Lovell's Food For Thought - Is Addressing Health Inequities A Bridge Too Far

Is Addressing Health Inequities in a Holitic Mannner "A Bridge Too Far?"

"Public Health Disparities Make Us All Sick" is the theme of this year's 15th Annual Disparities in Health in America: Working Toward Social Justice Workshop. This year, the workshop/meeting will be held on the campus of Rice University in the Shell Auditorium at the Jones Graduate School of Business. For 15 years, the workshop and the Fall course have been taking a different approach in educating the next generation. As Co-Chair Dr. Lisako McKyer said to one of the scholarship awardees for this year’s workshop, "I attended as a student, and it literally changed my life and impacted my career goals and aspirations deeply." The question that has perplexed me over the years is, how to translate this life changing event into attendance, and ultimately change the trajectory of health inequities and therefore the health of this nation, both mentally and physically? 

I have been told that the vision is too narrow. Not that it is too focused, but that it is ahead of the curve, the tip of the iceberg, where people see the tip and not the entire vision. It is evident that such doesn't serve the workshop well. That with Public Health, it is always playing catch-up. That the ideas and initiatives championed by the workshop and situated in biopsychosocial approaches were well before the new sexy term or flavor of the day and therefore didn’t gain traction easily. That visionaries are often alone... However, it has been 15 plus years, so it must be more than that. However, as the old adage goes, without a vision the people shall perish. 

I have also been told, Public Health periodically hits a wall typically induced by government freezes and political climates etc....so one can't expect them to come because you call or to get on board because you present the opportunities. In addition, there will always be a lag because the visionary will often be ahead of others and is therefore destined to be alone. Then add on that visionaries are sometimes accused of being self-serving.

At times if one is lucky, they will have the support of a small cadre who too share the vision and are willing to help make it manifest. I have been lucky to have such a group. Who year after year come forth to help put on the workshop. However, the question here becomes, how long does it take to see the vision that Health Disparities/Inequities are a societal problem. That it takes a populous knowledgeable and ability to recognize the inequity, not just in health, but the other contributing facts, even outside of the social determinants of health. A willingness to mobilize, and a willingness to be prepared to interrogate false narratives that say: “the gap between the rich and the poor is shrinking”, “people are living longer”, and “access to healthcare is better than ever”. For more than 15 years of the Disparities in Health in America: Working Toward Social Justice Educational Program has been a source of this very instruction, yet somehow, we, people aren't interested in attending. Could it be because health disparities are no longer the flavor of the day? Have people moved on to the latest sexy topic? Surely the prevailing attitude can't be that the wicked problems of health inequity in America has been resolved....I'll digress. 

As I have said, addressing health alone will not solve the issues of health and health inequities. Again, it has to be addressed in a holistic manner, involving more than health and health activists. Health disparities/inequities. are not just a health or public health issue it's a societal issue. It is our issue! Therefore, expanding the tent and reaching out to those in other fields in which the intersectionality of health issues nests with what they are doing either research-wise, in theory or in practice, is the path forward. This was the very sentiment behind the development of the Biennial Symposium Series on Minorities, the Medically Underserved & Cancer (now health equity), the Center for Research on Minority Health/Dorothy I Height Center for Health Equity & Evaluation Research and now the Health Disparities, Education, Awareness Research & Training (HDEART) Consortium and its course and workshop. Benefiting a broad range of disciplines, informing ideas and synergies on how we address Health Disparities/Inequities in America. So, who should be involved?

One of my mentees, Dee Jordan, summed it up this way.

Collegiate Education programs - often teach a critical race theory course which opens student’s minds to inequity and many levels that they might otherwise not understand or see on their own. 

African American African Studies programs, Chicano Latino Studies programs, Native American, Asian & Pacific Islanders Studies and other not traditionally thought of, LGBTs - would likely find a workshop like this appealing for the liberation of the populations and groups they serve.

Psychology - many students of color in school psychology training programs recognized that a child in poor health will exhibit health and wellness issues that impact educational performance and attainment. 

Economics – there are costs and steep economic impacts associated with Health Disparities 

Political ecology programs - Deal with historical disadvantage and disenfranchised people across landscapes 

Kinesiology programs - Can create programs that combat obesity within low income communities.

Food Science and Human Nutrition - Pretty evident why they would be good fit – nutrition interventions are necessary.

Law Schools - Students study these issues and litigate matters of social justice…look at Flint, Love Canal, Standing Rock etc.

These are just a small sampling of programs where health disparities/inequities engagement are poised and well suited. This has been what the workshop and course has been about for the past 15 years; having representatives from these fields and more. So, the question remains, is addressing health disparities/inequities in this way a bridge too far?

On LinkedIn, the workshop announcements have attracted over 3000 distinct visits, yet less than at total 100 likes and of those few have registered. So, the question is how to turn these visits into likes and ultimately, registrants.

One suggestion is to make it Free to all attend. Does anyone have a benefactor for such? We have been able to kept the registration fee low. Who can attend to a week-long conference for less than $1000, let alone $500, and have an opportunity to eat and learn. I have been told that it is too long. I have go thru this exercise. what I get is more suggestions about what we didn’t cover. And, the length allows people to earn academic credits, of which three four institutions offer it as a course, and three have it as part of their degree program. So, help me understand the Calculus. So how do we make people feel that it is worth their time or investment? Again, Is this “A Bridge Too Far.