Almost a year ago, I wrote a “Lovell’s Food For Thought” entitled “Reinventing the Wheel As a Threat to Progress” (http://stylemagazine.com/news/2017/aug/18/lovells-food-thought-reventing-wheel-threat-progre/). A recent op-ed piece by a number of scholars on Genetics and Race has brought the above Lovell’s Food For Thought back to mind in terms of threats to addressing health inequities, the threat of egos and the need for credit (https://www.buzzfeed.com/bfopinion/race-genetics-david-reich?utm_term=.rsmD52q30#.iqYR907eP).

To paraphrase what Benjamin Franklin once said: If we do not all hang together, we will all hang separately. The question that remains is: how do we get people and/or organizations out of their silos, especially in terms of health equity? We sure are not effectively addressing health inequities by remaining in our silos, especially scientific and advocacy silos.

The response I mentioned above, was by 67 scholars, many of whom I know, regarding a New York Times article on Genetics & Race (https://www.nytimes.com/2018/03/23/opinion/sunday/genetics-race.html). The scholars’ article has let me know that there are people out there who are seeing the same thing—the need to move out of our specialties and see the broader picture. It gave me the impetus to begin to reach out again. And in doing so, another person, Dr. Brian P. Mangum, reiterated that multidisciplinary action to address underlying developmental, socioeconomic and political disparities is the root cause of the vast majority of issues we face. Also, there is generally a positive response to such an approach from those working on the front lines in the field. But there is significant resistance from key stakeholders, particularly policymakers and politicians. Why? In Mangum’s opinion, there are two primary reasons: first, politicians and politically appointed leaders have a time-limited mind frame that is focused on immediate results to show constituents in an effort to be re-elected. Thus, investing time and resources into solutions that could take decades before showing results, is not a politically expedient thing to do.

I would also include that those in leadership roles in academia, as well, also need to show immediate results to get papers published and/or grants renewed and get tenure. Dr. Magnum also indicate something that impacts all: we are territorial and do not want to risk our funding sources by stepping outside of our silos. Even within our own disciplines, we are territorial among agencies, fearing newcomers, outsiders or those who might approach things differently than we do. He recently saw this in Fiji, while conducting a training in disaster risk management. WHO, CDC, the EU and an Australian emergency management team were all conducting trainings at the same time, in the same city, but to different audiences and using different frameworks. There was no coordination. When he and others suggested a regional organization to coordinate such training, it was seen as intrusive and presenting a threat to each individual fiefdom of trainers -- hence, nothing changed. He continues to see this issue month after month in the areas where he works.

So, when the 67 Scholars came out to encourage their genetics colleagues “to collaborate with their colleagues in the social sciences, humanities, and public health to consider more carefully how best to use racial categories in scientific research. Together, we can conduct research that will influence human lives positively," this was music to my ears. This is because almost a decade ago, the Center for Research on Minority Health (CRMH) Fellows came together to place in the peer reviewed literature 10 lessons learned as trainees (King, Miranda et al., Journal of Cancer Education, 24:S26–S32, 2009). Ironically, the first lesson states that NO ONE CENTER, INSTITUTION, OR PROFESSION WILL SOLVE THE PROBLEMS THAT WE FACE. Franklin D. Roosevelt once said, “Today we are faced with the preeminent fact that, if civilization is to survive, we must cultivate the science of human relationships—the ability of all peoples, of all kinds, to live together and work together, in the same world, at peace.” Every year since 2002, the Health Disparities, Education, Awareness, Research & Training Consortium (HDEART C) has held a course entitled, “Disparities in Health in America: Working Towards Social Justice.” The course was an academic outgrowth of the Biennial Symposium Series on Minorities, The Medically Underserved & Cancer and includes speakers and consists of a diverse group of individuals, including molecular biologists, social scientists, lawyers, health policy experts, economists, ethicists, politicians, environmentalists and others.

The HDEART Health Equity Scholars & Alumni (HHESA) Network is an outgrowth of this when attendees asked about joining HDEART C. HDEART C is an institution/organization membership consortium and was not set up for individuals; therefore, the launching of the HHESA Network. The philosophy encouraged by the 67 Scholars is something that we have been encouraging regarding health and health inequities– that all who are interested in addressing health and health inequities not only collaborate, but enter into open dialogue to address these issues. In that way, we can conduct, not only more effective research, but enter into a broad-based implementation that will positively influence human lives, reducing the gap between discovery and delivery. The HHESA Network was originally launched to bring together all of those individuals who were a part of the Center for Research on Minority Health (CRMH)/Dorothy I. Height Center for Health Equity and Evaluation Research (DHCHEER), the Intercultural Cancer Council (ICC) & its Regional Networks, the Kellogg Health Scholars or the HDEART C Education Programs. It is now open to anyone whose vision includes a biopsychosocial or holistic approach to addressing health equity. We are creating a space where one can connect to exchange information, ideas, opportunities, experiences, etc., to support and help facilitate each others’ success while advancing health equity efforts. The recent report by AHRQ (https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/nhqdr16/2016qdr.pdf) makes clear that the job to address health equity is still there and what we have been doing is not working as well as we thought. Therefore, whether you are an academician, community activist, politician, urban planner or just someone interested in addressing health inequities in a positive manner, please join us in not always doing what we have always done, but doing something different, by getting out of our silos and trying a different approach to address health inequities.

Thus, I have extended an invitation to all to leave your egos at the door, and come and join us by clicking on www.hdeartconsortium.org and then clicking on the button in the upper righthand corner.

So, my question to any group addressing this issue or any other issue is, have you surveyed to see what is out there? If so, is the group and/or organization still around? If they are, find out why have they been successful or not in addressing the issue? If they have or have not so far, is there a need to form a new organization? If so, why? Can an alliance be formed with the organization(s), bringing your strengths together? If there is a need to create something new after going through this exercise, that is great. However, if there is not a real need, forming such new group(s)/organization(s) may do more harm than good. Creating more slices to a pie does not necessarily increase the number who can be fed at the table.

As the 67 Scholars’ op-ed clearly shows, genetics, heredity, environment and societal equities and inequities mix together to make us who we are, and classifying us by historically charged terms, such as race, does every individual in society a disservice. But more importantly, that if we don’t start communicating we will continue to not solve health inequities. HDEART C and its HHESA Network is such a forum attempting to connect the dots so that communication can flourish across a broad spectrum.