Health Care

The Duke Endowment believes that maintaining health over time is dependent on a person’s ability to lead a healthy lifestyle and access essential health care services. We support reforms that ensure an individual’s basic medical and social needs are met, so they can enjoy the best health possible.


The U.S. spends more on health care per capita than any other country but does not achieve better outcomes in terms of life expectancy, health status or patient satisfaction. It fails to provide equal opportunities for health and well-being to all segments of the population. These failures contribute to large disparities in health status and health care utilization based on a range of social factors, including race and ethnicity, income, and where a person lives. Our health care system is designed to provide excellent medical care to the sick; however, it often fails to take a comprehensive approach to preventing illness and supporting wellness.

Our Objective

We seek to improve health status and reduce health disparities in the Carolinas by ensuring all people can access timely and appropriate health care, lead a healthy lifestyle and have their basic social needs met.

What We Fund

Improving health and reducing health disparities will require communities and the health care system to innovate. We look for opportunities to support the development and testing of new approaches that can outperform the current standard of care. These new approaches will require robust evaluation plans that can build the evidence necessary to understand what works and accelerate the systemic reforms necessary to scale and sustain best practices.

Our founder’s keen interest in innovation drives us to consider new ways to optimize person-centered and community-based approaches to improving health. The majority of grants will follow one of our two strategies.


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Enhance Patient Care

We work with health systems and their community-based partners to identify, test and spread innovative practices that have the potential for scale and sustainability. We prioritize models that build capacity to provide essential health and social services to vulnerable populations. We know that by providing access to culturally appropriate care at the right time and place, health improves, and disparities are reduced.

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Improve Community Health

We advance programs and policies that promote healthy lifestyles and address social determinants of health. We create opportunities for collaboration to meet community needs and ensure local voices inform improvements. We prioritize data collection and sharing so that partners are better equipped to identify opportunities and target interventions.

Apply for a Grant

Select 501(c)(3) organizations in North Carolina and South Carolina may be eligible to receive funding.

Before You Proceed

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Project Details

Project Details

Advancing Mental Health Services

The lack of access to mental health and substance abuse treatment services throughout the Carolinas significantly impacts the health of individuals, families and communities. The Health Care program area seeks to identify service delivery models that promote mental health and well-being for adults, adolescents and children, with a priority on holistic approaches to early intervention and treatment.

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Project Details

Strengthening the Health Care Workforce

Over 90 percent of counties in the Carolinas have at least one partial designation as a Health Professional Shortage Area (HPSA). The Health Care program area seeks to ensure an adequate diverse workforce that can address critical shortage areas, maldistribution of staff and support new complementary personnel models.

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Project Details

Improving Oral Health

Poor oral health can result in lower quality of life and poor health outcomes. It can negatively impact self-esteem, employability and the ability to learn. The Duke Endowment seeks to improve the oral health delivery system throughout North Carolina and South Carolina to ensure every adult and child has access to essential dental services.

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Project Details

Improving Population Health

As the United States advances value-based payment methodology, the Health Care program area is building capacity at the state, regional and local level to link government, health, and social services so that Carolinians have the opportunity to increase healthy behaviors and address their social needs.

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Project Details

Expanding Access to Care for Vulnerable Populations

Across the Carolinas, too many vulnerable residents lack insurance or go underserved. The Health Care program area seeks to reduce health disparities, improve clinical outcomes and reduce inappropriate hospital utilization by increasing access to essential services for low-income uninsured adults and underserved populations.

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Project Details

AccessHealth — Networks of Care for the Low-Income, Uninsured

The AccessHealth initiative launched in 2008 to reduce health disparities, improve clinical outcomes, decrease avoidable hospital use and expand access to care among low-income, uninsured adults.

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Health Care Grants

For a full list of our 2022 grants, see the 2022 Annual Report Grantmaking Addendum. Many of these grants represent multi-year commitments.

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