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It is the racism that has been built into multiple systems through law and policy such that discriminatory practices in one sector reinforce parallel practices in other sectors like health care, education, employment, housing, credit markets, and the justice system. Racism creates opportunity and perpetuates inequities, which results in conditions that unfairly advantage some and unfairly disadvantage others.
Below are some examples of the disparities and inequities created by racism:
Thirty years of “tough on crime” and “war on drugs” public policies have resulted in mass incarceration of primarily black and Hispanic males. This discrimination and inequity undermines the social and community fabric that is so vital to public health, narrowing opportunity, disrupting families and social cohesion, and preventing civic participation.3
For Black and Indigenous women, the history of motherhood is rooted in betrayal, exploitation, and denial of services. Black and Indigenous women were forcibly and unknowingly sterilized and experimented upon to advance modern gynecology. The consistent and systematic devaluing of Black and Indigenous motherhood directly impacts maternal health outcomes today. Black women often receive poorer quality care, consistently denied care, and are not treated with dignity or respect. The structural racism in healthcare and social service delivery experienced during sensitive developmental periods can trigger a chain of biological processes that puts Black women at higher risk for a range of medical conditions that threaten their lives and their infants’ lives, including preeclampsia (pregnancy-related high blood pressure), eclampsia (a complication of preeclampsia characterized by seizures), embolisms (blood vessel obstructions), and mental health conditions.4
Current events have generated a renewed focus on and more exposure of structural racism and health disparities. The time is now to enact the changes needed to dismantle structural racism. Our work at Unite Us, hinges on our ability to acknowledge the injustices faced within the communities we serve and build trust within our communities. To do this, we hire local teams that are reflective of the community to build multi-sector networks that identify and address communities’ unmet social needs and meaningfully engage communities in an inclusive manner that builds upon what exists, amplifies voices that were previously ignored, and engages populations that historically have been missing.
The COVID-19 pandemic has exacerbated existing health equity challenges across the US and brought into clear focus the inequities that exist between races and historically marginalized populations. Communities at greater risk of community spread, morbidity, and mortality include:
While COVID-19 provides devastating evidence of the health equity divides in our country, research has been mounting to suggest that the environments in which we live, work, and pray have a significant impact on our health and well-being. Addressing structural racism and its relationship to these impacts is equally important.
Health equity is a guiding priority of Unite Us. Health disparities in marginalized communities are symptoms of the social, environmental and/or economic realities born of historical and systemic discrimination across race/ethnicity, socioeconomic status, age, location, gender, ability, and sexual orientation, as these communities have not been cared for, protected, or invested in the same ways as others. We partner with communities through an intersectional approach to build a network that provides people a fair opportunity to access the resources they need to not only survive but thrive – leading to health equity.
Our model is rooted in community capacity building, in addition to individual impact. We meet communities where they are and take an asset based approach to elevate the resources that already exist and work together to build capacity where there are gaps. We recognize the work that’s already been done, and partner closely with existing collaboratives, coalitions, and community leaders to implement customized solutions for a given community. We also acknowledge the power of history and employ engagement strategies that mitigate the risk of building upon or exacerbating inequalities and inequities that may already exist.
Our community engagement experts are representative of the communities served, hired locally, skilled in stakeholder engagement and collective impact, and have past experience in public health, non-profit management, and community-based care coordination. Our ability to meaningfully and respectfully engage is rooted in our understanding of how injustice impacts health and health equity and our desire to be a true partner and ally to all communities we serve.
Referrals in our network flow from health systems, food pantries, homeless shelters, and also from churches, libraries, and barbershops. Our process ensures community voices are heard so that traditional centers of care and support are not overlooked and are onboarded to the network.
We develop an inclusive and culturally relevant network of providers to create meaningful access to care through accessibility, acceptability, availability, and accommodation. To build authentic partnerships, our community engagement managers conduct landscape analyses and asset mapping to identify local leaders, existing collaboratives, and community assets. Our team focuses on the interaction between gender, race, and other categories of social difference and recognize there is no one-size-fits-all solution. We reach clients where they are to ensure that all populations have access to network resources.
At Unite Us, we are using data meaningfully to inform the development and implementation of a health equity strategy that guides all aspects of our work with the ultimate goal of reducing health inequities in the communities that we serve.
Our Data and Analytics team prioritizes the following objectives regarding our health equity strategy:
Connecting health and social care to deliver mid-stream interventions to individuals is critical to advancing health equity, but the opportunities do not end there. Ultimately, health equity must be achieved by moving upstream and transforming systems, policies, and laws that perpetuate inequities and discriminatory practices. Our coordinated networks can support Health in All Policies, which is a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas while ensuring all decision-makers are informed about the health, equity, and sustainability consequences of various policy options.5 A Health in All Policies approach identifies the ways in which decisions in multiple sectors affect health, how better health can support the achievement of goals from multiple sectors, and forces the collaboration required to move upstream and enact the policies changes to address social determinants of health.6 Our Unite Us Platform powers networks that naturally are multi-sector as we connect communities to services across the social determinants, but with our data and community engagement process we can support a wide range of root cause policy initiatives to promote health in all policies and achieve health equity.
Creating centralized infrastructure that coordinates care and supports diversion and reentry initiatives to break the cycle of mass incarceration that costs governments billions of dollars with poor outcomes for communities and justice-involved individuals.
Supporting efforts at detection and early intervention of adverse childhood experiences (ACEs) and providing a platform for referrals and coordination of services and treatment.
Reducing racial disparities in maternal and early childhood health by partnering with states, health systems, and local organizations to coordinate care that addresses the social determinants of health for pregnant women and mothers with young children.
Learn more about Health Equity at Unite Us
The COVID-19 pandemic has had a disproportionate impact on women, particularly Black women. With over 860,000 women leaving the workforce in September and a staggering job loss number of 5.8 million since February, the economic fallout of COVID-19 may be causing equality setbacks that won’t easily be rectified and could be felt for generations to come.
At Unite Us, we bring together partners from government, healthcare, and the community to identify and elevate local needs by building an inclusive infrastructure that increases equitable access to resources and improves health for all.
This Black History Month, we recognize Black Americans who have made invaluable contributions to health and social care. Join Unite Us as we celebrate and respect the legacies of these leaders. No list is long enough to properly acknowledge all of the work that Black Americans have contributed to health and social care. From hospital executives and case managers, to executive directors and community health employees, Black Americans are working tirelessly to improve the health of all of our communities. We are committed to keep researching and celebrating their contributions all year long, during Black History Month and beyond.
Georgina Dukes Georgina is a Community Engagement Manager for our statewide network, NCCARE360. To learn more about this program, click here. (Pictured above: Community Engagement Managers Morgan Forrester, Megan Carlson, and Georgina Dukes.)