Social inequity: The next big public health intervention

Public health has a long history of improving people’s lives through work such as mass immunization and sanitation. Now, it’s time we turn a focus on why a person’s race and ethnicity is part of the health equation, presenters said during a Monday Annual Meeting racial equity panel.

“Social inequity is the next big public health intervention,” said Melissa Jones, executive director of the Bay Area Regional Health Inequities Initiative in Oakland, California. “Our organization looks at the intersection of race and income. We know that where you live impacts your health. Your ZIP code should not be more important than your genetic code in determining your level of health and life expectancy.”

Advancing health equity, which includes examining how racism negatively impacts health, is a strategic priority for APHA. And for good reason, according to Tia Taylor Williams, director of the Association’s Center for Public Health Policy and Center for School, Health and Education.

“Racial inequities are deep, pervasive and systematic,” Taylor Williams said. “They persist across all indicators for health and success.”

Opportunities to address those inequities sometimes arise from dark circumstances. M. Christina Santana of the Monterey County Health Department in Salinas, California, told attendees how the 2014 police shootings of four Hispanic people in Salinas galvanized action by her county government. The department used sensitivity trainings within government and healing work within the community to support racial and ethnic equity.

“It hasn’t been easy, but leadership was motivated to ease unrest, and we leveraged civic engagement when politics got in the way,” said Santana, the health equity and cultural competency coordinator for the health department. “Now, racial equity is not a taboo topic.”

Amy Verbofsky, a city planner with the Delaware Valley Regional Planning Organization in Philadelphia, spoke candidly about the ways in which her organization is working toward racial and ethnic equity within its ranks.

“Our staff is predominantly white and not representative of the population we serve,” she said. “We needed to find out why. So we hired an outside consultant and took a hard look at ourselves.” As a result, the organization is creating more inclusive hiring initiatives.

Raising awareness about racial inequity can be particularly challenging, though.

“Racial inequities have been baked into government,” said Nefertiri Sickout, deputy diversity and inclusion officer for the City of Philadelphia Mayor's Office. “We need to dismantle structural barriers and be intentional about imbedding a racial equity lens. We have to start with the laws and policies that lead to inequities. But it takes time, work and commitment.”

Funded by a technical assistance grant, the city created a pilot project within the parks and recreation department. The workforce development pilot used data analysis to understand the structural barriers to diversity.

The pilot program analysis revealed that by changing employment testing from written to verbal, six of the 10 top people applying for a determined position were now of color. The city is using the findings and recommendations move forward.

Learn more about APHA’s work to advance health equity and address the impacts of racism on health at www.apha.org/health-equity and www.apha.org/racism.