Perspectives on the Power of Policy for Health
She’s a Boomer, he’s a Millennial. She was born and raised in rural Robeson County, NC; he grew up in Southwest Houston, TX. She’s a Lumbee Indian, the largest tribe east of the Mississippi River, and he identifies deeply with his Ghanaian, West African culture. Both have close ties to their families and communities, share a broad definition of health, and are passionate about the power of citizen engagement as a requisite for transformative policy change. Meet Donna Chavis and Niiobli Armah, Chair and Vice Chair of the Active Living By Design (ALBD) Advisory Board. They recently shared their perspectives on the power of policy for health.
Both of you have been tireless champions for health equity. How do you think we’re doing? If you could enact one policy change to address the gaps, what would it be?
Niiobli: We need to raise the bar on what we’re aspiring to achieve. We can’t settle for status quo. Every planning process needs to start with an intentional conversation about what’s going to be done to close disparity gaps. We also need a more relentless advocacy base. If you look at effective movements, no one asked nicely for inclusion. Folks didn’t sleep. They made it a top priority. When zip code determines life expectancy, we need to find a way to rally those folks to demand better policy.
Donna: I can’t say that I think the country is doing very well. There was a recent Pew study showing that 43 percent of the population uses all of its income each month, and often goes into debt or uses savings to make it through. That has an impact on health. If there were a policy I’d really fight for, it would be to require employers to pay a living wage. Not a minimum wage, a living wage.
Niiobli: I completely agree. Income inequality is the root of health inequality. That’s something health advocates need to do—build an even more inclusive movement.
We’ve been hearing a lot about various efforts to build a culture of health across the country. What does “culture of health” mean to you?
Niiobli: To me, a culture of health should be flexible enough to where communities set their own definition that embody their unique experiences while raising the standard for health. I think the dialogue is shifting. We’re able to convene and talk about things we’ve overlooked in the past. As the conversation changes, the voices in the room should change. The door is now open, but we need to get new people at the table. It’s our responsibility as practitioners to invite them in.
Donna: The word “access” comes to mind for me. People will usually make healthy choices if they have them. When people have access they make better choices. The hope I have in my community is something very concrete: seeing all of these divergent groups working to improve overall health is encouraging.
Both of you have experience working locally, as well as with state and national organizations, to influence policy change. What are some of the most important lessons you’ve learned about achieving success at all of these levels?
Donna: We often talk about work at these levels as if they’re distinct. For me, the lesson is that that’s not the case. So often the locals feel like they don’t have access or are not important to state and national change. Or state and national people feel like they can get things done on their own. For me, longer term successes come when all three see themselves as interrelated. When the locals see themselves as the dominant force that they are, their steps are stronger and more forward-thinking, and they can often garner more support. When nationals see themselves as servant leaders, they can make better use of the work being done on the ground.
Niiobli: I want to build on that. It’s really important to have advocates working across the spectrum to do that very thing. Collaboration can’t be optional. In national conversations, local advocates need to be sitting next to us when possible. That makes for a more sophisticated movement that’s ready for the problems we’re facing.
What final words of encouragement do you have for those who’ve grown cynical with gridlock in their own town councils or in Washington, DC?
Niiobli: I think about the importance of building locally. We’ve lost many battles on Capitol Hill that we’ve won locally, and vice versa. If folks are frustrated, then they should hold a meeting, pick new candidates and work like hell to ensure they get into office. If the current body isn’t working the way it should, then it needs to be replaced. That’s the root of democracy, uplifting local voices.
Donna: I think it’s easy for any of us at any point to feel cynical. One of the best forms of encouragement is looking for wins. No matter how deep you are in the muck and mire of a campaign that may look that it’s going nowhere, find something to celebrate. It might be very small, but could help you move forward. Start off where you know you’ll have a victory. It’s critical in times like this.
