By JULIE MINDA
Growing up poor and biracial in inner-city Los Angeles in the 1970s and 1980s, Daniel Gibson says he experienced firsthand the sting of economic, racial and social inequities.
Gibson
Now a regional vice president with Trinity Health's Allegany Franciscan Ministries in Florida, he works to address inequity in Overtown, an African-American neighborhood in Miami that is marked by generational poverty and hindered by a lack of resources. Allegany Franciscan Ministries is a decades-old conversion foundation endowed with the proceeds from the sale of three Catholic hospitals. The foundation has invested $2.6 million in Overtown since 2015 in projects that benefit youth, improve access to high-quality jobs for vulnerable populations like ex-offenders and teach residents to advocate for the community's interests. Gibson has overseen those investments since 2016.
Gibson, 45, holds a master's in social work and currently participates in the Robert Wood Johnson Foundation's Culture of Health Leaders program. That program trains professionals to build cross-sector collaborations that advance health equity in their communities.
He spoke to Catholic Health World about countering long-standing inequities that diminish well-being, negatively impact health and shorten life spans.
How do you define health equity?
When I think of health equity, I really look at all aspects of life and society that impact an individual's health. That includes access to a good education, and economic opportunity, the potential to live free from fear and flourish.
How does your background inform your work in health equity?
Being biracial has brought wonderful gifts. I got to enjoy an amazing diversity and array of foods growing up — my black grandma's biscuits and my white Italian family's spaghetti dinners. But being biracial also brought societal stressors. Outside my nuclear family, I was seen as not white enough or not black enough. I internalized that racism. For instance, when I was my teens, I self-selected to attend a private school, spending the majority of my formative years in predominantly white, privileged environments. I inadvertently may have neglected my black side. But now I'm reacquainting myself with that side, and it's a beauty.
Trina Harris, a lifelong resident of Overtown, Fla., is part of a 10-person council of community members who advise Daniel Gibson in his health equity work. Harris, a mother, business owner and engaged community advocate, is seen here speaking at a community event in April.
Race, poverty and violence had a huge impact in my childhood. After my dad left, to provide for her kids my mother was always working — she'd work overtime all the time. When she worked the graveyard shifts she'd be coming home as we were headed out to school. She made sure we were well clothed and fed. I know it was a struggle for her.
There was the trauma of violence in my childhood. When I was 17, my 20-year-old brother was shot dead by gang members in Los Angeles.
At that time, in the early 1990s, I also felt the fear, grief and confusion of being a gay teenager when HIV/AIDS was just coming to the forefront. Everyone in the gay community was fearful of the health risks. I was afraid to talk openly to a health care provider to get my questions answered. I think teens today may still experience the same fear of being judged, and it could be putting them at risk.
All of these issues related to my identity had to do with the social determinants of health and environmental impacts. I learned that circumstances and environment have a huge impact on an individual's well-being, and this informs my perspective in my work now.
I believe the health inequities in our communities come down to status, and in our country, race defines status, and money defines status. This is a poverty issue as much as it is a race issue.
What evidence of inequity do you see in Overtown?
There is clear racial inequity in the community — that is evident in the condition of housing, the lack of jobs and in difficulty in accessing health care. Overtown is at the northern corner of downtown Miami. You have all these beautiful high rises that are all creating shadows on Overtown, and Overtown is probably the last piece of downtown Miami that is underdeveloped. It just is beginning to experience gentrification. And now people are being priced out of the community where their families have lived for over a century.
The individuals who live in this little pocket of Miami experience certain disparities around health including shorter life expectancy. You look at someone who lives in Overtown and their life expectancy is something like 16 years less than people in affluent Miami less than a mile away.
What are some things Allegany Franciscan is doing to counter gentrification?
The citizens say they had tried to go to meetings to have a say in the changes happening in their community but had felt their voice wasn't heard. There's a new high-speed train that runs from West Palm Beach to Overtown, and one would think that would benefit Overtown, but it hasn't. The line cut into their community, and people in Overtown didn't even get to be part of the construction crews building the line.
We are joining with other community organizations to help provide a voice for the citizens of Overtown. We're helping them understand their rights and responsibilities, strengthen their political networks, helping them with social media efforts and we're trying to have conversations with the developers to get community benefit agreements into their contracts.
What do you see as the best approaches community organizations can take to redress health inequity?
Well, I always think initiating the conversation within community organizations including health care providers is the first step and sometimes the most difficult step. People think either it's not relevant to them or too uncomfortable for the organization.
And then it's necessary to provide education and a platform for ongoing assessment and evaluation of whether and how our staff, patients and community members experience equity and inclusion and whether our organizations and communities are diverse. Equity has to do with equal access to societal goods, inclusion with involving all groups, and diversity with ensuring a full array of viewpoints are represented.
A lot of health organizations are creating departments around equity, departments whose sole role in the organization is to look at the experiences of that organization through the lens of equity. Trinity Health, which is our parent company, has created an equity and inclusion department. These departments make sure that the organization's policies and processes ensure equal access to societal goods for staff and community members.
How much of health inequity is related to an individual's behavior and choices, and thus addressable by the individual?
I think that our behavior is impacted by our environment and how we live, the air we breathe. How we think, and the way we think and react is based on how our world interacts with us. For instance, individuals who experience homelessness or are in a world where they feel that they don't have a fair shake, they may drink a little bit more. And I think it's way too easy to hold out behavior as sort of the root cause of inequities.