Articles, Blog

Advancing Equity by Culturally and Spiritually Transforming Ourselves and the Healthcare System

January 14, 2020

– Good evening. – [Audience Member] Whoo! – Hi, I’m Dr. Elyse Carter Vosen, director of the Oreck-Alpern
Interreligious Forum here at the College of St. Scholastica. Where I also teach in the Department of Global, Cultural, and Language Studies. The Interreligious Forum promotes respect, understanding and peace
among the diverse religious and cultural communities of our region through sustained cross cultural dialogue, shared study, collaborative
projects and events. And we are honored to have
worked with so many college and community organizations to
bring you tonight’s speaker. Who opens our Culturally
and Spiritually Responsive Health Care Conference. I would like to begin with
a land acknowledgement, inspired by the examples of ACO, UMD, and with insights from colleagues in our Native Studies
Center at St. Scholastica. We’re here today on the
traditional, ancestral, and contemporary lands of the Anishinabek. We reside on lands seated
in the 1854 treaty. We recognize and support the
sovereignty of native nations in this territory and beyond. By offering this land acknowledgement, we affirm the continued
vibrancy of the community, and the powerful example set
forth by the Fond du Lac Band through the highly
respected Minoyawin Clinic, and the Mash-Ka-Wisen Treatment Center. This model of integrative
medicine, healing and wholeness has been present in indigenous communities and communities of color
since they came into being. It’s our hope that this
conference can play a small part in honoring these forums of knowledge. And in drawing attention
to the critical role of attending to cultural
and spiritual values must neccessarily play
in healing individuals, families, communities, and
our planet in the years ahead. Minnesota has unfortunately
carried the mantle of having some of the greatest disparities in education, housing and
health during the past decade. And in our own city of Duluth, we know that life expectancies
can vary among neighborhoods by as many as 11 years. We’re grateful at this
conference on culturally and spiritually responsive
healthcare to have support from many organizations in our community. Which are strongly invested
in making structural changes needed to achieve equity, and
deepen respect for difference. Even if the road is long and winding. This conference would not
exist, but for the work of many of you in this room, who have devoted large
portions of your careers to opening up conversations
about making full health and healing possible for all people in what is still an inequitable world. We would like to thank
all of our major sponsors for their generous support. The Anishinabe Fund of the Duluth Superior Area Community Foundation, the St. Scholastica
Department of Social Work, the HRSA Grant, CSS Native Study Center, Braegelman Center for Catholic
Studies and Essentia Health. As well as our supporting sponsors, the Minnesota Organization
of Registered Nurses, St. Luke’s Foundation, CHUM, St. Scholastica Health Humanities, and Sustainability in
the Environment Programs, and the CSS Schools of
Nursing, Health Science and Arts and Letters, as well as the CSS Office of Diversity and Inclusion. So on your way in today
you received two items, and then another one as you were sitting. The most recent one should
be an evaluation form for this evening’s presentation. We would deeply appreciate your feedback, as we want to know its impact on you. And as we consider
programming for the future. If you need a pen there
are additional ones out on the registration table. And if you would leave it
on the registration table, or with an usher, that would
be wonderful on your way out. And you also received a postcard
that includes information about tomorrow night’s
presentation by Sam Grant, so is director of the
Sustainability Program at HECUA, co-founder of AfroEco, the North Minneapolis
Sustainable Food Lab, and Body Deep Democracy and the Grassroots
Public Policy Institute. Sam’s talk tomorrow night is entitled, Reawakening Our Deep
Ecological Wisdom Traditions for Community Health in the 21st Century. And it takes place at 6:00 here
in the Mitchell Auditorium, with a reception beginning at 5:30. Looking ahead, I would
also like to mention the next presentation in our Alworth Peace and Justice Lecture Studies coming up on Tuesday, November 5th. The talk is Transforming
Crime and Punishment, given by William Kelly,
Professor of Sociology and Director of the Center for Criminology and Criminal Justice Research at the University of Texas at Austin. And then on Thursday, November 14th, a talk entitled, Hard Lessons from the Catholic Abuse Scandal, Theological Consequences
for a Church in Crisis. Is a talk by Dr. Massimo Faggioli, Professor of Theology
and Religious Studies at Villanova University, and
writer for Commonweal Magazine. Both of these talks on
the 5th and the 14th are at 7:30 p.m., here in
the Mitchell Auditorium. Before I introduce tonight’s
speaker I would like to note that this screen on stage, on this screen, we are displaying the
text of tonight’s lecture through a technology called
Real Time Captioning. Although we anticipate
a high quality format, there inevitably will be errors that are inherent to the technology. Nevertheless, we believe
that many people may benefit from captioning, including
those with hearing loss. A special thank you to the
Edwin H. Eddy Foundation whose generous support make
this inclusive service possible. Tonight, we are deeply
honored to have with us a visionary leader in our state, with a powerful voice for
cultural inclusiveness and community health. In 2012, Maria Regan
Gonzalez began her first job in local government, working
for the city of Richfield in the area of public health. She says that she quickly
fell in love with Richfield and moved there with her family. She notes that Richfield is
home to the second largest Tibetan community in the state, a strong Latino community,
and many immigrant and refugee families. She said she liked that
she could see diversity while walking the streets with
a public school student body that is 72% students of color. As a Richfield City Council
Member, Regan Gonzalez became a strong leader
dedicated to building a more prosperous community oriented city. She championed projects
aimed at increasing equity, sustainability and
accessibility for residents. These initiatives included a
tenant protection ordinance, removal of barriers to hiring
diverse police officers, increasing the age of tobacco sales, and pursuing a dementia
friendly city designation. Elected in 2018 as the first Latina mayor in Minnesota history, Regan
Gonzalez pursued public office, because she wanted to be
a catalyst in diversifying political leadership in a state suffering from some of the highest racial
inequities in the country. By integrating her political leadership, cultural identity and spirituality, Regan Gonzalez prioritizes
social connectedness, public health and
inclusive decision making, envisioning her city as a laboratory for more inclusive government
amidst widening disparities across the state and country. Regan Gonzalez also acts as a change agent within the healthcare system. As a community health strategist
at Blue Cross Blue Shield of Minnesota, she focuses on health equity with a goal to improve the effectiveness of our healthcare systems
for all Minnesotans. Dr. David Erickson recently noted, that health happens in neighborhoods. Mayor Regan Gonzalez’
work certainly embraces this philosophy as she
uses her passion and talent to bring people from different backgrounds together to make change. Please join me in warmly welcoming Mayor Maria Regan Gonzalez. (audience applauds) – Good evening everybody. – [Audience] Good evening. – Good evening. It’s such an honor to be
here with you all tonight, and I want to say thank
you to St. Scholastica. And thank you to all the
sponsors and everybody who is here tonight. And everyone who has
helped make this possible, and for hosting this forum. I really think we are so
fortunate to just have this space and the time that we have
tonight and tomorrow. To build community with
one another, to learn, to make connections and to get inspired. And most importantly to grow
our leadership as it pertains to providing more
culturally and spiritually appropriate healthcare
for everyone in our state. So, I was thinking about
what I wanted to talk about and I was going through the sessions. And you guys have such an
amazing opportunity tomorrow to really listen to the
experts from across Minnesota who are doing this work. The community members who are leading, and the people who are really
innovating in this field. So I didn’t want to dive
deep into strategies and different examples
that people are doing. Because I feel like that’s what tomorrow’s gonna be about, listening
to what other communities are doing, getting ideas
and talking to folks who are doing the work. What I wanted to do was really talk about the big, big macro, big picture. And why this work is so important, why this work is necessary, and how our identities, how our culture, how our histories, and how
the work we do all connects. And how spirituality is a part of that. And that, if we really want to transform our healthcare system, we
must do nothing short of a complete transformation
of ourselves first. And make sure that when we’re
going through that process of self transformation and growth, that we’re reflecting our learnings. And that we’re putting that into practice in the work that we do
as healthcare providers, as community member, as
leaders and as parents. So that’s really what
I wanted to talk about. How many of you have been watching the presidential debates? Okay, I can kind of see, it
looks like a lot of you maybe. So, we know that
healthcare is a huge topic. And, every presidential
debate it is a huge topic. And, for everyone in
this country healthcare is a huge topic. But what I want to make sure, and again, this goes back to the
route of the topic tonight. This is not about the technical
and logistical aspects of the healthcare system. This is more about the theory and the connection in the role that we each play in
our healthcare system. So, if we are not mindful and intentional about dismantling the
racism, the classism, and all of the other
forms of discrimination embedded in our healthcare system, these forms of oppression will continue. Regardless of any direction
that our country goes in, regardless of if we
choose Medicaid for All, or we choose another healthcare system we will just be transferring
all of those systems of oppression from one
format to another format. So, that is the work that
I’m talking about tonight. We need to really have
a much stronger analysis of how race, class, and
oppression of our communities, plays into the healthcare system. And the role that we
each have in perpetuating that as individuals. So tonight, I want to talk
about the radical internal and external transformations
that we must go through to build a world that is
kind, and that is just. And understand that these transformations are what we need to connect to building healthier communities and transforming our broken system today. So, before I dive into that,
I want to share a little bit about who I am and why I lead. Because I’m up here saying that you know, it’s really important for us
to connect our identities, our values, who we are as individuals with our leadership and the work we do. And in order to model that I want to share a little bit about who I am, and how I came to this
position in the work that I do. So, I am very proudly a bi-racial Chicana. I’m one of two children. I grew up here in
Wisconsin and the Midwest. My mother is an immigrant from Mexico City from (speaks foreign city), which happens to be one
of the most impoverished, most dangerous and violent communities, neighborhoods in Mexico City,
(speaks foreign language) control my family’s neighborhood. And it’s a very unsafe community. So that’s where my family is from, and that’s where they
continue to live today. And my father, he comes
from humble beginnings on a dairy farm in Mora, Minnesota. He was the first kid in his family to not got the country school. He went to the new built
school in the city. And his great grandparents were immigrants from Ireland and Sweden. So I was the first in my
family to go to college. And like many people, at a very young age I had to start acting as an adult. Because the chaos and
the adults around me, unfortunately weren’t always
able to serve as adults, and to protect us young children. So, at a very young age I
had to make adult decisions, and lead as an adult. And go through traumatic things. That’s the case for a lot
of our community members. That’s the case for a lot of us, and that shapes who I am today. And that’s why I’m sharing that. Because the childhoods that we have, the families that we
come from inform the way we lead, the way we act,
and the way we practice and do what we do today. And understanding what that looks like for yourself is very important. And starting from a place
of understanding who you are in your family history,
and how that informs your work today is also very important. So, growing up I grew up in
the space between privilege and having identities of
being disenfranchised. I understood that my
family in Mexico did not, and even today still
doesn’t neccessarily always have money for food. The water comes and goes,
so they have a holding tank for water when there’s weeks and months where they don’t have
water, access to water. And knowing that a part of my identity was rooted in all of that. And growing up in this country,
growing up a US citizen growing up middle class,
I had access to education. I grew up playing ice hockey. I went to my family’s
cabin on Mille Lacs Lake. And I just had a completely
different reality than my cousins, just
because of where I was born. So from a very young age I grew up feeling that reality,
feeling that tension. And also feeling that, you
know, in neither space, I neccessarily belonged. I always felt a little bit different. People looked at me
differently than their peers, whether I was in Mexico, or whether I was here in this country. Again, something that you’ll
see is really important to the rest of the story that I’m gonna share with you later. So, when I had the
opportunity to go to college, I was the first person in
my family to go to college. And, I dedicated my
education to figuring out, learning more about my cultural roots. But also, I pursued an
education that was focused on trade policy between US and Mexico. So you know, of course again,
connection to that identity, and what I decided to
pursue with my education. So, I got my degree in
international trade and policy. And I worked for years
in Mexico and Ecuador working with indigenous
farmers on sustainable and traditional farming practices. And what I realized, and
actually I just asked myself the question, why am I over
here in another country in Mexico and Ecuador,
working with farmers who know exactly what the
solutions are that they need? Who know what is best for their families. And I’m over here coming from a different, a different community,
a different country. That dynamic just didn’t feel right. And, I also realized that
the farmers that were living in the deep poverty that
they were living in, was because of the trade
policies of this country. Because we have put structural
adjustment policies in place so that Ecuador would be
in debt to our country. And to use the US dollar. And the fact that the trade
policies of this country were exporting goods at
lower than it cost to produce in other countries. Putting thousands and millions
of families into poverty. So, I realized that what I
needed to do was to come back to my home country, the United States, and to make change from
within this country, and change our policies. So, after going through this journey, it brought so much
clarity to my priorities, and how I wanted to move forward. And I also became more
clear about the role of my identity, and the
role that that played in building courageous leadership. So something that I once
struggled with as a youth, the story that I told you
that I never felt like I was from either the Mexican
culture and community. From half of my family,
or feeling disconnected here as well, feeling like
I didn’t fit somebody’s box exactly, or the expectations of others. It now became my passion and my purpose. And it’s the reason that I live today. And it is my strongest asset. And, what I realized is that
I am a natural bridge builder. That I bring together people
from different cultures, from different communities,
different walks of life, to come and sit at the
decision making table together. To find solutions that are
best for our community. And, that’s what I do as mayor, that’s what I do at Blue Cross
Blue Shield of Minnesota. And it is because of my
identity, how I grew up and who I am, and what my values are, that I do the work that I’m doing today. And that identity and that realization was one of the main reasons that I decided to run for office in 2016. So, I didn’t come from politics,
partisan politics at all. I had voted, I had donated
to candidates that I liked, but that was all, that was
my engagement involvement in the political process. I came from a place where
I felt like each party, both parties, would use my
community and other communities during campaign season. But when it came time to
actually make radical changes that we needed, like hey why
not give a driver’s license to everyone in the state of Minnesota so that they can get
their children to school, and to their activities. Or things that would help my community. At the end of the day those
policies weren’t passed. And so I was really not
interested in doing anything more than voting. But, I saw so many things
happen in the healthcare system in my community, the Latino community. I saw young African
American men being shot by police officers, and I
was protesting in the streets with my husband and we
came back one night. And I just said, “I
can’t do this anymore.” I need to do something different. Because how many more
marches do I have to go to until this gun violence stops? How many more things,
opportunities for volunteering do I have to do before my community has access to healthcare? And I just felt like what I
was doing wasn’t adequate, and that I radically had
to change my life to lead, and to actually make
change in my community. So, I also worked for the city in our public health department. And I saw how many
resources, big institutions and big systems have. And luckily the city of Richfield, and this isn’t the case for
all systems and institutions, but the city did acknowledge
that we have a beautiful, growing, diverse community in our city. And that they wanted to reach
out to those community members that are refugees, new
immigrants, folks of color. But they just didn’t know how. But they acknowledged it
and they knew they had to do a better job. And when I was out in community,
I learned from families that they wanted to be
a part of our community. They wanted to be involved in sports and recreation services. They wanted to be involved in programming, but they didn’t know how,
they didn’t know what the process was. And in many situations
it was very different from what they were used to. So there was that disconnect. And, I realized again with
this identity that I have of being a bridge builder,
that I had something to offer. That with my public health background, with my community organizing background, with my ability to bring people together, we could have leadership
that could help co-create the future of our city. With everyone at the
table focused on building a healthy, thriving community,
where people felt safe, where people felt included. Where they could walk around,
where they had good jobs, where they had quality,
affordable housing. And that if we took a
people first approach and we focused on the health,
in building a healthy city, that that was something that
was possible and tangible. When I decided to run, of
course there was many voices that told me that I wasn’t ready, that I didn’t look like
a political candidate, or a politician, that I
needed to wait in line. That there was somebody
else that was prepared to be in that position, and
that was more capable than I am. And, I had constantly
these messages around me, telling me not to run and
putting barriers in place. And I decided that I was
gonna continue anyways. And that I was gonna run for office. And you know what? Maybe I had never run a campaign before, and I didn’t know the
political piece of it, but I knew that I had skills to offer. I know public health, I
work in public policy. I worked for the city that
I wanted to help govern. And I knew my neighbors in my community. And that there was a lot of
things that I could contribute that were missing. So, we decided to run,
and we had a very scrappy grass roots campaign that
really engaged so many people that were not typically
engaged in civic, and voting, and civic engagement in general. We had teams of Latino
youth, of senior citizens, of community members with
disabilities, of Tibetan. You’ve come together sharing the story of our campaign in the community. And, when election night
happened we were able to win with 58% of the vote. When everybody told us that
we didn’t have a chance. So that was absolutely an amazing night. And, shortly after, I had the
opportunity to run for mayor. And again, I knew that
there was a lot of change that we could do, and that
we had just began our work. And since then, Dr. Carter
talked about some of the things we’ve been able to do. We’ve been able to pass,
make changes that are public health changes, improving the lives and the health of our community members. Including increasing
the age of tobacco sales to our youth to 21. We’ve been working on
complete streets initiatives and safe routes to school, where we’re ensuring
that every single time we do updates of our infrastructure, we make sure that they’re
walkable, and bikable, and safe for our drivers. Creating an infrastructure
that’s healthier and safer for all of
our community members. We’ve reduced beauracratic
barriers to hiring and retaining officers
of color in our city. We got rid of our Police
Civil Service Commission, because we did a study and we found that that was creating so many
barriers to community trust, and to retaining officers that
looked like our community. We’ve done housing
studies on the connection between affordable housing
and health outcomes. And we unfortunately found that Richfield has some of the worst racial inequities in home ownership rates in Minnesota. So when we found that,
we made sweeping changes. We changed classes and
partnerships in the community to make sure that we were
supporting our residents, and finding ways to build their credit up. And to address the biggest
barriers to home ownership. Today, if you’re a Richfield
renter and you want to buy your first home,
and you’re middle income to lower income, there’s a
few parameters around it, requirements, we will give
you $15,000 down payment assistance for your first home. Zero percent interest and 100% forgivable. Because we want to support our residents to have housing stability
and home ownership in our community. So, I’m telling you all of these things, and all of this story,
because I want you to see the connection, and I
want you to think about what this means for yourself. What is the connection of who you are, how you grew up, what
your family history is, what your passions are,
what your identity is, to the work you’re doing today? And who you are today. And make that connection to health, and make that connection
to your spirituality. And the piece that where
spirituality comes into play for me, and this can look
different for everyone. As a young Latina woman of
color running for public office, it is very, very vulnerable
to put your face, your name, and who you are to the public, out into the public. There’s a lot of push
back, and like I said, this happens and continues today. People questioning my leadership,
questioning my authority. When I decided to run people telling me that I wasn’t fit or ready to run. And so me as a young woman of color, I need to dig very, very, very deep and find that spiritual depth
and connection to be bold. And to not internalize
those negative messages that come at me externally
on a day-to-day basis. And to find strength in myself, and to find the connection
to the greater good, and the reason that I’m here on earth. So that I have that strength
and the power to move forward. So, I’m asking you all
today to think about what is that story for yourself? And how do you connect who
you are and your identity to what you’re doing today? And where does your
spirituality come into play? Because at the end of the
day what we’re really trying to do is build a world
that’s more inclusive, a world that’s more compassionate, a world that’s more welcoming. And, we can perpetuate systems of inequity that bring us further and
further away from that. Or, we can dig deep,
find those connections and find those values,
and take steps and actions and say words that will get
us closer to that reality. (paper rustles) And part of the work, I want
to share a little bit about what this work looks like at Blue Cross Blue Shield of Minnesota. And I also wanted to say I’m
gonna end in a little bit and I would just be open to having, answering questions
and having a discussion back and forth with you all tonight. So, I do this work of
building healthy communities in partnership with community as mayor. But I also do it at Blue
Cross and Blue Shield. So, are there any public
health folks in the room tonight at all, any
folks from public health? Okay, so there’s a few. So we know as public health professionals, and health care professionals as well, that 80% of what actually creates health is outside of our genes, and is outside of the traditional healthcare system. It’s socioeconomic factors,
it’s our built environments, it’s our behaviors. So 80% of what creates
health and impacts health is outside of healthcare. And these are all the things that I was talking about earlier. Our streets, the zip code that we live in, the color of our skin, our
educational attainment. Do we have access to healthy food. Do we have access to affordable housing? These are the things that create health. So, as we know our
healthcare system is set up, is not set up to address those issues. So part of the work that I do, again, is using my ability as a bridge builder, and identity as a bridge builder to work with our community members to figure out how can Blue Cross Blue
Shield, a health plan, Minnesota’s largest health
plan do better at incorporating social determinants of health into our core business strategies. So we’re looking at how
do we address social needs in clinics and hospitals? How do we make sure that we are supporting community health workers and building out the pipeline of community health workers? And ensuring that they have
actual reimbursement rates that cover the work that they’re doing, and that are sustainable. How do we work with community
partners such as food shelves, such as economic development centers? When community members
come into our clinics and our hospitals and say
they have social needs that cannot be addressed
within the hospital, that we are giving them a warm hand off to community partners that
can help them grow and thrive for the long term. So, this is a little bit
about how I use my leadership, and use this identity and connection, between healthcare, health
and leadership at Blue Cross. So again, these are just
questions that I want to put out. How are each one of you in your role looking at those social
determinants of health and what your role is in addressing those? Understanding that maybe
if you’re a physician or a certain type of
provider, you’re not going to have the answers. But in order to change our system, we need to be leading collectively. So who are those community
partners and those folks that you’re working
with in your profession, to make sure that we’re all moving towards addressing those social needs? And making sure that social
determinants of health have less of an impact
on our community members. Lastly, I just want to
reiterate the point that if we want to make these sweeping changes of our healthcare system to be
more culturally appropriate, more inclusive, and more equitable, it’s extremely important
that we go through those changes with ourselves
and with our families. And that requires a process
of internal reflection, questioning things, and
asking why are things set up the way that they’re set up. And, doing the work we need
to do to shed generations of colonization that have
succeeded in limiting our beliefs and our actions, contributing to the systems
that we have in place today. So, I’m not neccessarily here to say we need to completely
dismantle every system that we have in place. But that as a part folks that
have commitment and passion to providing health and well
being for our community, it’s important that we start questioning, and getting different perspectives. And figuring out how we can
do better for our community. And understanding that every
single decision we make and action we take is
either an opportunity to move us towards advancing equity, or towards perpetuating inequities. And that’s why that self reflection, and getting to know who we
are is really important. I have seen in my profession, in my work, a lot of community members
and leaders of color, who have internalized oppression that they face on a day-to-day basis. To the point where we
feel, and this happens to women also, where we feel
that we’re not good enough, we’re not adequate, we
don’t have the skills, we’re not ready yet. Because that’s what we’re told. I’ve also seen many well
intentioned white community members who want to do good, who want to do the work of justice. But because there’s not self awareness of their privilege and of their role, there’s more harm done than good. So, this is the piece of
understanding who we are, where we come from, where those spaces of
privilege are that we hold, and where we may be disenfranchised. And how we can learn and lead collectively with one another. So, I think those are the main things that I wanted to share tonight. But, the biggest thing is
that I want ask everyone to just take time to reflect. And this is such a great space. You have so many mentors,
so many community members. And this forum is the
perfect space to do this. And just think about for yourself, what does the connection
between who you are look like with what you’re doing today? Think about your values,
think about the things that you’re most afraid of. And start to explore that, and start to know yourself better. And then start pushing
yourself past your limits, and past what you think is possible. Because if we seriously want to change the reality of the world we have today, we absolutely have to transform ourselves, and we have to step
outside of our comfort, and outside of our fear. And figure out how we’re gonna take action today to change that. And figure out in every
single role that we have what that looks like, so that we can have a more just, and equitable and
inclusive healthcare system. So thank you very much
for having me tonight. (audience applauds) So I don’t know if there’s any questions. – Is it okay if I just extend
a particular invitation? So one of the things we
really try to do here at St. Scholastica whenever
we have a guest coming to give us, share their knowledge. Is really encourage
students to come up first, you know if at all possible. I meant to extend that
invitation beforehand, so you could be thinking about it. I’d really like to encourage you. Even if you’re feeling a
little shy, or uncertain to come and ask a question. If nobody comes up I can always bring the microphone around too. One other thing I just wanted to mention to anyone in the room who’s holding a copy of the schedule for tomorrow, is that you can get on the
website and register tonight, or first thing tomorrow
morning and attend any session. Any student here can come for free. Any faculty or staff member. And if you have any
questions, just let me know. If you just Google
Culturally and Spiritually Responsive Healthcare
Conference you’ll find it. So I just want to invite
people to come up. (footsteps clicking) (audience laughs) – Hey everybody. Thank you for being here. I just kind of want to ask you, I’m Kim by the way. – Hi!
(audience laughs) Sounds like everyone knows you. – I’m an OT student. I just want to ask you kind
of how you’ve addressed the challenges of being a biracial women, how those challenges have like, you’ve overcome those
and shape your identity. I just identified with what you’re saying, and just kind of want to
know your point of view. It’s amazing what you’ve done today. – Thanks. – Just like your story on that. – Thank you. Yeah, thank you very much. So in terms of the
challenges of being biracial. So when I was a kid, I grew up and I went to a Catholic school. And my brother and I were
the only family of color, the only students of color. My mom would make us
like the most amazing, delicious Mexican food. And then I would take it to school, and super excited to eat it. And all the kids would be
like, “Ew, gross, what is that? “That looks like poop.” And you know all the things
that kids say, right? Except it was delicious
(speaks foreign word) and all this amazing stuff. And so quickly, I was
like, “You know what mom? “I don’t want your food anymore. “I want you to make me a peanut
butter and jelly sandwich “with like the edges cut
off, and a Jello cup, “and little carrots, that’s what I want.” And the kids put these notes
in there in their lunch that says I love you from
your parents, so that too. (audience laughs) Even in school, I got to
the point where I would say, please don’t call me Maria in public, call me Makenzie, my
middle name is Makenzie. And, it was just really sad, because I was really, I didn’t want to accept
that part of my identity, even though that part of my identity was very much about my home and my family. It was really difficult. And I’m very much, my identity’s very much like white passing. And so when I was a child,
I think people were not very threatened by me. Maybe I was more ambiguous
and I could be anything to them, and it was
friendly to them, you know? But, my brother does not look like he has a white father at all. And he, the discrimination he experienced was much, much worse
than what I experienced. And it still is today. So we pushed back as children I think. And, it wasn’t until college
that I started to explore my Mexican identity. And there’s a lot of books,
even if you’re not Mexican, Chicana, biracial, there’s a lot of work on Chicano identity. Which is great to read
if you are biracial, or multiracial, and it talks a lot about those mixed identities. And when I was a kid I didn’t feel like I was a part of my Mexican family, or my American family completely. But to be honest, I got to a point where I knew myself enough where
I said, “You know what? “I am who I am.” And I speak Spanish very well. But it definitely doesn’t
sound like the Spanish of my Mexican cousins, and that’s okay. And my brother doesn’t
speak Spanish at all. We’re no less Latino than anybody else. So today, I just, I’ve
gotten to a place in my life where I, it doesn’t matter
about the expectations that others put on me,
because I know who I am. And I’m very strong in that. And I will never compromise that. And that’s why I am, where
I would never be mayor. I would never have my college degree. I would never have done
anything if I listened to the expectations of others. And I think being
biracial, and multiracial and multicultural is my
biggest asset that I use today. So again, that’s just one of the reasons, whether you’re multiracial, or
whatever your background is, it’s so important to know who you are, and to accept that and to love it, and to be very strong in it. Because I think you can
never, you can never go wrong by doing that, but it was a journey. When I was a kid it was
much more difficult. Other questions? (woman speaks off microphone) – [Audience Member] I guess
just kind of wondering what kind of resources us as students, and as future health
professionals can use to help advocate for patients and make
that change in policy happen? – So, I’m wondering. What are the backgrounds
of a lot of the students here tonight, like
educational backgrounds? What are folks studying? (woman speaks off microphone) Okay, so it’s very much like
healthcare studying, okay. I think learning, maybe
if you’re able to take a class on public health
and public policy. Or public policy that’d be great. Just so you can learn
public health is very much about scaling what you all are doing to the population level. And figuring out how you set
up systems and interventions that impact the health
of huge populations. I think with the curriculum
that you will have in healthcare and in public health, you also need to have another perspective and learn about, I would
say the history of race and racism in this country. And how this country was built on that, and continues to be built on that. Because that plays into our day-to-day. That plays into the statistics
and the studies you read in class that plays into
the patients that you see. And understanding that big global context is really important. Because a lot of folks
who are trained in work in healthcare, it’s very
much about the individual. A lot of times it’s very
focuses on a specialization. And all of that is very important, and necessary and needed. It functions within a much global, systemic, institutional context. And so looking at things like, you know, like I said, our history,
looking at public health, looking at how public policies are made. Even if you go to a local
city council meeting, I’m sure there would be a
teacher here or somebody that could take the initiative or suite it when a health topic comes into play. Even when it’s transportation,
when it’s housing, these are all health issues. And go and take a field trip to your local city council meeting. Go and look at, listen
to a work study session, and learn how your local
policies are created. And maybe weigh in on
a comprehensive plan, or a infrastructure plan. So those are some things
that I would recommend. Also, if you have any
organizations in Duluth that are focused on community organizing, that would be a really good kind of a good discipline
or framework to also build. It’s about how do you
build community power? How do you build community voice? How do you build coalition
and collaborative work in a way that’s just and
puts community first? So, those are some resources
that I would recommend. – Hi thank you.
– Hey. – [Audience Member] And
maybe you’ve just answered my question about putting
community first being the answer. So I have gone to council
meetings and the school board. So thank you for the work you do. And it’s really contentious even in those community organizations,
it can be contentious. So, you use your knowledge and yourself, but perhaps you can give
us a little bit more. How do you build that consensus
and bring people along in that agreement? – (sighs) Yeah, so it
can be really difficult. And a lot of times I
think sometimes you just have to start, and it’s a little cliche, but like with a small group of people who are very much willing. So, when you look at community change, there’s all different
types of groups and people. And everyone plays a different role. And a lot of times community organizers, some organizers play
the role of agitation. They’re there to disrupt the system, they’re there to disrupt the status quo, the meeting, the whatever it is. And that’s their role. And that role’s a very
important, necessary role. And then we have people
who uphold the system, and uphold the status quo. And that plays a particular role. And then you have people who are impacted that sometimes don’t have a voice. You have all these different people. And, what I have found
is in order to build effective change you
have to start with people who understand that you need
to build community power and institutional power
and change, as well. And part of my journey was working so much with community, and
feeling like we had power and a voice amongst ourselves. But then when we got to the
table with decision makers we were tokenized, we were
discarded, put to the side. And we actually really
didn’t have a voice. And realizing that you can
build as much community power as you want, but if you’re
not building an opening, and an institution, and
decision makers that are open, and willing and able
to work with community, you don’t have anything. It doesn’t work. And vice versa. You can have a decision maker that says, “Hey I’m really open and interested “in working with community.” But if there’s no trust with
a community to work with, and if that trust is not there, and that partnership is
not there with community, you also don’t get anywhere. I always start with people
who know that sweet spot. The people who know what
their role is and understand. And sometimes I think
about this as diplomacy. You have to be able to
work across the spectrum of decision makers and
community with a shared goal. And people who understand what
that partnership looks like. Some people think that
working with decision makers is selling out. Some people think that working
with community is caving in. Those folks aren’t gonna be helpful. You need to find people in the middle that are bridge builders,
that are negotiators. And you have to start small, and you have to keep
building your work out. So that’s a strategy, that’s
a strategy that I use. And I’ll give a concrete example. When I was first employed
in the health department, I didn’t really know or
understand what public health was until I started working in public health. And that was because they
were looking for a biracial, bicultural Spanish speaking
public health masters. A person with a masters in public health to work in the Latino community on community health initiatives. And I didn’t have my degree,
but I had been working in that for a long time,
and I just didn’t know it. And I was one of the few,
I was only one of two people of color in my department
who were not translators. And I would get reprimanded
all the time by my boss and our health administrator for going out into community and having
personal coffee dates with people. And they said, “You
need to be at your desk “doing your job.” And I said, “I am doing my job. “I’m talking to community
and then learning about “what the needs are in community.” And it wasn’t until months and months in that my peer, who is an older white woman, who’s been working in public
health for over 30 years said, “I see what you’re trying
to do and I get it. “And it see the push back you’re getting. “So let’s work together.” And, one day she decided
to bring the great idea of going out into community as a team, and talking to community to figure out what the health needs were. (chuckles) And we planned this together. And they said, “That’s great!” So immediately after, our
whole team was out having one on one’s with community members, and getting to know what
the health needs were. And that was completely
infuriating to her. She had never seen that before. And it was completely infuriating to me, and I had seen that for a long time, and that was nothing new. But that created a relationship. But she had to be open enough, and aware enough to see what was going on. And I had to be open enough
and vulnerable enough to trust her, and to say that we’re gonna do this in partnership. And out of that partnership
came so many things, including finding ways to
funnel public health money to community members for work that we had not traditionally done ever. But that now is creating
amazing health impacts, including a community net
led by undocumented Latinas living in apartments in Richfield. A child care provider
network of over 300 Latinas. And that came out of me
having that connection with the community,
her having the know how of how to write grants, and
speak public health speak. Working together, and
getting a seed funding for $2,000 to do free Spanish language, culturally appropriate nutrition and physical activity education
for child care providers taking care of children zero to five. And out of that, the popularity
grew, the momentum grew. And we’ve bee able to
support the community to run the network of
themselves, for themselves. and have a whole huge robust
early childhood system. Focused on providing quality,
culturally appropriate care. But that came out of that partnership. And sometimes it just starts
with those small people who really understand what it means to be in that middle ground of
negotiation and collaboration. And it’s hard to find people like that. Other folks? Hi. – [Audience Member]
Your first election was to the city council? – Yes, in 2016. – [Audience Member] Did you
have a specific project goal? And how did you build the,
that’s a little different building coalition amongst, you must have had other council members who were supportive or to work with that? Just interested in
hearing a little bit about how you built that, used that philosophy in the city, existing
city government structure. And even as mayor, too. – So, what I did is, and
again this is I think community organizing would be great. If you want to make wide
change for a lot of people, community organizing will
teach you about an approach. And you can tailor that approach to what feels right for you. But, the strategy that I use
today and that I used in 2016 for my election, and for all
of the public policy changes that we’ve made since 2016, has been to spend the majority
of my time in community. And to spend the majority
of my time in community, in the communities where
people are not traditionally engaged, seen, invited. So I’m not spending my time at like, the groups that are always
doing the same work and leading. I’m spending my time in
mosques and Latino churches, in Tibetan community centers,
and apartment complexes, and senior centers. Where there’s a lot of
disenfranchised community members, where I can really build connection, build trust, and get to
know what their needs are, what their dreams are, their aspirations. And based out of that, we build
our public policy platform. And that’s where the dementia
friendly city designation came out of, was building
relationships with seniors that were really
concerned about isolation. That were concerned about being home, wanting to age in their
homes, and age in place, but not having the resources. And folks that the
increasing number of dementia in our city, and figuring
that there’s a program and a public health
approach that can focus on building a more
compassionate community, based on supporting our seniors. And so now the seniors and
our public health department are leading that work together. When I talk to renters and
to low income communities, job stability, early childhood, and stable housing were issues. So that’s where a lot
of our work has come out of in those areas. So part of my strategy
is to build and expand my base, and my leadership and connection. But not with the usual suspects. Those usual suspects are there, I’m already working with them. They’re already leading in our community. So it’s bringing new people to the table. Then, it’s building
trust amongst your peers, amongst other decision makers. And I’ve noticed this was
not a part of the plan. But I am the one that
does the most homework on all the issues
(laughing) on the council. So that helps, because
people have noticed that, and they know that you’ve
done your homework. They know you’ve done the research. And so, when you contribute
they know that that comes from a place that’s well informed. So that also helps. And then building your
relationship with those established leaders, the leaders who are there now, the leaders who have current, existing decision making power. And, finding ways to figure
out what the interests of all of those groups
are, and building trust. It’s all trust building
and relationship building. With the purpose of making
your community a better place. There are people and
there are politicians. And this is why people don’t like politics that build power in relationships
to serve themselves. To build personal power for themselves. That’s not gonna get you anywhere. And that doesn’t get
our community anywhere. So it’s about building
those relationships, building trust over time. And it’s depositing small little gestures of trust building with your constituents, and with your peers and
with other decision makers. And something I’ll say,
a lot of decision makers don’t neccessarily have
a big base of people. And so if you’re a
decision maker, if we want, we have a Tobacco 21 meeting. And we can mobilize 300 people to attend our city council meeting, that’s powerful. And, to be able to have
that decision making power and the connection with
your peers is important. So, building that community
network and that support, and building relationships
is really important. Thanks. Any last questions? – [Audience Member] I
have one that’s maybe more of a comment than a question. So I’m Dr. Vonyo, and I’ve
been on the Fond du Lac reservation for 22 years. And I mentor a lot of
students that are getting into medical school, that are
already in medical school. Students of color, primarily. And I had one just this
past week, a student come up to me and say, “You know, I
have this imposter syndrome.” And shes’s really doing
well and she’s smart, and she’s gonna be great. You know but she has
this imposter syndrome. And I had to tell her that I have it too. And I still have it sometimes when… I’m a physician, and
I still sometimes feel like I really don’t deserve
to be that physician. That I didn’t, I don’t really know how to express that, exactly. But what you were
talking about with having to dig deep and to push
back against all the forces out there that say, you’re
not good enough to do this. You’re not ready to do this. And a lot of students that
are going into healthcare, you know the system’s kind of set up, and the things are kind of
set up to make you think you’re the only one that feels like that. And everybody else is
doing well around you. Don’t feel that way. Any students at least knows
how to get ahold of me. I’m willing to talk to
anybody about that stuff, and to mentor students, and
to let you know you can do it. You can do this. And thank you, and I’m
gonna use Maria Gonzalez for an asset of my own. (audience laughs) And to talk back and forth, and thank you. – Thank you, and thank you
for bringing up the point of mentorship, and thank
you for being a mentor to so many young kids. I feel like I have and have had a village of mentors in my life. And I know friends, and
students and families who do not have a mentor,
or don’t feel like they have a mentor. And honestly I would say
one of the most important foundations of my success
in doing what I’m doing, is because I’ve had mentors. And people that love me around me, that have been telling me when
I have that imposter syndrome and I share it. When I did my first endorsement screening with an organization,
Take Action Minnesota, I didn’t know what that was. And it’s when organizations and groups ask political candidates their
positions on different things. And then they decide to endorse. And if you get the endorsement you have, they’ll donate to you,
they’ll give volunteers and you can use your name and say, “This organization Take
Action has supported me.” But I didn’t know that, ’cause again, I didn’t know what I was
doing when I ran for office. I had a girlfriend there and I was like, “I don’t know what I’m doing. “I don’t even know what this is! “I don’t know what they’re
gonna ask me, what the heck.” And she goes, “Look at me right now. “I don’t ever want to
hear a word like that “come out of your mouth again! “You are powerful, you
are ready, you’re able.” And I returned the favor
to her just a year ago in a job interview she was in. So having mentors is so important. You know there’s not like a formal way. There’s formal mentors in formal programs. But sometimes there’s just like not a way to formally get a mentor. And you can just ask an adult,
or somebody that you admire in life and say, “Hey can
I have coffee with you? “Can I check in with you once in awhile, “and just shop around some questions?” And just do that every once awhile. And that relationship will materialize. But mentorship is extremely important. And that’s one of the main
reasons that I’m here. Because I had mentors
and people in my life that told me, when I wanted
to give up they told me to keep going, and that
I was strong and ready. Anyone else? And, I don’t know what time it is, so you’re gonna have to just let me know when we’re close to being– (woman speaks off microphone) Okay, excellent thanks, hi. – [Audience Member] Hi, I’m an OT student, my first year. And, you mentioned talking about situations where people ended
up doing more harm than good. – Yeah. – [Audience Member] And my
guess is that has to do with a white savior mentality
and that sort of thing. So I’m just wondering what advice you have for making sure that what you do is actually beneficial and meaningful? – Absolutely, thank you for asking that. I think the most important approach is to always, to build genuine, authentic relationships with people in communities
that you can trust. And ask those most impacted and
the people directly impacted before making assumptions,
what is the best solution? What do you and your community think? And how can we support you? So, a lot of times in
public health I felt like I was trained to tell
people what they needed to be healthy. And I think that’s an inclination, because we have an
expert mentality, right? We’re trained in these professions. But we aren’t experts in what people know in their own solutions
and in their own health, and what is best for them. Again, just taking the
time to listen and to ask and to not make assumptions. But that also takes genuine
relationship building with groups, and with
people and with communities. And so I think it’s just
having that practice. So I’ll give an example of the
childcare provider network. So we started these trainings. And women were super excited and we had, today we have like 80 people
per class every single month were taking these free
childcare provider trainings. But at one point, as the
public health department, we said, “Oh well let’s
support the community “to be licensed childcare providers. “Because that’s quality
care, that’s gonna help them. “That will be great.” And, we started down
that path exploring that. And then, we went back to community
and they said, “No. “We don’t want to be licensed. “Didn’t you guys ever think
about asking us what we want?” They said, you know first of all, so there’s a perception
and it’s true, also. Licensed child care centers
and daycare centers, they’re not affordable
for so many families. They’re not neccessarily
very culturally appropriate. In our community, our childcare providers, our preferred childcare
providers are our aunties, our mothers and our grandmothers. We want our kids to stay in their homes. We want our kids to stay in our community. And they didn’t want to go
through a formalized process. And then of course there
was a lot of risk and fear. We found out that to be a
licensed childcare provider, you have to go through a
whole inspection process if you’re doing it in your home. And the fire department will come. They’ll do a fire inspection. And if a fire hazard of
found, regardless of if you get licensed, or passed or not, you have to fix it. So all of a sudden you
have an inspector coming into your home, and they
could possibly find a change. Which is very important
to make this change for your safety. That could $500, it could be $10,000. And now that community member
has a $10,000 fire hazard that they have to pay. Which of course I’m not
sitting here trying to promote living in unsafe conditions. But thinking about the
unintended consequences. There’s so many unintended consequences. And thinking through this. And so we sat down with
community, we paused, and we said okay, let’s reframe. Community, you lead and
tell us what you need for it to be a healthy community. And what this looks like with childcare. And they said, “Well, some
of us want to be licensed. “So we want to make sure
we create a mechanism “to be licensed. “Some of us don’t want to be licensed. “Or some of us want to
work in licensed places, “so we want to provide the
flexibility and support “for all of those options in our network.” And we don’t only want
to focus on the people coming into our network, focus on making sure they’re licensed. Because that’s either
not accessible to them, or that’s not an interest
of community members. I think it’s just, you
know, putting yourself in different, looking at different
culturally opportunities. Going to movies, reading
books, meeting new friends, going into spaces where people
are different from yourself. Building relationships of trust. And always asking those most impacted what they feel they need. And a lot of times, and
I think people are afraid to ask community. Because they’ll give you an
answer that you can’t fix. Or they’ll come, we’ll do
a healthcare screening. We’ll do a screening
for social determinants of health in the clinic. And then they’ll say they
have unstable housing. And then what are we gonna do? And the doctor already has
so much on their plate. And how are we gonna start
addressing these things in our 15 minutes together? That’s where partnership comes into place. We are silly to think that we’d be able to address all these things by ourselves. So that’s where you say, all right. I’m working in partnership
and collaboration, so that if we do get an
answer from community that’s not exactly what we can address, we can say, hey that’s a really good fit to talk to this organization
and let me connect you. So it’s about listening
and having the networks and the relationships so that we can move those solutions forward. Even if it’s not specifically and directly within what we’re able to do. There was another person, oh no. Oh yes. – [Audience Member] I
really want to thank you for being here. I’m not young anymore, but
you’re still very inspiring to anybody’s life.
– Thank you. – [Audience Member] I have
a nuts and bolts question. The $15,000 mortgage grants
that you give families. – $15,000.
– 15. – Yeah for down payment assistance. – [Audience Member] Correct, correct. Does that come from taxes? Did you as a mayor get the city council to pass a law for a tax hike? Where does that money come from? – So a lot of cities have a
housing redevelopment authority, and an economic development authority. And we had a housing
redevelopment authority, but not economic development authority. We had been doing a lot of these studies. I asked the health department
to do these housing studies. They did, we found an inequities, and a lot of barriers
to safe, stable housing for our lowest income residents. And they were thinking for a couple years about increasing a levy,
increasing the tax levy to build an economic
development authority. So that was done through
an increased tax levy. And now we have this. But those funds were
not, they were designated to supporting small businesses. But when we found this
inequity we were able to use some of the
money to support housing stability, home ownership. And use that money to
help reduce the racial inequity in home ownership in our city. But, there’s a lot of
different funding mechanisms. And you just have to be super creative. And so we use that little bit of money, and we leverage it to
apply for federal grants, for other types of
grants and other funding. We use matching dollars. So again, as folks working in
healthcare and public health, we may not even have the
resources community needs. Or we may have limited resources. But that’s where public
health and public partnerships come into place. We need to think about all
the partners that we work with to find those solutions. And piece meal, oftentimes,
solutions together to address those most pressing issues. Thank you so much for inviting me. I appreciate it. And hopefully my talk wasn’t too whoo! But, it’s I think thinking
about, going about the micro and really looking at the macro, and how our identities connect
with the work we’re doing is extremely important, so thanks. (audience applauds)

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