By Marjorie Wilson

I had the pleasure of interviewing Patricia Julio and Joy Wiggins, co-facilitators During the April 2017 Science of HOPE conference session “Reimagining Race-based Conversations.” As a participant in their session, I found it to be one of the most meaningful racial equity conversations I’ve ever experienced, thanks to their skillful facilitation and commitment to social justice.

With over 15 years of experience with affordable housing, Patricia is an adjunct faculty member at Seattle University and offers to consult on neighborhood revitalization and community development, especially in low-income communities of color. Joy is a professor of education at Western Washington University and offers consulting and speaking engagements on white privilege, feminism, and social justice in education. We chatted for a few minutes after their session so I could pick their brains about health equity as they see it influenced by their respective fields.

Marjorie: What is the biggest obstacle to achieving lasting health equity?

Patricia: I think a lot of the barrier is not understanding the interconnections between health and work, job, stability in housing. You could lose your job because of a health issue, you could get into an accident and no longer be able to provide for your family, or your children become sick… I think there is a lot of interconnections between lasting health equity and access to a self-sustaining income, safe and stable housing environment, and access to education and a social network. I think that all comes into play with sustaining health equity. Also, I think really understanding how culture contributes to [health] and being able to work with those cultural norms and have a system that can work with those cultural norms. I don’t necessarily see that [currently]. That also really impacts sustainable health equity, particularly in communities of color, immigrant, and refugee communities.

Marjorie: So I hear you saying sustainable health equity in really intersectional, so we have to be aware of all the things that add up to health?

Patricia: Yeah.

Joy: I would say too that it is looking at the systems and the interconnection of the systems. I’m in education, and in education, if you don’t have good health your education will be stifled or your education will somehow be stunted. Like Patricia was saying, it’s [health], intersected with housing, et cetera. I think about my own child and her health and her mental health, and how important it is for me as her mother to give her a very stable house and home, and to give her all of those things that a mother is supposed to give, a healthy upbringing like healthy food, good nutrition, make sure she gets enough sleep — all of these things, but I’m also a privileged, white woman, that’s educated and I know these things, and it’s still hard to do it, so I can only imagine if I have systemic barriers in my way constantly, how [much] harder that is and I think about [the story of] Ijoema’s [Ijeoma Oluo, writer. speaker. internet yeller.; another speaker at the Science of HOPE conference] mother who had Type 2 Diabetes and was on welfare, but when she went to go get her degree she wasn’t able to be there for her children so her children’s grades plummeted. It’s those intersecting systemic issues and oppression that happens that makes it nearly impossible to have health equity. So when we think about what is sustainable, we have to look at the systems and we have to look at transforming the systems completely. That means all of the systems, as far as education goes and the social systems, and speaking to the communities and getting the voices of the communities to help in the process of solving these problems, rather than putting a band-aid [on it]. The Health Department thinks they know how to solve the problem, but nobody has asked the community. That’s one of the things I do in my class is that we look at community asset mapping. My students have never even heard of that. I tell them to pick a classroom or school community and you need to go tie in all those systems: health, education, language services, banks, local experts, community experts, larger and smaller folks, macro and micro systems, and all of that. You need to know that as a teacher in order to help your families because you’re not just educating one child, but you’re educating all of them.

Marjorie: So I’m hearing intersectional, compounding and community-informed?

Joy: and systemic overhaul.

Patricia: You know, Joy, when you’re talking about your daughter, I started thinking about my partner. I’m newly married. (My whole family is like, “Thank God! Finally!”) My husband is an immigrant. I met my partner in Ethiopia, he’s Ethiopian. And he moved to Seattle two years ago. He’s never been outside of his country before and within 6 months of him moving here, his cholesterol shot up really, really high. It almost doubled. Obviously, it is a result of him eating new and different foods, fast food, trying different cuisines. He’s from an area in northern Ethiopia where there isn’t a lot of different food. For example, if I was really craving Korean, we’d have to fly down to Addis [Ababa], the capital to go get Korean food, and even then I wasn’t satisfied because I didn’t think it was authentic enough. He quickly learned [he] could not be eating junk food. [He has] to be really careful about what I’m eating here because [his] body has lived on organic food, homemade food, all his life. He comes here, within 6 months, his cholesterol doubles and he’s like, “ok you can probably eat fast food because your body is used to it, but mine just isn’t.” He’s really had to watch what he’s eating and because I’m not Ethiopian, it’s difficult for me to cook for him because it’s just never right. Some of the things I cook for myself, he may not like or just doesn’t have a taste for. That’s been really hard to navigate in our partnership. The most fights we have are over food. Circling back to your question, I think it is also about how to take care of yourself when you are part of the diaspora community, for whatever reason, either for asylum, for family or education, how do you then sustain that healthy lifestyle? Walking, eating healthy, which is something we’ve coined here as the new thing and is really hard to do, but in their lifetime it was just the norm. I think it really impacts immigrants and refugees, particularly, in his experience, what I’ve observed, Ethiopian food is expensive here. It’s not like he can just go and get some quick Ethiopian food for $10 or less. It’s expensive and the lifestyle here is just so fast paced. He’s lost the communal eating, which I think is also a part of that community and social network to keeping each other healthy.

Joy: Yeah, that’s so key.

Patricia: Eating alone or eating on the go, or while you’re on the bus, those are things I’ve observed in him. I’ll tell him to go to Starbucks and get something quick to eat before class, and he’ll say, “No, I don’t want to do that.” And that’s something that’s really a barrier to sustainable health equity, too.

Marjorie: Is there something you see about health equity that you feel others are not noticing or not paying enough attention to?

Joy: All of the above. One of the things I’ve noticed with these race-based dialogues, in particular, is looking at the connection from individual to system, and how our individual responsibility doesn’t always connect to the systems. When we think about health equity, again looking at, what is our individual responsibility to understand the systematic interconnections of all of these facets of our social and cultural lives. Like you said, food is such a big one. I think about my garden, but I have land to have a garden and I can go out to my garden at any time in the day and I have chickens. But I’m able to afford those things and get those things and I’m able to have access to the land and a lot of that is out of my privilege and also being American. I also have taught myself how to garden and grow my own food, and I specifically don’t live in Seattle so I can do that and have a big yard to do that. That’s all out of privilege. I think if we can start to invoke more gratitude in what we do have and to pay that forward and educate ourselves about the individual and connect to the system cycles that keep reifying themselves in communities of color especially. I think that’s why having race-based conversations are so important because I think race is such a big key to that. If we look at the research studies on just stress levels, cholesterol levels, and mental health levels in folks of color, especially in impoverished communities, we can’t stand by and continue to let this happen. As a white person, I cannot. It has to happen now. What was the question again?

Marjorie: That was great! It was, “what do you think people aren’t talking about in health equity?”

Joy: Oh, yeah! All that.

Patricia: A lot of my work stems from this place. I have a background in urban planning, I was in affordable housing for a long time and doing community development work and I think that maybe within the last ten years people are talking about food deserts and access to healthy food, urban agricultural and urban farming. I grew up in Rainier Beach in Seattle and I continue to live there today and it’s always been a disadvantaged community, which I think is why I got into the field that I did. I don’t think we’re connecting access to healthy food with … healthy food that is also culturally relevant. I don’t think we’re connecting public safety and crime in neighborhoods to health. Just two weeks ago, bullets were flying in the neighborhood and they were pretty close and there is only maybe 2 or 3 times in my life that I’m crawling on the floor trying to get to the phone because it’s that close. I don’t think the health sector is talking about that — or I’m not seeing [it]… Also, I think [connections between] health and migration and displacement is something that I would love to see happening. I know people are being displaced from their neighborhoods. Look at Columbia City, where a 2-bedroom is $2,000. Are you kidding me? But you know it’s interesting because then the PCC moves into Columbia City when it was over by Seward Park before. [Columbia City] has a farmers market, but there isn’t one in Rainier Beach. It’s just interesting how those decisions get made. When neighborhoods are experiencing more affluence, all of a sudden you’ve got this healthy fresh organic service in the neighborhood when you didn’t have it before. Mostly in Rainier Beach you’ve got fast food, Jack in the Box, McDonald’s. There was a rumor that a Trader Joe’s was going to go in… that’s not going to happen.

I think the point I’m getting at is we need to link health and place very concretely because studies show: where you are living, where you are growing up and where ever your primary residence is, your health is being impacted.