Sometime in 2012, while teaching Community Health Education at Kent State University it occurred to me that we were approaching health education from a narrative of deficit (“deficit language”), and this began to feel like a very heavy weight on my heart.

The most well-known public health report, the “leading causes of death” serves as a stark reminder of what is killing us. Literally. And while this is a very important piece of data, it always felt very one-sided, or perhaps incomplete. I often wondered: what are the leading causes of health? Where is that data? Where and how can we measure this?

Sometime in 2005, we formally recognized that there were social and environmental factors that support or hinder health status across populations. The social determinants of health provided a new lens and widened our scope well beyond individual agency to consider the social, cultural, economic, and environmental factors that contribute to well-being and productivity. It re-minded us that it is not either-or, but both-and.

For good reason, these “conditions” are very much front-and-center at the moment. Conversations around racism, sexism, abuse of women, access, economic justice, institutional racism, colonialism, and cultural imperialism, among other seemingly polarizing topics, are scattered across our shared landscape. These conditions are being illuminated for us– for all of us.

Personally, I’ve been thinking a great deal about this because these are the exact issues that plagued my daughter Serena’s heart-mind and her insistence that ‘everything was wrong’– and by that she meant her own personal condition (cystic fibrosis), but also the collective “wrongness” that is created by the illusion of separation and the economic power struggles that are generated from this distortion.

Imagine with me for a moment a community where every single person felt loved and that they belonged from the start.

Imagine a community where every single person felt that their existence actually mattered.

Then, from this personal higher perspective, better choices are made around physiological and safety needs. More self-actualized people means less suffering and more peace. More self-actualized people means wise leadership and therefore better administrators in our institutions, and in government. More self-actualized people means less abuse, name-calling, and finger-pointing because we realize, we are it.

Now, here’s the kicker. This is not something our government, social service agency, or church or anyone can “give us”. It must be nurtured within, in our schools, our homes, and reinforced in our institutions and in society. If you are in the majority in terms of love, belonging, esteem, and access, this is an invitation to personal transformation; to support others in this understanding and attainment, too.


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