To the Editor,
On April 27, the Oregon Health Forum presented a panel on “The Impact of Social Determinants on Health Outcomes”. It is well established that most social determinants of health stem directly from social inequities, such as racism and privilege. The Health Forum, like many organizations before it, missed an opportunity to advance the conversation of social determinants of health when it failed to assemble a panel that reflects the racial diversity of thought and lived experience that shapes social determinants of health research, policy and practice. The limited diversity on this panel signals a lack of awareness of what is going on within communities of color, and frankly, limited value for expert leaders, thinkers and policymakers of color in our region that have led and shaped the conversation on the social determinants of health for decades.
Conversations about diversity, race, privilege and inclusion must find a place in the planning of expert panels and discussions, particularly when the subject matter is so deeply linked to structural racism and inequality. This omission affirms the bias of white expertise that is pervasive in health care. And it is a symptom of structural racism that our community must work ardently and intentionally to dismantle. We cannot simply talk about doing our work differently – we cannot integrate the language of the social determinants of health if our very practices reaffirm the structural inequality we are hoping to redesign. We must begin to work differently. This panel highlights the work needed to advance awareness about diversity and inclusion, and how it impacts the healthcare community in every way.
Here are a few considerations that cultivate more diverse and inclusive panel selection processes:
Be accountable. Name past mistakes and make a commitment to reforming practice.
Design with intention. Look farther that your first and second degree contacts when you seek speakers for events.
Honor the wisdom of lived experience. Look past those with academic credentialing. People are experts in their own lives. Examine whose knowledge and expertise you are centering.
Be transparent. Share your progress and dialogue openly about successes and failures. The more we share our learnings, the more our community is able to grow in this direction too.
As potential panelists, when we are asked to share our expertise, a good best practice for us to adopt as a community would be to consider these questions: Am I the most appropriate person to speak on this topic, even if I am knowledgeable and passionate about it? By taking my place on a panel, who among historically disenfranchised communities loses the opportunity to share their wisdom? Whose perspective has taken a back seat to my own? How can I use my influence to amplify a voice that isn’t often heard?
My hope is that this event sparks the necessary and deeper conversation about how we do our work differently, starting with how we center and amplify expertise.
Sincerely,
Daesha Ramachandran, MHS PhD
Health Equity Strategist, Health Share of Oregon
