Interrupting health inequity with community-driven solutions

Mary Hearst

Healthy beginnings are important and can provide strong foundations for optimal health. Yet, healthy beginnings are elusive. Worldwide, the under-5 mortality rate is 40.8 deaths per 1,000 live births, with the highest rates in low-and middle-income countries, according to the World Health Organization. Worldwide, 8 million children live in orphanages, 1 billion children lack access to education, health, housing, nutrient and sanitation or water, and there are 240 million children with disabilities, according to UNICEF. In the U.S., access to equitable opportunities for education, employment, housing, transportation, food and health care is vastly different between white populations compared to Black, Indigenous and People of Color (BIPOC) communities, deeply impacting children, families and optimal life chances for all.

Mary Hearst, PhD, MPH, is a professor and center member, and her research interests aim to address these inequities. Her strategies for interrupting the social, structural, political and economic structures that interfere with health equity include community-driven solutions that create system change, using positions of power and privilege to elevate voices of the BIPOC community, and assuring families have holistic support for their children. Hearst, colleagues from St. Catherine and St. Thomas University, SPOON Foundation, and the Catholic Medical Mission Board–Zambia implemented Kusamala+. This community-driven solution including community health workers, health facility staff and local project managers alters the community-based stigma towards children with disabilities in Zambia by changing the health system practices around prevention and intervention, and build family and community support through home visiting. Hearst and colleagues elevate underrepresented voices in the U.S. and their daily life experiences coping with systemic racism and isolation. Finally, Hearst and colleagues have implemented interventions that provide holistic support to children and families domestically and internationally.