State-Of-Black-Oregon-2015

ESSAY 1HOW SOCIAL JUSTICE CANLIFT UP BLACK HEALTHLatricia Tillman, MPH, Director of Public Health,Multnomah County Health DepartmentLawrence Wallack, DrPH, Director,Center for Public Health Studies, Portland State University16At the core of public health is anupstream-downstream problem: we’reoften so busy pulling drowning peopleout of the river downstream thatwe don’t have time to go upstream, see what’scausing them to intially fall in, and do somethingabout it. For any community to improve its health,it’s necessary to make a difference upstream.It’s not news that poverty and racism arestressful and killing us, and that collectively,African Americans have less access than othersto political and economic power. It may beless well known that crucial to our health as acommunity is the health of our mothers—evenbefore they become mothers—and the health oftheir babies, even pre-conception through thefirst 1,000 days to roughly 2 years of age.Important new findings in biological and socialsciences have linked key environmental factorswith the very early development of chronicdiseases, such as obesity, heart disease, diabetesand some cancers. This research further linkssome of the same factors to a range of problemsrelated to brain development, school success andmental health. Our community, family history andcurrent environment may shape our health morethan our genes do. A recent Robert Wood JohnsonFoundation national commission concludedthat our zip code may be more important thanour genetic code in determining our health.PROTECTING THE FIRST 1,000 DAYSThe risk of deadly and disabling healthproblems is established much earlier thanpreviously understood. We now know thatthe most critical developmental period ispre-conception up to about age 2—the first1,000 days.The two main risk factors involvenutrition and stress. Biological changesin the developing baby are related to thenutritional flow from the mother to thefetus. Just as the mother is the environmentof the developing fetus, the communityis the environment of the mother. Thesebiological changes also reflect the intense“toxic” stress on the mother brought onby environmental conditions like racism,inadequate housing, unemployment and lackof options and opportunity.WHAT DOES IT MEAN IN OREGON?We understand what community means toour senses. It’s the sound of our music and ofneighbors greeting each other from across thestreet. It smells like barbecue. It’s a fierce andfriendly game of spades at a block party or asmile as you walk into church. It makes you feelfamiliar, welcome and known.