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Suggested Citation:"Appendix C: Continuing the Conversation." National Academies of Sciences, Engineering, and Medicine. 2019. Achieving Behavioral Health Equity for Children, Families, and Communities: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25347.
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Appendix C

Continuing the Conversation

Camara Jones, during her keynote address (Chapter 2), asked the audience a number of discussion questions to consider as they participate throughout the workshop. To engage stakeholders (researchers, policy makers, providers, professionals, community leaders, families, students, etc.) in conversations around health equity, these questions are delineated below.

THE CLIFF ANALOGY

Jones developed the Cliff Analogy as a way to illustrate how different levels of heath interventions can improve or worsen the health disparities. In relating the analogy, she posed the following questions to workshop participants to consider.

Related to the three dimensionality of the cliff:

  • How did the cliff become three dimensional in the first place?
  • How have historical injustices been perpetuated by present-day contemporary structural factors?
  • Given the cliff’s three-dimensional structure, why are there differences in how resources are distributed along the cliff base?
  • Why are some populations being pushed away from the edge while others are pushed closer to the edge?

Related to health interventions described in the analogy:

  • Why do we spend so much money on ambulances?
Suggested Citation:"Appendix C: Continuing the Conversation." National Academies of Sciences, Engineering, and Medicine. 2019. Achieving Behavioral Health Equity for Children, Families, and Communities: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25347.
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  • How can we, as a nation, understand the aphorism “an ounce of prevention is worth a pound of cure?”
  • How can communities begin to recognize health problems before someone has fallen off the cliff of good health?
  • How can we push people away from the edge of the cliff rather than catching them before they fall off the cliff?

Jones also suggested that individuals and communities might ask themselves the following questions:

  • Is there a net above us? How strong is the net? Is there a fence?
  • How close is the population to the fence?
  • What part of the cliff are members of the community operating on right now?
  • How should health resources be allocated? How much should be allocated for ambulances? How much should be allocated for moving the population away from the cliff?

ALLEGORY ON RACISM

Jones posed two questions based on her story about the restaurant with the open/closed sign at the door:

  1. How does one born “inside the restaurant” know about the two-sided nature of the sign?
  2. When considering the definition of racism, it can be generalized to define other kinds of structured inequity, like sexism. How does this definition apply to other kinds of structured inequities?

THE GARDENER’S TALE

Jones uses a story she created called The Gardener’s Tale to illustrate the causes and effects of institutionalized, personally mediated, and internalized racism. She asked the audience to consider the following questions:

  • Who is the gardener? Who has the power to decide and to control resources?
  • Why should the red flowers share their soil?
  • What if the gardener now is not the original gardener who planted the seeds?
  • How can one compel the gardener to equalize the resources for both the red and pink seeds?
Suggested Citation:"Appendix C: Continuing the Conversation." National Academies of Sciences, Engineering, and Medicine. 2019. Achieving Behavioral Health Equity for Children, Families, and Communities: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25347.
×
Page 97
Suggested Citation:"Appendix C: Continuing the Conversation." National Academies of Sciences, Engineering, and Medicine. 2019. Achieving Behavioral Health Equity for Children, Families, and Communities: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25347.
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Page 98
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In November 2017, the The Forum on Promoting Children's Cognitive, Affective, and Behavioral Health, in collaboration with the Roundtable on the Promotion of Health Equity, convened a workshop on promoting children's behavioral health equity. The workshop used a socio-ecological developmental model to explore health equity of children and families, including those with complex needs and chronic conditions. Particular attention was paid to challenges experienced by children and families in both rural and urban contexts, to include but not limited to poverty, individual and institutional racism, low-resourced communities, and hindered access to educational and health care services. Workshop participants also engaged in solution-oriented discussions of initiatives, policies, and programs that aim to improve social determinants of health, opportunities for behavioral health promotion, and access to quality services that address the behavioral health of all children and families. This publication summarizes the presentations and discussion of the event.

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