Ingham County Health Department

Contact Information

Website: http://hd.ingham.org
Contact Person: Regina Taylor
Contact Info: rtaylor@ingham.org

History

The Social Justice Initiative began in 2005 as ICHD's first effort to join in the national effort spearheaded by the National Association of City and County Health Officials to transform pubic health practice within a social justice/health equity framework, especially using facilitated dialogue as the primary vehicle for change. These Health Equity/Social Justice Workshops are provided to the public health work force and interested community members, including both county residents and leaders of other organizations. For more information about cost and scheduling, interested parties can contact Doak Bloss at dbloss@ingham.org.

Organizational Partnerships

ICHD partners with: the National Association of City and County Health Officials (NACCHO), MSU Extension Services, and Michigan Department of Community Health.

Activities & Objectives

The initial objectives of the Health Equity/Social Justice Workshops have been to:

  • Develop the capacity among ICHD staff and community members to facilitate workshops and activities that raise awareness of oppression and privilege based on race, class, gender, and other types of difference, and their impact upon community health.
  • Establish a foundation for an ongoing learning community organized around creating health equity.
  • Create an understanding of the differences between health disparity and health inequity, how the social determinants of health create differing opportunities among groups of people, the four levels at which oppression and change operate, how unearned privilege operates across multiple target and nontarget groups, and the difference between modern and traditional forms of oppression.
  • Develop strategies to engage others on the above issues.
  • Identify means to adopt and apply a health equity/social justice framework for improving community health.

Specific activities include:

  • Providing health equity/social justice workshops
  • Providing training for facilitators
  • Piloting the Health Equity Youth Academy for area youth
  • Development of an Equity Action Team
  • Assisted in developing the book Tackling Health Inequity through Public Health Practice: From Theory to Action (Oxford Press, 2010).

These activities have resulted in policy changes such as the establishment and definition of health equity as a core value of ICHD and the creation of positions within ICHD to develop the application of this value, and the mandatory participation in HESJ workshops by all ICHD employees.

Best Practices

We have attempted to get our public health work force to adopt a health equity lens for its daily practice through four-day, dialogue-based workshops, which are mandatory for all employees. Pre- and post-workshop questionnaires reveal significant growth in understanding and awareness of social determinants and root causes of health inequity, and in understanding of how social justice concepts change the work of public health.

Dialogue as a methodology is an important tool for navigating the difficult issues of racism, class oppression, and gender discrimination, which need to be addressed explicitly in order to change practice.

Lessons, Challenges, & Recommendations

Individual resistance to concepts such as unearned privilege and racism as root causes of health inequity, lack of political will to confront racism, classism, and other forms of oppression at the policy level, and accustomed regulatory, categorical approaches to public health practice within the discipline as a whole all pose challenges to the success of ICHD's health equity initiatives. However, from trying to overcome these barriers, ICHD has learned of the importance of dialogue of these difficult issues and the need to address root causes of health inequity explicitly.

Additionally, some insights derived from three years' experience applying these workshops, and monitoring similar dialogue-based efforts in other venues:

  • Institutional change will not likely occur without attending to the feelings, beliefs, and values of the people who occupy the institution. Institutional change is therefore reliant upon change at the personal and interpersonal levels.
  • The four-day duration of the workshop, which consists of two consecutive days follow by two additional consecutive days a few weeks later, is important for wearing down resistance to the reality of oppression and unearned privilege. Interventions of a shorter duration (two-hour, half-day, one-day) do not allow sufficient time for participants to reflect on their own experience and beliefs, and are much more easily dismissed. We have seen dramatic changes in perception and attitude by participants over the course of the four days.
  • Including both employees and non-employees in the workshop broadens the range of perspectives that inform the workshop, and prevents the focus falling exclusively on one organization's culture or dynamics.
  • Change is more likely to be enduring and meaningful if it is pursued on three fronts simultaneously: leadership, work force, and community.