We need to be bringing our collective strengths and community voices to bear in making sure that the path toward equity and justice in this increasingly globalized and multiracial nation includes a path toward health, particularly child health. Blazing that path begins with changing the way we think about child health and wellbeing and the systems that support it. We must recognize the sources and effects of trauma related to racism and white supremacy and work actively to eliminate them.
As the first day of Vital Village Network’s 2020 National Community Leadership Summit, “Our Future, Our Communities,” drew to a close, keynote speaker, Mayra Alvarez, crystallized the undeniable truth that in this nation the fight for racial justice and the fight for health justice for children and their families are inextricably intertwined and always have been. From the earliest days of European colonization, American history is replete with examples of policies and practices that have separated nonwhite families and inflicted trauma on children, from the separation of Black families during slavery, to sending indigenous children away to boarding schools to “civilize” them, to the internment of Japanese-Americans during World War II, to the ongoing disproportionate incarceration of black and brown people, and the lives lost and families shattered due to police violence.The Trump administration’s policy of separating immigrant families at our southwestern border is only the most recent example of the federal government’s history of disregard for the rights and wellbeing of nonwhite families.
Structural Racism and Oppressive Systems Harm Child Health
Alvarez substantiated the damage that structural racism does to child health by sharing lessons from her work with the Children’s Partnership and data from the “Healthy Mind, Healthy Future” research project the Partnership undertook in collaboration with the California Immigrant Policy Center. Shortly after California became, in 2016, the sixth state to expand Medicaid access to undocumented children from low-income families, rising xenophobia and the new Trump administration’s restrictive, punitive immigration policies created new challenges in getting parents to enroll their children. Families feared that their personal information could be used against them and that taking advantage of the opportunity to obtain health coverage for their children could negatively impact their immigration status. Healthy Mind, Healthy Future aimed to determine how the worsening situation was affecting the health of immigrant families living in the state and discovered an increased need for health and mental health care as well as higher barriers to care, both related primarily to concerns about the possibility of family separation.
The ripple effects of this intentional infliction of trauma by the federal government spread to immigrant communities throughout the nation. It is no coincidence that it is Black, Latinx, immigrant, and indigenous families that are being most negatively affected by the COVID-19 pandemic. Nationwide, three quarters of all pediatric COVID-19 cases are in black and brown children. Her lived experiences as the daughter of Mexican immigrants and the research data from the Healthy Mind Healthy Future project and other sources led Alvarez to conclude that “racial and ethnic inequalities, white supremacy, anti-blackness, and structural racism are baked into our programs and our policies and in our communities, robbing children of the opportunities, services, and support they need to live healthy and thrive.” Even when there is no evidence of deliberate discrimination, efforts to support child wellbeing are stymied by “a patchwork of policies … disconnected funding streams … poor coordination between and within government agencies … and burdensome administrative complexity.”
Creating a Path toward Healthy Communities and Child Wellbeing.
Surely we can do better. And we will if we work collectively and in community to transform policy to address structural racism, disrupt oppressive systems, and invest in community safety nets to ensure the health and wellbeing of our children. Current systems and policies, for the most part, fail to uplift the dignity of children and their families or ensure equity in matters affecting child health. We need to be bringing our collective strengths and community voices to bear in making sure that the path toward equity and justice in this increasingly globalized and multiracial nation includes a path toward health, particularly child health. Blazing that path begins with changing the way we think about child health and wellbeing and the systems that support it. We must recognize the sources and effects of trauma related to racism and white supremacy and work actively to eliminate them. We must also take a more holistic view of child health and wellbeing as encompassing not only physical health but also mental and emotional health and future social and economic health, emphasizing prevention and early intervention rather than mitigation after the fact. And above all, we must be firm in insisting that health in all of its dimensions is a right, not a privilege or a commodity.
Addressing Structural Racism through Community Leadership
Strengthening the safety net through further Medicaid expansion and increased support for nutrition programs such as SNAP and WIC would be a good starting point, but only if immigrant families have no reason to fear enrolling in them. Bringing about such improvements will require legislative action at the state level, which in turn is likely to require significant activism and a concerted effort to raise awareness of the inequities built into existing policies and programs.
There is much to be learned from what some communities have done because of the failure of the traditional health care system to meet their needs, unintentionally or by design. And that begins with an understanding of the differences between the individualistic, transactional view promulgated by governmental entities and the collective reality of communities. The former sustains racism and, according to Alvarez, “refuses to acknowledge collective harm, group responsibility, or a right to collective redress or reparations.” Communities, on the other hand, are where children and families can feel safe and protected through the bonds of relationships and shared experiences. One of the most vivid descriptions of what it means to live in a community was provided by Colleen Roan and Emerson Toledo, members of the Navajo Nation, which has been hit so hard by COVID-19. They spoke of working together and taking care of each other as “an underpinning of how we survive” and the Navajo clan system as the “glue” holding them together. From conception to death, through every stage of life, the Navajo have a process for everything and customs that remind them that they need each other and must take care of each other and that there will be better days ahead even in the most trying of times. And while the customs may have differed, how many of us grew up in neighborhoods where multi-generational families, churches, local schools, and community centers similarly provided support and strength? Communities are not only a source of support and strength for their members. They are also a source of much-needed wisdom regarding members’ needs and of ideas, ingenuity, and initiative for meeting them.
The entire summit was devoted to building community leadership, and nearly every session spoke to the fact that those who are closest to the problem are also best equipped to come up with the solution.If we want to make sure that the solutions to address child health and other issues that impact our communities meet our specific needs, they must break with the oppressive policies and practices that have resulted n the current status quo. It’s up to us to continue to develop community leadership, make our voices heard, propose community-based solutions, and demand “bold innovations” until black and brown children, immigrant
children, and indigenous children have access to needed services and supports in their own communities.