Springwell strives to provide as many learning opportunities as possible for its staff on topics relevant to its mission. As an agency, Springwell understands the deep significance of health inequity, looks to better understand the causes, and works to alleviate issues that result in disparities. “Our staff is passionate about making impactful changes in the lives of those that we serve and seek training that helps them to accomplish that. They have seen the effects of health inequity and sought to learn more to help them in their work,” shares Laura Oberlander, Springwell’s Associate Director of Community Services.

For a learning opportunity, Oberlander sought an educator who could bring specific relevance to the topic for Springwell and found it in Theresa Alphonse, MPH, Community Partners and Health Equity Program Manager for Steward Health Care Network. The training session was titled: Racism’s Impact on Health: Reaching Racial Equity for Our Community. It served as a seed to help staff in their ongoing efforts to understand historical, structural racism and mitigate its effects in our work at Springwell.

Alphonse began the training by discussing intersectionality, the way in which the effects of multiple forms of discrimination (racism, sexism, and classism) combine, overlap, or intersect in the experience of marginalized individuals or groups. The various ways people are identified such as race, class, language, culture, ethnicity, gender, age, ability, sexuality, and education led to a thought-provoking discussion that addressed having privilege or lacking privilege in any or several of these areas. People are intersections of so many things. When someone lacks privilege in an area, those who have privilege in an area can use their privilege in that space to listen to and help those lacking the privilege. Alphonse explained that understanding your identity and your areas of privilege helps you to make space for others. She asked “Are you building the same rapport with all populations you work with? Do you treat people the same way?”

Health inequities are differences in health status or in the distribution of health resources between different population groups arising from the social conditions in which people are born, grow, live, work and age. Disparities are quality differences while inequity looks to the causality of what is happening. A historical look at racism in health showed how some of the health disparities arose from racist   practices during slavery through the 1940s, with remnants of these practices still present in the United States.

Today we continue to see barriers to health care for multiple reasons including mistrust, lack of access, and stigma. Mistrust today is at least partially due to a history of systemic racism that resulted in less treatment and poor communication among healthcare professionals and individuals lacking privilege in some areas. Lack of access can be as simple as lack of transportation or more complex such as discomfort of trans individuals in seeking care. Stigma plays a role especially with mental health. Blacks and Asians tend to seek mental health care less often because of the stigma associated with it.

The program concluded with reflections on what individuals can do about these issues, even as we understand that there are institutional and structural dimensions to them. Alphonse emphasized cultural humility where everyone reflects on his/her own beliefs and cultural identities. We must each own our journey; as we all come to racial justice work with different experiences, we must continue to educate ourselves and reflect. We must uplift marginalized groups and make them visible. It is also important to look at the social determinants of health in the context beyond individual behaviors.

The Springwell staff greatly appreciates this educational program and the additional resources that Alphonse offered to help with ongoing learning.