ISSUE #04:

We spent time with Ruth Thomas-Squance to explore where public health and community development can meet, where that intersection stands coming out of the pandemic, and the importance of awareness in this kind of work.

Could you share about, you know, your work as a community development partner, and what are some of the ways that you connect to this work?

Ruth: I work together with Colleen Flynn, who’s my co-Executive Director, and we lead the Build Healthy Places Network. We’re a national organization, working at the intersection of public health, community development, and healthcare where we focus on transforming the way these sectors work together to create community-centered investments that can advance racial equity and improve the factors that impact people’s health and support  wellbeing in all communities.

We believe that by applying systems thinking to cross-sector partnerships we can create healthier thriving communities.

One of our recent projects is called Community Innovations for Racial Equity, where we’ve led peer learning cohorts with BIPOC-led community development organizations that were developing health strategies. One component of that project involved interrupting internalized racism because it was a safe space for practitioners to feel validated, to express the difficulties in this work, and to get that shared energy from peer-to-peer learning. We need to build into our systems and operations the opportunity for us to pause and assess where we are disrupting some of these deeply learned ways of working that are embedded in our systems. It can be challenging, individually and institutionally, to accept that you may be doing harm, or there may be collateral damage or unintended consequences of a well-intended policy or program. 

What do we do when we realize that we are perpetuating some of the same problems that we are trying to work against? How do we do that in, in practice?

Ruth: You have to have self-awareness and other awareness. The self-awareness to stop and do that interrogation, and other awareness, in listening to either the organizations we’re working with or the communities we’re seeking to serve, to understand how your work is impacting others to hear where that’s not landing where we intended. Then focus on making and sharing those changes in the spaces around you. 

It’s not a radical notion to say that every community deserves that agency. Sometimes we get so carried away with feeling good about the work, that we’re not listening to who we’re doing the work for, and how they might be driving that. It’s a simple thing to say, but it’s an actual systems change in how we operate. It would mean, you’re listening more, you’re deferring more. This shift involves reassigning value to community-driven data, changing how we’re collaborating and how we’re working with the community and centering them, and also acknowledging the power of the community.

As we are continuing in the pandemic, or, you know, in this era of COVID, and many other illnesses, how do we kind of navigate the current demands of public health while maintaining steadfast to our commitment to anti-racism?

Ruth: I think the key to this is that many of these deeper, persistent problems or multi-system problems, need multi-system solutions, and that it is almost impossible for a single sector to hold all those solutions alone. Collaboration across sectors can unlock new potential for addressing underlying drivers of health inequities.   One project that we have worked on most recently is looking at the role public health can play in multisector partnerships with community development. 

Last year, Frameworks released a report about navigating the terrain of spatial justice. In the report, they wrote that “racism is built into places.” That really resonated with me because we know that racism impacts this system, it impacts where people live, and then what resources they live with, and also what resources they live without. We know that we’ve got historically race-conscious policies and practices that have shaped this landscape resulting in persistently disinvested communities that lack affordable housing, food access, transportation, and quality education. What we know in public health is that all those things are factors that impact health and wellbeing. Our goals in public health are intertwined with the goals of community development in many ways. 

I love the opportunity of that, to think of the ways that community development and public health can complement each other. 

Ruth: We recently released a resource in partnership with the National Association of Chronic Disease Directors (NACDD). We convened a national thought leader roundtable with the help of Verge Impact Partners and emerging from the recommendations surfaced by that roundtable, we created a Public Health Primer: Engaging Community Development for Health Equity. At the beginning of the primer, there is data from research survey data by the de Beaumont Foundation. It was discovered that 81% of executives in public health agencies and 72% of state and local government public health employees believed addressing racism as a public health crisis should be part of their work, but then only 39% reported being highly engaged in those efforts. I think both BHPN and NACDD see that there’s a lot of opportunity in that disconnect. There is potential for public health to be very tangibly redressing some of the impacts of racism on social determinants of health, while also helping community development reach their racial equity goals. 

We have tools in the primer, like a “partner finder” that can connect you to national networks of organizations in these different sectors, and a “jargon buster” to help with common terms as they are understood across sectors. As partners in this equity work, these sectors should know each other and be working together. We also include organization reflection questions to encourage generative conversations and readiness for engaging in this work. The primer aims to create a foundation for action and a starting point to support organizations looking to partner with other sectors working alongside them.

What are some critical or radical hopes for the future as we move towards community health equity? 

Ruth: I think that if anything, coming out of the pandemic, we witnessed a very explicit demonstration of the links between health and place in the disparities in health outcomes from the COVID-19 pandemic. Because of the historical race-conscious contexts in how places have been and continue to be shaped, the link between place, health, and race saw the disproportionate burden of disease and death carried by certain communities more than others. Ensuring fair opportunities for health and wellbeing for communities is foundational to sustaining health and prosperity for all of us. A more radical hope for the future includes making inclusion-focused, multisector approaches the norm for our work … creating a future in which a portion of your work will always include working across sectors, as well as directly with the communities we serve, and that this will be resourced by people or departments that are concerned with perpetuating institutional knowledge about other sectors and when and how they may be able to join you, or you them, and add value to our collective equity work.

We caught up with Rahwa Ghirmatzion to discuss what it takes to do community organizing around public health and environmental justice; what kinds of things you need to build up to sustain that work; and what all of that contributes to the pursuit of a culture of healing. 

Could you tell us more about yourself and some of the breadth of your community development work?

Rahwa: How I came into this work is probably how I came into the world, which was to a beautiful little agricultural village in a small country called Eritrea along the Red Sea. I was born in the middle of a civil war. When I was five years old, we had to flee in the middle of the night for our safety.  The experience was not by choice, quite disruptive, and my family felt deeply displaced. Not only did we leave our home, our village, but we also made a harrowing escape into Sudan by walking for 16 nights while hiding out and resting during the day. After living in Khartoum, Sudan, for two years, my family was able to come to the United States with asylee status. My experience is that every country has its issues. My first experience with racism in this country was at the age of nine. I didn’t quite have the words for what was happening to me; I didn’t have the context. I had only been here maybe a year, but I could feel racism, and it was not a good feeling. All this before the age of ten is the foundation for my purpose or life’s work, to build a more socially just and generative world.

I think my work is to build up communities where we all can just be human. I’ve always worked on the frontlines, either in a volunteer capacity while in high school or my first job out of college at a political activist theater company. This is the place where I got politicized, as the purpose of Ujima Company was to use theater to build the beloved community. They were bold, courageous, and excellent in their pursuit of building a platform for oppressed peoples to have a stage dedicated to their lived experiences, struggles, hopes, and dreams. Ujima is one of the seven principles of Kwanzaa, meaning “collective work and responsibility,”  and it is from that tenet that all work was devised. We believed in owning the means of production, the right to culture, and owning our stories. From there, I worked in public health where I learned about social determinants of health and community-led policy development that address current and historic root cause issues that create the inequitable conditions that disproportionately impact BIPOC communities. Then I came to PUSH Buffalo, an organization committed to addressing racial, economic, and environmental justice by engaging working class and BIPOC folks. PUSH was intuitively working on a holistic community development model that addressed social determinants of health. PUSH engaged everyday residents upskilled in organizing, did policy research and development, then took the policy wins and turned them into community development projects that changed material conditions for the people on the ground.  

What are ways that you would advise folks to organize, especially around public health or environmental justice? And maybe, what are some important tactics or nuances you would consider?

Rahwa: There’s a chant our community members came up with, which is, “we know what we want, where we live.” This is the approach of how I do my work – we should always trust that communities do know what they want and build on that. There are a lot of problems in the world, and they can get very overwhelming. So where do you start? You should start somewhere and follow it everywhere. Very simply, start asking, what can I do on my own? What can I do with somebody else? And what do I need someone else to do? These are some of the tools we use when we do community planning and community development. We understand that it’s easy to get overwhelmed so shrink the problem to the capacity we have to begin solving for it. We have to meet people where they’re at and then from there, you follow it everywhere because new opportunities to deepen the solutions will continue to open up. For real impact,  you don’t want it to be individualistic because you won’t be able to go far as an individual. Collective power is what is needed by growing the member base. That’s how you build power. The power is on the people. The solutions are in the people, and the knowledge is in the people.

How do you keep people engaged? 

Rahwa: By making sure that when organizing people, the community is at the center. The work has to be community-centered, and community-led, all solutions are co-designed with deep community benefits. As organizers, we have to create the space and the conditions for people to come together. For example, if we have a meeting every Saturday at noon, we will have childcare, food, and so forth. We want to deal with whole families and with whole communities. When we create the conditions for people to fully participate, then we can expect deep, enduring engagement.

I appreciate both the simplicity and the complexity of “if you build the space, people will come”. 

Rahwa: Communities are complex networks. For me, I like to make sure that I am a navigator, and I’m making sure that resources are coming to my community because that’s really what’s needed. With more resources, we’re removing a lot of the barriers that currently exist and building in supports. You have to be holistic in your strategies that lead to transformative and enduring change. I also think it’s important that the people who are from those communities are participating in their solutions. 

In the spirit of what you said about pursuing more than justice, what do you think is essential to moving towards a culture of healing? 

Rahwa: A lot of systems are crumbling, and we need to let some of them just crumble. Everybody’s not going to respond that way. Some folks will want to hold on out of fear that they’re losing so much. And to that, I say we’ve already lost a lot. The question should be how do we get back into our humanity? I think it’s about understanding there has to be some equity. There has to be a way of acknowledging and repairing some of the harm that’s been done. Whether that’s land back or reparations we just have to repair. We need to apply that repair to every single policy, no matter what sector, whether it’s healthcare, housing, workforce, and employment opportunities, or access to capital.

I think most people will say, you know that we have to have a revolution, but what happens to the people that are on the opposite side of you in war? You shouldn’t have war unless you know how you’re going to get out of it, and it’s not by scorched earth; you get out of it through some kind of reparation and reconciliation. Then we have to forge a new path forward, but you have to do all that and it can’t just be in name only. It has to be through the action of actually beginning the repair and reconciliation to create new policies that are co-designed in ways that center our humanity.