I recently attended the Fifth National Conference on Health Disparities where I was honored to moderate a panel that focused on the role of public health in reducing the Nation’s striking health inequities. Hosted by the Medical University of South Carolina, over 500 attendees came together in Charleston to discuss the widening disparity gap and the potential avenues to close it.
Charleston is a beautiful city. But in the eighteenth century, Charleston served as the major point of entry for enslaved Africans arriving tightly packed on ships to be sold in America. Now there we were, sharing disparities data, discussing the challenges and posing solutions. We do this in solidarity, in scholarship, in earnest, and frankly, in frustration. Face it- we have been doing this for such a long time at so many conferences. The scholarly monographs line my bookcase and sit in e-files and power point slides. I chair the ASPH Diversity Committee and we manage the ASPH Health Disparities Research and Diversity Resource Center; I know this data all too well. The data has been presented and debated in the public domain for years. It both pains me and calls me to action.
Dr. Reed Tuckson, Executive Vice President and Chief of Medical Affairs for the United Health Group is an inspiring speaker. As he was outlining the issue and quoting the numbers he paused and said loudly “…Slave ships, packed like spoons…. for this?! I don’t think so!” “This,” being the significant gap between blacks and whites for so many health outcomes. More diabetes, more heart disease, more obesity, higher rates of tobacco usage, less access to health care services…. on and on. Reed also said “health is the place where all social forces converge”. Public health, that is. The place where societal factors and health entwine, creating some of our biggest challenges; calling for some of our most creative solutions. The Nation’s leading health indicators have demonstrated little improvement in disparities over the past decade. More complete reading on the actual data can be found in the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and the National Stakeholder Strategy for Achieving Health Equity.
Some major roles for public health include:
In addition to the listed work we do, there is the sustained need for discourse and solutions that address pervasive racism. During the conference, Dr. Gail C. Christopher from the Kellogg Foundation spoke eloquently about the connection between social injustices of the past and the health outcomes and issue of communities of color in America today. Her bottom line for all of us to ponder and address: our country was built upon the myth of racial inequality, the myth that skin color determines our differences. Racial injustice is the setting in which health disparities are born and fostered.
The current situation remains simultaneously unthinkable and yet so real.
Working for racial equity is the long-term work of addressing health disparities. It’s a powerful and important reality. Discomfiting? Maybe-- but it must be acknowledged and discussed- it’s our shared reality needing a collective solution. There is so much to do and our School of Public Health is dedicated to the work, as am I.
Yea, Dr. Gold for keeping this "elephant" in our living room. However, as a field you can also advocate for better policies. Yes, supply the data, but go one step further and use it to debunk fiction and myth. Congress will not let the CDC use any public funds to research our nation's leading public health issue: gun violence.
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