Sometimes, the best insights happen at the end of classes, conferences, and events. That is what happened at the Leadership Louisville November meeting held on Election Day. Some of the deepest conversations concerning how to achieve health equity in Louisville, partner with local government to make transformative changes, and give voice to those who are marginalized and voiceless occurred.
A presentation by Sarah Moyer and Aja Barber, of the Metro Louisville Government Department of Public Health & Wellness, had us grappling with health inequities in Louisville. It is disturbing to discover that there is nearly a 13-year difference in how long you are expected to live in Louisville, depending on what zip code you live in. There are significant health inequities in some communities, and with certain people groups, in the city.
Barber presented the 2017 Louisville Metro Health Equity Report.
Barber said, “A person’s identities, whatever they may be, should not predict how long or how well they will live.” She suggests that “‘health equity’ is where everyone has a fair and just opportunity to be healthy and reach their full human potential.”
In the Presbyterian Church (U.S.A.), where I serve as a director, we have shifted our focus to equity, just as the Department of Public Health & Wellness in Louisville focuses on equity. Equity, unlike equality, results when you cannot predict advantage or disadvantage. Rather, the route to achieving equity is not accomplished by treating everyone equally. It is achieved by treating everyone equitably or justly, according to their circumstances.
As some of our citizens have been systematically denied mortgages, fair housing, access to city services, economic opportunities, and have no grocery stores nearby or access to healthy fruits and vegetables, for instance, shifting circumstances and impacting communities where they live requires health, educational, economic and racial equity and justice.
One of the biggest challenges we face is that people with privilege do not know that they have it. Privilege is invisible to them. They don’t see the unearned advantages that they are afforded. And, many in Louisville do not seem to be aware that inequities exist in the city, which is why the Louisville Metro Health Equity Report is significant, as it highlights life expectancy by regions, leading causes of death for varying races, ethnicities and genders, sexual assault and intimate partner violence for different races and ethnicities, as well as drug and alcohol use, cancer, heart disease, suicides and more.
A first step in addressing structural health disparities that marginalize people and lead to low quality of life and early death is to create an awareness of the disparities and inequities that exist. That is why the Department of Health and Wellness posts and shares this report.
A next step is to join with others in changing the “environment” that we live in so that an “attitude of equity” becomes normative. We can reclaim the vision of the nation and our city, build the society that we want to see and dismantle the systemic structures that oppressed our siblings. This will require work, struggle, strength of character, a mental shift, and maybe some tears.
And, another step is to provide opportunities for those who have been marginalized to learn, grow, develop and thrive to their fullest potential.
This is best achieved, it seems to me, with a coalition of folks joining together to work on steps for transformative change that impact policies, programs, and structures both nationally and locally. I believe that we have the resources to do this. It’s time to take the steps!