The Conversation We Must Have

By Stephanye R. Clarke  |

#HealthIsWealth

That hashtag is just about everywhere—people are realizing now, more than ever, that living their healthiest life is a measure of wealth. If we’re honest, though, not everyone has the same opportunities to do so.

We are living in a climate where there is a near-daily assault on health care. Eligibility requirements for health care programs have already been reduced dramatically and face new, long-term challenges; people we know and love are making hard choices between putting food on the table or paying their insurance premiums; prescription drug prices are on the rise. Add to these transportation and language barriers; under- or unemployment; neighborhood safety; access to healthier food and lifestyle options; and we’ve a recipe for the disaster as reflected in just about any report on the health of communities in which we live, play, work, learn, and/or pray. The 2016 Community Health Assessment for the lower half of New London County was no exception.

In a previous blog I wrote “Here is what I know: until we are really able to have deep and uncomfortable conversations about how racism continues to structure where people live, how they live, how they are educated, how healthy/unhealthy people are, data will continue to reflect gaps in education, income and health status. Until we insist that policies no longer unfairly advantage some while unfairly disadvantaging others, nothing will change.”

The Health Improvement Collaborative of Southeastern Connecticut (Collaborative) made the choice to engage in a community conversation about health equity, social determinants of health, the idea/social construct of race, and institutional and structural racism, as part of its ongoing commitment to a creating a healthier region.

Health Equity Solutions, Inc. (HES) facilitated the conversation, encouraging Collaborative members to consider historical context in terms of housing, education, transportation and health care policy. HES Executive Director, Dr. Tekisha D. Everette had just returned from the Health Action 2018 conference, where she received Families USA’s Health Equity Advocate of the Year Award and participated on the Racial Discrimination and Health Care: What’s the Path Forward panel.

HES challenged Collaborative members to examine their institutions’ language, interactions with community members served, and policies and practices.

Imagine how any of the following statements impact peoples’ health:

• “The patient is non-compliant…”
• “I told her if she would stop eating rice, her diabetes would improve.”
• “We only see Medicaid patients on Tuesdays…”

These statements demonstrate a lack of empathy and understanding for where people are coming from, perpetuate inaccurate and unhelpful stereotypes, foster attitudes of blame rather than creativity in finding solutions, ignore best practices, create institutional barriers and biases, and are counterproductive to improving a person’s and the community’s health.

As the Collaborative embarks on its next round of data collection for the 2019 needs assessment and health improvement plan, members were happy to have HES begin dialogue that will inform assessment and planning processes.  This workshop will hopefully change the conversations the group has about the people they serve and the best solutions to address community health issues — especially if past solutions have proven ineffective.

Listen—learning about the social determinants of health, health equity and institutional/systemic racism is not just for people of color. It is for all of us, especially health advocates. If your agency/organization/collective wants to begin the conversation but you’re not sure where to begin, contact Claudine Constant, Program Manager, to see how HES can help.