SARAH VERBIEST

Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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american-flag

A few symbols of my identities as a runner, friend, teacher and activist: inspirational jewelry from BFFs, my sneaker wings, and the pussy hat my students made for me.

The transfer of power from President Obama to President Trump today has made me reflect on my different identities.  As a cis woman and feminist, my heart is heavy as the biggest glass ceiling in our country remains intact. The promise of a Cabinet with half of the seats filled by females is lost. As a white mother, I am very aware of my privilege today – particularly as I look at a sea of faces that look like mine standing against the backdrop of Congress. In my professional identity as a public health social worker, I worry about funding for many different programs that seek to support and elevate those in need. As a Democrat, well, dang – it stinks to lose, especially when Rachel Maddox said for months that we would win.

But I think the identity that I need to most consider today is that of being an American. I was born in Michigan, raised in upstate New York, and gave birth to my children in North Carolina. I was educated in American schools and universities. I’ve paid taxes and used my financial resources to support capitalism – even McDonalds once in a while. My grandparents were square dancers, and one of my favorite runs is along all the monuments in DC. I may try to fake it when I travel but my fundamental Americanism is hard to hide – that darn optimism and clothing style.

american-flagYet, I’ve noticed a deep division within myself over the past few months about which kind of American I wish to identify with – and those from whom I find myself desperately trying to distance myself. I feel an inner fissure that is new and really uncomfortable. I feel angry and sometimes even think in passing that if bad policy decisions are made now, the people who voted a certain way will just learn the hard way. How awful! I hate to admit this feeling but it is there.

President Obama urged all Americans to  “Understand, democracy does not require uniformity. Our founders argued, they quarreled and eventually they compromised, and expected us to do the same. But they knew that democracy does require a basic sense of solidarity – the idea that for all our outward differences, we are all in this together; that we rise or fall as one.” So I have to do my inner work here, too, if I want to fully lean in to my identity as an American. The divide can’t close entirely but I need to better understand it.

Regardless of how I feel, my Americanism also means that I can’t just sit on my couch for the next four years drinking wine and binging on Netflix. Being an American means that I have to be a more active citizen. I must engage more now than ever. Democracy may be messy and hard and imperfect…but what is the alternative?

Sarah Mink from Bitch Media offered some great suggestions for taking concrete action. These include writing actual, thoughtful letters to the people who represent us, as well as diversifying our media and getting out of our echo chambers. She suggests that we offer our skills and give money to the local groups and causes that matter to us. She also challenges us to fight racism and learn from communities who have had to resist for decades. To be clear, I am NOT saying that to be American I have to resist Trump nor that you should do everything she suggests. But as an American I do hold responsibility for participating in democracy and seeking to uphold and move forward our ideals of “liberty and justice for all”.

As Obama said, “The work of democracy has always been hard, contentious and sometimes bloody.  For every two steps forward, it often feels we take one step back.  But the long sweep of America has been defined by forward motion, a constant widening of our founding creed to embrace all, and not just some.” I know that my country has many problems – we were founded on a fault line of slavery and the murder of indigenous people. But I also fervently hold true to our highest IDEALS and my belief that the “arc of the moral universe is long but it bends toward justice,” as Dr. King so eloquently stated.

And for all of that, today I am going to wish our new President the best. Whether that makes you happy or sad, it doesn’t ultimately matter – as Americans he is our President now. I hope his heart is somehow moved to focus outside of himself as he assumes this most awesome and heavy responsibility. I pray that he can find words of unity in the future. And I offer my expectations that all of us – from members of the US Congress to the regular “person on the street” – wake up and stay that way.

Smiling Mother Playing With Baby Son At Home

Black women and their babies have suffered centuries of injustice. Black women’s voices are co-opted, but not heard. Change must happen.

Facts are facts, Black women living in the South face historic, ongoing challenges to their health and wellbeing. While we can argue that all women in the South could have better health outcomes, the reality is that Black women and their babies have suffered centuries of neglect and injustice. Further, Black women’s voices are often co-opted, paraphrased, summarized but not heard. There are insightful and important solutions, strategies, and stories out there that most of us never take the time to hear. Change must happen.More Link

switchpoint photoWhen was the last time you attended a conference where you were challenged with new ways of thinking, seeing your work and the world around you? The SwitchPoint conference hosted by IntraHealth recently convened unusual people from many different industries to create social change. I had the opportunity to participate and my head is still spinning (in a good way). The two day conference included power talks from scientists, artists, activists, engineers, entrepreneurs, gamers, researchers and emerging young global leaders. This was combined with microlab learning opportunities to bring people together to brainstorm as well as a number of impromptu group activities created interesting connections. More Link

GSGoldAwardWhile Girl Scouts cookies are without a doubt delicious and somewhat addictive (fess up – how many of you have eaten a whole sleeve of Thin Mints in a day), Girl Scouts as an organization has a long and proud history of providing girls with learning and leadership opportunities from Daisies (kindergarten) to Ambassadors (high school seniors). More Link

Children Discovering Starfish On BeachThere is a story that has been told for years in many different settings. Two people are walking along the beach and come across a large group of starfish that have washed onto the shore. One person begins to pick up a starfish and toss it back into the sea. The second person questions the value of the effort in making a difference, as there are clearly many more starfish that need to go into the water than the person can manage. The star fisher thrower responds as he/she tosses in another starfish, “it mattered to that one”.

While this story is often used to inspire staff that may often feel overwhelmed by the work ahead, it is a story that needs a new ending in my opinion. Perhaps this is a bit sacrilegious but I just need to say it. Yes, it absolutely is important when our actions can make the difference in a person’s life. But this story largely reinforces a focus on the individual (saver and saved) – the current framework in health care, social work and often even in public health. If we wish to make larger change, saving one starfish at a time is no longer adequate. Looking at this from an equity frame we might consider the possible bias of the starfish thrower. Is he/she selecting starfish randomly or perhaps unconsciously being drawn to the more colorful starfish or the bigger starfish, and picking those up first to save? From a prevention-focus the person could ask why the starfish are washing up on the beach in the first place? Is there a problem in the water? Are they escaping from a big predator? Or, it an unfortunate combination of sand erosion and wave pattern? Until that problem is addressed the few starfish being tossed back just might end right back up on shore! From a consumer perspective it might make sense to ask the starfish if they want to be thrown back. Perhaps they all wanted to be on the beach to enjoy the sun or stars.

Finally, thinking about collective impact, if getting those starfish back into the ocean is essential, then call out for partners. Get shovels. Get boogie boards. Rally other beach goers to lend a hand. In truth, ALL the starfish on that beach matter. Small victories are critical for helping avoid burnout and to know we are making a difference in spite of big odds. But there are many forces out there that have also made this THE time to think about prevention and population health. It is time for a new story.

 Sarah Verbiest, DrPH, MSW, MPH is the Director and Co-Founder of the Every Woman Southeast Coalition. She is also the Executive Director for UNC Center for Maternal and Infant Health and the CDC Senior Consultant to the National Preconception Health and Health Care Initiative.

HannahAs someone with a background in youth development and a love for promoting maternal and reproductive health, the fields of maternal/child public health and social work come together to encompass many of my deep interests. Professionals in both fields of social work and public health are working to advance individual and community health and healing, advancing social justice and health equity. Social work and public health seem inextricably bound to each other, as both are concerned with the confluence of social justice, physical health, and mental health.

However, throughout this past year in my study of maternal and child public health, the role of the criminal justice system was surprisingly absent from our discussions. As described in our newsletter this month, the criminal justice system has grown exponentially in our country over the past 40 years. In considering issues of health equity, there has been a striking absence of conversation in mainstream public health discourse about the devastating role that mass incarceration has had in communities of color in our country, particularly in African American and Native American communities, and the disproportionate rates of criminalization of young adults who identify as LGBTQ. It is promising to realize that the conversation is beginning to change, with the increase in national publications, and the release of the lecture series by Columbia University that examines the health impact of incarceration on individuals, their families, and communities.

Although our newsletter focuses on women and incarceration, the inequities in our system are even more drastic when looking at the rates of arrest and imprisonment of young men of color. The mass incarceration of young men, particularly young African American men, is inexcusable. Further, the negative impact of incarceration on individual, familial, and community health in our country are only beginning to be explored in public health research. Leaders in the field of public health are well positioned to strengthen collaborations with those working on criminal justice reform, to advocate for change in laws and policies that promote inequity in our communities, and to begin the work of promoting healing in our communities.

I hope that this newsletter and the resources we link to will help to spark more conversations about how public health leaders can become valuable agents of change in addressing the problem of mass incarceration. For more on the work to be done from one of the leaders in criminal justice reform, Bryan Stevenson of the Equal Justice Initiative offers inspiration and insight in his TED talk, “We need to talk about an injustice.”

Hannah Legerton is a graduate intern at the Center for Maternal and Infant Health, and is completing a graduate dual-degree in Maternal Child Public Health and Social Work at UNC, Chapel Hill.

By Kathy Hodges – Co-Executive Director, Family Violence & Rape Crisis Services

Violence in relationships is a reality for far too many women in our community, especially young women. The CDC estimates that at least one in every 3 women will be the victim of violence in a relationship at some point, and our history at our agency suggests that for many women violent relationships often start in their teens and twenties. This violence often impacts all aspects of a woman’s life and makes it difficult for her to seek health care, find support from her family and friends, or to support herself and her children financially.  Her partner may not only control where she goes and who she talks to, but may limit her access to contraception and coerce her into unwanted sexual activities.

Women who are being abused by their partners often carry around shame and guilt for their violence. They are isolated from community supports, and feel they have nowhere to turn.  Our communities must be prepared to recognize violence and provide support for victims in order to turn around this epidemic of violence.  We all must know the signs:

  • Injuries that don’t match the explanation or recurrent injuries 
  • Fear or anxiety about a partner’s response to a situation
  • Reluctance to participate in activities without a partner’s permission 
  • Withdrawal from family, friends and social situations 

Each of us can be the bridge a woman needs to safety in her life. We can help her to change her situation. The first step is to listen to her and believe her.  She may never have been able to share this before, so she may need to talk for a while.  It is important to let her know that you believe her.  If anything, she is likely minimizing the violence she has experienced.  It is every bit as difficult as she is telling you.  The next step is to connect her with supportive services.  Your local domestic violence agency is a powerful resource and ally for her.  Help her get in touch with the agency by sitting with her and helping her with the contact.  Finally, she needs you to keep the door open and help break the isolation she is experiencing.  She may not be ready to leave.  She may not be ready to do anything.  Just by talking to her and listening to her, your support can help her start to see her way to safety – the first step on her path.

For March we’re featuring our Pilot Project from Tennessee, CHOICES – Memphis Center for Reproductive Health and their featured leader is Assistant Director, Jennifer Pepper.

1. How long have you been in your current position? What brought you to the organization and your current work?

I have been with Choices, formerly the Memphis Center for Reproductive Health, since 2006. I came to the organization to serve as their Community Outreach Coordinator, and in 2010, I become Assistant Director. My path as a women’s health educator and advocate began when I was a young adolescent. My mom was the cool mom. She was open and honest about sexual and reproductive health from an early age with me, my brother, and our friends. It drove me crazy as a teenager, but today, my appreciation for her is immeasurable.

2. What are you most excited about or what is your favorite aspect of Choices’ project that provides reproductive life planning and warm referrals in a post-abortion care setting?

Choices is committed to providing comprehensive reproductive health care, and this project is a natural fit with our mission and vision for a healthier Memphis. Women’s reproductive lives are long, complex, and inter-related with many other needs. Everyone at Choices is excited to help women develop goals related to their reproductive live. Our patient educators are also excited to network with other local providers, so we can connect patients to other resources in the community. Providing birth control is just one piece of helping women realize their goals.

3. What do you anticipate will be the biggest challenge with this project?

This project is a major shift in patient education at our organization. Instead of asking women, “what type of birth control would you like?” We are asking, “What are your goals? When do you want to have kids?” Any large change takes time, and our staff is up for the challenge.

4. Can you share any books, articles, websites (or any great resource you’ve found) that helps with your work?

In designing our pilot project, the National Preconception Curriculum and Resources Guide for Clinicians was very helpful, and we recommend it to other clinicians interested in starting this work. We’ve also found a number of great reproductive life planning tools from other fellow reproductive health care providers. Here are just a few we really liked:

This month we’re featuring Margarita Franco, Director of Community Leadership Development at PASOs a community-based organization hosted at the Arnold School of Public Health at the University of South Carolina.

How long have you been in your current position?  What brought you to the organization and your current work?

I hold a degree in psychology from Colombia, South America and a certificate in Women and Gender studies, and I am currently working on my Master’s degree in Social Work. I have been working with PASOs and the Latino community in South Carolina for the past five years. I help at-risk Latino families, especially women, access the information and resources they need to be healthy. I am passionate about women’s health issues, and I love being a channel that empowers women to realize their potential and make positive decisions that improve their lives.

What are you most excited about or what is your favorite aspect of the Choose Today a Healthy Tomorrow project?

I am excited about the opportunity to work with the Latino community around reproductive health issues because there are some unique needs among this newly settled population in South Carolina. PASOs always tries to work in ways that are culturally appropriate, tailoring messages and approaches to the specific needs and realities of the community. One of our culturally competent approaches is creating teams of community health workers who can bring health information and resources to their peers and neighbors. In the Choose Today a Healthy Tomorrow project, the community health workers will reach their community through a local radio show. I look forward to watching the community health workers learn the new skills needed to educate others about preconception health and be a part of a radio broadcast.

What do you anticipate will be the biggest challenge with this project?

I anticipate that the learning process will be somewhat challenging because most of our community health workers have little or not experience working in the world of radio. Also, we are not sure if members of the community who are invited to call into the radio will want to do so at the beginning.

Can you share any great books, articles, websites, etc, that would help people learn more about using media to reach vulnerable populations (or any great resource you’ve found that helps with your work)?

The preconception health campaign called “Amor y Salud” (Love and Health) features a radio-soap opera, or radionovela, to reach Latina women in Oregon over the radio. It is featured in both English and Spanish.  There are two radio programs that broadcast out of Mexico that have been helpful guides for our work, “Red Nosotras en el Mundo” (Our network in the world) and CIDHAL. Both are dedicated to progressing the rights of women.

In January, PASOs will publish an article entitled, “Developing a Culturally Appropriate Preconception Health Promotion Strategy for Newly Immigrated Latinos Through a Community-Based Program in South Carolina,” in the American Journal of Health Promotion. It details how PASOs is incorporating best practices to create a new strategy to reach this population with messages on preconception health.

This month we’re featuring Mirine Dye, a Program Manager for Urban Health Partnerships and new member of the Every Woman Southeast Coalition.

How long have you been in your current position?

I joined Urban Health Partnerships (UHP) and our corporate arm Urban Health Solutions (UHS) in May of 2012. This EWSE grant project is my first venture with our non-profit arm, UHP.

What brought you to the organization and your current work?

The UHP Executive Director, Anamarie Garces, and I teamed up a few years ago to represent our graduate school of public health (Florida International University) in a Student Scholar Competition, which we placed third Campus wide. I then had the opportunity to put together a team to participate in the American Public Health Association Maternal Child Health Leadership Institute and felt Anamarie and I would be great team members. Our state project for Florida involved intersecting public health preparedness, epidemiology and maternal child health. We gained national recognition and remained in contact over the years. She reached out to me after forming her company and invited me to consider participating as a collaborator, and my grant funded position at the time was winding down so the timing was perfect. I came on board to assist with any projects that needed more staff, and was encouraged to seek grants in our areas of interest.

What are you most excited about for the Transportation Access Throughout the Life Course project?

I am most excited about the opportunity to creatively intersect two areas of public health, which usually do not get much attention together. Transportation and particularly active transportation (walking, biking, safe streets as well as public transportation) have been increasingly seen as not only a public health issue, but a public policy and urban planning focus. When we consider “access to care” usually the number of clinics or the number of providers and the cost is what comes to mind. We are looking at a broader view of access to care, meaning, how do women age 15-44 (and men) get to the clinics which are targeting them with reproductive and preconception care services? Miami-Dade has several areas of concern within this age group relating to reproductive health, and we want to see how do they access the services which are offered, and what improvements can be made. Are there plenty of bus routes or safe sidewalks? Are the areas shaded and comfortable for women and families in the Miami heat? What about bike routes for men and women to access the clinics easily? Are clinics and clients aware of these options? How easy is it to access information or plan your trip without a car? These are the questions we hope to answer with our project.

What do you anticipate will be the biggest challenge with this project?

I think we will have a couple of challenges; the first challenge being how can we engage our non-traditional health partners in this topic? We have reached out to our planners, engineers and transportation partners and we are at the beginning stages of the formation of the steering committee. I know we will have to sell them in the first meeting in order to ensure long-term participation and interest. The second challenge will be to create a marketing outreach campaign to translate our findings, and get the information into the hands of those who plan clinics and can influence street and transportation improvements.

Can you share any great books, articles, websites, etc, that would help people learn more about urban planning or transportation and the intersection with health?

Although I was not involved with this particular UHP project, I feel that the Broward Complete Streets Initiative was particularly influential in my recommendation to seek grant support for our Transportation Throughout the Life Course project. I would definitely recommend visiting the website BrowardCompleteStreets.org which then has other resources available as well. We have also set up a website for our project, and hope to list many references to help both transportation and maternal child health groups understand the significance of taking MCH out of a silo, and inserting MCH into the bigger picture of urban health and planning: Transportation4Families.org.

I am currently reading Making Places Healthy: Designing and Building for Health, Well-being and Sustainability, edited by Andrew Dannenberg, Howard Frumkin and Richard Jackson, and would recommend it for a practical, yet comprehensive, systems-level look at the built environment and health.

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