United Way of Dane County’s Health Community Solutions Team: Now Is the Time for Change
Gabe Doyle (l) is director of health at United Way of Dane County and Carola Peterson Gaines, longtime community health advocate and member of United Way’s Health Community Solutions Team
Part 2 of 2
By Jonathan Gramling
Who knows when the health racial disparities for African Americans living in Dane County began? Perhaps it was when the first African Americans resided in Madison in the 1800s. And the greater community didn’t notice or didn’t care because the African American community was so small even though it was painfully clear to African Americans. And some of that statistical significance is even lost today.
There are two Madisons, Just as Madison’s public schools were called some of the best in the nation due to the high number of National Merit Scholar semi-finalists, while African American students were experiencing a serious achievement gap, African Americans suffer severe health disparities that are disguised by the overall Madison and Dane County health numbers. Madison wasn’t that great if you were a person of color.
Traditionally, the definition of health has been very narrowly defined. But just like there has
been a push to name racism a public health issue, there is also a push to broaden the consideration of what contributes to poor health that goes beyond just the biological or treatment aspects. What is bringing it into focus is Black maternal and child health.
“Poor maternal health outcomes means $50,000 to $100,000 worth of debt right out of the gate for the family,” said Gabe Doyle, United Way of Dane County’s director of health. “That’s an economic challenge that will continue to grow. It means larger chances for cognitive delays and brain-development challenges across the lifespan that will cause an unfair disadvantage to the individual and their family. When you talk about the bags that people carry, as just being themselves and just existing, that’s why Ms. Gaines and so many people rightfully so are passionate about maternal health and making sure that we are having healthy babies.”
“We know that Black maternal child health is at the top,” said Carola Peterson Gaines, a longtime health educator and advocate at Quartz and member of the Health Community Solutions Team. “It’s critical. So we are all partners working on that first. And when we have healthy Black moms and healthy Black babies, we can have a healthy Dane County. And so that’s our first start, to begin to look at that piece and look at stress. We know that stress is a huge factor in everything that relates to your health. If you are stressing about paying your rent, if you are stressing about where you are going to live and being evicted, all of that affects your health. And when you look back at how all of those things occurred, you know it started some 400 years ago and the capitalism that white people have gained off of the backs of Black people. That’s how they have gotten where they are even today. Having people recognize that is kind of huge. And I think it has to be intentional on that person’s part to continue to recognize it, continue to make change and continue to be intentional about being anti-racist. That has to be a part of this piece of the plan.
In order to make headway against these community health issues, it is important the silos of “they work on health, they work on income, they work on housing” be broken down.
“We want to name racism as impacting the health and well-being from before birth through the end of life,” Doyle said. “And so racism isn’t going to say, ‘We’re just going to focus on the babies and we’re just going to focus on the seniors.’ We can’t categorize our work under an age range. But we can do is find the best practices with our little piece of the pie that we want to focus in on and we’re going to work with our community partners like Ms. Gaines said to break down those silos to say, ‘We think this is the right plan, but we can’t do it by ourselves. We need you to be in the game with us. What can you bring to the table to help illuminate or ripple out our desires to eliminate racism from being the driving factor of health and well-being in this community? We want to create communities of practices, information exchange and wisdom.”
And it is important that the histories, traditions and experiences of the different communities of color be brought to bear in the service delivery scheme.
“What we are going to be looking for out of our investment process is partners who are improving the health and well-being of our Black and Brown, Indigenous, Latinx and Southeastern Asian communities because we can’t just keep nebulizing this into a BIPOC issue as if everyone under that umbrella has the same shared experience,” Doyle said. “And so we need to be very specific in the cultural context that individuals are bringing to the table.”
And the solution to these issues — and the need to break down the silos — also resides with the large institutions in Madison.
“We’re going to need big systems to really think about their hiring practices,” Doyle said. “And that might be outside of our locus of control at United Way or the Health CST. I wish I could bring in a brand new group of doctors and mental health providers and psychologists and community health workers — and we need the community to think about this.”
Gaines admitted that this is a long-term process.
“Is this going to happen overnight,” Gaines asked. “Are we going to have healthy birth outcomes overnight? Are we going to eliminate diabetes, hypertension, HIV-AIDS, are we going to eliminate all of those things? Absolutely not. It won’t happen tomorrow. But it is a start to work on change that needed to happen. And so I am excited to see the change. And it breaks down silos. And so we all can work together.”
Doyle is more optimistic.
“Kudos to United Way of Dane County for really leaning into that work and saying, ‘You are absolutely right,’” Doyle said. “’We could keep giving money out to the different buckets of the social services fabric, but if we want to continue to be a leader for the next 100 years, we’re going to have to be way more intentional.’ I think that is a shift that United Way is really leaning into and I appreciate that our Health CST has been really passionate about delivering on this work. This work isn’t going to be just about passing out dollars at United Way. This work is going to ripple back into the organization from our team and see that network continue to grow and bubble into a way where this isn’t seen as a radical conversation for Madison and Dane County. This is seen as the new normal. I’m not too cocky to believe that there hasn’t been a tremendous amount work done a long time before I’ve come. But I am cocky enough to hope that it ends with my generation.”
Some would say that all life is interconnected. And so, it’s not just an issue of Black maternal and child health. It’s also about meaningful employment with a livable wage, affordable housing and the elimination of racism as a barrier to full participation in community life and enjoyment of its fruits and benefits. United Way is starting to connect those dots that will truly lead to the realization of Black maternal and child health. The movement has begun.