Health Justice, Time Poverty and A Way Forward.
IDEAS xLab co-founder, Theo Edmonds, on the front porch of his grandparents' country store in rural Appalachia. Circa 1979.
This is the first in a series of editorial essays by IDEAS xLab's team exploring the roots of why each of us, as individuals, have come to do the work that we do. First in the series is IDEAS xLab co-founder and Kentucky artist, Theo Edmonds.
SHARED VALUE.
My granny is 97 this year. Papaw died more than a decade ago. For 50+ years, they ran a little country store in rural Appalachia where most everyone was poor. The store was next door to a school, built not long after the civil war. It's where granny went (1st-12th grade). Education was a value. The entire community took part in making sure it happened for young people. Granny was postmistress and mentor to generations of kids who came to her for help with almost everything. If she didn't know the answer, she would work with them to figure it out.
Papaw would regularly take people in our community the 15 or so miles back and forth to town for doctor's appointments. He would haul coal to help people stay warm in winter. I never saw Papaw say no to anyone who needed help. Papaw himself had been raised by his grandmother in Alabama. His mother died in childbirth and his father was not around much. In part, I am convinced this is where his deep humanity came from.
In this little mountain community, it was understood that we were all in this life together. If one family needed help, it wasn't just their problem. Everyone had a role to play in helping to solve it. This is how granny and papaw lived their lives.
They were part of an informal community support network who worked together - farmers, teachers, preachers, artisans and the like - to reduce poverty, improve health, and increase education and access to information.
This integrated social network helped everyone to have more TIME to accomplish things in life that were meaningful because the work to be done was distributed.
As a result, generations of families in our poor Appalachian community were able to go on to college and pursue dreams of every shape and size. And, everyone has dreams. Dreams are not a one size that fits all thing.
IT'S EXPENSIVE TO BE POOR
For all of our discussions about the effects of poverty, "time poverty" is one of the things that I believe we are not yet talking about in a meaningful way.
In a recent article from The Atlantic, Derek Thompson writes:
"The world has its thesis on wealth inequality. But it lacks a comprehensive way to talk about something larger - the myriad forces that exacerbate inequality that have nothing to do with "capital."
Let's call it Total Inequality.
Total Inequality is not merely income inequality (although it matters) nor merely wealth inequality (although that matters, too). Total Inequality would refer to the sum of the financial, psychological, and cultural disadvantages that come with poverty. Researchers cannot easily count up these disadvantages, and journalists cannot easily graph them. But they might be the most important stories about why poverty persists across time and generations.
It's expensive to be poor - in ways that are often quantitatively invisible.
Research on the psychology of poverty suggests that not having enough money changes the way that people think about time.
It's hard to prepare for the next decade when you're worried about making it to next Monday.”
24,000 YEARS AND COUNTING
We all have 24 hours a day.
In poor communities, making the healthy choice the easy choice may be a luxury if a person is working two jobs.
Time poverty is further compounded in many communities of color.
Due to the structural racism in governmental policies that resulted in the mass incarceration of generations of African-American men, there are high rates of single parent households headed by women. Then, when you add in sexism, which causes women to earn less than their male counterparts in the workplace, it becomes easier to understand the systems at play.
The cumulative effects of the "isms" in general (Racism, Sexism, Classism, Ableism, Ageism, Heterosexism, etc.) are literally killing us.
We all have a limited number of years in a lifetime.
In communities of color, like Louisville's Smoketown, it is a statistical fact that the average life expectancy is about 9 years less than the average for the city of Louisville. There are roughly 2700 people who live in Smoketown. Just doing some basic math, this means that cumulatively, the families that live here have 24,000 less years than other communities.
24,000 less years to live, work, worship, learn and play.
Circumstances are cumulative. Parents are caught in a whirlpool of poverty which prevents them from escaping to the middle class when they grow up. Thus, catching children in the same cycle.
The silver lining is that the logic of Total Inequality suggests that interventions should be cumulative, as well. For example, when a person has the family and social support systems in place to help them finish college, they triple the chances that their child will finish college. Those with higher educational attainment also have a longer life expectancy.
Family and Social Support. Educational Attainment. Place-based jobs. These have been proven to increase both life expectancy and quality of life.
TIME IS MONEY.
Over the past couple of years, IDEAS xLab focused on innovative arts projects that helped us understand health in a new way.
This work resulted in a different kind of framework for deploying artists to support increased social connectivity, educational attainment and place-based job creation as the core elements of a new kind of health justice initiative called My Healthy Days.
Being healthy is not a "goal" for most people. So, the healthcare industry needs to stop treating it that way.
The goal for most of us is doing things in life that have meaning. Health helps us do the things we care about or holds us back. Different things are meaningful to different people. One size does not fit all.
Health, when combined with creativity and empowerment, transforms what a person can't do into what a person (or community) can do.
This is why health justice is also good business.
Healthy, creative, empowered communities can more fully participate in the economy. When all communities are able to fully participate, it creates a more diversified workforce. Diversity is the fuel of innovation and the cornerstone of resilient, integrated economies.
THINK CREATIVELY. ACT TOGETHER.
Led by groups like the Robert Wood Johnson Foundation, there is currently a national movement to build a culture of health in America. It is driven by the belief that true progress is made when we work together toward a shared goal which is valued and advanced by collaborators from all sectors. My Healthy Days© introduces a critical ally in the movement to establish a new culture - artists.
This coming Saturday, April 9, marks an important next step in IDEAS xLab's process. Together with a wide range of cross sector partners, we will begin a 6 month community organizing process in Smoketown. Our goal over the next six months is simple. Organize people and resources in order to Create Human-Centered Community Health Development Plan With Arts/Culture as the Unifying Strategy.
HEALTH IS A SOCIAL JUSTICE ISSUE. THE TIME TO ACT IS NOW.
