Editor's Note: This is a monthly educational series about racism. Contributors include Donna Hight, Beth Castle, Margaret Lin, Deanna West-Torrence, Renda Cline, Tiffany Mitchell, Crystal Davis Weese, Brigitte Coles and Amy Hiner.
Imagine finding out that you're expecting a beautiful baby. You’ve been looking forward to this moment for years. At your first prenatal appointment, the doctor has you sit down to discuss some important items as you enter this stage of life.
First, she discusses national statistics with you. She goes over the fact that simply because you are a Black woman that your baby is 2.3 times more likely to die at birth than a white baby. Then, she mentions that your baby is 3.8 times more likely to die in their first year of life compared to a non-Hispanic, White infant. Lots of questions and sadness start to fill your mind.
“So are you saying that just because of the pigmentation of my dark skin that my child and I will have different determinants of health?” you ask.
“Yes,” she responds as she hands you a report on the state of African-Americans in your community.
She points out that because you and your life partner earn less than the majority of the county (median household income for Richland County for African-American families is $29,913, compared to $45,623 for white families) that the social determinants of your health and in turn your baby’s health will create huge disparities compared to your White neighbors and friends throughout your life.
People who look like you are more likely to have high blood pressure, asthma, diabetes and are twice as likely to die from heart disease. Most of these health issues can be attributed to the systemic racism encountered throughout the lifetime of Blacks.
Empathy is the ability to understand and share the feelings of another. Although the story above is fictional, it is the reality for 18 percent of Mansfield’s residents or 7.8 percent of our entire county’s residents.
Here’s the good news for Richland County: A group of women have come together to partner with members of the community to seek solutions to eradicate racism in the systems and institutions here in our community.
You may be asking yourself, what exactly are social determinants of health and how do they impact so many parts of people’s lives? What are the details of the proposed task force that people have been discussing? What all does that entail?
Social determinants of health are defined by the federal Office of Disease Prevention and Health Promotion’s Healthy People 2020 Initiative as being the environmental conditions where people “are born, live, learn work, play, worship and age that affect a wide range of health, functioning and quality of life outcomes and risks.”
The availability and accessibility to resources such as education, public safety, availability of healthy foods, local emergency/health services and environments free of life-threatening toxins are challenges we have encountered in this community.
Examples of these social conditions that have, over time, created notably disparate conditions in our community include the availability of and access to resources to meet basic needs such as safe housing and healthy food, health care, education, transportation and job opportunities. A lack of these supports often result in poor health outcomes.
Interestingly, the report also cites the following as one of the items listed as a social determinant of health - social norms and attitudes (e.g., discrimination, racism and distrust of government). Also impactful on the health is exposure to crime, violence, social disorder and blight.
This is where the task force comes into play.
The task force will convene members of the community with an interest in creating more equitable conditions in this community. Comprised of subcommittees, each will explore health, mental health, housing, employment, education, business, and criminal justice sectors.
Ideally, it will consist of subject matter experts, concerned individuals and institutional representatives, as well as those entrusted with public resources who can help the committee understand the current local landscape.
Because of the composition of the committee, our housing systems, health systems, etc. become more robust, and more effective. It also channels the current energy of the community in a solutions focused manner that builds our relationships with one another.
Each subcommittee will do the following: Assess the current landscape by gathering data, analyze it, then the committee proposes solutions in the form of adjustments to existing programs, new programs, policy changes and procedures for our community.
It is in the creation of solutions that the assets of the community can be applied to creating new, more equitable systems that better accommodate all of our community. What follows is an evaluation of those efforts and lastly the committee will outline a plan to sustain the successful efforts.
We have been pleased that the early adopters of this concept have been the healthcare sector itself. From nurses and doctors to administrators who deal with the impacts of our inequitable systems on a daily basis, best understand the impacts of disparate conditions in so many areas.
We encourage anyone with expertise or interest in the areas of education, criminal justice, health, mental health, employment and business to contact us to get involved by emailing www.who.int