Health Equity and Healing Hate: A Conversation with Norman Oliver
February 20, 2020 | ASTHO Staff
As Black History Month comes to a close, it’s important to take stock of how far we still have to go in achieving health equity and optimal health for all across racial lines. The reality is African Americans still lag behind other races across many health outcomes: maternal mortality, obesity, hypertension, to name a few.
To get a better understanding of this, ASTHO staff spoke with Norman Oliver, MD, MA, the state health official for the Virginia Department of Health. Oliver is an expert on health inequities and was the keynote speaker for a recent conference at the University of Virginia called "Healing Hate: A Public Health Perspective on Civil Rights in America." Oliver spoke with us about the major health disparities that still exist, why public health needs to think bigger to solve them, and how his department is working towards those health equity goals.
Here’s our conversation with Oliver below.
More than 50 years have passed since the landmark Civil Rights Act of 1964. How far do you think we have advanced as a country in reducing and/or eliminating racial and ethnic health disparities?
Although the Civil Rights Acts of 1964 and 1968 officially ended de jure segregation, de facto segregation continues to exist. I believe that racial residential segregation and, thus, racial segregation in the schools is as prevalent today as it was in 1964. Racial residential segregation and the economic and social disinvestment in communities of color are major drivers of the racial and ethnic health inequities we see in virtually every disease category. While there have been improvements in the health of racial and ethnic populations, the disparities between those populations and the white population continue to exist.
As one of your agency priorities, how is the Virginia Department of Health tackling this issue?
We promote equitable health in collaboration with community partners at both the state and local levels. We've joined with community-based organizations, large employers, hospital systems, other clinical providers, faith-based organizations, philanthropies, other state agencies, and other groups to take action to meet the health-related social needs of the populations we serve, as well as to address key social determinants of health such as the lack of affordable housing or food insecurity.
Recently, you were a keynote speaker at conference focusing on impact of racial and ethnic discrimination in driving public health disparities. What are the new civil rights issues emerging in 2020 that impact health as health determinants?
Unfortunately, the civil rights issues are not new. They are the same ones we confronted in the civil rights movement: segregation in housing and education; unemployment and underemployment; unequal pay; under-resourced educational institutions, leading to poor educational achievement; lack of healthcare and other insurance; food insecurity; lack of affordable housing; increasing disenfranchisement from the right to vote; and the list goes on and on.
In closing, how do you suggest we heal hate using a public health approach?
I think we need more than a public health approach…public health needs a civil rights approach. The Civil Rights Act of 1964 was the result of massive civil action, involving millions of people. We need renewed mass action to rid ourselves of de facto segregation and other economic and social conditions that are the major drivers of population health and well-being.
Bonus: Do you have an African American leader from history or present-day that inspires you?
Malcolm X. It's fitting that I'm completing this as we approach the anniversary of his assassination.