"Shocking and inhuman"

WI COVID deaths in last week: 9

January 19, 2023

Dear Friends:

I had not planned to write on health equity the same week as Martin Luther King Day, but it seems appropriate. King, after all, was a proponent, saying in 1966 . "Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death."

Fifty-six years later, he's still not wrong.

But let's back up for a moment. What are we talking about when we talk about "health equity"? By the simplest definition, it's everyone having the "opportunity to be as healthy as possible."

That has an obvious dimension of justice. As Dr. King noted, many health disparities resulted from deliberate decisions made at the expense of the poor and racial minorities. For example, zoning laws created after World War II concentrated Black Americans in neighborhoods cut off from grocery stores and other sources of healthy food. This contributes to African-Americans having the highest rates of high blood pressure, diabetes, and heart disease in the U.S.

Health disparities and inequities come into play in a number of ways with COVID. Let's name a few relevant to Wisconsin:

Rural residents may have difficulty accessing health care near where they live. Rural hospitals are closing at an alarming rate in the face of financial pressure.

Spanish or Hmong speakers in those areas may face an additional language barrier.

In places like Milwaukee, neighborhoods may also lack nearby health facilities. Residents may not have adequate insurance to access the system.

Up to a third of child-care centers in Wisconsin could close after federal pandemic supports end. For working parents scrambling for coverage, that would limit time and energy for vaccination.

Government support for extra foodshares is also ending. Low-income families will be more vulnerable to poor nutrition and the way it complicates COVID. (To inform your community, here are some flyers from Feeding America, and in Spanish.)

We could probably go on, but the point is made. Health equity means setting conditions to give everyone a chance at a healthy life. That point is well-illustrated by these graphics from the Robert Wood Johnson Foundation:

EQUALITY: Everyone gets the same-regardless if it's needed or right for them. Image: a small child, a teenager and a woman in a wheelchair all have identical bikes. EQUITY: Everyone gets what they need-understanding the barriers, circumstances, and conditions. Image: the child now has a small bike and the woman has an electric wheelchair.

Click images for full-size versions.

EQUALITY: Everyone gets the same - regardless if it's needed or right for them. Image: A small child, a teen, a person in a wheelchair and an elderly man with a guide cane all at a curb. EQUITY: Everyone gets what they need - understanding the barriers, circumstances, and conditions. Image: the same people at a curb with a cut, walk lights and sound-based walk signals.

We'll talk more about concrete examples of health equity as go along. Right now, I have to say as someone who's been using a cane to get around lately that I appreciate curb cuts in an entirely new way.

What can we do? Many health disparities are rooted in "social determinants of health." Those are things like:

Safe housing, transportation, and neighborhoods
Racism, discrimination, and violence
Education, job opportunities, and income
Access to nutritious foods and physical activity opportunities
Polluted air and water
Language and literacy skills

As it happens, many of these are issues that churches love to work on. When your congregation helps to build housing for low-income residents or hosts a sheltering program, takes part in a feeding ministry, works to reduce violence in the neighborhood, seeks to overcome racism or to create a healthier environment, it helps to counteract the COVID pandemic and ease its effects. Even offering rides to the doctor's office is a help.

This may be very incremental work, but every little bit does indeed help.

More directly, your church can host a vaccination clinic. Yes, we're still doing them, and yes, they're still needed. As mentioned before, COVID primary vaccination rates have plateaued in Wisconsin. Rates for bivalent boosters and flu shots remain very low.

Every clinic we put on eases health inequities. It helps reduce the inhumanity of health inequities. It takes us one step closer to realizing Dr. King's vision of a free and equal community.

Get in touch today, and we'll get it set up.

P.S.—If you want to learn more about health equity and COVID, there are some terrific reading lists on the American Public Health Association and American Medical Association websites. Check them out!

Stay safe and stay together,

Rev. Daniel Schultz

Community Health

Program Director