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How a Nurse Leader Took on the Social Determinants of Health

Mar 17, 2022, 11:45 AM, Posted by Najaf Ahmad

Trailblazing nurse and recently retired CEO of a community health center reflects on her legacy of providing care that prioritizes the social determinants of health.

Doctor and patient illustration.

Maria Gomez was 13 years old when she immigrated to the United States with her widowed mother to escape violent political turmoil in Colombia. They landed in Virginia on a snowy day with no boots, no coat, and not speaking a word of English. Together, they faced many challenges while navigating their new life. In spite of them, Maria’s gratitude and drive to give back led her to a nursing career. She ultimately joined a group of advocates in launching Mary’s Center to address gaps in access to healthcare and structural barriers that many immigrants face.

Today, Mary’s Center uses an integrated model of healthcare, education, and social services to serve patients at five clinics and two senior wellness centers in Washington, D.C. and Maryland. In 2012, President Obama presented Maria with the Presidential Citizens Medal, the second highest civilian honor in the United States.

After an illustrious career, Maria retired in December of 2021. She shared reflections on how she has led efforts to serve a diverse population and insights into the challenges our healthcare system and nation face. In this interview, Maria discusses how she shaped a system of care that aims to build trust with patients and provide integrated care that addresses more than medical needs.

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Why Now is the Time to Pursue Bolder Gender Equity Policies

Mar 8, 2022, 10:45 AM, Posted by Shuma Panse

It's time to reinvigorate our nation’s fight for gender equity. Other countries can offer inspiration and practical solutions to improve health and well-being for people of all genders within our lifetime.

Two young girls play outside.

As a mother of two girls, I often wonder what would it look like if women didn’t have to exit the workforce to cover childcare? If men taking paternity leave was the norm, rather than the exception? If our kids had more female and LGBTQ role models to look up to in elected office?

I became hopeful last year when the White House launched the United States’ first-ever National Strategy on Gender Equity and Equality—a concerted effort to make these “what ifs” a reality.

While we have seen important advances toward gender equity in the U.S, most improvements in employment, education, and income happened before the turn of the century. Progress has dwindled or stalled entirely in the past decade. The COVID-19 pandemic, which has forced women out of the workforce in record numbers, is a stark reminder of the gender inequities that still exist. It's time to reinvigorate our nation’s fight for gender equity.

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Can We Redefine “Progress” to Center Well-Being?

Feb 23, 2022, 10:45 AM, Posted by Karabi Acharya

What can we learn from communities in the U.S. and around the world about changing the narrative on progress? What does it mean in practice to take a well-being approach?

A man rides his bike along a pedestrian only pathway.

For many months, our society has grappled with defining our “new normal.” The COVID-19 pandemic has exposed and deepened inequities that undermine well-being. Combined with a worldwide outcry for racial equity, we have been challenged to reconsider how the United States defines “progress.”

Our nation’s traditional story of progress has been limited to measures like economic growth and employment. When leaders tout our country’s successes, they cite GDP numbers, job growth, and unemployment rates.

On an individual level, a person’s bank account balance, the car they drive, and their generational wealth are heralded as markers of success. These benchmarks only tell a fraction of the human story. They also overlook how structural racism has undermined economic opportunity for communities of color among other outcomes.

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Lessons from a Malawian Farmer on Climate Change, Food Justice and Gender Equity

Feb 3, 2022, 1:00 PM, Posted by Jamie Bussel

Can people in the United States heed the lessons offered by Malawian farmers and use them to build a healthier and more equitable future?

A large tree in a field. Photo Credit: Kartemquin Films

This is the question at the heart of the award-winning film by director Raj Patel, "The Ants and the Grasshopper." It follows farmer, mother, and teacher Anita Chitaya as she travels from her home in Malawi across the United States to engage farmers, food justice advocates, and climate skeptics in conversations about how we can build a healthy future.

Malawi is struggling with severe child malnutrition. Rising temperatures and extreme drought have made it tougher to grow nutritious food and pushed more families into hunger and poverty. In the film, we meet and travel with Anita, who mobilizes people in her village—encouraging farmers to try new agriculture methods and plant nutrient-rich food, and even getting men involved in cooking family meals to help children in Malawi grow up healthy. We learn that Anita and the people in her village have achieved the seemingly impossible—tackling the issues of patriarchy, child malnutrition, and climate change in interconnected and impactful ways.

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In Mexico, Healthy Food Is a Child’s Right

Dec 7, 2021, 1:00 PM, Posted by Ana Larrañaga

Last year, Mexico took a tremendous step toward prioritizing childrens’ health by banning junk foods and sugary drinks.

A young girl at a produce stand.

“Children have the right to be in environments that are health promoting and free of unhealthy foods and drinks.” —Ana Larrañaga works with Salud Crítica, a public health advocacy organization based in Mexico City

Editor’s note: This post originally appeared on the State of Childhood Obesity website.

Last year, in the midst of the pandemic, legislators in Mexico moved swiftly to ban the sale of unhealthy foods and beverages to children.

Oaxaca was the first state to approve junk food bans.

This started as a true grassroots movement, ignited by the strong community advocacy of 13 different Indigenous groups who were determined to protect people from diabetes and obesity—and prevent the displacement of traditional foods that are deeply rooted in their culture. They fought to prohibit distributors from delivering sugary drinks and junk food to their local stores.

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What the United States Can Learn From Other Nations on Paid Leave Policy

Oct 13, 2021, 1:00 PM, Posted by Brigid Schulte, Jennifer Ng'andu

Policies like paid leave are working to advance gender equity at work and at home in other nations. We just need to expand them here in the United States.

Parents hold their infant child.

"We are one of the only countries in the world that doesn't offer paid family and medical leave to those who need it."  —Robert Espinoza, Vice President of the Paraprofessional Healthcare Institute

A study by Better Life Lab and the Robert Wood Johnson Foundation reconfirms that the U.S. status quo of gender roles, both at work and home, is not working for many families. Men are missing out on caretaking roles that enrich their lives and enhance the bonds with loved ones, while women are struggling with role overload, feeling unsupported and missing out on income and economic mobility.

In contrast to the U.S., many nations are advancing gender equity through solutions that benefit health, child development, family well-being, and advance racial equity, like paid leave. The United States can learn from the experiences of other nations that are implementing paid leave policies and find approaches that encourage fathers to take advantage of these policies.

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Learning with Indigenous Communities to Advance Health Equity

Oct 7, 2021, 11:00 AM, Posted by Karabi Acharya

Tribal Nations, resilient stewards of the natural resources that give us life, can lead the way to a more sustainable and healthy future. Indigenous Peoples' Day marks the urgent need to embrace the expertise they’ve held since time immemorial.  

A woman speaks into a microphone at a dance show. A Tlingit Native welcomes an audience to a community house. The traditions and leadership of the Tlingit, the people indigenous to Sitka, are infused throughout the community, including through educational and environmental programs.

For generations, Indigenous Peoples have known that our health is intertwined with the health of our earth. Their worldview recognizes that being healthy means ensuring the natural resources that give us life are well cared for.

In contrast, Western mindsets tend to view the natural world as an inventory of useful commodities—separate from, and existing only in service to, humanity. Overusing, polluting, and extracting without considering the long-term impacts has created conditions that fuel health inequities in our country: contaminated drinking water, food scarcity, air pollution, and extreme heat are contributing to poor health and driving up disease, particularly in low-income neighborhoods and communities of color.

Transforming our relationship with nature is key to building a sustainable, equitable, and healthy future for all. Through the forcible removal, violence, oppression, and other injustices Indigenous Peoples have experienced, they have remained powerful stewards for many of our natural resources. Their values, practices, and policies can show us the way to heal and reclaim the health of our earth and humanity.

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Healing Our Rivers and Ourselves: Learning with Indigenous Peoples of New Zealand

Sep 22, 2021, 10:00 AM, Posted by Aleena M. Kawe

Our health is inextricably connected to the health of land, water, and all living things. The ways in which Indigenous peoples live that connection offer lessons that could benefit all of humanity. 

A woman stands on a walking trail bridge over a river.

Our nation’s health is intertwined with the health of our rivers. And our rivers are unwell.

Drinking water, food, sanitation, clothing, transportation: almost everything we do involves an interaction with water. Yet many people in America take water for granted, not realizing that pollution, overuse, and climate change are putting a chokehold on the country’s natural water reserves—posing a direct threat to health, equity, and our way of life.

While many may think that new technology and innovation can resolve our water crisis, I believe that the solution lies with Indigenous practices that have fostered a holistic approach to living in relationship with the natural environment for millennia. Let me explain.

Our Relationship with Nature

Indigenous peoples share a common worldview of our relationship with the natural world. One that is guided by Indigenous values and principles of respect, cooperation and responsibility. These principles govern our individual and collective beliefs, behaviors and relationships—as given to us from our ancestors. While our customs may differ, our lived connection with our environment is universal. In sharp contrast, Western mindsets tend to view nature as a commodity, maintaining a relationship that is centered on resource-taking.

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How Taking a Simple Quiz Reaffirmed My Love For Global Learning

Aug 12, 2021, 1:00 PM, Posted by Shuma Panse

Can the bold ideas needed to advance health equity be found beyond our borders? A global learner reflects on the value of looking abroad for solutions and the 12-question quiz that can help us all get started.

The Blue Marble

One out of four people living in the United States today are either immigrants or children of immigrants. That’s approximately 85 million people, all of whom have connections to other countries and cultures. I’m one of those people. While I was born in Michigan and call New Jersey home today, I’ve spent considerable time visiting, living and working in Mumbai—the city my parents migrated from and where my public health career kicked off.

My connection to my country of origin—through ties to family and friends, time spent living and visiting there, language and culture—has profoundly shaped me and made me the person I am today. Perhaps most importantly, though, it has fostered a deep appreciation for the many different ways people experience, live day-to-day and move through the world—and the great possibilities for learning this brings. Years ago, as a new mother in the United States, I benefited enormously from Indian postpartum food traditions, lovingly prepared for me by my mother and mother-in-law. Now, with school-age children, I wonder which Indian teaching methods could be helpful, trading notes with my cousins and their kids.

These types of exchanges have enriched my life, and I often hear the same sentiment from friends and colleagues with immigrant backgrounds from various other countries. Moreover, they remind us that the way things are done in the U.S. isn’t the only way to do things. Countries around the globe, from Brazil to Malawi, are finding creative ways to overcome similar health challenges to the ones we’re facing in the U.S. By looking beyond our borders, we can uncover new inspiration for advancing health and health equity across our communities.

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Global Approaches to Well-Being: What We Are Learning

Oct 13, 2020, 2:00 PM, Posted by Alonzo L. Plough

What can we learn from other countries about advancing well-being—a notion of health that extends beyond the absence of disease? A new, free book will offer examples and actionable ideas. 

A father and mother hold their baby.

Since we originally published this post in July 2019, more cities and countries are exploring ways of centering decision-making on human and planetary well-being—from Iceland, which revealed a new well-being framework, to Canada, which is exploring budget indicators that encompass happiness and well-being. 

Meanwhile, the COVID-19 pandemic is a reminder of how interconnected we are and always have been across lives, livelihoods, and well-being of communities and societies everywhere. In the United States, its spread has sharply illuminated inequitable conditions and ongoing systemic racism. Rates of infection and complications from the virus are significantly higher in communities of color, Native communities and tribes, immigrant communities, and other groups that live with higher rates of air pollution, spotty health insurance coverage, persistent health inequities, and lack of paid leave or a financial safety net to follow “stay home” public health orders. As we recover, prepare for potential future outbreaks and rebuild, we must prioritize equitable well-being as the ultimate goal. We might take a lesson from New Zealand, which adopted a well-being budget last year, has made significant investments in vital services like mental health and education as well as environmental protections, and has had an exceptionally low mortality rate and relatively rapid recovery from COVID-19.

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