Why Do We Focus on Equity?

Since 2018, when we first started contracting with clinical and community providers, we have asked for twice-yearly updates reporting on progress, challenges and how to mitigate them, and what aspects of innovative work can be sustained without Medicaid Transformation Project dollars. The past two years have been challenging for staff and the people they serve.

Every six months one partner or another will raise the question of why we focus so much on equity when we could be looking for administrative or legislative fixes for reimbursement or access issues. I get an email from one of my staff, each reporting period, asking “what should I say to this partner in response?” I usually have a long-winded answer, but the crux of the matter is this – we cannot create a culture of belonging without advancing our understanding of communities around us, their history, and the structural barriers that have disadvantaged them over decades or centuries. We cannot work in true partnership to co-design or co-create new initiatives or projects unless we understand who gets left behind by common ‘one-size-fits-all’ approaches.

The last couple of months have been brutal. People are struggling, suffering, and dying – violence, extreme heat and flooding, and limited or no access to basic needs. Our region’s two northern counties still have thousands who are displaced by flooding in the fall, looking for permanent housing and that is on top of those who were looking for housing already. This impacts all of us, which is why we all have to understand and see our roles in what happens next.

We have the contradictions of close to 20 mass shootings over Memorial Day weekend, coupled with the knowledge that Congress has been deadlocked on gun legislation for close to 30 years. While they are stymied, children were being killed on the streets and in school buildings. I wonder if Congress would be deadlocked if they were debating the best ways to nourish, feed, and educate children. I want to believe that well-intentioned, smart people represent us in Congress and I want to help them focus on the questions and issues that will make communities safer and healthier, and allow people to thrive.

I collect photos of my family – we are a diverse collection of people connected by love. Perhaps for that reason, I also am moved by images that others create and share during these tough times and I want to share some with you. Not because I am trying to influence your point of view or politics, but because they are all asking questions that point to what I call ‘the creative tension’ in most decisions. Rarely is there a decision made where one solution benefits everyone; typically the choice made will advantage some and might disadvantage others, especially if we aren’t paying close attention to intended and unintended impacts.

I know that I gravitate toward images that affirm my viewpoint, but sometimes they challenge my thinking too, which I appreciate. I would also appreciate you sharing images or thoughts that have moved you and that you’d like to share. North Sound ACH has tried to stay in a nonpartisan space, which I also appreciate, but addressing gun violence and the public’s safety is a debate that will occur in many settings over the coming years. I have to believe that we will come out on the other side with a brighter future ahead, but it won’t happen if we stay within a debate designed by lobbyists from any side. We need to come at this as community members who actually care about the people in our communities – all the people, leaving no one behind. I hope you will join in those dialogues with an open heart and an understanding of our history of laws and policies that have left legacies of structural and systemic exclusion in many communities.

We emphasize equity so that our team, board, and partners understand the past and present, and find ways together to make the North Sound region a place where all people feel a sense of belonging and find ways to thrive, leaving no one left behind. We believe we can craft new legacies to leave for future generations.