Conversations in Equity

It is customary at the end of each year to pause and celebrate achievements, ponder lessons learned, and renew commitments to do more, even better. Having marked our accomplishments, we look to the new year with anticipation and new aspirations. As we begin 2013, I want to reflect briefly on progress in the national agenda to improve minority health and reduce health disparities, share some shifts in our thinking, and greet the new year invigorated and ready for the opportunities and challenges ahead.

A colleague and I were recently discussing “the good ole days” over lunch. We reminisced about the neighborhoods we grew up in, the influence of our families and friends, and how we dodged poverty, violence, and isolation. When I look back, my years in college were probably the most significant period of personal growth, hard work, and good times. I can also remember times of confusion and indecision—particularly as I struggled to declare a major. I had always been interested in a health career. During high school, I was exposed to physicians, nurses, physical therapists, and pharmacists, and decided I would become a physician. However, after receiving a C- in my freshman chemistry class, I knew the “pre-med” curriculum was not for me. During my junior year, I took a course in medical anthropology and was introduced to public health by my professor who was also a physician. I learned that “health” was determined by so much more than the provision of health care services. It was during my senior year in college that I decided to pursue a graduate degree in public health, and the rest (as they say) is history.

This summer, my nephew was killed while riding his motorcycle. He was just 2 months shy of his 41st birthday. I can still hear my daughter saying “I have some really bad news…Junior died.” The crash happened at night. He was hit by a car turning left into the entrance of an apartment complex, and although my nephew had the right of way, the driver said she “didn’t see him.” He was wearing a helmet and driving within the speed limit. According to a recent CDC study, between 2001 and 2008, more than 34,000 motorcyclists were killed, and there was a 55% increase in motorcyclist death rates during this period. More people in the U.S. are riding motorcycles today than ever before, making motorcyclist deaths and injuries an important public health concern.

Having been raised in the South by my grandmother, I was taught there were topics that were inappropriate to discuss in public. There often was a culture of silence around issues of sexuality, marital infidelity, homophobia and other forms of sexual difference, poverty, neglect and abuse, and specific health problems people were experiencing. It wasn’t that people didn’t talk about these matters; they just didn’t regularly talk about them in public spaces. Instead, we whispered about them in safe, private spaces with people who shared our sensibilities. Any public talk that would expose, embarrass, alienate, or bring harm to a member of our family or close social network was avoided. While some of this silence was meant to be protective, there were unintended negative health consequences that emerged.

As part of the celebration of this year’s National Public Health Week, I was invited to participate in a day of events sponsored by the College of Health and Human Services at the University of North Carolina, Charlotte (UNCC). We began the day with Charlotte Talks – a local radio talk show – discussing the role of prevention and access to health care in reducing health disparities. I was joined by Dr. Crystal Piper (UNCC) and Mr. Brad Wilson, CEO of Blue Cross and Blue Shield of North Carolina for the interview with Mike Collins, host of Charlotte Talks. For an hour, we engaged in a rich dialogue and debate about issues ranging from personal responsibility for health, poverty and other determinants of health, to the benefits, challenges, and costs associated with insuring access to health care for all. We were kindred spirits and like minds sharing the microphone –understanding what can be accomplished when public health and medicine join forces to reduce health disparities.  However, the questions and rebuttals from Mr. Collins and his listening audience reminded me again that we must continue to host these conversations in communities, come with examples that people can relate to now, and not shy away from the hard questions that begin with Why? and How?

Welcome to CDC OMHHE’s New Blog: Conversations In Equity! In this 1st Blog Post, Dr. Leandris C. Liburd, Director of CDC’s Office of Minority Health & Health Equity (OMHHE) explains what she does.

Leandris C. Liburd, PhD, MPH, MA, Director, CDC OMHHE

An awkward pause often precedes my response to the question “So, what do you do?” Describing in plain language what we do to address health disparities and reduce the high burden of preventable disease and premature death experienced by communities of color and other population groups is rarely a quick response.

Helping people understand why these disparities persist, sharing effective public health approaches for reducing this burden, and showing how what we do in CDC’s Office of Minority Health and Health Equity (OMHHE) ultimately impacts health outcomes in communities is often challenging and never achieved in the time it takes an elevator door to close.

The Centers for Disease Control and Prevention (CDC) first established our Office of Minority Health in 1988 through the advocacy of minority scientists and public health practitioners and the support of then agency director, Dr. James Mason.  Since its inception, our office has championed a number of initiatives and collaborations that have helped to institutionalize a focus on minority health, eliminating health disparities, and more recently, achieving health equity.