By Esther Babawande
When there is a conscious shift in our ideals, beliefs, and attitudes—we respond.
When that conscious shift happens on a national scale communities’ band together and responds collectively. We gauge different communities’ responses to compare them and look for what works, we ask questions expecting answers.
As a nation, a collective shift is occurring that reveals more than ever before the reality of being a person-of-color (POC) in America, the intersectionality of living with COVID, and being a POC, and the grave consequences this experience has on an entire community’s health and wellbeing. Along with that shift, came a question, many communities are exploring the answer to How do we bring about change to this seemingly never-ending system of racism in America?
On June 4th, Health Leads’ hosted a webinar titled Equity’s Role in SDOH Interventions: Advocacy and Systems Change, that involved a panel led by three “health equity champions” in their respective fields advocating for their answer to this question: broad systems changes that dismantle institutionalized inequity, with a focus on race and power structures. The panel consisted of Dr. Rhea Boyd, a Pediatrician and the Chief Medical Officer for San Diego 211, Dr. Daniel Jones, a Chair on the University of Mississippi Medical Center board, and Dr. Lauren Powell, Founding Executive Director of TIME’S UP Healthcare. Dr. Boyd and Dr. Powell and Dr. Jones all spoke on representation, equity, allyship, and emerging opportunities for widespread change. Yet, each focused on specific aspects of action to dismantle these inequities.
For Dr. Rhea Boyd, the present systematic inequities are the result of a well-functioning system designed to keep power for the few.
“When we see situations of racial inequity, it’s not a glitch, it is the system working as it was designed to,” said Boyd. She goes on to explain that racial inequity is ingrained in the makeup of every part of the health system. As one goes up to the highest echelons of the healthcare system, it becomes less and less diverse. It results in a cycle where those making widespread decisions don’t represent even a percentage of the people impacted by their choices. Racial inequality affects “the populace never the individual.” Boyd affirmed that healthcare systems need communities of color to own and drive their narratives.
Dr. Lauren Powell drives that point across, by encouraging present communities to be proactive rather than reactive to these truths through messaging, education, and policy work. Community voice can be leveraged for systemic change, according to Powell. “This is a chance to right some wrongs,” Powell emphasized. “Remind our leaders to move towards righting wrongs.”
Powell recounted her positive experience on the Virginia Equity Task Force, when formulating a COVID public health messaging campaign, the team had to acknowledge that telling black communities to “wear a mask” also came with an additional step of “not weaponizing black and brown bodies through the wearing of a mask.” They had to explore what that looked like, whether it was providing masks to black communities specifically, in addition to changing their messaging campaign. Powell’s team took responsibility for protecting their communities from “the double fear of getting COVID and also being killed as a black person wearing a mask.”
This bright spot in Virginia highlights what happens when people in power keep community voice as a priority. Before communities of color can truly own seats in power those people in power who are not representative of the community must relinquish their power to these community members.
This is where allyship is critical.
Dr. Dan Jones is experienced in healthcare interventions in communities of color as a chairperson on the University of Mississippi Medical Center Board. Jones is a white man. White people in power— specifically white men— need to shift their thinking of allyship. They need to acknowledge their privilege. And, they need to understand how people view them as a result of their position. Most importantly, “white allies must be ready to yield power to Black and Brown community members.”
Jones acknowledges that this process is difficult but affirms that it is necessary. He supports other allies who are actively learning when to be a loud voice, and a quiet voice.
“You have to tackle your subconscious bias and be open to yielding power to the community and people representative of change,” Jones said. Acknowledging bias is just one way to address the effect of bias on our work. According to Jones we must go a step further by developing accountability structures, even checklists, to monitor and prevent SDOH intervention perpetuation of bias (implicit and explicit), systemic, racism, and white supremacy.
To engage with more of the strategies the panelists have, check out the video below:
1. Healthcare organizations should leverage all their assets, including hiring, purchasing, and investment for equitable, local economic impact. Government organizations need to recognize, single out and dismantle policies of oppression.
“Budget decisions have to be made before the fiscal year. Be cognizant of cuts to programs to certain communities. CARES money is pouring into states. Ask where it is going.” – Dan Jones
2. Create processes and structures that allow health systems to proactively hear and understand community priorities and nuances to inform the development of SDOH interventions.
“Actively develop relationships- bidirectional communication between community leaders (faith groups, cbos, etc.) and your organization. Include community voice upfront, not after the decision has been made.” -Lauren Powell
3. Move SDOH interventions beyond resource navigation to explore the root causes of inequities and address it in policy reform. Leverage data and move to action.
“It is a manifestation of white supremacy, to show the numbers and try to justify discrepancy. People sometimes use data as an excuse not to act. Continuous data collection to define an already acknowledged issue is a waste of resources and money.”– Lauren Powell
- Dr. Rhea W. Boyd, pediatrician, medical educator, child health advocate, and health data activist, discusses racial biases in big data on the All In podcast.
- Ruha Benjamin discusses the concept of the “New Jim Code” to account for the range of discriminatory designs that encode inequity in this talk
- Watch Dr. Boyd’s memorable keynote speech at the 2019 All In National Conference.
- Data for Black Lives Takes the Movement Digital
- Rob Goyanes, Vice reporter, covers D4BL in “Data for Black Lives Is an Organization Using Analytics as a Tool for Social Change.”