Rediscovering Public Health and Social Justice

1. Celebrating our Work and Carrying it Forward Rediscovering Public Health and Social Justice New Mexico Public Health Association and UNM National Health Disparities 2014 Joint Conference April 2, 2014

2. Public Health and Social Justice History Celebrating our Work and Carrying it Forward Major social reformer Labor Movement Labor Movement Civil Rights Movement

3. Public Health and Social Justice History Celebrating our Work and Carrying it Forward Environmental Movement Women’s Movement

4. Public Health and Social Justice History Celebrating our Work and Carrying it Forward Labor Movement, Civil Rights Movement

5. Universal Declaration of Human Rights Adopted by the United Nations General Assembly on 10 December 1948 Celebrating our Work and Carrying it Forward

6. Public Health as Social Justice Dan Beauchamp Celebrating our Work and Carrying it Forward … makes a case for the importance of tying these two together, that the issues of poverty, racial discrimination, poor housing, unemployment or the abandonment of the aged requires sometimes painful costs that the dominant interests in society are unwilling to pay, and that our public ethics do not seem to fit our public problems.

7. Justice means (in the broadest sense): • Each person in society ought to receive his or her due and… • The burdens and benefits of society should be fairly and equitably distributed. Celebrating our Work and Carrying it Forward

8. Beauchamp is speaking here of politics not as partisan politics, but as the more ancient meaning of political life as the search for the common goodand the just society. Celebrating our Work and Carrying it Forward

9. Celebrating our Work and Carrying it Forward Market Justice Vs. Social Justice

10. Market Justice Vs. Social Justice Celebrating our Work and Carrying it Forward • The dominant model of justice in the • American experience has been market justice, the norms • of which are that people are entitled only to those valued • ends such as status, income, and happiness, which • emphasize individual responsibility, and minimal • collective action. • The counter narrative of marketjustice • is social justice

11. Doing Justice: Building an Ethical Paradigm for Public Health Celebrating our Work and Carrying it Forward • “Doing public health should not be narrowly conceived as an instrument or technical activity. Public health should be a way of doing justice, a way of asserting the value and priority of all human life… the elaboration and adoption of a new ethical model or paradigm for protecting the public’s health. This new paradigm will necessitate a heightened consciousness of the manifold forces threatening human life, and will require thinking about and reacting to the problems of disability and premature death as primarily collective problems of the entire society…(Beauchamp, 1972)”

12. Social Determinants of Health Celebrating our Work and Carrying it Forward World Health Organization (WHO) Definition (2008): The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries, and more locally, between communities.

13. What we Mean by Social Determinants of Health • Vicente Navarro critiques the long awaited WHO Commission on Social Determinants of Health report (2008) • Class – the avoidance of this conversation in the report • The Commission’s “studious” avoidance of the category of power (class power as well as gender, race, and national power) and how power is produced and reproduced • Speaks of policies without touching on politics. • It is profoundly apolitical, and therein lies the weakness of the report. • So, we need to talk of politics (not only policies ) and Action !! Celebrating our Work and Carrying it Forward

14. What we Mean by Social Determinants of Health • As public health workers, we must take our work forward and denounce the process of killing… but also the FORCES that do the killing! • We can recall Edwin Chadwick , one of the great founders of public health, who, as Commissioner of the Board of Health of Great Britain in 1848-1854, declared that the poorer classes of that country were subject to steady, increasing, and sure causes of death. Celebrating our Work and Carrying it Forward

15. Public Health and Social Justice Working Group Participants: Celebrating our Work and Carrying it Forward Dana Schultz Millen, PhD, MPH Ray Baca, BSW Erica Newfield, RN, MSN Anne Marie Sekula, BA, RN Harold Vann, MA Clara Yuvienco, MPH, CHES Contact information: (505) 222- 8601 or Dana.Millen@state.nm.us

16. Tobacco Use Prevention and Control(TUPAC) Program 11 Program Staff Members 20+ Contracted Partners including Six Priority Population Networks

17. CDC Goal Areas for Comprehensive Tobacco Control Programs • Cessation for Youth and Adults • Prevention of Youth Initiation • Secondhand Smoke Protection • Address Tobacco Related Disparities

18. CDC Goal #4:Address Tobacco Related Disparities • Importance of Goal 4 elevated within NM • Effort to Incorporate Goal 4 into all activities • Activities include internal and external program activities • Anti-Oppression Model introduced in 2006

19. Definition of Anti-Oppression Actions and attitudes which challenge personal, cultural and institutional oppression Cultural Bridges to Justice

20. What does it mean to work from an anti-oppression framework? • Actively working to acknowledge and shift power towards inclusiveness, accessibility, equity and social justice. • Ensuring that anti-oppression is embedded in everything that you do by examining attitudes and actions through the lens of access, equity and social justice.

21. Anti-Oppression Training • Original Training hosted by TUPAC contractor • Training attended by six program staff • Action-planning component led to TUPAC toward adoption of anti-oppression principles in all aspects of program activities • Training for all program staff began in 2007

22. Cultural Bridges to JusticeTraining Objectives • Familiarity with concepts and development of a common language re. Systemic Oppression • Understanding of historical, political and social context for systemic oppression in U.S. • Review systemic linkages among various forms of oppression • Development of an understanding of oppression as a social determinant of health

23. Program Efforts to IncorporateAnti-Oppression Model • Training began for all program staff in 2007, Required for all contractors beginning in 2008 • Additional staff who have since joined the program have been required to attend • TUPAC program has done organizational development work, including Mission Statement, Guiding Principles • Development of Priority Population Networks

24. Program Efforts to IncorporateAnti-Oppression Model (continued) Requirement that all TUPAC-funded Organizations attend anti-oppression training Incorporation of definitions, description of anti-oppression model into RFP’s Requirement that all contracts address disparities and incorporate anti-oppression principles

25. TUPAC-Funded Priority Population Communities Native American/American Indians African Americans Asian/Pacific Islanders Spanish-Speaking Communities People Living With A Disability LGBTQ

28. TUPAC Mission Statement To improve lives by eliminating the harm from tobacco abuse through the implementation of effective strategies that incorporate an anti-oppression model