Making Health Equity Visible: Results and Recommendations from the Unnatural Causes User Survey

Discussion

When California Newsreel began the Unnatural Causes project, scientific evidence already indicated that the social and economic conditions that surround us drive population health even more than our individual behaviors, genes, and health care access. However, the story of how society shapes our health was virtually absent from the mainstream media, and public dialogue on health was narrowly focused on health insurance and healthy behaviors. Today, while “health equity” is far from a household term, the general discourse has changed considerably.

Thousands of organizations around the country are using Unnatural Causes. Dozens have already organized ten or more events or distributed DVDs to all their member organizations or grantees. Comments from survey respondents were overwhelmingly positive: “Amazing tool.” “Great discussion starter.” “It changed how I do my job.” “Puts into simple language complex issues.” “Community partners are very grateful for a piece that highlights how racism and poverty adversely affect health.” “The most outstanding tool on social justice policies we’ve ever used.”

Clearly the commitment to health equity is large and momentum is growing. For many organizations, screening the series was their first experience engaging in health equity work. But that also meant they had to grapple with what a commitment to health equity actually implies for their organizations. Moreover, many groups had little prior experience hosting and structuring film screenings, doing outreach, convening community dialogs, and building alliances. Because health equity has not yet coalesced into a national movement able to provide guidance and leadership, many actors seem hindered by a lack of a specific action, policy, or legislative agenda around which to organize on the municipal, state and national levels and find themselves stymied by the question of what to do next.

Respondents often write to us, “We had a great discussion but wonder where to go from here,” or, “People really want to take action but are unsure how.” Unsurprisingly, many feel paralyzed by the abyss separating the conventional, immediate, and do-able (e.g., building jogging paths, starting an employee wellness program, fighting for health care access) and what appears to be aspirational, distant, and hence overwhelming (e.g., fighting for living wage jobs, desegregating neighborhoods, achieving universal pre-school, increasing job autonomy and security).

Providing ways for audiences to get involved and take action is key to transforming anger and distress into energy, engagement, and a commitment to work for social justice.  As one respondent commented:
It is critical that there be real organizing vehicles for people to be able to plug into around concrete proposals and policies. Otherwise it is just an interesting conversation. Second, there needs to be a strategy to move this frame [forward] in the context of national health reform in the current climate and context.
Clearly, those using Unnatural Causes are eager to get moving.

Advocacy for health equity is particularly challenging since by its very nature health equity demands reforms not in any one arena but in all, and is tightly linked to the movement for a more democratic and just society. Anti-poverty work, early childhood development work, racial justice, community organizing, affordable housing, residential desegregation…they’re all health equity work.

However, the wide-reaching relevance of health equity also means there are a wide variety of ways to take action. And as discussed below in our recommendations, the role of many organizations may be to keep doing what they’re doing – with new awareness and attention to the health equity implications of their work.