Now Viewing: Public and Community Health

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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How a Native American Tribe Found Healing Through Horses

Oct 6, 2021, 10:00 AM

Bring horses and Native youth together, and connections are built that can change lives. 

Editor’s note: Shortly after this video was published five years ago, Charlie Four Bear—the Native elder featured—passed away. His teachings about how to build resilience, however, continue to endure.

Deep ties to the land and close connections with animals have long helped to define Native American culture and make their way of life possible. In Fort Peck, Montana, Charlie Four Bear reclaimed that legacy by helping young people develop enduring relationships with horses. Four Bear (Dakota and Lakota) was an elder on the Fort Peck Indian reservation and a former police officer.

 “First they took away our land,” he said, describing the destruction that occurred as White settlers pushed West. “And then they took away our buffalo. And then they took our horses away.” The theft of so much Native culture, and the inequitable distribution of resources and opportunity that continues to this day, have damaged lives and undermined communities. The scars are apparent in the substance use and loss of hope revealed in one horrifying statistic: in a single year, 28 of 223 students at the local high school attempted suicide.  

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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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The Case for Having Health Equity Guide Community Preparedness

Aug 24, 2021, 1:00 PM, Posted by Anita Chandra, Carolyn Miller

The coronavirus pandemic has exacerbated long-standing inequities in communities across the United States. To prepare for the next crisis, communities must build health equity infrastructure now.

Health equity and community preparedness illustration.

We can’t prevent disasters, but proactively developing strategies to address health equity can ease some of their most harmful effects on people and communities. 

In our research, we’ve found communities that developed these strategies before and throughout the pandemic were better positioned to target resources to address health disparities that were highlighted and exacerbated by COVID-19.

Take Harris County, Texas, for example. In 2014, Harris County Public Health (HCPH) developed a health equity framework that was tested by an outbreak of the Zika virus in the county two years later. This experience informed HCPH’s management of the COVID-19 vaccine rollout and decision to collect vaccination data by race. While the state of Texas’ vaccination strategy emphasized mass vaccination sites, mobile vaccine clinics administered the one-shot Johnson & Johnson vaccine in parts of Harris County that were hit hardest by the pandemic.

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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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Nurse Leader Shares Five Lessons on Breaking Down Barriers to Vaccination

Jul 19, 2021, 10:00 AM, Posted by Maria S. Gomez

A nurse leader who has been vaccinating a diverse community offers a candid assessment of false starts, wisdom gained, and the best way forward.

Vaccine barriers illustration.

Maria S. Gomez is a public health nurse who received a Presidential Citizens Medal in 2012 from President Barack Obama. She along with other colleagues founded Mary’s Center in 1988 an innovative community health center in the D.C. region that has been using an integrated model of health care, education, and social services for more than 30 years. Today, it serves over 60,000 people each year. Here, Gomez shares lessons learned through Mary’s Center vaccination program.

Lesson One: No Wrong Door

Mary’s Center’s vaccination program didn’t have an easy start. Like the community we serve, our team was fearful and struggling in the pandemic. Suddenly, there was a vaccine that offered promise to keep us safe, but people were confused and anxious about it. It fell to us to provide information—but first we had to educate ourselves. There was no shortcut and no chance of success unless we did. So we put in the time, even holding Town Hall Meetings with our team of nearly 800, to learn and become effective messengers.

We learned that for some in the Mary’s Center community, a lack of trust stemmed from our country’s history of medical abuse—and not just horrors like the Tuskegee syphilis study but also more recent atrocities including involuntary sterilizations of Puerto Rican women and of women detained at the U.S. border. Many in our community have experienced those abuses well.

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Bringing Clean, Running Water to the Navajo Nation

May 3, 2021, 12:45 PM, Posted by Cindy Howe

Broken promises and structural racism have deprived New Mexico’s Navajo Nation of safe, running water for generations. A Navajo woman shares how she is actively changing this reality, one family at a time.

Darlene Arviso fills water tanks for Navajo tribal members. The "Water Lady" Darlene Arviso fills water tanks for Navajo tribal members who do not have access to running water. Photo credit: DigDeep, 2019.

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.  

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How Communities Can Support Children and Families to Recover From the Impacts of COVID-19

Apr 26, 2021, 3:00 PM, Posted by Brian C. Quinn, Carolyn Miller

Communities nationwide are showing that helping families recover helps our society recover.

Family greets each other while wearing masks.

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.

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It Is Time to End the Sale of All Flavored Tobacco Products

Apr 23, 2021, 12:30 PM, Posted by Matt Pierce

Taking flavored tobacco products off the market would save millions of lives, reduce health care costs, and ensure an equitable approach to better health in the United States.

Smoke free signage is on display at a bustop.

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.

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Normalizing Men as Caregivers Helps Families and Society

Apr 8, 2021, 2:00 PM, Posted by Gina Hijjawi

Busting the stereotype of men as breadwinners and women as caregivers benefits families and our economy. New research reveals conditions and supports needed for men to fulfill their caregiver roles.

Father and daughter do laundry together.

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.

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