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ESSAY 8AN ECONOMIC JUSTICEFOUNDATION TO HEALTHRachael Banks,Director, Healthy Birth Initiatives (HBI)Healthy Families of Multnomah CountyShavantee, a college-educated motherof five, struggles to “get it right” asa parent. She often feels that she’sswimming upstream against a currentof life circumstances outside of her control.These include struggling to make ends meet andpolicies that make it harder to raise her kids.Shavantee’s journey has taken her through achallenging childhood, a college degree andmotherhood—trying to do all the “right things”society says you should do. When her familymembers fell ill, she stayed home to care forthem. She went to work when she could. Whenher kin needed help running their businesses,she helped them. Now that her childrenneed her in their most precious years, she’scommitted to that.In order for Shavantee to do what science saysis most beneficial and society says is mostnoble, she suffers as economic pressure andpoor housing push in on her and noticeablyimpact her family’s health.Shavantee’s pregnancies have shown howeconomic security, stable housing and asupportive family affect birth outcomes. Whenthese key conditions were met, she deliveredhealthy babies. She didn’t understand why herthird baby was born too early and too small. Sheracked her brain trying to figure out what she’ddone wrong—why this outcome was differentfrom the others. Then she saw a skit about thesocial determinants of health, and it all clickedfor her.The poor birth outcome of her third child wasnot about her individual behavior, but a result ofher living conditions. While she was pregnant,she was experiencing discrimination at work,then she lost her job of 11 years—all while she livedin a gentrifying neighborhood and watched herrent rise beyond her reach. Her health outcomeswere reflecting her economic reality.Despite this, Shavantee continues to press on.She’s resilient, strong, smart and dedicated.Public policy has a role in creating systems tosupport her. Shavantee’s story is one of manythat highlight the need for jobs and policies thatsupport healthy, stable, attached families.Over 100 years ago, Frederick Douglass said,“Where justice is denied, where poverty isenforced, where ignorance prevails, and whereany one class is made to feel that society is anorganized conspiracy to oppress, rob and degradethem, neither persons nor property will be safe.”72