Equity, Ending Racism, and Advancing Justice Top of Mind at Community Health Center Conference

SAN DIEGO, CA —There was standing room only at the Taskforce for Undoing Racism meeting on Sunday morning. The limited space signaled high interest in ensuring everyone has fair and just access to live a healthy life, a top priority for community health centers nationwide.

On the fourth floor of the Manchester Grand Hyatt Hotel in San Diego, people gathered to discuss pathways to more inclusive, equitable and non-racist healthcare. The taskforce’s discussion was hosted on the first day of the National Association of Community Health Center’s Annual Community Health Institute and Expo. Those in attendance included health center clinicians, executives, health center board members, primary care associations, and health center control networks.

Participants sat around a boardroom table, with many more standing against the walls of the room and some overflowing into the hallway. The theme of racial equity was supported throughout the day as NACHC members celebrated and welcomed a new CEO, Dr. Kyu Rhee, and board chair, Paloma Hernandez— the third Latina to ever take on the role. The theme continued throughout the week with keynote speeches from the taskforce co-chair Gerrelda Davis and Heather McGhee, author of The Sum of Us.

“There’s a lot of interest,” said Yuriko de la Cruz. “Then in sessions like this, there’s really just a validation that what we see and what we hear is shared by others and that we’re on the right path in terms of understanding and that we want to advance health equity.”

De la Cruz became the program manager of Social Drivers of Health at NACHC in March 2020. She participated in NACHC’s Board Taskforce for Undoing Racism conversation and hosted a bilingual session on advancing health equity immediately following. The group discussed simple changes that promoted long-term solutions, like printing information in multiple languages, providing car rides to health and well-being activities, and declaring racism a public health crisis.

The task force began its work after the murder of George Floyd in an effort to intentionally address structural racism and discrimination within health care settings.

“We can’t address everything; we can’t fix everything or change everything. But what we can do, little by little, is make those steps towards justice and liberation,” she said.

Across the nation, 31.5 million patients are seen at health centers in medically underserved areas. About 63% of those patients identify as members of a racial or ethnic minority group. Health disparities can be exacerbated by social determinants, like access to reliable transportation, home and work locations, and other conditions of a person’s environment, all of which are being considered as contributors to health more often.

Almost 6 million of those patients live in public housing, over 7 million are best served in a language other than English, and 90 percent of all health center patients live at or below the federal poverty line.

The mornings’ discussions included dialogue on the damaging effects of stress, whether acute or chronic, at the intersection of a patient’s race and their lived experience.

Leon Harris, Ph.D., is chief diversity equity and inclusion officer at The Centers in Cleveland, Ohio. He shared that cultural factors within a community can sometimes outweigh a patient’s economic position. While 90% of community health center patients are considered low-income and 19% are uninsured, there are cultural health beliefs that can influence whether a person seeks care or adheres to the treatment a provider offers.

During small group discussions, participants said that listening to their patients, understanding their lifestyles and needs, and working with community partners will be paramount in advancing health justice.

Kevin Holmes, of Community Health Centers of Arkansas, said that health centers could create better, more equitable conditions for health by connecting to communities and patients through lived experiences. Holmes said that people are more likely to show up, listen and participate in spaces where they feel seen and heard.

Wanda Mitchell, of Sun River Health in New York, discussed the importance of a shared sense of community. She said that when people living, working, and playing within a certain geographical area are willing to address barriers to equity together, better outcomes can be achieved.

There are still many obstacles and questions regarding how to build more equitable and just systems. However, de la Cruz said that CHI participants are willing and eager to have challenging discussions that lead to inspired changes.

“We want healthier, thriving communities where children, families and individuals are living the life that they want as healthy as possible,” said de la Cruz.