Understanding Health Equity

This is part of a series highlighting the workshops from the TJCOG 2020 Regional Summit, “What’s Equity Have to Do With It?”.

Michelle Wright is the Equity and Community Engagement Initiatives Lead at Chatham County Public Health Department. Karinda Roebuck is the Interim Executive Director of Chatham Organizing for Racial Equity. Both serve as Co-Chairs for the Chatham Health Alliance’s Equity Sub-Committee.

1. What is the relationship between health and equity, and how might we see this play out in government systems?

Equitable structures lead to healthier outcomes by eliminating bias. Government is not exempt from inequitable outcomes. County governments can address disparities within their institutions and mandate change for equitable outcome across all departments.

2. It can be easy to get caught up in interventions or programs. How do you not lose sight of the human element in your work and why is that so critical to success?

Community engagement is the foundation of equity work. We recommend redefining what community engagement looks like in practice. Think instead of merely engaging but leaning more towards shift power. By shifting power to people of marginalized communities you ensure their voices are uplifted and heard. You can, therefore, keep their voices front and center. Keeping the insights or values of the communities served is critical to meeting their voiced needs. Authentic community engagement goes beyond informing people to instead inquiring about their needs.

3. Terminology and words matter. Can you explain why you use the term “marginalized” instead of phrases such as “minority” when discussing populations that are disproportionately impacted by health and social service systems?

Part of equity awareness is building a shared language – a language in which we address the inequity without victimization. We substitute “slaves” for “enslaved persons” to separate a person’s identity from their circumstance. “Minority” assumes that those identified as such are inferior. This assumption perpetuates stereotypes and biases that continues to feed structural inequities.

4. Can you briefly outline the impetus of the Chatham Health Alliance realizing that an Equity Sub-Committee was necessary?

In examining disaggregate data from the 2018 Community Health Assessment, the need to adopt an equity lens before any initiatives were to be implemented was quickly realized. As across the nation, our data in Chatham County was no different than anyone else’s: whites on top, blacks on bottom, and other races falling somewhere in between with few exceptions. These results occurred despite socio-economic status or education. We are mirroring national data and the Alliance saw an opportunity for change.

5. During the Regional Summit session, you discussed the importance of understanding and shifting power dynamics through equity work. Can you explain why shifting power (to the community) matters?

Mechanisms that promote a shift in power, transparency, participation, and equity are key in addressing inequities. By bringing in Black Indigenous People of Color (BIPOC) from marginalized communities early on in the planning stages of equity work, you can begin the steps towards ensuring a true community-led initiative. By entrusting BIPOC we are accepting perspectives critical to achieving equitable outcomes. This recognition of the power of the BIPOC voices drives equity work. To truly elevate the voices of BIPOC, we must develop relationships inside their communities and create ways for people to speak honestly and listen to each other. Their stories are essential, and serve as a mechanism to understand how systemic inequities affect them. We must engage in ways that shift the power dynamics that changes how it is expressed. Shifting power to stakeholder communities is a human-rights principle that we intend to practice at every phase of the process. Instead of independent-dependent models that emphasize and produce “power-over / power-under” relationships, we will move to interdependent organizing models that emphasize “power-with” relationships. We do this by intentionally developing relationships with community members and provide the tools for them to become organizers, facilitate with authority, and become change agents where they can.

6. How have you brought community partners (and/or residents) to the table, ensuring transparency?

The Chatham Health Alliance is a member-led organization – it is free to join and open to all who are invested in the health and well-being of all Chatham communities.

About the Chatham Health Alliance

The work of the Chatham Health Alliance is rooted in the belief that health decisions are directly impacted by the social, cultural, and environmental contexts in which individuals live, work, play, and pray. Addressing these contexts is larger than any one individual or agency can address on their own, and the strength of the Alliance to create change lies in the participation and engagement of Chatham’s residents, businesses, faith communities, civic organizations, nonprofits, and agencies. Joining together, we can identify solutions for our communities rooted in data, evidence, and partnership.