211: Equity Under Pressure with Dr. Giridhar Mallya
Health doesn’t begin in a doctor’s office — it begins in the policies, systems, and opportunities that shape our daily lives. In this episode of The Health Disparities Podcast, we sit down with Dr. Giridhar Mallya, a physician and national policy leader at the Robert Wood Johnson Foundation, to unpack what it really takes to advance health and racial equity when the environment around us is shifting fast.
Dr. Mallya brings a rare blend of lived experience and professional insight. His family’s immigration story began during a pivotal moment in U.S. policy, giving him an early understanding of how laws can expand — or restrict — opportunity. Years later, his work as a clinician and public health official in Philadelphia exposed him to the preventable suffering created by inequitable systems, and ultimately pushed him toward policy change as a tool for collective health.
In this conversation, he joins host Christin Zollicoffer to break down the realities of today’s climate: the rise of restrictive laws, the misinformation surrounding equity work, and the fear many organizations are navigating. Dr. Mallya offers clarity on what remains legal, what remains essential, and why stepping back from equity is not an option if we want healthier communities.
Together, they explore:
- How funders are defending equity work in the courts
- Why integrating equity into everyday health initiatives strengthens outcomes for all
- What governments and institutions can learn from states facing the toughest restrictions
- How leaders can stay grounded in mission while adapting to new constraints
- The personal values and experiences that continue to guide Dr. Mallya’s commitment to justice
Dr. Mallya’s message is both practical and hopeful: equity work is not only lawful — it is effective, necessary, and central to building a nation where everyone has a fair chance at health.
The transcript from today’s episode has been lightly edited for clarity.​​
Dr. Giridhar MallyaÂ
You know, I think a story that’s been told, especially over the past year by this presidential administration, is that work on health and racial equity is illegal, divisive and UN American. We’ve been hearing that over and over again for the past year plus. And I think what we are saying to people is that that’s a false narrative. It is meant to distract and divide people, and it is keeping all of us, every race, every background, every zip code from achieving our full health. And what we’re saying instead is that the vast majority of work around health and racial equity continues to remain legal, that it is essential and necessary because we are still seeing disparities in health outcomes by race, across basically every health issue then that you can see. And then last that Lastly, health and racial equity efforts, when they’re designed thoughtfully and implemented, well, do improve health. They close gaps by race, and they actually improve health for everybody.
Christin Zollicoffer (she/her)Â
You’re listening to the health disparities podcast from movement is life. I’m Christin Zollicoffer, movement is life board member and an executive coach and Health Equity facilitator. Today’s episode is one I’ve been anticipating, because we are joined by Dr. Giridhar Mallya, a family physician, policy leader and Senior Policy Officer at the Robert Wood Johnson Foundation. Dr Mallya has dedicated his career to advancing health equity, ensuring that health is not a privileged reserved for some, but a right for all, and as a child of immigrants, Dr Mallya’s own family story reflects the power of policy change. His father came to the US as a graduate student in Mississippi in 1965 at a time when immigration laws shifted to open new opportunities. That experience shaped his deep commitment to equity and his understanding of how laws and systems impact real lives. So today, Dr. Mallya joins us to discuss how funders are continuing to invest in health and racial equity work despite political and legal challenges, and really how organizations can remain resilient and true to their mission in these uncertain times. Dr. Mallya, welcome to the health disparities podcast. Thank you for being here.
Dr. Giridhar MallyaÂ
Thank you so much, Christin, and I really, really appreciate the kind introduction and welcome. Absolutely.
Christin Zollicoffer (she/her)Â
We’re excited to have you. We have so much to talk about. We have a good 30 minutes, so let’s just go ahead and dive in. All right. So folks, let’s just get started. Can you start by sharing why health equity is so central to the mission of the Robert Wood Johnson Foundation.
Dr. Giridhar MallyaÂ
Yeah, our mission as an organization is for health not to be a privilege just for some people, but a right for everybody. And I think it’s just based on this basic premise that everyone deserves health, and that our current system, our current health system, and really just our nation, hasn’t been able to guarantee that for everybody, and the folks who have been deprived of health to the greatest degree are people of color, people with limited income and limited wealth, people who are geographically isolated from things that promote health and who are in communities that actually have things that are harming their health. So these are all based on decisions that we make as a as a society. These systems are designed to produce the type of inequitable outcomes that we we see, and that can feel very it can feel very heavy. But at the same time, if we design systems to produce these unequal outcomes, we can also design systems to produce more equal outcomes for everybody. And I think that’s that’s the basic basic premise, that everybody deserves health, and we have an ability to to achieve that if we work together in concerted values driven ways.
Christin Zollicoffer (she/her)Â
Robert Wood Johnson Foundation has a strong mission and always has. So I’m thinking you’re a family physician and you were based in Philadelphia. How has your clinical experience informed your perspective on health equity? What have you seen that really influenced this work for you?
Dr. Giridhar MallyaÂ
Yeah. Yeah, so in Philadelphia, I both practiced as a family doctor, and I also was a senior leader in our public health department for about seven years. So I think it’s both the clinical side and the public health side that really helped me see both the challenges, but then also point pointed me towards some solutions. I’ll take you back to a very particular moment. I was a family medicine intern. I was working in the intensive care unit in South Philadelphia in Methodist Hospital. It was a fairly small ICU with maybe about 20 patients, and I was just taking a moment during a very busy night to think about the people I was helping to take care of, and as I started to look down the line of patients who are under my care and a colleague’s care, I realized that every single one of them was now suffering a serious consequence of an illness that was completely preventable and treatable. So a stroke from high blood pressure, acute respiratory distress from alcohol poisoning, another patient who had had a severe heart attack and additional complications because of a very, very long history of smoking. And I thought, this is tragic, this is unnecessary, and I’m so thankful that we were able to provide them this very high level of critical care, but I just wish that we could have kept them healthy and prevented them from having to experience this. And I think that was one of the moments that really helped me realize that while I loved the practice of family medicine, I wanted to be able to work on the conditions, the policies that were either enabling or preventing people from staying healthy, from being able to live out their full purpose and calling. So I think that’s one of the things that really drew me to work on policy and community health.
Christin Zollicoffer (she/her)Â
Oh, you know, that resonates, and when you see it firsthand, and you see, because you know, when you’re looking at those conditions and you’re saying, Hmm, what’s the common factor? Is it access? Is it education? What was it for Philadelphia, for those patients, for you, did you think was the common, you know, denominator that you wanted to be able to solve through policy? Was it access? Was it just disparities? What was what came to mind for you?
Dr. Giridhar MallyaÂ
Yeah, I think, I guess I eventually thought about it in two ways. The first was that, you know, let’s, let’s take the patient who was there because of complications of 30 to 40 years of smoking. When I started in the health department, our rates of smoking in the city were close to 30% and that really struck me, because I thought, I thought we had kind of solved the problem of tobacco use in this country. This was in the late 2000s right around 2008 so I was I had lived in the city and practiced in the city for a while, but I didn’t realize the rates of smoking were so high. And I thought, there, I know that we can do something about this, but, but why haven’t we? And I started to kind of unpack the problem with my colleagues in the health department, talking with a lot of people from across the country who had had success with tobacco control, and I realized that we really hadn’t put in place the effective policies that make a difference, so things like making sure that Medicaid programs actually covered Smoking cessation services and supports ensuring that tobacco products that their prices actually reflected the degree to which they caused harm in communities, and thirdly, that the main messages that were people were Seeing about tobacco products in our city was that tobacco products were cool, that they were appealing, that they were part of a vibrant life. We heard this from school students all the time, that the thing that they that they saw as they walk from home to schools they passed a corner store, was just ad after ad after ad for tobacco product. So that first part of the answer was, let’s then put in place all the things that we know can reduce the harms of smoking and at the at the individual level, if you ask a smoker, I’ve had many smokers in my life the. Vast majority of whom have now quit. Nine out of 10 smokers, and this is true across the globe. Regret ever having started in the first place, and the vast majority of smokers have tried to quit in the past year, but it’s incredibly hard to do because these products are designed to addict people. So we put in place over the course of about 10 years, a series of policies to reduce the burden of tobacco use, and now we are down to about 14% in our city, which is the national average, and we have seen particularly big declines among racial and ethnic minorities and among people with limited incomes, and that is making a difference now to their health, and is it is making a difference in the future to the health of our community? We’ve seen cancer rates, cancer mortality rates go down partly because of this. So I think that’s one part of the answer. Put put effective policies in place that can help people in communities stay healthy.
Christin Zollicoffer (she/her)Â
I appreciate you walking through that example, because it does speak to a couple of things, the power of one person, right, and the desire and the shift that says, I can make a change. It may feel like a large problem, but we can make a difference. And even though the systems may be in place to influence those who may not know or may not have the power to impact change. We certainly can as individuals. So thank you for walking me through your historical background. That is powerful. Now I would love to shift organizationally when we’re thinking about funders and practitioners in our current space of health equity, it has been under attack since last year, and we know that many funders and practitioners worry about the legal risks and even lawsuits in today’s age. How do you advise organizations to maneuver in this climate of uncertainty?
Dr. Giridhar MallyaÂ
Yeah, you know, I think a story that’s been told especially over the past year by this presidential administration, is that work on health and racial equity is illegal, divisive and UN American. We’ve been hearing that over and over again for the past year plus, and I think what what we are saying to people is that that’s a false narrative. It is meant to distract and divide people, and it is keeping all of us, every race, every background, every zip code, from achieving our full health. And what we’re saying instead is that the vast majority of work around health and racial equity continues to remain legal, that it is essential and necessary, because we are still seeing disparities in health outcomes by race across basically every health issue then that you can See. And then last that Lastly, health and racial equity efforts, when they’re designed thoughtfully and implemented, well, do improve health, they close gaps by race, and they actually improve health for everybody. One, one example I like to point to is around cancer care. Cancer Care is complex, and people who are experiencing cancer, as many folks listening, probably have somebody in their family that has experienced it. It is a scary, unsettling experience to go through. And then on top of it, to try to have to navigate Cancer Care becomes just even more difficult. So this one set of health providers said, Okay, we want to try to make cancer care less complex, and we want to make it responsive to people’s needs. In addition, we want to close racial gaps in access to cancer care. So here’s what they did. They said, We’re going to actually track outcomes by race and use that as one of the metrics for tracking our success. Second, we’re going to train our providers, not only on high quality cancer care, but also on core elements of health equity. And then third, we’re going to give cancer patients and their families cancer care navigators that are culturally rooted, including having care navigators that look like the patients in that system and come from the same neighborhoods, as you can imagine when you put all those things together, the results were incredible. So not only did racial gaps in completion of care for breast cancer and lung cancer close, not only did those gaps close for the timeliness of that cancer care, i. Yeah, but those outcomes improve for patients of all races, and I think that is one thing that we’re emphasizing, that health equity work. Yes, it is about repairing past and ongoing discrimination, but it’s also about bringing higher quality care to everybody here.
Christin Zollicoffer (she/her)Â
Speaking of cultural concordance with the health navigators, it raises trust, it raises adherence levels. It really does speak to the core of the patient, and provides customized needs, you know. And I, you know, this is just Kristen, because I’ve been in the DEI space for quite some time, you know, to me, health equity also means customized, yes, and that customization goes to so many different levels, whether it is gender equity, race, ability, whatever it may be. So yes, strong work on the health equity space. We know funders like Robert Wood Johnson Foundation, they have legal strategies to protect them against equity work. And can you speak to the efforts that you’re supporting now and why they are essential? Yes, so
Dr. Giridhar MallyaÂ
if we want this type of work to be able to continue, we need to be able to take the fight to the courts, if there are people saying claiming that this type of work that health systems and the governments and that private sector institutions are doing, if they’re claiming that it’s illegal, we need to be able to show in court that, no, that’s actually not the case, that most of this work is really about advancing civil rights and that these institutions actually have obligations to address disparities in quality and outcomes. So two things that I’ll highlight for you Kristin, the first is that we are supporting civil rights legal organizations who, among other things, are actually challenging policies from the Trump administration that are constraining diversity equity inclusion efforts, and they’re often winning in courts. One great example is a case that was brought against the termination of NIH grants focused on diversity, equity, inclusion, one of those cases brought by the ACLU foundation basically argued that these decisions by the NIH were arbitrary and poorly defined, that they did not follow the protocol that is required by law for canceling or terminating grants, and that the terminations were racially discriminatory. And the judge in the case said, Yes, I believe that argument that you’re making and these grants need to be reinstated. And hundreds of grants were reinstated because of that. Now there are still hundreds, if not 1000s of other NIH grants that have been canceled, and they’re having a huge impact on researchers, patients and communities, but that that was a win, and I think our partners are using those cases not only to get recourse for these unjust decisions, but also to tell one part of a larger story that this work is is necessary and lawful.
Christin Zollicoffer (she/her)Â
It is necessary. I’ve had many friends whose work has been canceled. Decades of work and research, of work that’s been canceled due to the loss of their grants over the time. So I appreciate the win, and hopefully we have some more wins coming down. But even with the stoppage of those grants, we know that some of the harm is close to irreparable, because to now, even if they were able to restart them, they’ve lost some of the momentum and some gaps, but so we are hopeful that we can pick up the work. You’ve emphasized that health equity work shouldn’t be hidden but folded into a broader health initiatives. Can you explain what that looks like in practice?
Dr. Giridhar MallyaÂ
So I think maybe another, another good example of this is work that we are seeing in governments. So I used to work in local government, and especially over the last four or five years prior to the start of the Trump administration, we saw governments at every level saying that a core purpose for us, if is to make sure that there is truly equal. Opportunity for everybody, regardless of race, classes of code, and that that is a core purpose of governing, because if everyone in a community, or if everyone in our nation can’t thrive, can’t fully participate in their family’s life, in their community’s life, and in the life of our nation, then that is not a true multiracial democracy. And we saw many governments, local, state and federal, say we are going to look at how government has caused racial harm and racial discrimination in the past. We’re going to audit it, we’re going to document it. Then we’re going to put in place strategies that try to reverse those to reverse those harms, and actually create some progress. And I think the governments that have been most effective at that have done two things, one, they’ve said racial equity strategies need to be incorporated into every part of government, into who our staff and workers are, into our policies and practices, into where we have public meetings and how we enable residents to engage in in those public meetings, so they integrate it throughout government, but then they also have offices and leaders that are specifically dedicated to the work of racial equity as a source of expertise and also as a source of accountability. So it’s a little bit of both, and where the work is integrated into every part of government’s function, but where you also have dedicated offices that are saying we’re going to help keep all of us accountable to the goals that we’ve we’ve set, and also to the values that we’ve said, that we’re committed to, and they’ve been able to continue that work and that structure over the past year.
Dr. Giridhar MallyaÂ
That’s a good question. In many, many cases, they have had to revisit how they structure the work, how they describe it, the titles that people and offices have, and when I talk with and I think it has revealed that some of the commitments were were not true and enduring. And that’s the case for government. That’s the case for the private sector. That’s the case for philanthropy. I think what we are seeing that some of some of the commitments weren’t genuine. Because I think you truly know if you’re committed to something in times of challenge and distress, that’s that’s what Dr King said. That’s right. But on the other hand, we are still seeing, and I think this is under reported in the press, we are still seeing governments and private sector institutions continuing to do the work. Some of them have had to kind of tuck and roll, as one of our partners describes it. They’ve had to tuck racial equity initiatives into other offices and strategies, and they’ve had to roll with resistance. They’ve had to sometimes compromise thoughtfully, for example, on what a program may be named or where it sits in the government structure, but while at the same time staying committed to the work. So I think, I think we’re seeing a little bit of both, some that are just pulling back, but others who are saying, No, this work is essential to the work that we do. It’s wanted and needed by our people. So we are going to find ways to do it creatively, even even with the pushback.
Christin Zollicoffer (she/her)Â
And quite frankly, what I’ve experienced is that, for those who were creative, it actually created even more expansive program. Even if the name changed, you’re relicking and rethinking policies, you really start to think outside the box, to say, how do we lift the tide for all? And then some gaps have even been opened and broadened when I say that. So for instance, if you’re looking at a policy for at an institution, and perhaps there was a specific program that was targeted for a specific group of people, but now they’ve created it creatively, revamped it, like you said, tucked it in, folded in equity differently so you think creatively like, Okay, actually, more people can benefit from this in a way that was unexpected or unintended. So looking ahead, how do you see philanthropic organizations evolving to better support health and. Equity and racial equity, specifically in diverse communities.
Dr. Giridhar MallyaÂ
I think the first thing Kristin is really what we’ve been talking about, that if part of your mission is to address health and racial equity, stay committed to the work. Be public and vocal about it if you can, and help provide cover for your partners in the field who are facing the real the real threats many, many of our partners are not only under threat of funding loss or potential investigation by the IRS for the nonprofit status, but but leaders of health and racial justice organizations are facing physical threats to themselves, to their families. So I think what it’s really important for philanthropy to remind itself is that we have a tremendous amount of power and privilege and protection that our partners in the field do not. So now is the moment to double down on financial commitments to health and racial equity work, but also to speak out, because we’ve seen that so many institutions have not been willing to do that, and I think philanthropy really does not have an excuse. We don’t, we don’t depend on the federal government for funding, and that has been used as a powerful tool against health and racial equity, against so many organizations, but philanthropy has been protected from that. Now, have we been under scrutiny as well? Yes, but you know, this is a moment when we really get a chance to live out our values and to build the trust of our partners in the field and our grantees, to show them that even in times of difficulty, that this is when we’re going to stick close by your side and continue investing in this work, because we know that it matters.
Christin Zollicoffer (she/her)Â
That resonates, because fear isolates, and the cure for fear and isolation is connection and talking to one another, whether it’s on an individual level, to know what else everyone is experiencing, but also connecting organizations to say, this is also What we’re doing to encourage creative thoughts and creative solutions. So spot on. And if you could leave one last message to our listeners who include funders, practitioners, clinicians, community leaders, what would it be?
Dr. Giridhar MallyaÂ
I’m going to give you two things, but I’ll be brief. The first is just restating what I said at the top, that work to advance health and racial equity is really about living up to the ideals of our nation that we’ve never fully lived out. So it truly is the work of America. It truly is the work of American democracy, and it by and large, remains legal, very necessary, and when done well, it improves the health of not only communities that have been marginalized because of their race, but it improves the health of all of us. So that’s the one thing I want to make sure people people hear. The second is that I think it’s more, maybe more about my personal motivation for this work. I do believe that every person, every human being, has inherent value and inherent dignity, and that that’s something that we get the privilege to really honor in our relationships and in our work. And one scripture from my faith tradition that really grounds me and gives me hope and purpose says that you know, what is our responsibility? Our responsibility is to do justice, to walk humbly and to show mercy, and that’s something that for me, every day reminds me of what I’m called to do and what I believe that we’re called to do as human beings,
Christin Zollicoffer (she/her)Â
Such a strong Guiding Light. Thanks. I’d love to thank our guest, Dr. Giridhar Mallya , for joining us today and for sharing your insights, your personal story and your vision for a more equitable future in health and in policy. That brings us to an end of another episode of health disparities podcast from movement is life. I’m Christin Zollicoffer until next time, be safe and be well.