.