Closing General Session: ‘History isn’t our fault, but it is our responsibility’

Racism and its defining role in American history must be acknowledged and called out if we’re ever going to achieve true health equity.

That was the overriding message at today’s Closing General Session in Philadelphia, where about 13,000 public health practitioners, students, educators, advocates and supporters gathered for APHA’s 2019 Annual Meeting and Expo. The session, which zeroed in on a theme of “Health and Justice Denied,” explored the history of racism and oppression in the U.S. and how its traumatic legacy continues to impact the health and well-being of our communities.  

“We have to own the problem before we’ll be inclined to try and solve it,” said session speaker Gail Christopher, who previously served as senior advisor and vice president at the W.K. Kellogg Foundation, where she helped lead the Truth, Racial Healing and Transformation initiative to address the historic and contemporary effects of racism. 

Christopher spoke on a “prescription” for racial healing, defining the process as individually and collectively ridding ourselves of the ideology that underpins structural racism — the ideology that some people are more valuable than others. A key ingredient in that difficult process, she said, will be bringing a majority of people on board in an effort to build relationships and bridges of trust.

“We have to accelerate that pace for the sake of this country,” Christopher said.

Session speaker Makini Chisolm-Straker, co-founder of HEAL Trafficking, a group of multidisciplinary professionals dedicated to ending human trafficking and supporting its survivors using a public health perspective, said that like health disparities, the scourge of human trafficking is a symptom of racism and other forms of oppression. Human trafficking, she reminded attendees, disproportionately affects people of color. 

“When we think about human trafficking as a symptom and these oppressions as the root cause, we recognize that anti-oppression work is anti-trafficking work,” said Chisolm-Straker, also an assistant professor of emergency medicine at the Icahn School of Medicine at Mount Sinai in New York City.

Human trafficking interventions often focus on tertiary prevention — or intervening in the aftermath, such as prosecuting traffickers and providing services and support to survivors. But that approach can’t reach all those in need, said Chisolm-Straker, who called for primary prevention efforts that address systems change, such as expanding access to affordable housing, health care and high-quality education. We need to recognize human trafficking as a symptom of historical and ongoing oppression and attack white supremacy as a disease, she told the audience.

“We all need to remember that history isn’t our fault, but it is our responsibility,” she said.

Thomas LaVeist, dean of the Tulane University School of Public Health and Tropical Medicine in New Orleans, noted that while the country has certainly made progress on issues of equity, that progress is less of a steady march and more like a pendulum that moves forward only to keep falling back. 

For example, while the 13th Amendment ended slavery, it made an exception for those convicted of a crime, he noted. The Social Security Act of 1935 had huge ramifications for poverty in the U.S., but it also excluded farmworkers and domestic workers. More recently, he said, the Affordable Care Act expanded access to health care for millions of Americans. But a key part of its strategy — Medicaid expansion — was rejected in states home to the largest black populations.

“We have moved closer to that perfect union,” LaVeist told attendees. “But there’s always a carve-out that made it less effective and made it possible to continue to exploit the labor of black and brown people.”

To help address such injustices, public heath professionals need to be fully engaged in their communities, LaVeist noted. That could range from working to elect supportive leaders to volunteering with a local Girl Scouts troop to help young people develop a sense of agency and increase the likelihood they grow up to be “fully actualized” adults. 

“The public health professional needs to be at the table,” he said. “Be a full participant in the community.”

Ultimately, we need interventions to help us act with kindness and caring, Christopher told attendees — that’s the prescription for racial healing. This is the work of public health, she said, calling on the audience to help their communities develop the “capacity for love for one another.”

“We as health providers need to recommend with a great deal of authority that the idea of racism must die and be replaced with a heartfelt understanding of our sacred interconnectedness as a human family,” Christopher said. “That’s the work that’s been missing.”

See everyone next year at APHA’s 2020 Annual Meeting and Expo in San Francisco, which will have a theme of “Creating the Healthiest Nation: Preventing Violence.”

From top: Gail Christopher, Makini Chisolm-Straker and Thomas LaVeist speak during Wednesday's APHA Annual Meeting Closing General Session, and audience members listen to remarks around the session's theme of "Health and Justice Denied." (Photos by Jim Ezell, courtesy EZ Event Photography)

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