Event Recap: Is Your Race Bad for Your Health?

How do racism and poverty impact health? Can inequality make you sick? What disadvantages come from these inequities?

Featured Guest Opening Remarks:

Dr. Lisa Werkmeisters Rozas: Associate Professor at the University of CT School of Social Work

• When we think about health disparities we often think about race
• Race is one of the variables that is connected to disparities in health
• Race is a social construct, not a biological truth. Pigment of skin is the only difference in the biological make-up. 
• Racism does exist and we have to think about this when we think about inequities.
• Social determinants of health determine why people are healthy than others: clean air, quality food, access to quality and affordable housing, access to quality education, access to safe employment, access to clean water.
• Economics and health have a strong correlation, but even those who are in the same economic situation, but are different races have different health outcomes. 
• Social identities that are targeted for discrimination have poorer health outcomes. 
• Privilege (better access), power (who you know, networking ability), racism (health and mental health) are all big factors in health disparities. 
• Pre-term labor and infant mortality rates are higher for black women. 
• Racism is stressful and those who face this deal with more stress in their life and this has a huge impact on people. 
• We have to begin to think and have a loud and clear discourse that health is a human right. It doesn't matter where you were born, who you are, what language you speak. 
• It is everyone's obligation to make sure that everyone has access and equality in health care.

Dr. Raja Staggers-Hakim: Executive Director at the CT Commission on Health Equity

• The Commission on Health Equity is a legislative commission that works in committees. We want to engage people who normally wouldn't participate in conversations about health equity. We support and work with community based initiatives. We have a public voice committee to work with communities and host public health forums to bring the voice of the people back to the General Assembly. 
• Teach race, ethnicity, and gender at Eastern CT State University
• When we look at a white male and a black male, black men are not going to live as long as white men and this is true among all economic groups. 
• A lot of research points to discrimination and the experiences people of color face on a daily basis. The stress associated with the everyday painful experiences people face.
• Everyday oppression due to race, class and gender impacts your health.
• CT residents have the highest health outcomes in the nation when we compare to other states nationally, but we have such great disparities in our state
• People in Bridgeport are still taxed the way the rest of Fairfield county is, so we can see that disparities occur here. 
• Commission is concerned with 6 health areas: low birth weight (consistent in all women of color), HIV/AIDS, obesity, asthma, cardio-vascular disease,  and cancer. 

Group Discussion:

What are you seeing at the childhood level in terms of health?

• Broad issue in childhood obesity, asthma, and dental issues. These are issues keeping kids out of school

In your work with state agencies, how are agencies working to provide equal access in communication? This is one of the most difficult ways to get state agencies to apply.

• Commission is working on language access and cultural competency. 
• Legislatively we proposed a bill to ensure that people can receive cultural and linguistically appropriate care. 
• People don't show up for treatment because of a history of poor care and limited access to common language at their provider. 
• We need to have a discussion about limited resources. We need to share resources among organizations/hospitals, etc. 
• Beyond health care, because social determinants impact health, we have to develop health equity plans for all state agencies. There is a lot of education needed. We plan to work closely to engage these discussions. 

Nothing could be more productive than a single payer health system. Could this eliminate discrimination? 

• Health care is one aspect. People need health care. 
• We need to consider more than health care, we have to consider access to food, education, etc. 
• Changing health care is not the only factor
• We have signed many international treaties with clear agendas about equal access and we as a country have said we would do this, but we have not done so yet. 
• There are more obligations that we have not fulfilled yet. We said we would do it, but we haven't. 
• No one is pushing for monitoring our obligations. 

Disparities serve to divide people. What can we do to lift everyone up to a clearly defined standard?

• This is the basic premise of human rights.
• You are always going to have people that have more or less, but we can have a society that prioritizes, but we need a full change of culture. It is difficult to shape our founding ideology. 
• Do we divide us from the start and then everyone fights for their piece of the pie? This wouldn't work. How do we agree on what the highest standard of health?

We have to look at cultural competence. There are middle and upper class African Americans that don't want to the deal with a racist health system. How do you address health care providers so that they are providing culturally competent health care or any other care? 

• The Commission on Health Equity is trying to address these cultural competence issues. 
• People need to feel respected
• There is not just one type of cultural competence. 
• People need to understand why things are important to others
• We are a part of a racist system
• We need to discuss this because we will not understand each other the way it is. 

How do we organize? 

• Organization has been a weakness. 
• A lot of professionals who know about the issue come to the public forums, the community is not represented enough. 
• There is a trust issue. When community members see people in suits, they turn away.
• We need to get into communities and connect with community members who are trusted within their community.
• The CT Commission on Health Equity is creating a community committee so that members who would not naturally show up at a public forum are represented.
• People have concerns that there won't be real change 

If we are seeking to provide not just adequate supplies of health care butr a target health standards, we have to consider that we don't all start at the same place, such as environmental health. How are we addressing this?

• Hartford has a very high percentage of childhood asthma.
• There is a different world. Modern society is unequal environmentally. Environmental justice is a huge issue. 
• The CT Commission hasn't targeted environmental justice, but we are looking at social determinants that include asthma. We look at transportation, park locations and highways, and other factors. We haven't used the environmental justice "label".
• Environmental justice is something the Commission could be educated on more. 

Publicity and exposure is so critical. Students could provide data and a comparative study of hospitals and other community health services. We have to educate for social change. What can publicity do?

• Community organizing is critical
• We need to rejuvinate the entire population, but it is most important for the younger population. 
• It is very difficult to mobilize the younger generation. It isn't the majority that has been moblilized. 
• There are opportunities to mobilize in social media, but they need inspiration first.

There are not only intervention points, but there are systemic issues. There are these predestined issues. How do we address systemic intervention issues and general health? 

• The intervention comes too late. 
• This is an issue of prevention as opposed to care. 
• Research needs to be done to see what cures diseases, but we need to look at the entire system that isn't providing for everyone. 
• Changing a system is overwhelming, we don't have the capacity at this point. 
• People need to be invested and people who hold power and privilege are not willing to change it yet.
• We need to educate policy makers
• We need to reach beyond health care issues. ALL policies are health policies. 
• This doesn't only concern health professionals

How do we work with all cultures? 

• Cultural competency takes years and years
• Being culturally sensitive is the first step.
• At the root of it there is respect. It reaches deeper. 
• We need to go beyond the training and experience different cultures. We need to understand why things bother different cultures.