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Health Equity is a Journey Not a Destination: True Dialogue Can Make for a Nicer Ride

5/31/2017

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By Shannon Kolman, CALPHO Project Manager
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Health equity has become a popular and widely used term in recent years, however if you ask a group of people what health equity is you’re likely to get a variety of definitions. The definitions that I prefer the most talk about health equity as a state in which all people, regardless of race, ethnicity, religious beliefs, income, or address have the opportunity to attain their full health potential. This requires valuing all people and addressing inequalities.

Staff at CALPHO have been intimately involved with health equity work over the past few years through participation in The Colorado Trust Health Equity Advocacy (HEA) Cohort, which includes 18 organizations from areas throughout Colorado. The work of the Cohort is not easy, in fact it’s darn hard. Health inequities stem from centuries of policies, systems, and beliefs that were often intentionally designed to result in more opportunities for some and less for others. As Nelson Mandela said, “poverty is not an accident. Like slavery and apartheid, it is man-made and can be removed by the actions of human beings.” The same is true of health inequities. However, addressing the insidious and deeply rooted nature of health inequities requires looking at infrastructure in our society, and this is no small matter. There is no easy fix. There isn’t one program that will make even a large dent, only many seeds, planted one by one, that eventually lead to a different landscape.

As groups like our HEA Cohort start to emerge among local public health agencies (LPHAs), we have heard an all too familiar tune. It goes something like this: “our health equity team is only talking, we’re not doing anything”, and “health equity work is much too process oriented, we want action”.  We know the feelings well. Our HEA Cohort struggled for years with the process of understanding what health equity really is, with developing enough trust to talk about really difficult issues, and dialogue that was necessary to lift up underlying issues.  Unfortunately, this process cannot be skipped if we truly want to work toward health equity.  Fortunately, the talk is more than just talk.
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I recently heard a presentation about using dialogue as a vehicle for change. The presentation helped me understand that, if done properly, dialogue is action. To conduct effective dialogue, it’s important to understand: 
  • Dialogue is not a conversation. A conversation is more casual and often includes focusing on differences or taking sides. Dialogue is directed and channels energies to provide a context from which new associations and ideas can be presented.
  • Dialogue is not a didactic type of discussion which focuses on a unilateral exchange of information. Dialogue is a mutual exchange of information in an environment that encourages everyone to learn and embrace what is not known.
  • Dialogue is not a debate which has an emphasis on persuasion.
  • Dialogue emphasizes listening. This includes listening to others, with respect of their views and experiences, as well as listening to ourselves through reflection.
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If these ideas about dialogue are interesting to you, take a look at the book Dialogue: The Art Of Thinking Together by William Isaacs, who presents these and other concepts to get people talking together for real change.  In the meantime, enjoy the ride, sprinkle some seeds and see what grows.
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  • Home
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    • Strategic Focus
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    • CALPHO Board
  • Contact
  • Local Public Health
    • History
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    • Community Health Strategists
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    • Advocacy Partnerships
    • Health Equity Advocacy
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  • Resources
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    • Newsletter
    • Public Health Jobs in Colorado
  • Transformation
    • Structure
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    • Focus Groups