This article is part of ‘.Innovation: Solutions for health equity”, an editorially independent special report produced with financial support from. Takeda Pharmaceutical Company.
THis journey toward health equity can sometimes feel endless. But it’s also exciting and stimulating. scientific american We asked researchers, physicians, advocates, and others working on health equity what they are most excited about. While there were many concerns for each, there were also reasons for optimism. They pointed to progress in expanding access to health care, increasing the inclusiveness of science, and reducing the health burden of systemic racism and other biases. They are also encouraged by the energy and enthusiasm of their colleagues working to advance health equity.
“Justice work at any level has to be rooted in a context of hope, right?” said Aretha Maybank, chief health equity officer at the American Medical Association. “Hope and belief that we will all be able to experience optimal health.”
About supporting science journalism
If you enjoyed this article, please consider supporting our award-winning journalism. Currently subscribing. By subscribing, you help ensure future generations of influential stories about the discoveries and ideas that shape the world today.
The following interview has been edited for length and clarity.
Madhukar Pai
Head of the School of Epidemiology and Global Health, McGill University
My greatest source of hope is young people. It is the youngest people who are shining a clear light on why climate change is catastrophic and why our leaders aren’t acting on what has been clear for years. The people who are doing a great job on gun control in America are the youngest people, even though they are being slaughtered in their schools. Young people are alarmed by the rollback of reproductive rights in the United States, Afghanistan, and elsewhere.
I find their moral clarity to be the clearest. Because unlike older people who were already passionate about something and worried about the next paycheck or position or award, young people are devastated at what they can do wrong. Because it’s clear. Their questions are incredibly accurate and to the point, which gives me great hope. That’s part of the reason I still teach global health to young people.
Fueling their energy and passion may be the greatest source of hope for all of humanity. But even if their diagnosis is perfect, there are limits to their ability to act, and we need to go beyond them. they have no power. They often don’t vote. They are usually given two minutes to speak at the front of the meeting and are ushered out the door while the adults make the big decisions. So how can we empower them to take action and empower them to do things, rather than just make some noise or take a nice photo?
Saye Abimbola
Associate Professor, University of Sydney Health System
One of the things I look forward to is the confidence and restlessness of medical professionals and academics around the world, both in the Global South and beyond, about how the field itself functions and needs to change; Anxiety is on the rise. Historically, the field was premised on the idea that the West, or the Global North as we call it today, had rights and duties to impose on the rest of the world.
For example, if someone wants to do research in Nigeria and the people leading it come from London, they will rely on a lot of infrastructure in Nigeria, but their local collaborators will know nothing. will be ignored. Then they go home and write this paper and publish it in a journal. BMJ or lancet. Now, for me, what I think has changed, and what I think will continue to change, is a reaction against it. That’s just the tip of the iceberg. However, the physically measurable and countable phenomenon of partnership research rests on a whole foundation of assumptions and standardized practices that we derive from our colonial experience.
Rachel Hardeman
Director, Center for Antiracism Research for Health Equity, University of Minnesota School of Public Health
One of the things that gives me hope is the work I’m doing with many other very talented scholars across the country on measuring racism. In my work and within my research center, I have to make the invisible visible. Racism is all too often misidentified as something insidious, built into the system, and it’s very difficult to identify, especially when it’s not an explicit interaction with someone.
A lot of my work, and what I see with other scholars across the country, especially incredibly talented Black scholars, is how we use data to measure structural and other forms of racism. investment and interest in understanding how to measure racism. We use it to notify you of policy changes. We are united around the need to understand that health policy and social policy are inextricably linked. For example, without data, we can’t talk about historical redlining and racial codes and birth outcomes in those communities without understanding the history and what’s happening now. And we use that evidence to inform housing policy, just as it informs health policy.
Wafa El Sadr
Director of Global Health Initiatives, Columbia University Mailman School of Public Health
When I think back to 25 years ago, it’s like night and day compared to now. Investments in health systems driven largely by the HIV epidemic have paid off in surprising ways. Either no services were available, or those that did exist were broken. There were no resources. There was no access to medicines or laboratory tests. So much has changed in just a few decades that it gives me hope for the future.
More than 20 years ago, I remember going to a clinic far from the capital of a South African province. There was nothing available for HIV testing or treatment. And I remember this vividly. This nurse proudly opened a notebook in a very rickety desk drawer and said, ” Then she pulled out another piece of paper and said, And I remember walking away thinking, “Look at this. I have my credentials. I’ve been trained. I’m ready. I want to save my people.” There are people who care about their community. They are ready and willing. “And I’ll never forget that, and I’ll never forget her ‘I can’t wait’ look.
barney graham
Founding Director, David Thatcher Institute for Global Health Equity, Morehouse School of Medicine
Having hope comes from faith and belief that there is a way for things to evolve for the better. The moral arc of the universe bends toward goodness. But it may take a long time. Helping to diversify the public health workforce by providing more opportunities and knowledge to students is a multigenerational process.
Four African American students performed nearly all the benchwork needed to bring Moderna’s coronavirus vaccine into its first Phase 1 clinical trial in March 2020. We’re very proud of the way they’ve launched the entire vaccine program.
We have to change the narrative about what people can and can do and ask who gets trained. Who can gain knowledge? Who gets to make decisions? Who decides what gets built and where it goes? All of these decisions are made at some level of leadership. If you diversify that leadership, you’ll have better, more balanced opinions on how things should be done. That’s how we begin our journey toward equity.
aretha maybank
American Medical Association Chief Health Equity Officer
It will help you check your progress. Over the past four years, since the public murder of George Floyd, I have been able to speak out about racism in a way I previously could not. Until the public killing of George Floyd, people would not have expected the AMA to issue a statement that racism is a public health threat. And the AMA’s House of Delegates passed a policy reaffirming the exclusion of medical essentialism from medicine and the exclusion of race from medicine as a substitute for biology. This goes hand-in-hand with the movement to eliminate racist and clinical algorithms (see “Doing Better” by Cassandra Willyard). It would never have happened without this national, collective movement that has taken its name to expose racism and inequality during the coronavirus pandemic. That response and that collective response certainly offers hope.