Our Vision (Part III): Leading the Fight for Health Equity

Our Vision (Part III): Leading the Fight for Health Equity

About a month ago, I was asked to give a lecture at the University of North Carolina at Chapel Hill to a gathering of women student leaders. I used the opportunity to urge the students to learn from women leaders who came before them. I also explained my guiding principle of “blooming where you are planted.” In honor of International Women’s History Month, which has been observed every March since 1987, the National Health Law Program has adapted my speech into a blog series.

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The National Health Law Program’s vision is health equity, where people’s health does not depend on their race, gender, economic status, sexual orientation or any of a number of other factors that now stand in the way of health. I am proud to serve as director of this organization, to carry forward its fifty year history of fighting inequities in the health care system.

Leadership, both individual and organizational, requires introspection and willingness to grow. Like individuals, organizations need to take stock of where they can make the most difference, including what they are really good at and where they can lead. Essentially, organizations, like people, have to bloom where they are planted, while always being willing to change and grow.

At the National Health Law Program, we are really good at fighting to get health care to low-income individuals and families. This work is vitally important. And, for me, it connects with the work I started doing in my 20s and 30s, when I was unsure of how I wanted to better the world, but I had to choose a path and start digging deep.

I know from my public defender days that if we wait to get resources to people until they are charged with a crime, it is too late to make a big difference in their lives.  And there are way too many lives being wasted, potential that can’t be realized because we didn’t do anything about the truth we know – that many children growing up in very low-income families and neighborhoods that lack resources and may be dangerous start out with heavy anchors that hold them back in school and for the rest of their lives.  We can change those children’s futures if we invest the resources early enough into health care and support for the whole family, including in many cases, behavioral health care for adolescents so they can succeed in school. We also have to ensure that women have access to the full range of reproductive health care, so they bring children into the world when they are able to care for them well.

Health care isn’t all those kids and families need.  Economic inequality in our country, the greatest it has been in more than 50 years, is going to keep leaving large swaths of our population behind and mired in poverty until we have the will to change. As part of this, we must confront racism head on because it makes people and communities sick and destroys societies. We increasingly understand that the constant stress of experiences by people of color in our country is taking a toll on their health.

Access to quality and comprehensive health care is not alone sufficient to address the stark disparities in health in our country, but it is basic and necessary to achieving health. And health is essential to being able to succeed, in school and in work. It is integral to breaking the cycle of poverty and overcoming the health consequences of racism.  We know how much our work matters.

This takes me back to the advice I gave the college students:  wherever you find yourself, you can make a difference; start by digging deep so that you are good at something and you can lead. At the National Health Law Program, we are really good at what we do. We are lawyers who go deep into the weeds of health law and policy. We are experts in the details of how Medicaid works, the Affordable Care Act’s provisions impacting low income people, the Americans with Disabilities Act, and other civil rights statutes. We fight for reproductive health and justice, with a particular eye on the impact of policies on low-income women.

It is also our 50th anniversary and a good time to reflect. So we ask ourselves as an organization whether we are putting our energies in the right places? Should we be adding to our agenda, such as fighting for different economic policies or policing strategies? Would we then be spread so thin that we could not keep to the large goal of defeating health inequities?

I am satisfied that we need to keep pursuing our course, to keep going deep in the weeds of health care and policy because we are needed there, especially now, when the Trump administration is doing all it can to sabotage the Affordable Care Act and Medicaid.

We also need to keep evolving. We need to develop more relationships with people and organizations who bring a different lens and different experiences to the work. We have always done that, but can do better. We are better at shining a light on racism as the root of maternal health disparities because of our relationships with organizations led by people of color. Because of our partnership with the National Immigration Law Center and the Protecting Immigrant Families Campaign, our expertise in calling out the health consequences of the administration’s immigration policies has become an important piece of the challenge to those policies. We work with groups that do grass-roots organizing. We partner with reproductive justice organizations and other groups that bring a different perspective so we keep learning and seeing things differently.

Challenge for Us

Now my challenge to readers. Find something that you care enough about to dig deep and excel at, so you can make a difference. Then do a lot of listening and learning. Listen to different voices, including older people who have fought battles ahead of you and cleared some of the way, people your age whose life experiences are different from yours, and sometimes people you fundamentally disagree with. Those hard conversations help make you better leader

You are needed; women are needed. Our country and world face enormous challenges: racism, income inequality, discrimination, sexual assault, the destruction of our environment, lives wasted in prison, failing democratic institutions, and, unfortunately, many more. The issues are so numerous and challenging that it is tempting not to try to change them.  We can’t afford that response. We have to have a vision for the world we want to live in and want our children to live in. We have to change what we can change.

I will repeat my parting message to the students: Please go better the world. Determine to make a difference by digging deep and get really good at something and then using that skill for good. Build relationships, both within your group and without, so you can keep learning, from your friends and colleagues and from people who see things from a different perspective. And if you find yourself in a position of authority, hold to your vision. Be leaders.

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