By Bharathi Radhakrishnan
In the midst of downtown Boston in early December 2015, conversations focusing on the values of diversity and inclusion filled the conference rooms of the Park Plaza Hotel where the School for Global Inclusion and Social Development at UMass Boston (UMB) held Building Inclusive Communities (BIC): Neighborhoods to Nations, its first global conference on inclusion.
This event brought together hundreds of professionals, academics, and students to discuss the importance of developing inclusion strategies and addressing marginalization. Diverse institutions were represented at the conference, from the Girl Scouts of America to the University of Lublin in Poland.
The conference was filled with lively discussions covering a variety of issues related to inclusion such as education, health and wellness, research, funding, and economic opportunities. The entire conference had an extremely collegial and collaborative atmosphere as discussions were facilitated through plenary sessions, breakout sessions, and group activities conducted over lunch.
Inclusion and health equity
A great strength of this conference was its ability to discuss a variety of different issues related to inclusion. Health and wellness is one such area that the conference addressed, particularly health equity. Health equity is defined by P. Braveman and S. Gruskin (2003) as the lack of systematic differences in health, or the social determinants of health, among groups of people in the same setting who have different social advantages and disadvantages, such as economic status or power.
One of the conference panels focused specifically on global health equity and was titled “Our Differences Shouldn’t Mean a Difference in Care.” During this session, the panelists discussed how their respective institutions are contributing towards efforts to promote greater global health equity and thus global inclusion. This panel, moderated by Dr. Courtenay Sprague, Associate Professor at UMB, and Dr. Jean Edward, Assistant Professor at UMB, involved two panelists – Ms. Pat Daoust, the Associate Director for Nursing at the Center for Global Health at Massachusetts General Hospital, and Cory MacMahon, a Nursing Educator with the organization Partners in Health – who both spoke about the importance of adequate healthcare services and health equity in the global context.
When discussing MGH’s global contributions toward health equity, Ms. Daoust emphasized MGH’s foundational principle that healthcare is a human right and should be available, accessible, acceptable, and of good quality for the communities it serves. Through her work with MGH, Ms. Daoust described how MGH’s Center for Global Health has 50 programs in over 40 countries that focus on three issues critical to achieving greater health equity worldwide – care, education, and innovation. Regarding care, MGH provides disaster relief services worldwide, including in response to the April 2015 earthquake in Nepal. Along with care, MGH also focuses on education for healthcare workers worldwide, which is particularly important given the global shortage of health workers. MGH’s Global Nursing Fellowship Program and its degree programs aim to contribute to advancing the skills of health workers worldwide. In regards to innovation, Ms. Daoust explained the role of the Consortium for Affiliated Medical Technologies (CAMTech) at MGH in this endeavor, which works to help advance medical technology worldwide.
Complementing Ms. Daoust’s discussion, Ms. MacMahon described how her work with Partners in Health (PIH) as a Nursing Educator is also helping contribute towards greater global health equity. Just like MGH, the same foundational principle – that health is a human right – guides the work of Partners in Health. Ms. MacMahon described how PIH operates over 60 health facilities in 12 countries with about 13,000 employees that are based locally in those countries. Specifically, PIH focuses on strengthening the health systems of the countries within which it works by building local capacity and working with the local public sector. The organization prioritizes partnering with local organizations in order to ensure sustainability in its programs. Specifically, PIH follows a principle of “accompaniment” through its work with local partners. Ms. MacMahon also emphasized that the impact of disease cannot be separated from the local socio-economic context, which plays a great role in PIH’s work worldwide.
One of the most prominent and compelling messages highlighted throughout these two presentations was the importance of understanding the local context in order to attain health equity. Ms. Daoust and Ms. MacMahon both described how two Boston-based institutions are having a global impact in trying to improve inclusion worldwide by contributing towards greater health equity. However, both panelists emphasized that implementation at the local level with local partners is critical for any international institution to adequately contribute to global health equity. Since health equity cannot be separated from a country’s specific local context, it is critical to remember that health equity efforts must be tailored to each specific context.
The way ahead
The closing plenary with Senator Tom Harkin, the architect of the Americans with Disabilities Act (ADA), was another highlight from the conference that provided valuable insight into issues that need to be addressed in order to progress towards further global inclusion. For example, Senator Harkin discussed how even after the ADA passed, there are still attitudinal barriers that need to be broken down in order to achieve adequate inclusion of people with disabilities. In particular, people with disabilities still need more access to higher education, which is something he praised UMB for undertaking.
Despite his discussions about people with disabilities, Senator Harkin emphasized that there are also other excluded groups in addition to the disabled, such as the homeless and people of lower income. As a result, in order to adequately solve these inclusion issues, Senator Harkin emphasized that we need to include those who are marginalized in solving these problems.
The conference’s spirit and message can be well-captured in a closing remark made by Senator Harkin. He ended his inspiring speech by emphasizing that we should not put limitations on any segment of the population and that we should not accept anything as being fixed. Progress can always be made towards inclusion, particularly by including the excluded.
P. Braveman and S. Gruskin. 2003. Defining equity in health. Journal of Epidemiology and Community Health 57: 254-258.