Breaking Barriers: Securing Partnerships to Advance Health Equity

RANIYAH COPELAND: 
Hi everybody, and welcome to ASTHO’s podcast series Public Health Review, where we feature leaders discussing emerging public health policy, programs, and initiatives. We're really excited to be here. My name is Raniyah Copeland. I am the founder and CEO of Equity and Impact Solutions. We are a consulting firm that works with health departments and fortune 500 companies on their health equity and racial equity work.

And my background, how I entered into the field of equity and health equity, has really been through my experiences working in the field of HIV for nearly 15 years and the experience of what it takes to advance health equity, how we are mobilizing communities, how we're developing partnerships and response to HIV. And so I'm really excited to be here today to have a podcast where we're talking about striving for sustainability and the journey towards health equity.

We want to, during this time together, give insight to the resources and landscape for doing health equity work in jurisdictions across the nation. We know, particularly from COVID-19, that health equity work is really the critical kind of work that has to happen to advance any type of health advancement in communities, and so really kind of taking that lens and digging into how public private partnerships help with that sustainability towards health equity.

I have some amazing guests who are going to be sharing some strategies and approaches that can be utilized to secure multi-sector commitments to health equity work, and I think for me, one of the things that has been critical to the frameworks that I utilize when it comes to advancing health equity is thinking about how equity has to be a whole society approach.

It can't just be one group of folks, one group of dedicated, well-meaning people within health departments or in the nonprofit sector that believe that equity and that health is something that all folks should have, it really has to be all of society coming together, and I believe that's really where public private partnerships help advance that cause. And so, I'm super excited to bring two folks who are doing that work every day, into this conversation, to this podcast.

I'm excited to first introduce Tawana Saunders. Tawana is a seasoned product manager and grant administrator who hails from the Maryland area but has made South Carolina her home for the past six years. She has a dual master's degree in management and business administration from University of Maryland Global Campus. Tawana is currently enrolled because she loves to be very educated, clearly, in the Doctor of Business Administration program at Liberty University online.

So Tawana initiated her public health career with the South Carolina Department of Public Health, AKA the South Carolina Department of Health and Environmental Control, in November 2022, where she serves as the grant administrator on the OT-212103 Health Equity Grant. In the short time Tawana has managed the grant, the team has successfully secured a no-cost extension of the grant, improved partner relationships, we're going to delve into that, directed health equity initiatives through internal and external partnerships, established more transparency on the grant, and increased the spend down from 24% down to almost 50% spend now. It's amazing!

Since joining the Public Health Team at South Carolina, Dr. Tawana has been committed to using the grant funding to break down health disparities in Black, Brown, and underserved communities, and improve the health and welfare of South Carolina through the successful administration of the Health Equity COVID-19 Grant. Tawana’s commitment to quality healthcare is the driving force behind her transition into public health from the business world. And she's leveraged her background and experience in project management and business to be successful in the public health field. Tawana, thank you so much for being here and excited to spend some time with you.

TAWANA SAUNDERS: 
Thank you.

COPELAND: 
My second guest is Katia Worley, and she is the coordinator for the Hawaii Department of Health Office of Health Equity. Previously, she served as the state opioid project director for the Hawaii Department of Health, focusing on Native Hawaiian and indigenous health, increasing access to substance use services, and expanding cultural harm reduction and telehealth resources.

Prior to that, she served the patients on Kalaupapa, Molokai, where more than 8,000 people with Hansen's disease were exiled. Katia is a Native Hawaiian, Marshallese, and indigenous woman born and raised on the island of Oahu. She has a passion for Native Hawaiian and indigenous health, addressing multifaceted public health issues through a culturally safe and interdisciplinary approach, and navigating the ever-changing public health landscape to promote wellness for her Loa Hoi community. Thank you so much for being here.

KATIA WORLEY: 
Thank you.

COPELAND: 
So when we thought about what it meant for striving for sustainability and vision towards health equity, we really wanted to bring in two different jurisdictions who are striving for sustainability in different political landscapes, in some ways it’s very similar, with resources, and really hearing from and I think you two in particular have such unique backgrounds that gets to bring in these different concepts, these different frameworks, into what private sector partnerships and expanding and like nontraditional partnerships to health equity look like.

And before we kind of start diving into it, I'm really interested, you know, what does the landscape for health equity look like in your jurisdiction? We have Hawaii, we have South Carolina. And I think, you know, across the country, when we look at health equity, sometimes what we're seeing is, the term equity being used as a divisive term, and that, you know, we have strong kind of, political feelings around it and sometimes the word itself is politicized and thrown into other concepts that we regularly see on the news. And, we know that the resources that we have for health equity is also changing. Right? I think we saw an increase and resourcing for health equity work from COVID-19, now, multiple years into what looks like, you know, is an ongoing issue, but that we've normalized right, and figured out how to kind of work around them with it, that the resources that we see for health equity, and the support, whether it's from federal government or private sector, has changed dramatically.

And so I feel like in some we've kind of in this whole new world, when it comes to health equity, but with some of the same challenges that have morphed into different issues or merged into other areas. But I'm interested—Tawana, I'll have you go first—around what does health equity in South Carolina look like?

SAUNDERS: 
Well, in South Carolina, it's health equity has just been something that I think it's very political, unfortunately. When I first came on the grant, we had a diversity, equity, and inclusion office, as a part of the grant. And within the past year and a half, I've seen a change that, well, we're no longer supposed to say DEI. You know, it's now the bad word. So now we're looking at ways of how do we not say DEI, but also focus on health, the equity and health care within the state of South Carolina? Particularly in some of our rural areas, where it is a challenge to get good healthcare or to get the basic—let me just start there, to get basic health care and, to provide for the communities that are here.

So, in South Carolina, it's, I think it's challenging. but I am optimistic about it. I think it's changing. I think it's going to take a lot of policy and advocacy that we'll probably talk about a little bit later on. And, you know, some of the things that we've done on this grant, I think are like stepping stones to making an impact in South Carolina for health equity.

COPELAND: 
Awesome. Yeah. And you have such a diverse space, you know, huge rural communities but you have metropolitan cities and the spaces, so...

SAUNDERS: 
Yeah, we also have a growing tribal community in South Carolina as well. So trying to network and have influence in the tribal communities, within South Carolina's also another area that, we've been looking at, as well.

COPELAND: 
Awesome. Katia, tell us a little bit about Hawaii and what does health equity look like there?

WORLEY: 
Yeah, so Hawaii's kind of geographically challenged, we’re a group of islands in the middle of the Pacific. And so, we really have to come together as a community quite often to address different issues. And, for example, like during COVID, we saw a really big, like, upheaval of people coming together in the best way that they could to support each other.

And then with the Maui wildfires, again, the community was the one who mobilized to assist each other. but geographically, it can be challenging. Our resources are kind of disproportionately distributed across the island. So a lot of our resources are located on Oahu, in Honolulu County. And if people need to get specific resources or specific or specialty healthcare, they sometimes have to fly to Honolulu or Oahu. And that can be difficult because flights are not always reliable. And so a lot of our geography puts some barriers in navigating the different systems.

And then we also have like not equity for us isn’t just, we are working on healthcare and we're working on a lot of things, but addressing all the social, social determinants of health across the board for us because our community of Native Hawaiians are disproportionately represented in many of the difficult parts, like in the criminal justice system or in, substance use and homelessness.

And without Native Hawaiians, we don't have Hawaii. It wouldn't be what it is. And so we do. However, it's not always bleak. We do we see a revitalization of culture and kind of going back to that source of who we are as like people who are, as an, as like our identity. And, for me, I'm really blessed to be in this, this position as a native Hawaiian because I can help navigate, the systems and the processes that people have to go through and recognize which systems aren't necessarily built to support the health and well-being of our people, and how do we kind of adjust or maybe break down or change those systems to better support our people?

And so, we see a lot of community-based programs that are working really hard to address the different social, social determinants of health and to address the barriers that we have. Wnd where Hawaii's a very beautiful place, we're very tiny. So all of the difficulties are very amplified when you're walking around, you can see a lot of homelessness and a lot of, poverty. And so trying to bring the community together and build partnerships to help support our community is really important. And, I’m just very lucky to be here and be able to do that work.

COPELAND: 
Yeah. That's great. You know, I think when it comes to partnering around health equity, it's really the only way that it can happen. You can't, none of us can do it by ourselves. And I think particularly for folks, that sit within health departments, to want to refer to this earlier, there's things that are needed to advance health equity that are often outside of the responsibilities, the scope, that a health department can do work around and to want to you’re talking about advocacy and policy level changes that that's not often something that health departments are driving, but with a partnership, that's something that can be, something an organization or a nonprofit or an elected official can try and champion, and it takes this kind of diverse partnership to really be able to fit and respond to the needs of various communities who are impacted by health outcomes and health issues like COVID-19 or, maternal mortality or, or opioid use.

Like the list. Katia, like you're saying, it really does kind of go on and on. What we see when communities are impacted by health inequity, they're often impacted by inequities overall. So you can talk about health, you can talk about housing. It really kind of runs that gamut. And so partnership can help with that.

And so I'm interested Tawana I'll go to you first, what's important for you when you partner with entities for health equity, what are the types of partners that you're looking for, who have an ideal partners in you guys's work thus far?

SAUNDERS: 
Okay. Most of our partners, that we've worked with have been our community-based organizations, our HBCUs, have been very instrumental, in South Carolina and helping to, work with us as a public health department because I think you, Ronnie, you made a good point about public health departments are kind of limited in the scope of the services and things that they can do but when you partner with an external organization or a community-based organization, and you utilize those resources that are located in the community that they're serving. But they also have the capacity to reach beyond those communities. I think those are some of the important things that we look for, so having just the capacity to be able to reach out into the community, and also the ability to be advocates for healthcare, for health equity, for, even driving the data.

I mean, we haven't talked a lot about that, but I think that developing the data that's needed. So it's important to work with a partner that can take that, that can compile that data so that then it has a trigger effect on creating policy, because then you have the numbers that are supporting why a jurisdiction or why a rural area, or why a tribal community needs such and such. And without that, I think it just makes a big difference. So those are some of the things that I think we look for. And then just representation, being able to have representation in the communities that we serve.

One of the grants, that partners that we're working with, is University of South Carolina College of Nursing, and they created an academy called Stand Up. And they are developing nurses, and they recently, nurses that will go out and serve in the communities which they represent. And they recently in May had their graduation of the academy, it's like a ten-week program that they commit with, and they partner with other schools that have nursing programs. So it's not just University of South Carolina. They are bringing in students from Midlands Tech, which is another jurisdiction in South Carolina and then other jurisdictions. And it was just so nice to be able to see the array of representation at this graduation, and not just Brown and Black, but I'm talking Asian, I'm talking Indian and Hispanic. And that's kind of the thing that we need to look for, particularly here in South Carolina, and I'm sure in other jurisdictions, because we're all we're not just one set of people.

We are multi, you know, multicultural, multi-vibrant, we're rainbow, you know, if I could put it that way. And we should always represent that. So that's, that's kind of what I think we're looking for. Yeah. And I'm not going to keep talking. I'm going to let Katia go for it.

COPELAND: 
No, but I love that, I mean I think you gave so many gems. I think, you know, when I think about what partnerships look like at this kind of level, they, to me, are like a plant. Right? Like, it's not like you can just set them up and then that's it. Like, you put them in this new pot, you leave it by the window, and then it's done. It needs constant watering and nurturing, and you don't know why the plants turn brown and, but you still have to care for it and figure it out. Right? There's nothing you can specify and point and say, this is what's not going well, but you know, you need to readjust.

And I think that partnerships, particularly as relates to health equity, really need that. And so, you know, from setting folks up so there's common language. Is there regular capacity building and training happening? So that there's cultural humility that's constantly happening, making sure that you guys are on the same page and the foundation around how work is happening. You talked about data reporting, which is I think it's touching an important one, like how I think for any person in any group that's a part of the partnership, you want to know what your impact is.

And so being able to measure that and what does success look like. And being able to report out to your partners around what that is. And then, just maybe the last point before I go to Katia is you talked about the diversity within partners, which I think is so important. Right? It's not like you just find one partner and then that's it, but you're looking for education. You know, you're looking for academic institutions. You're looking for nonprofits and CBOs. You're looking for. Are there any like, you know, elected officials that, that are championing this? Are there businesses that are willing to support the nurses in some type of role, you know, like, and it kind of becomes a puzzle.

It can become a jigsaw puzzle of what this partnership and this collaboration looks like. But the beautiful thing about that is that if something falls out, if one piece falls out, the whole thing can fall apart. Yeah, right. And that's what the sustainability looks like. You know, if we have federal funding for x, y, z type of health equity effort, this continues, which we know happens, right, priorities change. We don't want that to leave community completely. And so thinking about, you know, this rainbow. And I love that you're giving that to us as we, just closed Pride Month out as well, like having our all coming together, I think is is very beautiful.

Yeah. Katia, what about you? What? What does partnership look like? Who do your ideal partners look like when it comes to your health equity work in Hawaii?

WORLEY: 
Yeah so I look for a few things and sometimes I might be kind of a little bit different but, like, I look for people or organizations that understand the landscape of Hawai'i, understand the history of Hawai'i, which can sometimes be a little bit difficult.

We've gone through a lot in Hawai'i, like the overthrow of our kingdom and the repeated mistrust and devastation that has happened throughout our islands. And just understanding that and recognizing that can help people build relationships a lot easier. And relationships in, in our islands are really important. I'm sure they're important, everywhere else. And, but it's critical for our survival, sometimes. And, I think one of the things that I look for is people are located in, again, located in the places that, that they work, and are sometimes like built from the people that work in that communities that live in those communities because it's important to understand what that community needs.

And just being honest and having that opportunity or being accountable and listening to what the community actually needs. And so my ideal partners look like people who are, revitalizing culture, people who work in the land, like our farmers, like our fishpond conservationists, or even forest conservationists, because that's the basis of our culture here. And, even though I talk about the Native Hawaiian culture, because that is the whole culture that we're in, that's where we work, and this is where we live. It has universal concepts that can be utilized throughout anybody's culture. And, it's important for people to kind of recognize and adopt those things. And being culturally safe or being culturally anchored, or having the openness and flexibility to to learn those things.

And I think that's really critical to the work that we do because we do serve Pacific Islanders, we do serve Native Hawaiians, and we do serve a wealth of people. But being open and learning and being flexible and the ability to work through barriers, because we do have to navigate many, many barriers. and so the beauty of partnerships is if I am not able to work through a barrier, maybe one of my partners has an easier way to navigate it.

And that's really how public health works here is. It's it's absolutely amazing to have partners. And that's how Office of Health Equity at Hawaii started is our internal internally at the Department of Health recognized that there was a need for the Office of Health Equity to be revitalized. And then we brought together community partners, and then our government also realized, or recognized how critical it was to have Office of Health Equity. And so we actually were able to generally find all eight positions so that is really important for like the sustainability portion of our office so that we can continue to do the work. And we're not necessarily just have one person that is tied to a specific fund that you don't necessarily know if you're going to have all the time.

This is more like permanent for us to do the work that we have. So we don't necessarily have to rush in. You can spend the time to build those relationships. So it will take time for us to build those relationships. So yeah.

COPELAND: 
You—this is an audio podcast—but Tawana and I, we’re here like shaking our heads up and down and, like, in agreement and love. Like it wasn't if I wasn't trying to mute myself in between. Because I think you gave so many good points. You know, I think one, I love this idea of, like, thinking about partners in a nontraditional way and, like, who you can reach out to. So, like, I love the idea, and which has doing, like, reaching out to, like, people who work the land. Right. And understanding the cultural resonance that, that has. And so I think that that is, a really kind of unique way, I think, to also build off, cultural strengths. Right. And beauty and bringing those kinds of partners in. And I think that's a and that these are also folks, there's the partnership, but then there's also them as individuals that I think benefit from this health equity work and hopefully resources and information.

And I think that Hawai'i, has such a unique example of how you guys have worked to sustain, been able to sustain your health equity efforts that really, blossomed underneath COVID. And, I mean, you guys have had engagement and support from your highest levels of leadership within the health department. it seems like you have strong kind of leadership from within the team who said this is a need and that the, you know, folks above are heard and said, yes, let's go ahead and take this up and champion it.

You have, folks with who are elected officials, from what I understand, on both party sides who agree this is something that's really important that we want to maintain. And then strong community support, that has, been able to institutionalize the work that you guys have been doing. Are there like recommendations are there tips that you have for other jurisdictions they think about, like bringing folks together as a coalition to try and, institutionalize some of the health equity offices across the country.

WORLEY: 
Totally. And I am I'm newer to the Office of Health Equity, so I can't take any credit for all the work that was done to, to make this, actually, the Office of Health Equity, but I think what I've seen that was really critical is, really having different types of partnerships. So we, we have like a roundtable of community and stakeholders. And, we also have internally in our department that's not just for housed in the Chronic Disease Prevention and Health Promotion division, but we have partners and an internal workgroup that really advocated for us, to our director and to the, to our government to be able to secure our general funds. And I think that is that's the beauty of these types of partnerships.

Like if, if I say that I want something done, it's just me saying that. But if my if other people in different departments say that they would like this to be a thing, the Office of Health Equity, and then you have the community also advocating for you as well and you have different types of community partners such as like heads of organizations. And then you also have the people on the ground doing the line staff that do amazing work. And then you also have people who are in the community that benefit from the resources that we give. I think it's extremely powerful to have those types of relationships to help advocate for you, because sometimes our voices aren't always heard. And so it's strategic in that way that that helps to navigate.

And then you have to find a champion in whatever government, that, structure that you have to be like, yes, I'm going to help you push that through. So it was kind of a perfect storm in that way, where we were kind of able to, bring everybody together. And if there was a barrier, we were able to bring the right people together to advocate for us. And yeah, that's pretty much how we got it done. And with the, with the funds from CDC 2103, we were able to kind of start that up and then, kind of sustain those efforts with general funds, which I'm really excited about. So, yeah.

COPELAND: 
I love that. I love that. I want to stay with you, Katia, and then we'll come to you Tawana with this question, but I'm interested if there's any tools or resources that you've used or your team has used that have been helpful, and your efforts around, sustaining health equity work and partnerships, is there like websites or other forms or other processes that you're like, this is critical to have in our partnership work and our health equity work.

WORLEY: 
Totally. So one was the CDC 2103 funding, which I think was crucial to help start that up for us. And then we've got some TA from ASTHO, which was really helpful and important. and then in general, in, in the state of Hawaii, in Hawaii in general, we have multiple policies that helped to, kind of boost and like, help us build upon. So we have like chapter 321-1 in the Hawai'i revised statute that helps to, kind of provide or give the Department of Health oversight and, the ability to kind of consider the social determinants of health for our communities and our state. And then, chapter 22 or 2226-20, another Hawai'i revised statute that kind of prioritizes specific demographics of people that could benefit or will then we need to address, we need to help boost up their, their, work and, and their population and the health of those people.

And I think that another thing that I came across that was really crucial in, in developing our Office of Health Equity and the work that we do is, the, map of the islanders jurisdictions and how health equity works as an island jurisdiction or territory. And it's unique in a way that we have different issues and we have different problems. Issues and problems and different barriers, versus people on the continent, that we might need to navigate.

So those are some of the tools that we've kind of utilized. And again, our relationships have been absolutely a tool to help navigate barriers and to celebrate and to really, come together as a community.

COPELAND: 
That's great. Tawana. What, what else do you add? What, like you're like, yes, yes, yes.

SAUNDERS: 
I think yeah, I was definitely going yes, that's true, that's true. I think one of the things that I would add to, this conversation about, you know, partnerships, and bringing people together, I think it's important, you know, I talked a little bit in my bio about breaking down silos, and I think that we underestimate the power that silos has and how crippling it can be.

One of the things that we've done or that I've done on this grant is, we brought together all of our partners. When we started this grant, we had 19, about 19 or 20 internal and external partners, and they'd never gotten together to see how what they were doing had interacted or impacted what someone else was doing.

And as a result of that, bringing those our partners together in one room, they fussed and complained about it, but the outcome was very successful. So now we have partners that had never thought about working together and networking together. They're now sharing information, and they're now working together to see the linkages between what they are doing and how it can help what someone else is doing.

And because we're bringing them together from our grant, a lot of these organizations have other grants from other resources that they're able to utilize. So it's kind of like a trickledown effect, because the work is still being sustained. But, you know, being able to be transparent and bring your partners together and help them to engage and giving them the freedom, to, to work together, I think is one of the tools that I thought I think is, is very helpful.

And then, I think the other thing is just community health workers and community advocates. I can't stress the importance of that, that partnership, and, being able to utilize that in, particularly in South Carolina and, you know, there are a lot of things that I'd like to see happen. And then also utilizing resources from ASTHO, I have to say that because I've used a lot of the resources from ASTHO, and just utilizing partnerships outside of, of the norm, I think it's one of the things that I would, little nuggets that I would use. Don't be afraid to utilize other resources or at least ask about them.

COPELAND: 
I feel like, you all's work is such a great example of how when you seed, and resource like this kind of initial health equity work and really a lot of this work that's happened with community health workers, the way that it can grow and the way that it can really be sustained.

I think you guys are such shining examples of that work. I'm interested in how you all tell the story of your work to your partners. You know, like you guys are doing such amazing work and I've had the privilege of over the past year, really engaging with jurisdictions around their, sustainability work around health equity. And I have been pretty floored with the amount of work that y’all have been doing and how intentional it's been, how it's been built upon and built upon.

Like, I feel like, you know, you guys can talk about, you know, this is what happened in 2020 is when we want to see the way that the work is built upon. And, Katia, I feel like you talked about this a little bit, but, like, you're standing on the work of other people. And you have such, reverence for that, which I think is a beautiful thing.

And so, I think I have some insight into the amazing work y’all have been doing with health equity, but I'm interested how you tell that story to other people. How do you tell that to your partners, and how do you tell it to that community? Katia, do you want to take this first?

WORLEY: 
Sure. Yeah. So again, I am still a little bit new, but as we come to the end of the year, we'll probably gather people and that's a really amazing thing and a really powerful tool as we gather people together to celebrate the things that you've done.

And, with the Office of Health Equity has done that two times previously. And I think it's so crucial to, to bring those people together and to celebrate the things that we've done and to talk about the difficult things. And so we're going to do that again and maybe change the format, and utilizing like a talk story type of format where we, we sit together and we have a conversation and we talk about the things that are happening, and we kind of navigate those, those feelings and emotions and difficulties together, from people all over.

So different departments, people who are receiving services, people who are just in the, in the community, and coming together to figure out the needs and also, see what resources are available. I have been working in public health for a bit now and realizing that there are a lot of resources that we have available and people just don't know about them.

And so how do we kind of bring that to the forefront and, and kind of highlight what people are doing already, instead of recreating the wheel? And how do we support them in the work that they're doing, whether community-based organizations, our community health workers, they do amazing work. And so I think this next gathering that we have, we're going to really celebrate what our different organizations are doing and different communities are doing to address health inequities within their communities.

And also, how do we kind of learn from that? and so I'm excited to celebrate with them. We have a project that is kind of towards the end, but there's so much that we can do with it. Our life expectancy project. And, what we would like to do is figure out how to present this data from an assets perspective, not saying that people, the life expectancy in this one population is not so great. And so why? It's more of what's already being done in that community that helps uplift that community. And how can we build upon that? And I think that's really powerful and really beautiful to be able to do and I'm excited to celebrate with our partners because it's been a while since we've gotten to come together and kind of uplift all of the things that we're doing. Yeah.

COPELAND: 
I love that. I love a party. Maybe, no, we can't say the word party. I love a gathering. I love a celebration. Right? We can't. It's not a party, but it is networking. It is connecting. It's relationship building. And I think that important, that that in-person piece is so important, especially because we're engaging communities who historically have been disenfranchised, that being able to find the joy and the wins and what can feel like a really hard fight.

But there's all these personal feelings and experiences people have with it, I think is so important. And, you know, when a partnership, needs something that I feel like the in-person that, that relationship is built from that in-person engagement is so important and it pays dividends in the future. So, I love to hear that.

I hope you can like, take pictures and send them over to the ASTHO team. 
 
WORLEY: 
Definitely.

COPELAND: 
Tawana, tell us a little bit about how you tell the story of your work to your partners?

SAUNDERS: 
A little bit of what Katia mentioned, we started to bring all of our partners together so that they could know and understand what the others were doing. That was very exciting. We do that. We're now doing that twice a year with our partners. And that's been very helpful because they find out, “Oh, I didn't know you were doing that. I didn't know how you were doing that.” And so that's opened up a door. But I also think the other way that we tell our story is we, we utilize every resource that we have. We, we use our partners to tell a lot of the stories because they are the boots on the ground. They are the ones that are out there. They are, we have one partner, South Carolina State University, that hosts several different activities as it relates to COVID and comorbidities and mental health issues as it relates to COVID. And we've been helping them to drive that.

And they are out on the weekends during the week and they are engaged. And of, you know, I have to use my word again, a rainbow of people in order to promote healthcare. And really, they've done a lot of work in dispelling, especially in the early days of COVID. They were really very good about getting the word out about some of the myths and some of the untruths about COVID.

So we really do utilize our partners in order to tell the story. We've done story walks, we've done listening parties. So and then we've also taken that information and we've published it on our, you know, on our dashboard, on our website, so that people can hear and listen. And, we use the CDC, we make sure we tell the story there.

But we try to do with whatever resource we can use, we use pretty much. I don't think that, we try not to not use anything, but yeah, we, we try to get the word out, but it's our partners. I have to give it all to our partners. One other thing. One of our partners, one of their projects was, these free little libraries.They were like these little bird houses and the little. And they put literature and things in it. And I had never seen one, but I knew our partner, that this was one of the projects that they were doing. And I was at a park nearby my house, beautiful, it's called Hatcher Gardens, and I'm walking through the gardens and I see a little library.

So, I mean, there are so many different ways to get the word out in the communities in which you live. And that, to me, was just a perfect example of, "this is how we reach the people." It's it's sometimes it's a nonstarter. It's a no brainer.

COPELAND: 
I love that, I love that, you guys have such beautiful stories and have done really such amazing work, impactful work, when it comes to advancing health equity. And, you know, as we kind of close out our time together, my final question would be to you guys, you know, what can be done to recreate sustainable health equity approaches across the country that work? If there are two or three things you can leave folks with when it comes to creating sustainable health equity approaches, what are those two to three recommendations you have for folks that are listening in today?

Katia, we'll start with you and then we'll close up with Tawana. 
 
WORLEY: 
Yeah. I think again, I'm going to go back to relationships. Hope builds a framework, from utilizing relationships to help secure maybe, funding that would be more sustainable. And helping to advocate for that. I think that's one of the, the tips that I have.

And then bringing, whatever your culture is, bringing that to the forefront, for us, it's, kind of listening to and kind of going back to the source. So we have all these resources, but going back to the source of what we are as a people and how, how do we provide those things, the things that were ripped away from our culture? And we were not allowed to do. How do we provide opportunities for people to kind of navigate that, to create more sustainable change? And then also recognizing and being innovative and not being afraid to change systems that do not support the health and well-being of our people.

I think, often we we say that this is just the way that we do it, but in reality, some systems are not built to uplift our community, and we need to take a really critical look at what that looks like and gather the people that would be able to make that change and kind of not be afraid to to create that change within our systems so that we can hold our people instead of continuously bringing them down. And so I think those are some of the important things, and also some of the things that I’m sure our office will continue to try to pursue. Yeah.

COPELAND: 
Amazing, amazing. Tawana, what are your final words? Your gems.

SAUNDERS: 
Yeah, my first or my initial response was, don't let no be the final answer. Because a lot of times, we don't see how a certain program can fit into, and I'm coming from a grant perspective, how a certain program can fit into the guidelines of a grant, figure out how it can fit and then justify it. So that's kind of my one thing that I've kind of learned on this grant is don't let no be the final answer.

COPELAND: 
I think that's a, a good model to have, probably like a mantra that needs to be on the top of every jurisdiction's desk, folks who do this work that, no, can't be the final answer. We could push and push and push.

SAUNDERS: 
Yeah, yeah, yeah, I do believe you have to push, push and push. And then the other thing would be collaboration. Collaboration and transparency. It gets, I found that it has gotten me further and has lessened the burden. Once you bring people together and they start talking, they start networking, they start engaging one another and thinking outside the box. It makes life a lot easier. It brings many rewards, and those are probably two of the things that, I would say, will help to advance equity and, you know, totally, I agree with what some of the things that Katia said, and you've got to be, I come from a non-public health background and I would probably say don't, if you have a passion, you have to have a passion, for healthcare or for health equity and let that be your driving force because everything, the skills and the, the background that you have is transferable if you allow it to be, and you can be successful at it. So that's all I've got.

COPELAND: 
I love this. No, this is great. Thank you guys so much. I'm very excited for folks that are listening in, I think, you know, you know, Tawana, you talked about, like, having, you have to have like the passion for it. And I think we all do this work because we believe that we can get there, that we can see, advancements, inequities, that we can see communities who are, you know, being devastated by certain disease states. So we can see that change. And I think we have in some areas which I think is really exciting, and I would venture to say that we haven't, that the areas that we've seen the biggest advancements in health equities are efforts that took a whole of society approach that it was partners, on partners, on partners that were collaborating towards this one effort.

And so I think when it comes to us trying to advance health equity, if we look around the table and there's empty seats, if it's not a big enough table, then we're not doing it in the way that we can be doing it without having the impact that we can be having, and so, I think when we're thinking about sustainability and partnerships, it has to go hand in hand. And, we know that's critically important from a funding perspective. But it's also really important from an impact perspective as well. And so I hope that folks who are listening take that away and have some of the gems that we heard from Tawana and Katia, and can utilize that in their efforts when it comes to expanding the impact and sustaining the work they're doing when it comes to health equity.

Thank you guys so much for being here and looking forward to next steps

SAUNDERS: 
Thank you.

WORLEY: 
Thank you.