Tag Archives: Community Organizing

Building Hope with Community: The Right to Affordable Housing in South Central Los Angeles

This week’s blog is a repost from Esperanza Community Housing. The post discusses the right to affordable housing in South Central Los Angeles and preliminary findings from HIP’s HIA on a development in the area

The narrative of South Los Angeles has been one of serial displacement. Community residents, primarily low-income people of color, have systematically been priced out of our homes and neighborhoods to make way for industry and for gentrifying trends. We’ve faced higher rents, skyrocketing property values, and a cost of living that has become unmanageable — even when working multiple jobs. This combination is a result of the city’s poor planning and spot-zoning policies, and the real estate development industry’s unchecked pursuit of profits without consideration of the human cost of housing, health, and security. This has put not only our homes at risk, but also our health, our identities, our livelihoods, and our environment. Read more…

Does Organizing Have a Place in Public Health?

Many social movements in the United States have used community organizers to mobilize and strengthen collective power to liberate communities from systems of oppression. Today, the concept of “organizing” is becoming mainstream as we watch Black communities unite to address police brutality and reform the criminal justice system.

Some people relegate “organizing” as an advocacy strategy to push a single-issue, minimizing the historical impact. I consider organizing a strategic process that brings together community to influence institutions, policies, and government through relationship building and education.

The purpose of public health is to protect the health of individuals and communities from harmful conditions in the workplace and the environment where they learn and live. With public health’s unique focus on improving the health of populations, the field has set workplace safety standards, enacted policies to ban smoking indoors, and created nutrition programs in schools. These are all institutional, policy, and government changes; the same kind of changes influenced through community organizing. By organizing and framing issues as a public health matter, our profession has been able to elevate the health of communities.

Historically, communities have relied on their own power to organize against injustices they were experiencing and/or witnessing. The long history of organizing is rooted in changing structural systems to grant civil liberties to those who have been marginalized. Ella Baker, a community organizer during the Civil Rights Movement, was a leader in collective leadership development. Rejecting the need for a charismatic leader and formal hierarchy, Baker preached, “In order for us as poor and oppressed people to become part of a society that is meaningful, the system under which we now exist has to be radically changed…It means facing a system that does not lend its self to your needs and devising means by which you change that system.”

My own experience with organizing started while I was a public health student in Seattle, Washington. I worked closely with Ending the Prison Industrial Complex (EPIC), a coalition organizing to prevent the building of a new youth jail. Organizing around mass incarceration helped me to understand the intersectionality between systems of oppression and health outcomes.

Over the past two years, I’ve been on the ground working with EPIC to bring public health analysis to the No New Youth Jail campaign. EPIC uses ten anti-racist principles from The People’s Institute for Survival and Beyond to transform communities by providing political education to understand their power and hold elected officials accountable. During my time with EPIC, I along with other public health students expressed our strong opposition and challenged city council members to consider their support of the jail as being in direct contradiction with the goals of protecting our youth. We highlighted the health consequences of incarceration; beyond individual health, we talked about community and economic effects like the high costs associated with incarcerating youth, the justice system’s perpetuation of racism and discrimination against Black and brown youth, and incarceration’s inability to solve the underlying problems of communities.

Because of our strong organizing, we garnered support from one city council member, Kshama Sawant who voted “no” to investing over $200 million dollars in building a detention center. The persistent pressure from organizing groups and community did not end even in the face of adversity. Modeling alternatives and changing the narrative of incarceration, a resolution to end youth incarceration was written with the support of EPIC and Youth Undoing Institutional Racism. On September 17, 2015, the City Council’s Public Safety committee voted to end youth incarceration in Seattle and now the measure will go to the city council for approval.

The fight to end youth incarceration is far from over. Patrick McCarthy, CEO of Annie E. Casey Foundation in June 2015, urged states to close down youth prisons. “We need to admit that what we’re doing doesn’t work, and is making the problem worse while costing billions of dollars and ruining thousands of lives,” said McCarthy.

On the ground organizing is pushing elected officials to consider the unfair treatment of Black and brown people from early childhood to adulthood in school, employment, housing, criminal justice system, and other sectors. Public health has a unique opportunity to use anti-racist community organizing principles to frame issues to radically transform the living conditions and opportunities for communities.

Good Jobs For All Would Boost Health, Reduce Inequities

Last week several national organizations launched the Putting Families First: Good Jobs For All campaign to bring the issues of jobs, poverty, and inequality to the center of the national debate. “Today, our country is more aware than ever before that our entire economic system is out of balance. We have reached a time in history where the need, the opportunity, and the energy are all here to create an economy that works for our families—now we need the will and the dedication of the American public to make it happen,” wrote Deepak Bhargava, Executive Director of the Center for Community Change.

The campaign will mobilize people around the country – especially poor people and people of color – to advocate for a national agenda focused on:

  1. Guaranteeing good wages and benefits, including a $15 minimum wage, access to paid sick days and paid family leave, and protections from wage theft;
  2. Valuing families by making high quality, affordable early education and child care available to all working parents and their children;
  3. Building a clean energy economy through large-scale investment to substantially reduce our reliance on carbon-based energy and to repair and rebuild our infrastructure;
  4. Unlocking opportunity in the poorest communities by channeling federal investments to communities with high unemployment and low wages to help rebuild their local economies and provide access to jobs and wealth-building opportunities; and
  5. Taxing concentrated wealth, including eliminating differences in taxation of capital gains and income, strengthening the estate tax, increasing taxes on the highest incomes, ending the ability of corporations to defer US tax payments on offshore income, and taxing corporations for wage inequality.

This is a bold and ambitious agenda that would create over five million new jobs a year by directing government to take an active role in guiding our economy through investing and shaping new and emerging sectors. These investments would be targeted to help those who need it most, closing racial and gender inequities, and be paid for by changes in our tax system that reward those who create wealth in this country – hard working people.

While those leading the campaign – the Center for Community Change (whose board I am chair of), the Center for Popular Democracy, Jobs with Justice, The Leadership Conference for Civil and Human Rights, and the Working Families Organization – are thinking about this as a jobs campaign, it is also a campaign to improve health and reduce health inequities. Several speakers at the launch event, including Senator Sherrod Brown of Ohio and SCOPE Executive Director Gloria Walton, noted the impacts of income on health and lifespan, but health is still an underutilized frame when talking about social and economic policy.

The Putting Families First campaign aligns with HIP’s new Economic Security Program, which will bring public health data, framing, and voices to social movements advancing a range of economic security policy campaigns.

As we’ve said before, no single factor is more important for healthy living than an adequate income, and none is more harmful to health than persistent poverty. Economic security is necessary for people to thrive, successfully manage stress, and prevent disease. Overwork, poor quality food, housing insecurity, and other consequences of low wages and unemployment contribute to physical and mental health problems including high blood pressure, diabetes, heart disease, and depression.

Economic security requires guaranteeing that work is available, safe, and pays a decent wage. Ensuring that families have a decent standard of living is one of the most powerful tools we have to protect and promote health.

Beyond Band-Aids: How Public Health Can Address Root Causes of Health Inequities

The Ebola outbreak in West Africa is an unambiguous reminder that social and economic conditions, like the lack of reliable public infrastructure in Liberia and Sierra Leone, are at the heart of many public health problems. In such an extreme case, public health and medical officials agree that once the epidemic gets under control, we must focus on improving these root conditions to prevent future crises. But even in the United States, where most places have reliable public infrastructure that protects people from such heart-wrenching scenarios, social and economic conditions lie at the heart of most serious public health issues and the inequities that result.

A new book, Expanding the Boundaries: Health Equity and Public Health Practice, released by the National Association of County and City Health Officials (a collaboratively written document with primary authorship by my friend Bob Prentice), focuses on the importance of social and economic conditions as keys to public health. Its central thesis is that “Health equity practice should consider the underlying social inequalities that are the root causes of health inequities, rather than only their consequences.”

Expanding the Boundaries begins by tracing the history of public health in the United States. Public health today takes a biomedical science approach – vaccines, laboratories, clinics, screening for disease. But many of public health’s most important advances were part of social reform movements responding to industrialization and urbanization. Reforms in sanitation, urban planning, food safety, child labor, and other areas resulted from public health advocates working with reformers in labor, women’s rights, housing, and other social movements.

The book argues that we must return to such collaborations to truly address the social determinants of health and health inequities:

The notion of an expanded health equity practice that can directly confront the sources of social inequalities is not a wistful claim to a romanticized history of public health. It is, rather, an argument that a public health that uses its resources, perspectives, commitment, and savvy to challenge the structures of power that create and maintain social inequalities and unhealthy living conditions is grounded in its own history.

It examines the root causes of health inequities – class, racism, gender inequity and heterosexism – and the structures that perpetuate these inequities. Disaggregating data, improving clinical management, and health education for specific demographic groups are all necessary, but not sufficient if we want to address inequity. “An expanded health equity practice,” NACCHO writes, “. . . asks how these [populations] came to be the way they are, and how public health might influence the forces that shape them rather than contend only with the consequences.”

Inspiring case studies – from Alameda County and San Francisco in California, Ingham County in Michigan, and the State of Minnesota – show how this can be done. Public health agencies in these places have been tackling such issues as goods movement, foreclosures, displacement, public transit, minimum wage, and planning and zoning.

Expanding the Boundaries identifies seven elements of health equity practice. For me, one resonates most and reflects where HIP is heading: “Some health departments have learned how to participate strategically in campaigns initiated and led by others, which might not be primarily about health but nonetheless advance health equity goals.”

This approach to public health is far from commonly accepted today and far from what is possible now in many places. But as the book concludes, “Developing health equity practice … is best seen as a movement-building strategy. It is a long-term process that requires a transformation of organizational culture and practice, and the larger public understanding of what most influences health.”

Am I a Scientist or an Activist?

For a recent graduate of a master’s in public health program, Human Impact Partners’ Health and Equity Fellowship was a golden opportunity to put those three little letters at the end of my name to good use. Health Impact Assessment combines both analytic rigor and a participatory, community-driven approach to promote health, equity and justice. So on my first day at the HIP office, I had to ask myself: Am I a scientist or an activist?

As a biology undergrad researching the genetics of virulence in human-parasite interactions, I was squarely in the scientist camp. As a public health graduate student, participating in city council meetings to support changes to Oakland’s rent ordinance to protect low-income tenants, I was treading into activist territory. At various points I’ve identified more strongly as one or the other as these split personalities played a constant tug-of-war.

Now, almost two months into the fellowship, it seems that these two sides of me are pulling in the same direction. Health Impact Assessment – the HIP way – is both science and activism.

Public health has always been a complex field, but in the last decade our definition of public health has expanded so rapidly that it seems to burst at the seams every few years, challenging us to adopt ever more expansive and rigorous frameworks to address the full scope of the issues it encompasses. Public health’s scope has expanded from contagion control to prevention to behavior change and more recently to social justice. Given these changes, it seems that the reach of science is simply no longer expansive enough to encompass that scope on its own. Nor are traditional scientific approaches rigorous enough. Public health needs to look more like advocacy and community organizing to remain relevant to the populations it seeks to benefit.

In graduate school at UC Berkeley, I found myself working to promote the health of undocumented immigrant Latino day laborers. I did this in part through ethnographic research, direct services to help meet day laborers’ basic needs and educational sessions on occupational health — all part and parcel of traditional public health practice. But that alone was not enough. It was only a start.

How do you take control of your own well-being when your health is hugely influenced by a city ordinance that prevents you from seeking work and wages to support your basic needs and those of your family? How do you ensure on-the-job safety when your labor is simultaneously a highly sought-after commodity and a political lightning rod for anti-immigrant sentiment?

These issues, and many others like them, are complex and yield no easy answers. HIP’s combination of public health and social justice frameworks help us ask better questions and use the evidence to tip decisions in the direction of health and social equity, and to empower communities to make change happen.

I’m humbled at the challenge of working with the talented team of smart, motivated professionals at HIP — already, I have learned so much, and hope I can contribute as much as I receive. And I’m privileged to work in solidarity with communities and be a part of movements to make good on the promise of health for all.

HIP is pleased to welcome Darío Maciel as HIP’s 2014-2015 Health and Equity Fellow. As one of our strategies to advance health and equity in decision-making, HIP offers a yearlong, fulltime Fellowship for an emerging public health professional, with a goal of increasing the racial and ethnic diversity among practitioners of Health Impact Assessment and Health in All Policies approaches.

HIP’s Emerging Leaders in Health and Equity

In our research on issues like paid sick leave, alternatives to incarceration, and immigration policy, HIP has been a leader in advancing the ways Health Impact Assessment (HIA) can be a tool for equity. HIA practitioners face common challenges when working to advance equity, especially for those with limited familiarity with equity issues or vulnerable communities.

Part of HIP’s strategy for advancing health and equity in decision-making is diversifying the field of HIA practitioners. HIP’s Health and Equity Fellowship was established in 2013 with the goal of increasing the racial and ethnic diversity of emerging professionals who are committed to promoting the consideration of health and equity in decision-making through Health Impact Assessment and Health in All Policies (HiAP) approaches. The fulltime fellowship, offered to one candidate each year, includes ongoing education and training in the practice of HIA and other approaches to integrating health into policy planning decisions.

HIP’s first Health and Equity Fellow, Fabiola Santiago, reflects on the values and experiences that drew her to this work and the fellowship. We are pleased to announce that Fabiola has joined the HIP staff as a Research Associate.

Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.– Audre Lorde

Fabiola Santiago
Fabiola Santiago

First and foremost I was drawn to HIP’s mission of transforming the places and policies people need to live healthy lives. Too often we blame people for their poor health status; rarely do we consider the larger systems and polices that affect health. Leading an HIA and working on issues affecting communities seemed like an ideal starting point. I also thought I could apply my community research experience, while learning from professionals with extensive HIA experience.

The other thing that drew me in was HIP’s unique focus on equity. Marginalized communities continually face the burden of unjust polices, projects, and programs. HIP places a priority on equity, and as a woman of color from a low-income and formerly undocumented background, I could not be more satisfied with an organization and fellowship that elevates the voices of the most vulnerable. My academic training taught me different ways of thinking and essentially a new language but also limited my contact with vulnerable communities. Collectively working with individuals and organizations that are likely to be affected by polices and programs is needed in order to prevent and mitigate negative health consequences.

My involvement in the student immigrant rights movement showed me how policy changes, even within one institution, can make a difference in health. The organization I was involved with successfully put changes in place that made school less stressful. For example, garnering support from our counselors, professors, administrators, and staff led to establishment of a food pantry for undocumented students and a payment plan for students who could not pay full tuition.

Overall, HIP’s Health and Equity Fellowship mirrors my personal values: health, equity, community, and redistribution of power. The fellowship seamlessly bridged my public health background with my interest in working with low-income communities. We cannot advance in issues of social justice without first tending to our health. Good health is the strongest tool for justice.