As we prepare for the 2018 Public Health Law Conference featuring sessions focused on health justice, Network attorneys reflect on their work and what health justice means to them.
Q&A with Mathew Swinburne, Associate Director, The Network for Public Health Law — Eastern Region Office.
Q: What does health justice mean to you?
. . . Eating alone is a disappointment,
but not eating matters more,
is hollow and green, has thorns
like a chain of fish hooks
trailing from the heart,
clawing at your insides.
Hunger feels like pincers,
like the bite of crabs,
it burns, burns and has no fire.
Hunger is a cold fire.
Let us sit down soon to eat
with all those who haven’t eaten;
let us spread great tablecloths,
put salt in the lakes of the world,
set up planetary bakeries,
tables with strawberries in snow,
and a plate like the moon itself
from which we can all eat.
For now I ask no more
than the justice of eating.
Pablo Neruda - The Great Tablecloth (Read the full poem. It is worth it.)
We live in one of the wealthiest countries in the world and 41.2 million Americans struggle to secure enough food to feed themselves and their families.
It is not surprising that this food insecurity has devastating health implications. Food insecurity is associated with higher risks of hypertension, coronary heart disease, hepatitis, stroke, cancer, diabetes, arthritis chronic obstructive pulmonary disease, and obesity in adults. The effects are equally tragic for food insecure children who are at a greater risk for a range of mental health disorders and chronic diseases, including obesity, cardiovascular disease, and cancer. Food insecurity can also impair a child’s physical and cognitive development.
Food insecurity is a public health challenge that exhibits all too familiar disparities. According to the United States Department of Agriculture, 9.3% of non-Hispanic white households were food insecure, compared to 18.5% of Hispanic households and 22.5% of non-Hispanic black households. While this dynamic reflects the racial contours of poverty in our country, it also alludes to another related issue: food access.
Food access relates to the geographic availability of affordable healthy food within a community. The concept is often discussed in terms of food deserts, areas with few healthy food resources, and food swamps, areas with an abundance of unhealthy food options. Unfortunately, research shows that people of color are more likely to struggle with healthy food access than their white counterparts.
This means, not only are people of color less likely to be food secure, it is harder for them to access healthy-affordable food. Given these realities, there are predictable racial disparities in diet-related health issues. For example, the obesity rate for adult non-Hispanic black Americans is 38.3%, while the obesity rate among non-Hispanic white Americans is 28.1%. Disparities in diabetes prevalence reiterate this inequity with people of color suffering from the condition at shockingly higher rates than white Americans do. For example, the diabetes rate is 6% amongst non-Hispanic white women compared to 13.2% of non-Hispanic black women and 15.3% of Native American/Native Alaskan women.
Food is many things. Food is culture. Food is comfort. Food is family. Food is health. Food is justice.
Q: What are some of the key issues or initiatives you’ve been working on at the Network?
Working at the Network, I have had the opportunity to work on a diverse collection of public health issues, including local public nuisance authority, intimate partner violence, lead poisoning, and medical cannabis. However, my primary interests are food safety and security. My food safety work has run the gambit from analyzing the Food Safety Modernization Act, the Food and Drug Administration’s regulation of trans fats, raw milk deregulation, the federal regulatory inefficiencies related to catfish, and state and federal regulation of certain fertilizers. In terms of food security, I work on issues related to the major federal nutrition programs, like the Supplemental Nutrition Assistance Program (SNAP). In particular, I am interested in ways they can be used to incentivize healthier eating and the utilization of technology within programs to improve food access.
Q: What is one of the most important things that we as a nation should be doing with regard to public health policy?
Address privilege. Social justice is at the very core of public health, and to advance the health and well-being of our communities, we need to address societal systems that perpetuate inequity. This is more than identifying disparities. Social justice, and by extension public health, requires the acknowledgment of privilege. In our society, there is privilege attached to race, to gender, to religion, to sexual orientation, to income, to able-bodiedness . . . . Privilege is often imperceptible to those who enjoy it. This failure to recognize and address privilege propagates and maintains societal structures that perpetuate health inequity.
Acknowledging and owning this privilege can be uncomfortable and disruptive to our concepts of self. However, rather than allowing the exploration of privilege to paralyze us with guilt or discomfort, we can utilize it as an opportunity to be responsible, informed advocates for a more equitable and just system.
2018 Public Health Law Conference — Health Justice: Empowering Public Health and Advancing Health Equity
As part of our work on issues like food insecurity, we are dedicating the 2018 Public Health Law Conference to programming that examines how laws and policies both impede and advance health justice.
Read Mathew’s recent blog on food insecurity.
Leveraging E-Commerce to Fight Food Insecurity
We’d like to hear from you!
What does “health justice” mean to you? Your feedback will help guide our programming for the year and will inform our planning for the 2018 Public Health Law Conference.