My 2023-24 Annual Letter on Philanthropy

When a crisis recedes from view, it’s natural to want to move on. But it’s also a mistake — and a surefire way to sleepwalk into the next crisis. There is no better time to take stock — and act — than in the aftermath of a crisis.?

When the global pandemic receded from everyday life, many elected officials couldn’t wait to move on, including here in the United States. Because of that, many serious problems that existed before COVID-19 have only grown worse. Without urgent action, they’ll continue to snowball — with tragic consequences. That’s particularly true in two areas that are major focuses of Bloomberg Philanthropies ’ work: health and education.?

U.S. life expectancy was declining even before COVID. And while other countries have seen their life expectancy return to (or close to) pre-COVID levels, the United States has lagged behind. Even though life expectancy for Americans is lower than it has been in two decades, elected officials have mostly shrugged. At a time when the country is deeply divided by politics, confronting this health crisis should be an issue that unites both parties, because the challenges that lie at the heart of it — from drug addiction to obesity — affect people of all political stripes.?

The same is true when it comes to public education. America’s schools have long been failing to prepare students for college and careers, and the pandemic made the problem much worse. Remote schooling was a disaster for students, especially those who were already furthest behind. Unless we find ways to help students make up for ground lost during the pandemic, the learning loss caused by COVID will haunt them — and our country — for many years to come.??

These twin challenges — declining levels of health and education — are too big for nonprofit organizations to tackle alone, but they can help lead the way. Bloomberg Philanthropies is focused on both challenges — and for each, our team is working to create new models that can be scaled and replicated.

HEALTH

While healthcare providers are focused on saving and improving one life at a time, public health leaders are focused on saving and improving millions of lives at a time. Both fields are crucial to reversing Americans’ declining life expectancy, and strengthening both is a major priority for Bloomberg Philanthropies.?

Healthcare

One of the problems that has gotten much worse since the pandemic is the shortage of primary care doctors and nurses. That’s partly because of a wave of retirements and early resignations, but also because the high cost of medical and nursing school is keeping away too many prospective students.?

That’s especially true for students from low-income families who face the prospect of taking on heavy debt in order to graduate. Many who do matriculate end up dropping out because of financial pressures. And those who graduate often choose to work in the most lucrative specialties in order to repay their debts, rather than in fields and communities that are most in need. As a result, the United States has too few primary care doctors and nurses, especially in low-income areas, making the decline in life expectancy especially difficult to reverse.

Making medical and nursing school more affordable is a society-wide challenge, but individual schools — and donors — can help lead the way. To reduce the financial barriers at my alma mater, The Johns Hopkins University , Bloomberg Philanthropies is making a new gift that will cover tuition for a majority of students at its medical school — and many of those students will also have their living expenses covered.?

Experience shows that knocking down barriers to education can lead to real progress. In 2018, Bloomberg Philanthropies contributed $1.8 billion to Johns Hopkins to ensure that students are accepted regardless of their family’s income, so more applicants from families of modest means — like I was — can have the same chance I did. This gift has permanently established need-blind undergraduate admissions, and reduced the debt burdens that students are forced to carry.

That has helped to change the makeup of the student body. Over the course of a decade at Johns Hopkins, students from the families with the greatest financial need went from making up only nine percent of the student body to 21 percent of the student body — a higher percentage of high-need students than there is at Harvard, Princeton, MIT, and nearly every other Ivy League and Ivy League-adjacent institution. And as Johns Hopkins has become more economically diverse, it has also become more selective. More generous financial aid has attracted more of the nation’s top students, including many from lower-income families who might not have applied before.

This additional new gift of $1 billion will not only make Johns Hopkins’ medical school tuition-free for all with limited means, but it will also increase financial aid for graduate students at its schools of nursing, public health, and all its other non-medical graduate schools. This will help Johns Hopkins attract more of the nation’s brightest minds and help free more of them to pursue the fields that most inspire them, rather than ones that will best enable them to repay loans.?

I hope other schools will follow Johns Hopkins in reducing barriers to enrollment — and that other donors will help them do so.

Public Health

Just as the United States needs more doctors and nurses, we also need new approaches to preventing the problems that are harming Americans’ health.?

That’s the focus of the Bloomberg American Health Initiative , based out of the Johns Hopkins Bloomberg School of Public Health . The initiative, launched in 2016 with a $300 million commitment, brings people together from across society to comprehensively address five major causes of declining life expectancy: diet and lack of access to healthy food; environmental hazards like air and water pollution; adolescent health; violence, especially gun violence; and the devastating epidemic of opioid addiction and overdoses.

Guns and opioids in particular are major reasons why the United States has fallen behind other countries in life expectancy, thanks in no small measure to the lack of action at the federal level. The United States has far higher rates of both gun deaths and overdose deaths than other high-income countries. Our team has been leading the charge for common-sense gun laws by supporting Everytown for Gun Safety , which is making progress state by state, despite inaction by Congress. And in the absence of a comprehensive national strategy, our partners have been working with some of the states hit hardest by the opioid epidemic to implement efforts that can be replicated around the nation.

Our support for cities that are committed to protecting public health has also continued to grow. Mayors have a critically important role to play in helping bold new policies take root and spread, and through our Partnership for Healthy Cities, mayors are taking action to confront the causes of noncommunicable diseases like cancer and heart disease.?

For a long time, these and other illnesses were considered unavoidable, but mayors are helping to prove otherwise. The policies they’re adopting — from passing smoke-free rules and tobacco taxes, to restricting junk food advertising and expanding access to healthy food — are helping to save lives. And to help bolster their efforts, Bloomberg Philanthropies has launched an initiative that is working to block the construction of new, polluting petrochemical plants. The last year produced some important early victories, as our partners prevented six major plants from being built, each of which posed serious health threats to surrounding communities.

EDUCATION & EMPLOYMENT

Students across America continue to suffer the consequences of learning loss caused by overly long school closures and poorly designed remote education. According to data from the National Assessment of Educational Progress, the pandemic wiped out a full two decades of student gains in both English and math. The pandemic also worsened the achievement gap between students of different races and between the highest- and lowest-performing students. In other words: The pandemic did the most harm to the kids who could least afford it.???

This amounts to nothing short of a national emergency. Nowhere near enough has been done to reverse the damage, despite an influx of funding from the federal government. That is leaving millions of students unprepared either for college or the workforce, with dire consequences for their career options. Bloomberg Philanthropies is working to tackle the crisis, both for college-bound students and those who seek to begin their careers earlier.

Basic Skills

Despite being far behind, far too few districts offer intensive summer instruction to give struggling students a chance to catch up. And many of those that do offer summer programs have focused on social and emotional support, not academic intervention. Learning social and emotional skills is important, but without a command of reading, writing and math, children will struggle to follow their dreams.

In 2022, our team joined a group of philanthropic partners to help launch an intensive summer learning program for New York City’s charter schools, called Summer Boost. More than 16,000 students participated in the first year, and the results were extremely promising: The percentage of students who met standards in math nearly doubled. In English, the percentage more than doubled. By the end of the summer session, many students had caught up and were back on track for success.?

Based on that success, in 2023, we joined with our partners to expand the program to seven more U.S. cities: Baltimore, MD; Birmingham, AL; Indianapolis, IN; Memphis and Nashville, TN; San Antonio, TX; and Washington, D.C. Students made similar progress across math and English as they did in the previous year. Bloomberg Philanthropies has committed to funding Summer Boost for a third year and hopes that other cities and districts can learn from the program and create or expand their own programs.?

The pandemic also accelerated a decline in public school enrollment in many cities, as more and more parents search for better alternatives. Meanwhile, charter schools saw major increases in enrollment. But there are long waiting lists for charter schools across the country, and not enough support has come from the federal government to open new charter schools. To begin meeting the demand, in 2021, Bloomberg Philanthropies made a $750 million commitment to create 150,000 new charter school seats in 20 U.S. metropolitan areas. Over the last year, progress toward that goal continued, with more than 100,000 new seats created and more than 30,000 students already enrolled in new or expanded charter schools.?

Employment Skills

Millions of students do not wish to go to college, yet when they graduate from high school, they don’t have the skills they need to enter the workforce, leaving them stuck looking for jobs that have little in the way of career growth and advancement.

At the same time, there are millions of open jobs that employers cannot fill. There is an enormous need for high school classes and curriculums to be restructured around student needs and interests, rather than the current one-size-fits-all approach, which is failing to serve students — and harming our economy, too.

The healthcare field is a great example. There are currently two million open healthcare positions that high school graduates could fill, if they had a modest amount of training and education in high school. And unless something is done, the number of open jobs is expected to double by the end of the decade.?

Making matters even worse: The staffing shortage is on a collision course with America’s aging population. By 2030, all baby boomers will be 65 and older, and their longer life expectancies mean that the need for intensive, hands-on, 24/7 medical care will continue to rise.

Until elected officials get serious about addressing the shortage of qualified healthcare workers, the quality and availability of healthcare will decline — and millions of students will be stuck working jobs with lower wages and fewer career opportunities than they should be enjoying.

We can’t accept that. Too many lives are at stake. And so in 2023, we teamed up with school districts, healthcare systems, and local nonprofits to create specialized new high schools that will provide students with hands-on training and paid internships at partner hospitals. Upon graduation, students will have the option to continue their education or go straight to work at a partner health system.?

If this initiative succeeds, it can serve as a model for other high-growth industries. The operating model of American high schools is stuck in the past, and it’s leaving too many students behind, with tragic consequences for them, their communities, and our country. We need elected officials and education leaders to find new and better ways to connect them to growing fields and careers, whether or not they decide to go to college — and philanthropy can help lead the way.

Taken together, we hope these health and education measures will inspire leaders, especially in government, to think and act more boldly. Until that happens, the pandemic’s tragic consequences — shortened lifespans and diminished opportunities — will continue to plague us.

Sincerely,

Michael R. Bloomberg

Read the full Annual Report here: https://bloombg.org/3NciECs