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Marisa presented on her research in Medellín, Columbia conducting interviews among residents of Popular, Comuna 2 regarding the city's new reputation as "la ciudad mas inovadora del mundo." Specifically, we defined social urbanism as a change within the governance and political will to invest in communities that have been disenfranchised. Some of the projects have ranged from incorporating ski lift technology as a mode of transportation, Parque Biblioteca España, and Escaleras Electricas. We examined violence and trauma as drivers of health, the connection between transportation and spatial connectivity, the importance of social cohesion, and who the "innovation" is for when referring to social urbanism.
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This week Professor Jason Corburn gave a presentation about his work in Nairobi, Kenya by discussing the importance of GIS mapping as an advocacy tool. Mapping can be used to depict a baseline for health equity. We also discussed the slums of Mukuru in Kenya which Marisa spoke about her time there this Summer. Pilot programs in specific communities were examples cited of situational analysis. By focusing on incremental change and making sure there is no "bulldozing," reframing issues around health equity appear more approachable. These projects spoke to the action piece of HEAL and sparked the interests of everyone in the room to find out how they can become more involved.
This week HEAL students paired up to compare and edit each other's resumes. In those pairs and later as a larger group, we discussed positions we are currently looking for or applying to and offered general advice and support. We even started a Google doc with links to internships, research positions, and employment opportunities to share our knowledge of resources and opportunities. Some of the seminar was also spent sharing tips about Linkedin and then "connecting" and endorsing each other.
Dr. Howard Pinderhughes from UCSF came to speak to us about racial discrimination and structural violence and how those effect health outcomes. We watched a clip of the Netflix documentary, "13" which spoke to the 13th amendment's loophole so prisoners could no longer have rights under the constitution. We discussed at great length how this became the basis for mass incarceration because there was an incentive for prisons to use incarcerated folks as labor.
Dr. Pinderhughes guided us through the changes he and his family noticed during their time residing in Roxbury, Massachusetts. From the "tipping point" of a community rapidly transitioning from a White to a Black neighborhood, to slumlords renting out units, decreasing property rates, and contributing to overcrowding along with changes in infrastructure by building a highway surrounding the city and the only construction occurring between 1968-1990 being a Juvenile jail, all of these contributed to the health of the community. However, now the narrative has become displacement into suburban and ex-urban communities. Since we are in the Health Equity Action Lab seminar, we also wanted to take some time to focus on the action piece of the seminar. Dr. Pinderhughes spoke about some of the solutions he has been a part of proposing to local communities. Health of communities are determined by three things: equitable opportunity (economic/educational), people (social/cultural environment), and place or the built environment. By addressing solutions specific to each of these three determinants, health equity becomes more feasible. This week we collaborated with the Graduate Seminar to discuss the California Propositions 51 through 67 and how they would impact health equity. Some of the graduate students presented on each proposition and the graduate and undergraduate students all discussed items including its benefits, its adverse effects, who endorses it, what groups oppose it, and its impact on health equity. Following our discussion, we took a straw poll with the people in the room to get a general sense of how people may vote in the upcoming election. Some controversial topics and great dialogues ensued regarding plastic bags, marijuana legalization, condom use in adult films, the death penalty, and more.
We began with watching a short clip about the Inner Harbor Project, which gives teenagers the opportunity to engage with their community and come together to find solutions to divisive concerns of race, class, and culture. One reaction to the video was skepticism with getting police involved or rather only one officer involved. This may be harmful if the teenagers involved assume all officers are like them because unfortunately, not everyone is open to conversations about police brutality and discrimination. Another response pointed out how some people find protests destructive but others want a platform to say what they want to say. This segued into how people may care deeply about a place but feel as though they don't belong there.
We discussed the connections between gentrification, displacement, and health. Gentrification is the influx of wealth into a community of lower income and resources and new demography (younger, less diversity) which results in rent and property values rising, observed lower crime rates, general economic prosperity for large businesses, and displacement. The existing population is pushed out of their community due to the rent inflation and experience negative physical, emotional, and environmental changes such as an increased allostatic load, lowered immune response, new environmental exposures, and less access to healthy foods and resources. The Silicon Valley and its impacts on not only San Francisco but also Oakland was brought up as well. Oakland lost 50% of its African American population between 1990 and 2011. Now, people most in need are not getting housing due to increase in rent and housing costs, so vouchers are no longer sustained in the housing market; the government is not matching these rising rent and housing costs. Winifred Curran in his TedX video criticizes the dominant discourse surrounding gentrification as a means to "improve a neighborhood" that used to be filled with crimes, drugs, etc. while ignoring the people who are already there. Curran points out how something is clearly wrong with this mentality of property values over people. She goes on to encourage the audience that everyone is involved in "communities of care" which extends to "communities of responsibility" by encouraging people to reach out and get to know their neighbors and mobilize that way. However, some reactions from HEAL students were that sheer optimism cannot change everything and should not reduce the experiences or complexities of gentrification today. Getting to know your neighbors won't stop your landlord from raising rent prices. Someone also commented on specific language Curran used about the "gentrifier settling the pioneering frontier" which sounds like colonialism. Nowadays, people want to move to the Mission because of its culture, which displaces current residents there. Then 50 years later, these displaced people are displaced again because of another influx of people which perpetuates the cyclical nature of gentrification. Art specifically has a role in trauma; often times, when a place experiences trauma, in order to process it or spread its awareness, art comes out of it which makes that place attractive to people. Historically, people of color and LGBT community members were confined to the Mission, but now people are "choosing" to go there. It is important to make visible the history, the culture of survival, and the beauty that was created out of that trauma rather simply seeing the fascination of the beauty the grew in spite of its history. Some solutions to gentrification we brainstormed include:
This week we began with sharing our Professional Development Plans (PDPs) in small groups. Then we collectively named common themes:
We discussed redlining as a way to historically rate neighborhoods according to a criteria based on what people wanted to invest in i.e., race. We pointed to the juxtaposition between more affluent people who were often White living in the suburbs while minorities would reside in the inner cities where there was divestment from banks, companies, businesses, making land worth less so there would be less money allocated for schools due to the connection between education funding and property taxes. We watched Michelle Alexander's TedX video comparing the criminal justice system to a modern day caste system and a system of racial control. Although crime rates have fluctuated, incarcerations have steadily increased from 300,000 in the 1970's to now over 2 million. Federal drug forfeiture laws allow officers to keep 80% of the money, car, and valuables if someone is simply suspected of having drugs; there is a monetary interest in the longevity of drugs on war among law enforcement. According to recent statistics, 70% of released inmates return to prison within a matter of months. After hearing this, we discussed our frustrations with how private prisons are making money from ruining people's lives and that there is a monetary incentive to keep the prison population up. Watching "Millionaire or Felon?" and following Wanda James who is the only African American woman to own a dispensary points to how a zipped determines whether someone will become a millionaire or a felon. There was open criticism in the video and in the classroom on white males profiting off of black males using a product and being incarcerated for what the white males themselves are selling. One of the HEAL members pointed out how easy it is to not have to think about the criminal justice system if you are not part of it. However, not everyone gets the choice to not be shuttled toward it. During HEAL this week, we explicitly defined the difference between health disparities versus health equity.
In one of our readings, "Health Equity: Moving Beyond 'Health Disparities,'" we discussed four primary factors that impact health:
We viewed another episode of Unnatural Causes which pointed to how the choices of individuals are greatly limited by their environment. The poverty tax was a phenomenon brought up during our discussion along with how this continues to perpetuate the cycle of poverty and preserve the status quo. In this episode of Unnatural Causes, the concept of mapping was introduced as well. Although the idea of being able to predict someone's health by a physical map is alarming, this could mean we would know where to start, what to invest in, and how to reform policy. Finally, we completed a case study on Flint, Michigan. After learning the background and context of the water crisis occurring in Flint, we discussed how access to clean water should be a human right and should not be privatized in the first place. We also discussed the additional burden of Flint residents under current laws which state that if lead is present in the home, it can not be sold until it has been fixed. However, if Flint residents can't even afford clean water and still expected to abide by this law, they would not be able to sell their house leaving them stuck and unable to move or relocate. We also discussed at great length the following cycle of disinvestment in Flint: This week during HEAL we watched the documentary, Unnatural Causes, which gave incredible insight into the hierarchical nature of health equity. We were able to follow along the lives of four people: a CEO, lab supervisor, janitor, and unemployed mother, and see how their respective socioeconomic statuses impacted their health. The connection between economic policy and health policy and how one's socioeconomic status is equivalent with his or her health outcomes was made abundantly clear. Someone who is of a high socioeconomic status, has greater control in their job, and thereby less stress has better health outcomes than their counterpart of lower socioeconomic status with a less controlled, high stress job. This relationship holds true not only when comparing the CEO with the unemployed mother but in every category in between.
We discussed how the Whitehall study correlates to this fact as well. During this study, it was determined that the lower the grade of someone's employment, the higher the rate of every major cause of death. This relationship was evident even in the intermediate categories along the gradation of socioeconomic status that is often depicted as a ladder. One criticism brought up during our discussion was that this documentary created separate categories according to socioeconomic status, race, and other identities. What the documentary failed to do was determine how the intersectionality of someone's identities may have accumulative effects on health. In other words, what are the accumulative effects of not only having a low socioeconomic status but also being a person of color, a woman, etc.? By no means do these conversations end here. This semester should be a great opportunity for further discussions around health equity and ideas about where we should go from here. HEAL was given the opportunity to tour the Iron Triangle in Richmond, to see various projects of the Richmond Health Equity Partnership and the site of the new UC Berkeley Global Campus. We first visited Pogo Park, where community members have been directly involved in the planning and construction of shared community space. We were able to see the strategic use of space for parks and murals around the Bay Trail where residents and visitors can bike and walk.
We later visited historic areas around the Port of Richmond and saw the Chevron refineries and various other factories that contribute to Richmond's reputation as an industrial site. We were able to talk to city planners along with involved community members that play a key role in rallying community support, input, and investment in development projects. There was a large focus on the community's young people, with the building of elementary and high schools and an emphasis on providing better educational opportunities. We ended our tour at Richmond City Hall, where we discussed how recent developments in Richmond are planned at the city level, and how important it has been that the development plans value involvement of community members themselves. HEAL was able to gain insight into the multifaceted and holistic approaches taken by the Richmond Health Equity Partnership. Every person we spoke with during the tour was extremely friendly and welcomed us with open arms. Some of our members hope to get involved more directly this summer on various projects, and as a whole, HEAL was very inspired by the people and places we saw. |
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