Culture of Health Blog

What does it take to overcome systemic racism and become a community where race is not a predictor of success? An assistant county administrator shares the steps her community is taking to transform vision into reality.

During the early days of the COVID-19 pandemic, Bo-Yee Poon and her children left China, where she had been studying Tai Chi for 16 years, to return home to Vermont. What she thought would be a short stay before returning to her studies turned into a much longer one as all flights back to China were grounded indefinitely. With a home but no immediate job prospects in Vermont, Bo-Yee managed to access insurance through Vermont Health Connect, which fortunately made her and her family eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).     

WIC is a federal program that provides critical nutrition assistance to lower-income women, infants, and young children. In 2019, more than 6 million people participated in WIC each month, including roughly half of all infants born in the United States. 

WIC turned out to be just what Bo-Yee and her children needed. It provided access to healthy groceries and tips on how to feed her children vegetables and fruit. But more importantly, it helped alleviate her stress and anxiety around providing nutritious food for her family. She knew that even though she couldn’t work or afford childcare, her family would be taken care of. Today, WIC has helped millions of families like Bo-Yee’s eat healthy food on a lower budget, providing a sense of relief during particularly difficult times. 

Go to the sink, turn on the tap, get yourself a glass of water. To most people in America, this sounds like the most routine of activities. But for the families I work with on the lands of the Navajo Nation in northwest New Mexico, it is not something we can take for granted. And so when water does flow from a faucet inside a home for the first time, the tears often flow with it. This is a moment of deep gratitude and joy for us.

Tó éí ííńá át’é. In the Navajo language, that means water is life. You’ll see these words painted onto our homes and graffitied across the landscape because we understand that life can not be sustained without water. In our culture, it is a sacred element, along with Earth, fire, and air.

And yet almost one-third of my tribe lacks running water. Pause for a moment to consider what that means. The U.S. Geological Survey estimates that people in America use an average of 80-100 gallons of water every day. Our families know how to preserve scarce resources, so we use a lot less than that—but meeting basic water needs is still a complex, time-consuming task. Imagine the difficulty of attaching a hose to a 55-gallon water barrel, filling a bucket, and hauling it inside every time you want to cook, bathe, do laundry, or clean the house. Add in the costs of buying bottled water to make sure that what you drink is safe.  

COVID-19 has been devastating for children and families.

Millions of parents and caregivers lost jobs and income, hindering their ability to put food on the table. School closures, remote learning, and limited-to-no access to child care has weighed heavily on many, especially those with lower incomes working essential jobs everywhere from grocery stores to nursing homes. The pandemic has also exacerbated existing housing challenges, from high rental costs to an ongoing eviction crisis.

In spite of these challenges, our colleague Jennifer Ng'andu recently noted that families are resilient and hopeful. Because the pandemic weighs so heavily on working families, a key piece of inclusive recovery is ensuring that caregivers and their children have the support they need to thrive.

As researchers, our job is to glean lessons from the data and understand what will help communities recover. Since 2016, we’ve been following 29 diverse communities to understand how they approach health, well-being, and equity. When the pandemic hit, we pivoted to focus on nine of these communities. Doing so allowed us to closely follow COVID-19’s impact and understand local response and recovery efforts.

Over the past few years, we have seen a growing number of states and cities adopting policies that restrict or end the sales of flavored tobacco products. For these policies to work for everyone, equity must be a central focus, and all populations must benefit from the movement’s success. This means we must push for comprehensive flavor bans and, above all, restrictions on the sale of menthol cigarettes and flavored cigars.

Tobacco companies rely on flavors because of how well they work to attract and keep new customers. For decades, the tobacco industry has specifically targeted Black people in America with advertising campaigns for menthol cigarettes and other tobacco products like flavored cigars. Like menthol cigarettes, flavored cigars have been designed to hook kids and have disproportionately harmed Black youth. After Congress banned all flavored cigarettes except menthols, cigar manufacturers increased their marketing of flavored little cigars—or cigarillos—which closely resemble cigarettes. Youth use of flavored cigars increased in subsequent years and has remained especially high among Black youth.

As a result of these pernicious marketing and sales tactics, tobacco use is the number one cause of preventable death among Black people in America, claiming 45,000 Black lives a year. Black people in America die at higher rates than other groups from tobacco-related causes like cancer, heart disease, and stroke.

Earth Day will be 51 years young this April 22^nd—and I have been a witness to every one of them. The environmental activism that it launched and inspired has shaped me as an individual, shaped culture in the U.S. and beyond, and shaped the planet we all share. And it continues to evolve, as evident by the present-day focus on environmental justice and disproportionate health impacts felt by low-income communities and communities of color. As a child of the 1970s, I have seen momentous changes—environmental policies and discoveries that pointed in the right direction, setbacks and disappointments, and profiles in courage.

As a youngster, I drew inspiration from the boldness of Jacque Cousteau, the brilliance of Jane Goodall, and the courage of Norma Rae. As an adult, I look to the power of local change agents like Majora Carter of South Bronx, NYC and Margie Eugene-Richard of Southern Louisiana. In my lifetime, I have seen the institution of recycling, lead removed from gasoline and paint, asbestos banned from buildings, and consumer preference shift toward plant-based cleaning products and chemical-free food. I am excited by the burgeoning international movement for green schoolyards. I have also seen devastating environmental crises in places like Love Canal, N.Y., Flint, Mich., the Gulf of Mexico, and Prince William Sound. All of these represent both the incredible harm and good we can do when we act collectively.

I hope in my lifetime to witness less David vs. Goliath battles for the environment and a reckoning of environmental injustices. I have hope to share.

Now that Congress has approved more than $46 billion in emergency rental assistance, will that money reach the millions of Americans who need it most—the lowest income and most marginalized tenants and small landlords?

The Centers for Disease Control and Prevention (CDC) recently extended the national eviction moratorium, which will prevent tens of millions from losing their homes through June 30. Beyond that, it’s crucial to ensure that emergency rental assistance funds from the two COVID relief packages passed by Congress are distributed swiftly and equitably to tenants with the lowest incomes and others who face systemic disadvantage in accessing public benefits such as Black, Indigenous and People of Color and immigrants.

When we imagine a caregiver, we often picture a woman: a mother caring for young children, spouse, and the daily household chores, a daughter nursing a father with disabilities, or a female child care provider. Historically, women have been expected to serve as primary providers of “caretaking” work, whether it’s parenting or caring for an aging family member or paid work in positions typically associated with women such as child-care providers, nurses, or health aide. Alternativley, men are often expected to be the primary breadwinners and play less of a role in the emotional or physical caretaking of a family. And men in caregiving professions that are most often fulfilled by women (e.g., nursing, child care) are often seen as the exception. While the role of women as caregivers may have been true for much of history, gender roles and intergenerational dynamics are shifting and as Ai-jen Poo, director of Caring Across Generations, notes ‘continuing to associate caregiving with one gender does more harm than good.’ 

Here is the reality: before and during the COVID-19 pandemic, men have been significant providers of care work, both within their families and in their careers. In fact, men actively contribute to the care economy. This is good for them—but, just as importantly, it benefits women and society broadly.

“The biggest hope every parent has for their children is for them to be healthy, happy, and educated.”

This quote sums up a universal sentiment, expressed by a mother living in New York, about what all parents and caregivers want and strive to provide for their children. But what happens when parents are doing everything they can to fulfill those hopes and it’s still not enough? More than meeting families where they are, we need to meet them at their aspirations.

We can begin by truly listening to parents and caregivers, and building from their wisdom. To help achieve this understanding, over the last 18 months, the Robert Wood Johnson Foundation (RWJF) commissioned in-depth research with parents and caregivers to learn about the aspirations they have for their children, the challenges they face, and the factors that help them thrive.

In Harlem, girls as young as age 6 are figure skating while receiving academic, social and emotional support. In Cambridge, people who were once incarcerated are now on a career path to become fitness trainers. In Atlanta, youth are playing soccer on previously unused land near train stations, repurposed as soccer fields. On both sides of the United States/Mexico border, youth are building friendships and getting professional tennis instruction coupled with academic enrichment.

All four of the unique programs doing this work have received the Robert Wood Johnson Foundation (RWJF) Sports Award for catalyzing and sustaining change and addressing social determinants of health. They and similar programs that have received this honor are made possible by professional teams, athletes, coaches, and community-based organizations that are using sports to make communities healthier places to live, learn, work and play. In doing so, they are reaching people who might not otherwise have the chance to engage in organized sports, with the physical and mental health benefits that come with it.

Launched in 2015, the RWJF program now gives up to five awards each year to organizations that bring a deep understanding of community needs, provide safe places to play, and help youth reach their potential by building meaningful relationships, life skills, resilience and more. Acknowledging that sports has a history of oppression and racism, the program also recognizes that it has the power to provide healing, prevent violence, and galvanize communities. We have seen evidence of that over the last year, as athletes and teams have used their platforms and megaphones to advance racial justice, oppose police violence, and more, and teams have turned their stadiums into voter registration sites, polling places and, in recent weeks, vaccination hubs.