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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How Can We Prioritize Equity in Public Health?

Mar 10, 2022, 12:01 AM, Posted by Maisha Simmons, Sallie George

RWJF leads the design and development of an independent public health institute in New Jersey.

Young woman takes blood pressure of a woman at a table.

We are proud to live in one of the most racially and ethnically diverse states in the nation. Our home state of New Jersey is also a national leader in areas such as expanding health care coverage, enacting paid family leave, and maintaining low smoking rates.                                                       

Unfortunately, however, these bright spots are offset by glaring disparities with roots in our nation's long history of racism that persists to this day. For example, a Black woman in New Jersey is seven times more likely to die from pregnancy-related causes than a White woman and Black babies are more than three times more likely than White babies to die before their first birthday.

The COVID-19 pandemic exposed and worsened these inequities, especially along racial/ethnic lines.  

In addition to the role played by social determinants of health, a major contributor to these disparities is a state public health system strained for decades by lack of funding and insufficient coordination across health and related sectors. Experts agree the system lacks the capacity to simultaneously achieve its core missions while equitably responding to and managing public health emergencies such as the COVID-19 pandemic.

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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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The Pandemic Underscored Why We Need Equitable Telemental Health Services

Mar 3, 2022, 11:00 AM, Posted by Daniel Do

Policies that increase access to telemental health services are key to ensuring mental healthcare is equitable and inclusive.

Online therapist talks with patient.

As a practicing social worker, I believe that mental healthcare is a right, not a privilege. LGBTQ+ and persons of color face numerous barriers to finding affirming mental healthcare and often experience racism and/or discrimination while accessing those services. Through support of the Robert Wood Johnson Foundation’s Health Policy Research program and in collaboration with my research partner Liana Petruzzi, I’m working to help shape a health and mental healthcare system where racism, homophobia, and transphobia are not tolerated or perpetuated.

The COVID-19 pandemic forced us to look at how trauma, stress, and a public health crisis combine to influence our mental health and wellness. This new reality drove the nation to significantly increase its investment in telehealth services. Now in our third year of the pandemic, we must reflect and ask ourselves if that investment is working, and more importantly, if it is equitable. We have a serious opportunity to better meet the needs of Black, Indigenous and People of Color (BIPOC) individuals and communities—needs that must not be ignored. 

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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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What Research Tells Us About Effective Advocacy Might Surprise You

Feb 17, 2022, 11:00 AM, Posted by Jeff Niederdeppe, Liana Winett

Storytelling can be a powerful tool to increase support for policies; but, depending on the audience, it can also have the opposite effect.

Megaphone illustration.

As the pandemic continues, our early child care and education systems have become increasingly fragile. Decades of divestment in school buildings means that many schools are ill-equipped to confront an airborne virus. Educators and others in the workforce are calling in sick or quitting at such high numbers that some areas have called in the National Guard to help schools stay open. The strain when children are sick or when schools close is impossibly hard on working families foremost, but it also disrupts society writ large.

Parents and other advocates are speaking up to demand better solutions. They share personal stories to illustrate both where systems have failed them, and also what is desperately needed. But when is storytelling effective and when does it backfire?

We recently conducted two studies: the first looked at communication to the general public, and the second to state legislators, both designed to generate support for public investments in affordable, accessible, high-quality childcare for all. What we found might surprise you (it definitely surprised us!)

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Black Men Who Care Are the Role Models We Need

Feb 10, 2022, 10:45 AM, Posted by Dwayne Curry

How can encouraging men to share the joy and challenges of caregiving help erase stereotypes and transform the nation’s culture of care?

Men caring for family.

The acclaimed Carter Woodson, who is often called the father of Black history, said: You must give your own story to the world.

Those have been guiding words for me these past few years as I’ve shared my deeply personal journey as a Black father and family caregiver. My goal in doing so is to help break stereotypes, create a new narrative, and offer solutions to the caregiving crisis that is holding our country back.

I’m proud to be a caregiver to my family, which includes my wife, her 9-year-old daughter and 8-year-old son, my 9-year-old son, and the 2-year-old son we have together. Caring for four children, including one with special needs and another who is an active, curious toddler, is not easy. Doing it during a pandemic that has made life much more difficult for both kids and adults has been especially challenging.

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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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This Valuable Data Tool Informs Policies that Shape Child Opportunity

Jan 25, 2022, 11:00 AM, Posted by Dolores Acevedo-Garcia

Millions of children live in neighborhoods with limited access to safe housing, green space, or good schools. Data can inform efforts by local leaders to build a brighter, more equitable future for all children.

Child Opportunity Tool blog graphic.

The pandemic has underscored how profoundly factors like where we live, our income, the kind of job we have, and our race and ethnicity affect our health, well-being, and ability to prosper. Some families and children in the United States have had the resources to weather this storm. But far too many have struggled to meet their basic needs. A poll from late 2021 found that about half of households with children had no savings to fall back on. Significantly more Black and Latino households with children and households with incomes below $50,000 reported not having this buffer.

These are not individual failures. They are societal and systemic—stemming from the pervasive and persistent harm caused by long-standing racism, redlining, and segregation. They affect immigrant families, too, who have trouble accessing social safety net programs, even if they are U.S. citizens.

To advance equity for all, we must address child poverty, unequal access to education and healthcare, and environmental conditions for what they are—structural and systemic in nature. Change can start in your backyard.

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Protecting Employee Health in Tomorrow’s Workplace

Jan 13, 2022, 11:00 AM, Posted by Paul Tarini

The pandemic, renewed attention to racial justice, climate threats, and evolving technology herald huge changes in the nature of work. To center equity in that shift, policies, practices, and culture need to change, too.

Future of Work illustration.

When the COVID-19 pandemic took hold in early 2020, the workplace almost instantly transformed. Many people began working remotely and long commutes vanished. Despite heightened anxiety and danger, the public health emergency ushered in unexpected benefits for some in the form of flexibility, accommodations to family life, and recognition of “whole person” needs.

In frontline settings, such as healthcare, grocery stores, public transit systems, and manufacturing sites, the situation was drastically different. While the workers who kept these essential services operating were rightly touted as heroes, many had little choice but to risk infection, hospitalization, and death to keep the lights on for the rest of us.

These very different experiences show the challenges we face as the structure and nature of work evolves. How the risks and opportunities are distributed in that emerging future will largely depend on the decisions we make as a society.

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