Creating Diversity in Public Health Leadership: A National Priority for Health Equity and

Environmental JusticeDr. Britt Rios-Ellis

Dean, College of Health Sciences and Human ServicesCalifornia State University, Monterey Bay

Co-Director and Founder, Center for Latino Community Health, Evaluation, and Leadership Training

2015 National Environmental Justice Conference

Education and the Environment

• “There is an old saying that the course of civilization is a race between catastrophe and education. In a democracy such as ours we must make sure that education wins the race.“ John F. Kennedy, 1960

• Educations leads to longer lifespan and lower rates of morbidity(Lleras Muney, 2005).

What Does Our Environment Have to Do with Who We Become?

• We discuss place-based health, but not place-based training and education.

• "What we are finding is that these stereotypes actually reflect something much deeper, and that local context shapes us in dramatic ways. Place does shape people at a fundamental level,“ (Plaut, 2014).

Environmental Issues• Neighborhood dictates quality of

schools, career role models, social network contexts, neighborhood safety, expectations in terms of behavior and educational achievement.

• The lack of available peers as role models in environmentally related careers dictates the lens through which questions are asked and programs are developed.

Catastrophe

• Zip code, not genetics, predicts a longer lifespan of up to 20 to 30 years. (Mikulich, Cassidy, & Pfeil, 2013).

• Income however, overrides zip code with a 10% increase in income raising educational attainment regardless of race.”

4%12%

53%

109%

3%16%

58%50%

1%11%

43% 43%

-50%

-30%

-10%

10%

30%

50%

70%

90%

110%

130%

150%

White Black Latino Asian/Pacific Islander

Decadal Population Growth Rates by Race/EthnicityUnited States, 1980-2010

1980-1990 1990-2000 2000-2010

THE GAP MATTERS

AGAINST A CONTEXT OF GROWING INEQUALITY

Educational Attainment by Race/Ethnicity/Nativity, 2006-2010

0%

5%

10%

15%

20%

25%19

17

1920

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1926

1929

1932

1935

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1947

1950

1953

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perc

ent o

f inc

ome

Income Distribution in the U.S., 1917-2012

Top 1% (incomes above $394,000 in 2012)

Top 5-1% (incomes between $161,000 and $394,000)

Top 10-5% (incomes between $114,000 and $161,000)

Source: Emmanuel Saez, Striking It Richer: The Evolution of Top Incomes in the United States (Update : September 15, 2013.

Context

Perceptions of Discrimination Increase with Age and Permeate our Learning Environments

Who is a Scientist?

Few Role Models

• Defining Academic Darwinism• URM faculty are still severely

underrepresented – URM students and their families don’t often see a

reflection of themselves within their faculty– PEDS data show markedly low levels of URM

faculty: 5% African American, 3.6% Latino, and 0.4% African American• Particularly low representation in R-1

environment where research solutions to health disparities are presented and funded

Finding an Occupational Home

• Occupational stress levels are high leading to reduced productivity, and low retention of URM faculty

• URM and first generation-educated students report higher stress, depression due to racism, and microaggressions, and higher physiologic manifestations such as high blood pressure

• URM faculty are used to “represent” but are not mentored and fully integrated

• Dissatisfaction with family/work/life balance

• Faculty and students of color need to know what is expected of them in order to facilitate academic success and leadership.

• Reviewing or relearning something should not be viewed as remediation but rather framed as a meaningful part of achieving academic goals.

Barriers to Academic Success

A Vital Part of Our Nation’s Health

• URM are needed to change the current paradigm and develop relevant solutions to address contemporary issues– Diverse lenses are needed

• Cultural and gender capital, persistence strategies, and demonstrated resilience are valuable to academic understanding

• Academia presents a discriminatory environment due to unclear expectations, a Darwinistic ‘survival of the fittest’ atmosphere, an un-level playing field, curve grading, and exclusionary practices that inhibit the development of a sense of belonging.

• Recognize that the youth of today are dealing with race/ethnicity in very different ways than we were taught within our PC culture.

Addressing Discrimination

• Women report that gender biases leading to credit and opportunity given to male colleagues over female counterparts is equally damaging as racism/ethnocentrism.

• Minority students and professors, even when they are the majority, often feel tokenized by leadership.

Addressing Discrimination

• Diversity programs aren’t just “nice things to do”– The US has consistently framed diversity

programs as something that benefit the few. It’s convenient and perpetuates an “us vs. them” perspective.

– There is a need for diverse perspectives in the biomedical and behavioral sciences if we are to solve contemporary problems associated with health disparities.

History of Diversity in US

• Leaders committed to diversity will stay places where they can make a difference, as they see their commitment to good science intricately tied to diversity among URM.

• Young Latino professionals should be encouraged to challenge their own perceptions of geographic diversity.

Diversity

• Good mentors are those who create a sense of belonging, direct programs that attempt to avoid URM isolation, and sincerely believe in URM ability.

• A good mentor knows you need more than one mentor and will refer you to other colleagues.

• Mentoring has not been historically valued within the biomedical and academic culture.

Mentoring

• Effective mentorship programs work with students’ families and their support systems.

• Mentors must be leaders so they have the leverage needed to create transformative change.

Mentoring

• Need to move from cultural competence to cultural responsiveness.

• Cultural responsive practices are both morally and economically sound.

• Cultural responsiveness translates to more efficient health care and government service.

Cultural Responsiveness

• Institutions need to honor and highlight cultural assets and not work from a cultural deficit model. – This includes recognition that URM, particularly

first generation-educated URM, are highly resilient and persist against heavy odds.

• Culturally-relevant education and integration of families is critical to URM success and familism and collectivism are vital to professional and institutional success.

Cultural Capital and Assets

I apologize for not reaching out sooner. I feel like I’ve been going non-stop ever since I left L.A. in 2007 (after completing my Ph.D. at USC and on to law school in Utah)! I went from law school, to getting married and having a baby all in a span of 3 years. And then studying for the Utah bar was no joke. I practiced mostly tribal and SSI law for underserved populations. Then I worked with the Dept. of Veterans Affairs in Salt Lake City. And in 2012, we moved to Baltimore, were I started working at CMS and I really enjoy working at this Agency! We were in Baltimore for 2 years, and we had another child. Four months ago, I transferred to our office in Dallas so we could be closer to extended family. I finally feel like I have time to breathe and reach out to folks to say hello. With family and work, I’ve had very little time for anything else. But, I finally made time! I was reminded to reach out to you when I received an email about your speaking in DC. I am involved with a workgroup at CMS designed to recruit and retain Hispanics within CMS, and one of our DC contacts forwarded your speaking event to our group. You have no idea how happy I was to see your name on the speaker list! Unfortunately, I won’t be able to make the trip out, but would love to hear about the strategies you propose.  I shall always remember, quite fondly, all the opportunities LHPP gave me way back when, and your guidance and passion have always been evident. You showing us a way to be better prepared to meet the challenges we, as Latinos, will face in the future was a great starting point to my career. Thank you!

• Questions? Comments….

¡MIL GRACIAS!