A Workshop Explores Racism

Jim Wuelfing, left, and Art Woodard lead a Racism of the Well-Intended workshop at Hypertherm in Lebanon, New Hampshire.

On May 20, 2019, The Public Health Council of the Upper Valley and the Hypertherm HOPE Foundation presented a free full-day public workshop, Racism of the Well-intended: Examining Privilege and Power.

“Racism of the Well-intended.” It’s a somewhat unusual title for a workshop, which is why presenters Art Woodard and Jim Wuelfing asked 100 participants in Hypertherm’s conference room to spend 15 minutes thinking about how to define the term. Many came up with a definition for racism similar to the presenters’: “any attitude, action or institutional structure which lessens or denies the power to be or do of a person or group because of their race.”

Participants seemed to struggle, though, with the term “well-intended” in this context. As the workshop progressed, we explored the meanings behind these words. We discussed microaggressions: verbal, nonverbal, or environmental communications that contain a hidden insult to the target group to which it is directed. We explored the concept of white privilege in an exercise that feminist and anti-racism activist Peggy McIntosh calls, “Unpacking the Invisible Knapsack.”

A Training Born of Friendship

Art and Jim, who have been friends for decades, offer Racism of the Unintended workshops to organizations throughout the United States. They hope the presentations serve as a model for changing relationships between people.

As part of their work, the two men conduct field studies together in which Jim, who is white, is attuned to the injustices Art, who is black, faces in daily life. In the same convenience store, Jim is not asked to show his driver’s license when he makes a credit card purchase, while Art carries a license with him at all times, as well as two other forms of ID.  Jim has witnessed Art get harassed by clerks in stores and followed by police in his car. I found it heartbreaking to hear about this inequality, but I would be naïve if I didn’t think it existed: I read about it every day in the news. And just because I don’t have the opportunity to interact with many people of color in our mostly white Upper Valley community, doesn’t mean that the scourge of racism doesn’t affect me, or that it doesn’t affect my community: Since we live in the United States, we live in a racist society.

Several people in the training wondered how best to explore the topic of racism in an area that isn’t racially diverse. Indeed, most of the participants at the workshop were white, and when we broke into smaller discussion groups throughout the day, I discussed heavy topics with others who, like me, were white. I felt I couldn’t fully explore some of the issues at hand because I couldn’t hear the perspective of someone who had experienced them first-hand. I also felt left off the hook for something I often fear when I’m in a diverse gathering: that I may hurt or offend somebody when we try to have an honest conversation.

We All Have Different Identities

The most powerful exercise of the day was when Art and Jim asked all participants to stand around the conference room in a circle. They told us they would name different identities, and if we claimed the identity they called, we were to walk to the center of room. Once there, we were to notice what we were feeling, notice who else was in the center of the room with us, and notice who was standing on the outside of our marginalized group. If we identified with one of the groups called and chose not to walk to the center, we were to take note of that, too, and consider why we kept our status hidden.

Jim began to call out marginalized identities: “If you are a woman, walk to the center of the room…”. He continued to read about 20 more identities. “If you have ever been treated for a mental illness, walk to the center of the room”; “if you were raised by a single parent…”; “if you or someone in your family identifies as LGBTQ+, walk to the center.”

I noticed I felt scared, at first, to publicly acknowledge my marginalized status in some of these categories—especially since we live in a small community. Many people in the room knew me personally but didn’t necessarily know these details about my life. Once I was in the center of the room with others in my group, though, I felt a sense of belonging within the minority.

It became easier, I felt stronger, to walk up each time to claim my marginalized status. While I was there, I noticed the people standing on the outside, and I felt somewhat exposed. I felt the others were lucky, in a sense, not to experience my particular hardship. But later, when I observed them walk to the room’s center under a category under which I didn’t fall, I was reminded of the feelings of my own marginalized status, and I felt connected to these people, even though I now stood on the outside.

The starkest examples were when Jim called for groups including African Americans, and Asian Americans, and only two or three participants stood alone in the center, surrounded by almost 100 people. I thought of how vulnerable those in the center looked: just a couple of people—surrounded by so many others. I also considered, since these were topics of race, these individuals could not choose to hide their identity: it is something that can be seen by all.

I was reminded of this image later that week when I read a column in the Valley News by Deb Beaupre about how a hateful object made her feel unsafe as an African American woman in our community. I recalled the sense of connection I felt that day in the training as participants walked back and forth, together in our very differences, united in our humanity. It was a feeling of compassion I will strive to carry with me.

Elizabeth Kelsey is a writer who specializes in mental health topics.
 www.elizabethkelsey.com

Mental Health Month is May

Upper Valley Stigma Stompers celebrate May Mental Health Month.For Mental Health Month, Donna Stamper, Public Health Council partner and volunteer with the NAMI Upper Valley Affiliate Support Group, submitted the following Letter to the Editor to the Valley News. It appeared in the Forum on Wednesday, May 08, 2019. We reprint here with permission of the writer.

 

Because May is Mental Health Month, and because 46.6 million adults in the United States experience a mental health condition in any given year, I want to share some local resources for families looking for support, information, education and advocacy opportunities for themselves and for their loved ones with schizophrenia, bipolar disorder, depression, anxiety or post-traumatic stress disorder.

These illnesses are treatable, but fewer than half get the help they need. Earlier efforts can save lives and reduce suffering.

Local Resources for Mental Health Help

Here are some ways to find help and hope.

The National Alliance on Mental Illness. NAMI-NH (naminh.org) and NAMI Vermont (namivt.org), are statewide organizations that provide information, classes, training and support groups.

Support Groups Around the Upper Valley

The NAMI Upper Valley Affiliate Support Group is for families and friends of adults who have or are coping with symptoms of mental illness and is led by NAMI-trained family member volunteers. Attending a support group is a form of self-care and a way to learn from others facing similar challenges. There are two meetings a month, on the second Monday and the last Wednesday, both from 5:45-7:45 p.m., at Dartmouth-Hitchcock Medical Center.

The NAMI Claremont Family Support Group meets on the first Thursday of each month, from 6-7:30 p.m., at Valley Regional Hospital, in the Buckley conference room.

The NAMI Connections Peer to Peer Support Group is for adults with a mental illness who support one another by sharing stories with a focus on wellness. This meeting is the second Monday of each month. from 5:45-7:15 p.m., also at DHMC.

Online Resource for the Upper Valley

See uvmentalhealth.org for contact information for these groups (click on “Support Groups”), as well as resources and events related to mental health topics.

Exploring Community Health Priorities in the Upper Valley

Improving community health is at the core of the mission of the Public Health Council of the Upper Valley. Most of our partners share this goal, but contribute in different ways to reaching that goal. Some partners are health care providers, some provide treatment for substance use disorders or mental illnesses, others support people in our communities who struggle with various social determinants of health.

Every three years, the Public Health Council works with our many partners to update a set of regional priorities that answers the questions: What are the health issues our community members are most concerned about? How can we make a difference, especially by using the strength of our collaboration? And every three years, nonprofit hospitals, like Dartmouth-Hitchcock and Alice Peck Day Memorial Hospital, are required to complete a community health needs assessment and a community health improvement plan. Over the course of 2018, the Public Health Council was able to work with these hospitals, and others in our region, to complete a joint community health needs assessment. As we move into 2019, we continue to work together to explore more deeply what the assessment results tell us and how we can share in the work of making a difference.

The Greater Upper Valley Works Together

All nonprofit hospitals in American must complete community health needs assessments and community health improvement plans. These plans identify priority needs in hospital service areas and direct the hospital’s community benefit investment in their communities. However, our region has taken this work to a new level, by combining the resources of six health care institutions in the region to complete a large scale assessment. These institutions include Dartmouth-Hitchcock, Alice Peck Day Memorial Hospital, Visiting Nurse and Hospice for VT, Mt. Ascutney Hospital and Health Center, Valley Regional Healthcare, New London Hospital. The purpose is to identify community health concerns, priorities and opportunities for community health and health care delivery systems improvement. By gathering the same data across a large region, we are able to see similarities across our many communities, identify differences (or disparities), and coordinate strategies to address concerns.

Upper Valley Community Health Needs Assessment

The Upper Valley Community Health Needs Assessment generated for the Dartmouth-Hitchcock and Alice Peck Day primary hospital service areas covers 19 municipalities in Vermont and New Hampshire, with a total resident population of 69,467 people. Data came from surveys of community residents; a direct email survey of key stakeholders and community leaders; a set of community discussion groups; a behavioral health needs assessment conducted in 2016; and a review of available demographics and health status indicators. The New Hampshire Community Health Institute conducted the survey, data analysis, and report generation. Throughout the process, they were careful to focus on vulnerable and disproportionately served populations in the region. We wanted to ensure all populations that could experience limited access to health-related services or resources due to income, age, disability, and social or physical isolation were seen in the results.

Taking It Back to the Community

Beginning in January 2019, the Public Health Council has been working with partners at Dartmouth-Hitchcock, Alice Peck Day Memorial Hospital, Visiting Nurse and Hospice for VT to share the results with members of our communities and get input into where we go from here. In January, we co-hosted two Community Health Improvement Summits open to all community residents to review the priorities emerging from the recent results and share thoughts about what the results tell us, what opportunities we have to address them, and what strategies we might help. In February, we took advantage of a training co-sponsored with the Special Needs Alliance, Cultural Competence with Disabilities, to address the priorities from the perspective of people living in our communities with disabilities.

Community Health Priorities from the 2019 Upper Valley Community Health Needs Assessment

Capturing Input from Our Communities

Notes from all the discussions held so far are available for review. You will find links to these notes below.

Community Summit Notes from January 18 @ 5:30 pm (Dwinell Room) and Public Health Council Partner Meeting (open to public), January 18 @ 9:00 am (Tracy Hall)

Mental Health Services
Substance Misuse
Child Abuse and Neglect
Primary Care Services
Domestic Violence
Health Care for Seniors

Discussing issues of child abuse and neglect with Nancy Bloomfield, of The Family Place, as a subject matter expert.

Forum at Cultural Competency with Disabilities Training, February 8 (Kilton Library)

Mental Health
Domestic Violence/Child Abuse and Neglect
Primary Care Services

Over the next several months, we will continue to present results to community groups, looking for insights into what work the results tell us to do. Each of the organizations collaborating on this work will develop their own Community Health Improvement Plan. Most of these plans will be completed by the end of 2019 or soon thereafter.

For more information about the community health improvement planning process or ways you can participate, please contact Alice Ely at the Public Health Council.

2nd School Summit Focuses on Schools’ Greatest Concerns

On October 4, 2018, the Lebanon School District Office gym was humming with the chatter of new connections, putting faces to names, and busy professionals all focused on addressing schools’ greatest concerns for children and their families. The Public Health Council of the Upper Valley and Dr. Joanne Roberts, Superintendent of the Lebanon School District, hosted the second forum bringing together school personnel and local agencies. The purpose of the event was to: 1) Increase regional understanding of what challenges schools face in providing the best learning opportunities possible; 2) Increase understanding of what resources are available to help schools serve the needs of their students and families; and 3) Provide a forum for building relationships between schools and providers that can lead to new (or deeper) formal and informal working relationships.

Prior to the event, registrants were asked to share what they hoped to get out of the summit. Posters at the front of the room displayed the main themes of what people were hoping to learn.

“To acquire knowledge of how these organizations and other schools best support students and families.”
“I want to better serve the community I work with.”
“Improve community contacts to help ensure wrap around services for our most vulnerable students.”

To open the event with a call to action, Alice Ely, Executive Director of the Public Health Council, asked everyone to use the day to share their story, listen to what others have to offer, and find at least three things they can do as a result of the discussions.

What are Schools’ Greatest Concerns?

To determine schools’ greatest concerns for children and their families, the Public Health Council conducted a survey of Upper Valley schools in June and July to identify their main topics of concern. Alice Ely and Dr. Roberts then worked with a small planning committee to develop facilitated workshops for the four most common concerns: mental health, substance use disorders, meeting basic needs, relationships with child protective services. Attendees were able to attend two different workshops during the event. [Learning Objectives: Click to learn more about the workshops provided at the Summit.]

After workshops, attendees shared a delicious lunch and talked over what they had learned in their school groups and visited the resource fair. Tables along the back wall were covered with pamphlets, pens, contact and informative materials, and posters from the seventeen Upper Valley organizations present.

Closing with Stress Reduction

The whirlwind conversations, networking and discussions came to a close with a stress management activity from Kate Gamble of Open Door. The quiet meditation brought attention to the importance of stress management and introduced a strategy for the school personnel and social agency providers in the room. Summit attendees left with a list of the names, organizations and contact information for everyone in attendance.

Attendees from Many Schools and Organizations

The thirteen schools or districts whose staff attended the summit included: Lebanon School District, Rivendell Interstate School District, Windsor Schools, Central Vermont Supervisory Union, Mascoma Valley Regional School District, Marion Cross School, Hartford Area Career and Technology Center, Ledyard Charter School, Grantham School District, SAU 23 North Haverhill, Tunbridge Central School, and Plainfield School District.

Representatives from the following organizations attended to share information about their services, discuss partnership opportunities, and facilitate workshop discussions in their areas of focus: Good Beginnings of the Upper Valley, Child and Family Services, The Family Place, LISTEN Community Services, Open Door, Health Care & Rehabilitation Services of Vermont, Dartmouth Hitchcock Pediatrics, WISE, ALL Together, HALO Educational Systems, Second Growth, Second Wind Foundation, Twin Pines, Upper Valley Haven, HealthHUB, VT Department of Health, VT Economic Services Division, and the Public Health Council of the Upper Valley.

This is Only the Beginning of the Conversation

The idea for the Summit came about in 2017 from conversations between Dr. Roberts and Alice Ely about the need for improved connections between school personnel and local resources to meet schools’ greatest concerns for children and families in the Upper Valley.  Ms. Ely recognized an opportunity for the Public Health Council to help connect the two. She said, “We have so many great resources available here in the Upper Valley. However, sometimes the challenge for busy professionals is making connections to others who can help them better serve their constituents. That is one of the key roles the Public Health Council plays. I was thrilled to partner with Dr. Roberts to make this event happen.”

The overwhelmingly positive feedback to the event noted the “professionalism and caring nature of all who attended.” The event was a great success in making connections and networking. However, there was much talk about needing to continue the conversation about meeting schools’ greatest concerns. Ms. Ely sees the role of the Public Health Council to help facilitate these conversations and looks forward to seeing what happens.

PHC Annual Meeting Addresses Health Equity

The Public Health Council Board of Directors hosted their Annual Meeting on Friday, November 16th, despite the first snow storm of the season. Only a small portion of the people who expected to attend decided to stay home, for which we are very grateful. Many thanks also go to Hypertherm’s technology team members, who allowed us to connect with Heidi Klein, our Keynote Speaker, remotely so that she did not have to travel from Burlington, Vermont, through the snow.

Meeting Dedication

This year the Board of Directors dedicated this meeting to the memory of Laura Cody McNaughton. Laura joined our Board of Directors last January before she was tragically killed in an automobile crash in June. Laura served as the District Director for the White River Junction Office of the Vermont Department of Health. She was noted for her kind and collaborative spirit and her dedication to addressing health disparities in our region. She is missed by all who knew and worked with her.

Conducting Business

The Annual Meeting is where the Board of Directors elects new members and officers. This year we welcomed Matthew Cole to the Board and bid farewell to Nate Miller. The Board Treasurer, Bob Kingman, presented a financial review of 2018 and the proposed budget for 2019, which was approved. We thank all the foundations, corporations, municipalities, and individuals who provide the financial support the Public Health Council relies on for our operations.

What brought most people to the Annual Meeting, however, was the chance to hear Heidi Klein, Director of Planning and Health Care Quality at the Vermont Department of Health, discuss developing the Vermont State Health Assessment and Plan with a focus on health equity. We invited Ms. Klein to speak because we hoped to learn from Vermont’s experience as we move towards developing a new Community Health Improvement Plan for the Upper Valley. The Upper Valley, like Vermont as a whole, struggles to recognize, understand, and address the diversity and disparities that exist here. We hope to do a better job in this next community health improvement plan of addressing health equity.

So what did Heidi share with us about the Vermont planning experience?

Heidi Klein, MSPH

When developing their state health assessment and plan, the Vermont Department of Health generally looks at two questions: What do we know about the health of Vermonters? And what are we going to do about it? When they thought about how to explore the root causes of health outcomes, especially in populations affected more or less by some outcomes, they realized the importance of understanding inequity. According to Heidi, “This means we are now looking at very different data than before. Before, the assessment showed what we were seeing, but not why.”

When they looked at the data to understand what populations were most affected by poor health outcomes, they identified the LGBTQ community, people of color, people with disabilities, and people living in poverty. They also realized the need for qualitative data – stories – to more fully understand what was driving the inequity. So, when it came time to identify strategies, they added a new step to the process. Instead of ending with partner engagement to determine readiness for action, they moved on the working with people experiencing inequity to explore where there are shared agendas. This entire exercise – which is not yet complete – changed a 1-year process to a 2-year process, but the Vermont Department of Health had the courage and the wisdom to recognize it as the right thing to do.

Inequity = Differences in health outcomes that are avoidable, unfair, and shaped by condition of people’s lives related to the distribution of money, power and resources.

Ms. Klein has generously shared several resources, including her presentation slides. She also suggests reviewing two resources she referred to in her talk:

More About Heidi Klein

Heidi serves as the Director of Planning and Health Care Quality at the Vermont Department of Health. She possesses over 25 years of experience in public health practice, public engagement, and collaborative planning. She worked with leaders at the national, state and local level, to design programs and policies which recognize the interconnection between public health, environmental protection and economically vibrant communities.  Heidi’s current position includes: strategic planning and performance management; development of the State Health Assessment and State Health Improvement Plan; integration of public health programs, including, the State Office of Rural Health in health system reforms; and workforce development.

The Public Health Council Board thanks Heidi and the partners and new friends who braved the storm to join us at this Annual Meeting. For more information about the Public Health Council, please visit our website at www.uvpublichealth.org or reach out to Alice Ely, Executive Director, at alice.ely@pubhealthtest.wpengine.com.