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By Thomas Goldsmith
Contemporary problems of health, hunger and wealth grow from deep roots of institutional and personal racism, said participants at this year’s Healthy Durham meeting during sometimes heated discussions.
The event at Durham Convention Center on June 8 brought together city and county officials, academics, social workers, private and nonprofit providers, and a strong contingent of neighborhood activists. The summit is a project of the Healthy Durham 20/20 partnership, which urges people and organizations to make sure that Durham keeps showing improvement in health and quality of life, with special attention to health disparities seen in the community.
Tim Stallman and John Killeen of Dataworks, which creates data tools such as the Neighborhood Compass, addressed the entire gathering of several hundred people about the dramatic differences in social determinants of health across Durham neighborhoods, reflecting racial concentrations and income gaps that are also a statewide and national phenomenon.
“With racism, we are talking institutional and we are talking about interpersonal,” Killeen said.
“There’s that historical part and the interpersonal part that we all have to work on in different ways.”
Advocates from Durham’s African American communities spoke of racism lasting decades and even centuries. One discussion in a breakout session on improving food distribution and related information centered on the range of attitudes that providers of food might expect from clients.
“We need to think about their history,” said Shaneka Grimes, of the state Office of Minority Health and Health Disparities. “I would shy away from terms like ‘anger.’ You kind of can’t ask them to do that when they have been hurt for years, for hundreds of years.
“We can’t confront them and tell them, ‘Don’t be angry when you’re coming to me for help.’”
A breakout session leader, Abbey Piner, took up the point.
“There’s a need for an acknowledgment of the history … who’s vulnerable and what that means to them,” Piner said. “There’s a need for de-centering institutional power.”
Community organizer Veronica Perry reacted strongly to a suggestion by another attendee, Angel Romero Ruiz, that neighborhood organizers could further their goals for a healthier community by bringing their cases to the city council or other public forums.
“A lot of the reason people in the community don’t come out is, we don’t trust you!” said Perry, who works with the nonprofit REAL Durham. “Y’all are just making it for show. Show me what you are going to do.”
After the meeting Romero, who works in health-care access and is a member of the College Grove neighborhood group, said he had been referring to the tangible success he had experienced in working with Durham City Council on sidewalk issues.
“I’m not the government,” he said.
The role of racism in hunger in the U.S. was reflected in a 2014 RTI International Center for Health and Environmental Modeling review of academic findings on food insecurity. Research showed that “African American, American Indian, and Hispanic households experience food insecurity at higher rates than white, non‐Hispanic households.”
“The same neighborhoods …”
The relationship of economic and other factors and community health emerges in the disaggregated, “HIPAA-safe” information that Dataworks gleans from local health care providers.
“For the first time we can look at almost a real-time picture of what health looks like at different neighborhoods across the city,” said Tim Stallman from Dataworks. “When you look at how that plays out across the city … the same neighborhoods have high diabetes rates and high eviction data.”
Katherine Turner, founder of Global Citizen, a firm that consults internationally on health affairs and human rights, wanted to make sure that this year’s Healthy Durham discussion broke new ground.
“I feel like we had a number of similar conversations last year,” Turner said.
Marissa Mortiboy, program manager at the Durham County Department of Public Health, and Turner talked in a separate interview about the way that decades-long studies and programs brought by academics and government researchers had come into the inner city promising new approaches and reform. But when grants ran out, or program leaders moved to a new phase, the community remained without noticeable makers of progress, they said.
Mortiboy said there’s need for more hard data such as asset maps and gap analyses reflecting the location of food supplies and of people in need of more healthy fare. Those resources could remain once the academics move on.
Identifying community need
Churches often work to fill community needs, participant Priscilla Ramseur said.
“They do go out and identify what needs are in the community,” she said.
“People became healthier; few people died,” Worthy said. “When a community, i.e. a church, gets really involved, you can have positive outcomes.”
In other settings, societal barriers can make it difficult for help to reach clients, said Maria Luisa Solis, a community outreach educator with El Centro Hispano.
“We come from other cultures,” Solis said.
Some Hispanic residents were disappointed at the kinds of food available at a local food pantry, she said.
“This food was canned,” Solis said. “They had food, but not healthy food.”
People at the conference offered both recent and long-ago examples of economic and racial impacts on health and well-being. In an interview as the event began, Durham resident Wilma Liverpool said the town has yet to overcome developments she described as oppressive, such as the Durham Freeway’s damage to the city’s black society and institutions starting in the 1960s. Liverpool, 69, said she came to the summit as a longtime advocate of reparations to African Americans.
“Until we hit it on the head, that racist withholding of money that belongs in my community, none of this is going to be corrected,” she said.
In the breakout session, Senior PharmAssist director Gina Upchurch said also traced the problems of ensuring healthy food to larger social issues.
“I’m feeling that equity is at the center of what we are talking about,” she said. “Equity and poverty.”