“Equity is the path to justice. Justice is when we have complete elimination of systems of power that cause the inequities to begin with,” Dr. Medell K. Briggs-Malonson explained. Dr. Briggs-Malonson is the chief of health equity, diversity and inclusion at UCLA Health System.
As one of the keynote speakers during the fourth annual Health Disparities Research (HDR) Symposium, Dr. Briggs-Malonson spoke about the importance of examining the underlying factors that impact health and what steps it will take to achieve health justice.
“But in order to do that — and even when we are impacting health — we have to take a look at the social factors, the structural factors, the political factors, the economic factors. And that’s what takes us into the steps to achieve health justice. Equity is a step in justice, equity is not our endpoint, justice is,” Dr. Briggs-Malonson stated.
Hosted at the California Air Resources Board (CARB) Southern California headquarters on Feb. 15 and Feb. 16, the annual two-day conference gathered health officials, researchers, advocates and community members to examine health disparities in the Inland Empire.
With keynote speakers like Dr. Briggs-Malonson and Dr. Marshare Penny, deputy director at the Riverside University Health System – Public Health, the conference emphasized a central theme: addressing the root causes of health inequity and identifying solutions to achieve health justice.
Health disparities impact everyone
Dr. Penny’s presentation on day two examined existing health disparities in Riverside County using references to the Healthy Place Index which identifies 23 social indicators of health that are associated with life expectancy. The index uses data from California counties, census tracts at the city level, and organizes them into a set of quartiles. Quartile one is characterized as the most disadvantaged people in the community and quartile four is characterized as the most advantaged.
During her presentation, Dr. Penny emphasized the fact that on average, Riverside County has more residents that live in the most disadvantaged quartiles compared to 23 other counties in the state of California.
“So, why should we care about the health inequity?” Dr. Penny asked the audience. “Nobody asked to be born vulnerable. No one asked to experience [to] not only to live in a disadvantaged community, but experience disadvantage throughout the entire course of their lifetime. No one asked for that. That’s why we should focus on health inequities because no one asked to be born that way, or have that experience as a result of who they are and where they live.”
Both Dr. Penny and Dr. Briggs-Malonson presented dynamic ways in which health systems, community partners and academics can approach the problem of health inequity using upstream approaches and eliminating systems of power that perpetuate inequities.
In an upstream approach, root causes to health inequality are addressed. Consider someone who has poor eating habits that impacts their health, but lives in a food desert and does not have access to healthy and affordable foods. An upstream approach considers how to get that person access to healthy groceries through food delivery programs.
“Everybody deserves high quality access to care. Everyone deserves the right outcomes,” Dr. Briggs-Malonson stated. She ended her presentation with a challenge to researchers in the room, informing them that in order for their research to make a difference, to have impact, they must acknowledge the “business case.”
“If you can’t show the value of your intervention, and the value of no longer accepting the status quo and changing the system, if you can’t show the monetary value of that, it will be dead before it starts. And that’s just the truth,” Dr. Briggs-Malonson said candidly.
Research focused on underrepresented communities
Throughout the conference, research students, PhD’s and professors presented their ongoing research regarding different health issues that impact underrepresented communities across the inland region and Los Angeles.
One of the panels featured working research projects about COVID-19 challenges such as Dr. Kalina Michalska’s presentation on the neurodevelopment of children during the impact and the impact parent’s had on their children’s emotional development. Dr. Michalska’s research comes out of the Kids Interaction NeuroDevelopment (KIND) Lab at UCR where she is the lab director.
Another featured presentation by Dr. Yulja Zhang on research by Dr. Zhang and Dr. Ran Wei showcased evidence from social distancing, risk of interactions and access to testing on health disparities in the spread of COVID-19 in Southern California. Their research covered 600 zip codes across Southern California and noted interesting conclusions such as their testing accessibility index found that low-income groups tested at higher rates than higher-income groups.
Day two of the symposium consisted of an interactive workshop led by Wendy Hetherington, chief of epidemiology and program evaluation for the Riverside County Department of Public Health. Her presentation, “Reducing Stigma and Increasing Harm Reduction to Address the Overdose Epidemic,” focused on how Riverside County has faced drastic increases in overdoses in the last five years due to an increase in fentanyl and methamphetamine use.
Hetherington guided attendees in a workshop that encouraged the audience to form groups in order to practice the use of person-first language when talking about people impacted by the overdose epidemic. Using a case study exercise with four scenarios, groups were tasked with discussing how to practice harm reduction and stigma reduction.
“The ultimate goal of harm reduction is to reduce misery…,” Hetherington said. “Ultimately, it takes a village to do this work. We need to increase partnerships across organizations and public health cannot do this alone. So, we can improve access to services regardless of use, advocate for harm reduction, safe consumption sites and ultimately reduce interaction with law enforcement.”
The annual HDR Symposium allowed researchers and academics to engage with one another across different fields as well as interact with community members for their input on ongoing research projects. This year’s symposium emphasized the need to move toward health equity and how to achieve that through collaborations, dynamic problem solving and community engagement.
As Dr. Penny’s presentation came to an end, she left the audience with some food for thought:
“Our privilege will not always protect us. Whatever level of privilege each of us experiences in this room, whether it’s a privilege of occupation, privilege of education, that will not protect you forever. So, the experience of disparity and inequity absolutely will impact all of us.”