Championing Equity in Boston
Leveling the playing field has always been a priority for Boston Public Health Commission (BPHC) Executive Director Monica Valdes Lupi and her colleague, BPHC Office of Health Equity Director Margaret Reid.
Valdes Lupi is a first-generation immigrant; her parents moved from the Philippines to the United States when she was 3 years old. Growing up, her family was among just a few families of color living in a small town. Racism was a factor as her family met challenges accessing services and community resources, she recalls.
Reid comes to social justice from another angle. She spent much of her 20s and 30s working as a community labor organizer, mostly with low-wage women of color. Advocating for people who were living from paycheck to paycheck, she learned firsthand how important government services were to their survival.
“It’s an issue that can’t change for people without advocacy of some kind,” Reid says.
Advocacy is what a recent BPHC health initiative is all about. Earlier this decade, after an assessment revealed disparities in how health resources were being communicated and administered among different populations, Valdes Lupi, Reid and other BPHC leaders set out to rethink their approach and establish the department as the city’s health equity hub. They identified the need to change organizational practices to align better with racial justice values, engage other city departments in the cause and create new community advocates and organizers to ensure that health equity is key in all decisions, policies and programs.
The commission turned to The Kresge Foundation in 2017, receiving about $125,000 in grant funding through Kresge’s Emerging Leaders in Public Health (ELPH) later that year. ELPH is a leadership development initiative funded through the foundation’s Health Program that equips public health officers with knowledge and skills to lead in today’s changing health care environment. Through ELPH, Valdes Lupi and Reid spent 18 months working on projects designed to enhance organizational and leadership competencies in business, planning and public health systems development. Armed with additional skills and tools, Valdes Lupi and Reid set out to inspire trickle-down leadership by emphasizing narratives.
“In the past, we haven’t done a great job in describing the innovative work we’ve done and the resources we have,” Valdes Lupi says. “Being part of the ELPH cohort has helped me be more aware of how to tell stories about what we do, and how we do it in more effective ways.”
Advancing Health Equity
“Being part of the ELPH cohort has helped me be more aware of how to tell stories about what we do and how we do it in more effective ways.” —Monica Valdes Lupi, Boston Public Health Commission
With the rest of their colleagues at BPHC, Valdes Lupi and Reid created an interagency task force to promote health equity citywide.
To ensure that community voices were being heard, they created advisory boards that equally represented mothers receiving services and physicians administering them. They also redesigned the format for community dialogues they hold to present data differently. Instead of giving hard and fast numbers, they used the numbers to tell stories designed to keep constituents engaged.
In addition, at their prompting and at the behest of the BPHC, city transportation department crews shifted from prioritizing street repairs by the number of complaints to a more chronological approach.
“Data indicated that when (the city) got complaints, most of them came from wealthier, whiter neighborhoods,” Reid explains. “Now crews are responding on a need basis (regardless of who complains), which levels the playing field quite a bit.”
Valdes Lupi and Reid engineered other major changes.
Take procurement. Each year, the commission doles out approximately 1,000 contracts for services. In the past, there had been no mandate to prioritize awarding contracts to minority- or women-owned companies. Now BPHC is being joined by other agencies in pushing to source from a more diverse roster of companies.
Valdes Lupi and Reid also redesigned new public-facing messaging. BPHC’s “Moving Equity Forward Together” social media campaign featured print and online ads and banners, as well as a video series designed to demonstrate — rather than define — racial justice and health equity in public health practice.
“These are stories of amazing work that’s going on with job training for our homeless clients, with recovery programs (and) how recovery services need to look a little different for women (than they do) for men, with how we’re reaching other lingual communities,” Reid says.
And because Valdes Lupi and Reid participated in an ELPH cohort with public health organizations from around the country, including neighboring states such as New Hampshire and Rhode Island, they will continue to sharpen their approach as they turn to colleagues to share best practices and resources.
“The world of public health is always changing,” Valdes Lupi says. “When we’re having challenges, we can connect with like-minded people who may be trying things in different places — and learn.”
With the support of other Emerging Leaders in Public Health, county and local health departments can think beyond their traditional roles and transform public health in their community.