Anonymous Interview; Region X (7/13/16)
1.
Identification:
-What
is your name? Anonymous
-Where
were you born? Olympia Washington
-Where
did you grow up? Olympia Washington
-Profession
currently: Women’s Health; Breast Feeding
-Region
working in right now: Region 10 in Washington State
-State
living in right now: Olympia Washington
2.
Why
are you interested in public health and how did you get into the field of
public health?
I think I have a strong sense of justice,
which is what brought me to public health. When I was a teenager, I stayed at a
reservation in Washington to do community work with the local food-bank; I was not
prepared for this experience and was horrified with the lack of access to
resources or care I saw. This was only a few hours away from where I lived, and
in my small bubble of Olympia I never knew there were people who didn’t always
have clean running water or access to a dentist so close to me. An elder woman explained
to me about the history of the boarding schools and the reservation beyond just
what the textbooks in my high school taught me; it was such an eye-opening
experience. I remember a deep unsettled feeling for weeks after returning home
and trying to explain to my friends what I learned. Reflecting on my short time
there, I went off to college and was on
the pre-med career path, thinking I could help people if I become a doctor or
even a chemist. But when I continued to learn more about complex social issues,
I realized I need to look into a systems approach, and this is how I ended up
in public health. Thereafter, I got an internship within the department of
health working with legislation analysis and how proposed bills or policy
change affect population health, and I’ve been here ever since.
3.
What
is health equity to you?
Health
equity is a form of social justice. When I think of health equity, I think
about the cross-sectionality of everything. For example something as simple as access
to a bus stop could impact health equity. If you don’t have access to a bus
stop, or if there are budget cuts that impact the time or place to access the
route, you might have limited access to your job which will in turn affect the
number of hours you are working at that job and the amount that you get paid. This
could impact your access to insurance or to adequate food and nutrition.
Something as simple as a bus route change could create a ripple effect, so when
I think of health equity, I think of equitable access to the basic things
people need to live.
Essentially,
health equity to me is helping others receive equitable resources or support,
such as health care or nutrition so that we can all live healthy lives.
4.
What
are some challenges (that still persist) within the field of health equity in
public health?
They
are big and little issues—but one of the biggest challenges is that people are
afraid of having their experiences erased. Especially those people that might
have more privilege, but still experienced
struggle in different ways. Sensitivity and misunderstanding is the issue. Just
because one group of people needs something more or we are bringing light to an
issue within one population of people, doesn’t mean we are erasing the needs or
invalidating the experiences of those in a more (privileged) group that might
not need similar support. There is definitely a misunderstanding and fear of being
forgotten (for those people who already have the resources but think it’s
unequitable to give others what they are not receiving themselves). These
misunderstandings cause some people to avoid the topic all together, or to make
blanket statements that everyone struggles the same and if we all put forth the
same effort we can equally get access to the things we need.
On
the other hand, grant funding is also another barrier, and a lack of
representation within public health. It becomes a challenge to address
disparities if all the people at the decision table come from all similar
backgrounds, life experiences, and cultures.
5.
Why
do you think those challenges still persist?
Similar
to 4. Lack of representation, sensitivity issues, and limited funding sources
to do the work.
6.
What
models within your workforce have worked to encourage health equity?
Our department has 5 ways of doing it:
a)
One is building department organizational health equity- representation
b)
Developing and implementing health disparities tool; analyzing health outcomes
c)
Working on partnership and assessment partnership
d)
Policy related; facing economic issues
e)
Ensuring that all organizations are visible and utilizing all social media
outlets for health equity
7.
At
the beginning of your career, what were some root causes for health inequities
and health disparities? How has those changed (or not at all) following the end
of your career?
Breastfeeding
world- big public health issue, as breastfeeding can be an indicator for other
health outcomes. Some root causes in breastfeeding rates are barriers in the
workplace, hospital, clinical setting, and social pressures (including shame, historical
trauma, and lack of representation). There are also issues with access to
lactation consultants. There are ACA mandates that should cover lactation
support visits, but insurance companies won’t recognize lactation consultants
in our state since they’re not licensed, thus women have to pay out of pocket
for care that should be covered. There have recently been pushes toward
licensure of lactation consultants, so we will just have to see what happens.
Reflecting
thus far in my career, I’ve found that policy and systems changes are important.
This push for licensure within the breastfeeding world has opened doors that
highlight bigger issues within public health, such as lack of representation
and the social determinants of health. Some people even talked about racism. I
didn’t expect this kind of conversation to come up from a push to license
lactation consultants. There hasn’t been much change so far, yet, but the conversation to start
change is happening in a way I never imagined it would.
