Episode Transcript
Speaker 1 00:00:10 Hi, I'm eWAY. So from Rethink Health, a Ripple Foundation Initiative, and we're hosting a new podcast series called Unsung Stewards. Yours are people like you that are taking responsibility to tackle the big question of our time. Why do we create conditions so that all of us, everyone can thrive? You're not alone And wondering, can we break from business as usual in practical ways? Can we lead our communities and institutions to think and act in ways that will actually make a difference? In this series, you'll hear human stories about real people in real places who are taking on these questions. In this turbulent season we find ourselves in today, we are speaking with Qua asu, the Chief Strategy Officer of Change Lab Solutions. When the city of Roanoke, Virginia received federal HUD funding, rather than simply rely on experts and officials to decide where to invest the Money Change Lab and the New York Academy of Medicine, support of the city through a public deliberation process, that process empowered community residents to address historical fractures among one another and ultimately shape the investment decisions.
Speaker 2 00:01:35 We need people to have the knowledge base to operate in spaces where they may not have the power to have the language of that particular space.
Speaker 1 00:01:52 As we look towards rehabbing from the pandemic with the support of federal resources from the American Rescue Plan Act, Hanoi's experiences shed light on how we can ensure these resources lead to equitable and community driven investments, it also highlights the importance of demystifying laws and policy to shape the underlying distribution of power. Hi, Sean Iqua, thank you for joining me today.
Speaker 2 00:02:19 Hello. Thanks for having me.
Speaker 1 00:02:22 So I wanted to start off our conversation today by asking a question that I ask all of my guests, which is, you know, what is it about your life journey that really draws you to take on the mantle of stewardship?
Speaker 2 00:02:35 I will start with something that I used to hear as a kid all the time and, and still do as like an adult child of my mom, <laugh>. And she would make this statement, you are disturbing the smoothness of the household to me and my sisters, my cousins, when they were around. And the, the point to that statement was that there is something bigger than you. It's not just about you or the actions that you're taking right now, have a direct impact on those around you in this household. I think that that instilled in me early on, helped me to understand that things are interconnected, that people are interconnected. What I do also has an impact on, on others and vice versa. And then more broadly speaking, just thinking about all of my family, both sides of my family, my maternal side hails from New York and the rural south.
Speaker 2 00:03:46 And my paternal side is from Ghana, um, west Africa. And what's interesting about my family combined, or, or maybe this is why my parents got together, is this notion or around community and family and like the community is your family. And so a real dedication to that and responsibility, if you will. So I can recall numerous Thanksgivings with my family, and there would be people from the building folks we didn't know those who were less fortunate than us who would just join my family. And I come from very humble beginnings or just thinking about a visit that I took to Ghana with my dad and, um, you know, witnessing how our family's like home base really is the home base for the entire village. And that's where people come, they come to know like what is going on. It's kind of like the commons in the square or also like knowing if you need something you, you can go to what's dubbed the yellow house, which is the literal color of my <laugh> of my grandmother's house. When I was a kid we had gardens <laugh>, this was a, a big deal. And my grandfather grew up during the Great Depression, I understood and was taught how important land itself and to respect the land and the food you grow. So stewardship in so many facets and forms really was a part of my formative development, really.
Speaker 1 00:05:35 Oh, thanks so much for sharing that. And I'm really struck by the story you told about when you went back to Ghana and just realizing that your grandmother's yellow house was the center of the village. And I think so much of what we carry in, how we're shaped, we don't always see it, but it's, it's sort of passed down from our ancestors and instilled, you know, through our parents and then they get passed on to us and then we it it, and, and not all of us get a chance to go back and see that. So that's just a, a beautiful story.
Speaker 2 00:06:03 It's like in my DNA, <laugh> to do community service, it became more clear to me how I ended up in the space of public service because before that trip it was in my mind like, oh, I just landed in public service <laugh>. But I I I, you know, just thinking about some of the, for lack of better terms right now, the, the mystical to stewardship, if you will, this was supposed to be my path,
Speaker 1 00:06:34 <affirmative>. Mm-hmm. <affirmative>. Yeah, no, it's deeply resonating with me. And I also just love, um, that proverb or whatever you would call it that your, your mother said, which is like you're disrupting the smoothness of, of this household. Like that's in a nutshell, I think what, what stewardship is about. You know, what's, what's our role in not disrupting or or exploiting the, the kind of smoothness of our ecosystem. One of the systems you are stewarding is actually our, our legal and policy ecosystem. Um, through your work with Change Labs, um, which focuses on demystifying law policy and in many ways addressing the distribution of power, could you share an example of, of how you and Change Lab have done this?
Speaker 2 00:07:18 Yeah, it was my pleasure to tell you more about that experience. So Change Lab was working with the city of Roanoke to do two big things. They wanted to think about like how could they structure their governance practices or enhance their governance practices to think about like things across the social determinants of health to center health equity. And we started talking to them about health in all policy. In 2018, the city planning department needed to identify some neighborhoods in the city of Rooke that could be prioritized for HUD community development funding. And it decided that they wanted to use a public deliberation approach to incorporate community views into local decision making in service to health equity. Just to give you a sense of just public deliberation in and of itself, it is a type of community engagement method. There's all kinds of ways you can do community engagement.
Speaker 2 00:08:26 And it's used specifically when there is a value laden issue that cannot be decided through a technical solution alone. And public deliberation, solicits input from like a cross section of informed participants will be affected by the decision. Um, and it provides the sponsor. So in this case it's the city of Roanoke vis-a-vis the planning department, um, with thoughtful reflections of constituent values and priorities. It's also worth noting the distinction because I think it'll help put the surround sound around like the shifting of power in a public deliberation. What's different about it? There are three fundamental differences than other methods of community engagement. One, participants are presented with relevant and unbiased educational information that provides a shared knowledge base to draw from. So more simply, you have a room of people we're all establishing the same baseline of understanding, and you have a someone who may have a particular expertise in a particular topic just sharing in an unbiased way.
Speaker 2 00:09:42 Let me tell you like what a health disparity is, what that means, what that looks like, for example, who participants engage in a series of discussions that are focused on the educational information that they all have now to explore individual and group values and underlying beliefs. So this is where you start wrestling <laugh> with some of the tensions, and then participants make a specific recommendation or set of recommendations to the sponsor. So right, they're also representing or stewarding, if you will, the voice of their neighbors. So to that end, it is huge for a local government to take on that approach where they have an openness and a willingness to not just hear from community members, but quite frankly like receive their recommendation on something that is like in real time. This is not a, you know, an um, an abstract activity like this is really going to affect people.
Speaker 2 00:10:54 And then the other thing to note is that the sponsors are receivers, they are not part of the discussion. So they're able to participate in a way of like listening. Like, and that takes like a lot of patience and humility, particularly in this kind of environment because you as the local government representative or working in the agency, you're gonna have to implement <laugh> and you are probably hearing what people are saying and thinking about like all the ways you could in all of the challenges that might come up. Hence that humility. There's like a shift in power because it's not just about inviting people to the table in this case with respect to public deliberation, but actually more so it's people like choosing the table and setting the table and deciding the menu.
Speaker 1 00:11:57 Wow. What's such a fascinating example and process because it seems like it's trying to generate learning for everybody involved, right? The city needs to learn and really wrestle and hold steady and listen, I love that you said that that's when people start to wrestle internally as well as they're listening to the different options, the unbiased facts. Because part of it is like, it's our work too as citizens to kind of wrestle with how we want our community to look like. It's sort of a process that's generating learning on, on both sides and it's increasing the capacity of the city, but also the capacity of the civic capacity or the civic muscle of, of those residents.
Speaker 2 00:12:36 Yeah, there are some very powerful, profound things that came out of that experience. I'll just name two one in my group. There were two individuals from two different communities. One community was like a long time historically black community. And I think it's also worth at some point, like looking into Roanoke and its history because that historical context is so key. And if you don't know where Roanoke is, is in the southwestern part of the state of Virginia and it's like at the gateway of Appalachia in the base of the Blue Ridge mountain, all that to say. Then you had another individual from a different community and they're talking about all kinds of things from like perceived safety and why they may not wanna walk out of their house here or at this time or talking about like, oh, the long term disinvestment in their different neighborhood.
Speaker 2 00:13:39 It just so happens that this one participant was an African American woman and the other was a white woman and they're just, they're sharing their experience of their neighborhoods and their neighborhoods are like actually touching each other in terms of boundaries. Through this discussion and everything, they come to this conclusion because both werere like the money needs to go to our neighborhoods <laugh> and here's why. All compelling, all compelling reasons. And then something happened where it clicked for one participant who happened to be white, said, you know what, no, this money needs to go to your neighborhood and here's all the reasons why. And she's connecting historical context, he's connecting the long term disinvestment. And she also connected that, you know, what really stinks about this situation is that we have to choose one neighborhood because that's the stipulations from hud, but really we should be looking at all of our neighborhoods together because of this interconnectivity.
Speaker 2 00:14:55 One harm done to one neighborhood affects all neighborhoods and like, how might we get to that point? And the planning department was like, yes, <laugh>, it was, it was, it was a really impactful and wonderful and beautiful moment. Another moment in terms of having, you know, people come experts and like share data and information was this huge shift in the room in terms of criterion. So that was one of the things that the folks needed, the participants needed to land on. Like what criterion do we wanna emphasize in making these choices? There was a huge shift in energy when people learned the numbers in terms of third grade reading level in the city and the connection, here's the shift, the connection of third grade reading level to health outcomes. When people learned that there's a, there is a relationship there without question, they shifted and said, that needs to be our number one indicator and we wanna know why <laugh>, we, we wanna, we actually wanna know why all of our kids are not, you know, meaning that, that metric. But that really helped to illustrate for people, oh, I now understand the notion of social determinants of health and if the kids are not reading at a third grade reading level at this point in time in their development, this is going to be, and there's gonna be an impact on the, their health, on the health of the community and on the health of the city and the health of the region. They came to that conclusion and that was just amazing. Wow.
Speaker 1 00:16:57 Wow. Yeah, I know, I mean I think that the city could have come to that conclusion on their own, but there was something about giving the, holding a space for the residents to, because it sounds like there's a fracture as there is in many communities between two groups of people or two geographies and and there's nothing that's gonna heal the fracture unless people's own kind of hearts and minds change. And it sounds like you witnessed that happening even in this short process of, of residents kind of coming to that own realization. And that's, that's really powerful. I'm, I'm curious about these, um, it doesn't have to be these two women, but, but the folks that participated in these, um, public deliberation processes, what happened to them? Like, because, because what you've essentially done in some of these cases and all the work you do is you've created almost lay experts, a little bit of, of folks that now know a little bit more about how things work and, and how structures and decisions are made that are just kind of gonna be out there in your community for like decades sometimes. So, so I'm just curious if there's any stories or, or examples of, of what happens to the folks that participated in it.
Speaker 2 00:18:00 Yeah, we saw <laugh> one individual who, from one of the expert presentations learned about, oh, this is how decisions are made around like planning <laugh> land use. Oh this is the role of the planning commission. And came to me. He was like, that's so interesting. Uh, how can I be a member? Like how, how can I get more involved? Was her question, I want to get more involved. Meanwhile, she had no idea that the, you know, the director of the planning department had, you know, expressed before, man, I wanna see more people on our planning commission. We, we, we need to have that, we need to have more diversity of like people from neighborhoods and thoughts and race and gender. All of the things' pretty tune. And, and she just signed up, she's signed up to, um, to be on the commission, which was awesome and amazing.
Speaker 2 00:19:01 Another thing is, you know, as a result of this process, the planning department did not go with the neighborhood that was recommended. And the reason why is because the infrastructure was not there in order to, for the uptick of the, of the investment. However, what the planning department did do, and that was really astute of them because you wanna set a community up for success, what they did do was allocate funding and resources to start building up the infrastructure of the community that was chosen, the neighborhood that was chosen in order to then like set it up to be able to receive these HUD dollars. So, um, that's been amazing. There's a whole like building out of like resident engagement <laugh>, um, for the city in partnership with, with others, um, or stakeholders in anchor institutions, um, in the city. So that gave them also the platform to pull in more people from the city to come to these meetings to be a part of these conversations. Cause sometimes it can be challenging or you might see the same set of people showing up and you wanna get as much, you know, reach and diverse thought into these processes. Um, which, you know, engagement with residents, engagements with stakeholders is a key tenant of like planning.
Speaker 1 00:20:43 I think it's even more interesting and powerful that, um, they ended up having not to go with choosing that neighborhood because you know, obviously there are reasons, architectural or whatever that you need to go with something sometime. But then this process, um, it sort of, it it was more about generating the kind of civic capacity of the people, but also then they came to a creative solution that they wouldn't have come to if they didn't go through that. I think the benefit of this isn't just about, okay, what was the final outcome like this neighborhood or this neighborhood, but it's, it's, it's about generating that those relationships, that legitimacy too, that consent and then the creativity around what, what can we do given the constraints because yes, we need experts, we need architects and other infrastructure experts to be able to help us here, but, but they came to a different solution because they went through this, this process.
Speaker 2 00:21:35 Mm-hmm. <affirmative>, you know, I wanna uplift the planning department here as well. Having the experience of watching others wrestle with many of the questions that they have to wrestle with and that they really appreciated that. But what they also took away from that was, oh, you know what folks, folks can handle it. Yeah, yeah. And I, and so I think that that builds relationship and trust. And the one other thing that I should say that was part of this process is that individuals who were participants were treated as experts because they are, they're experts in the community. They're experts on their own lives. So what that means is you gotta be respectful, you gotta be respectful of people's time. Here's what is going to be entailed during this time. We paid people and I'm not talking about, you know, here's what you might get in a focus group, but literally this is gonna take time away from your job. You might have had to ask for time off. We're gonna pay you like your wage for the time that you're gonna spend. All those things we know you might have to bring childcare. So you were coming with a particular orientation of respect. I respect your time, I respect what you have to say. I wanna know what you have to say. And yes, your expertise matters. It's not just lip service.
Speaker 1 00:23:16 Yeah. It's the remarkable posture that the planning department took on. And, um, I I guess, um, I, my question is, you know, cuz I I've I've worked for the city of Boston as well and you know, as other cities and institutions are, are pursuing, you know, investments to really rehab our our communities from this, this pandemic, why is it important for, for other city officials to deliberately kind of steward participation and distribution of power in this way when it can be incredibly messy and sometimes risky to embark on, um, opening up these processes. And so it sounds like the public deliberation brought like an intentionality and a and a strategy to this and structure to this. What would be your advice to folks that are worried about, oh, this seems like this can get really messy and risky.
Speaker 2 00:24:08 What I would tell people in terms of the messiness of policy making, of course it is because there's so many elements at play here. A humans themselves, we, we are complex beings, right? And then systems people make up things, people, you know, together make up a community. People together make up a system, people together make up a organization or an institution. Why do I keep flying back to people and why did I start with like humans or complex beings? Because there's a multiplier effect when you bring people together in whatever construct. And so therefore that level of complexity is going to multiply. And so when you think about policy as a tool or as a vehicle or as a intervention by design, by nature, it's going to be messy. And so just to connect it to like why we're here today about stewardship stewards, embrace the complexity stewards, embrace the ambiguity of it all and stewards embrace the very real idea that there might be failure. And I put failure in quotes because I don't believe really in failure, I think it's more of, nope, it's information you receive to like pivot.
Speaker 2 00:25:48 And that to me is like the world of public policy. It's about the like nuance and the subtleties and the wrestling and the pivot and you repeat and you will always need to do that. Public policy is not a spectator sport sport. You gotta get in the ring and you gotta rumble as I think Renee Brown would say. So that's what I would, I would tell people and that that fear, that fear contributes to or can contribute to paralysis, which in the end is like the worst outcome because the intention behind all of this is to like make things better for people.
Speaker 1 00:26:41 Yeah. And that, and that paralysis oftentimes can lead to distrust because imagine if that city just said, oh well the architect said we need to just go in that neighborhood, you know, what would people say that that have been examining this, this development and, and and all that. And um, it's, yeah, this is such an important point, which is I think stewards art need to, and honestly it's hard for people like me cuz I, I do like having things kind of structured and ordered and, and, but just to accept the feeling of being in suspense and um, that, that things are going to need to pivot and change.
Speaker 2 00:27:18 Yeah. Well what's connected to humans and body, right. And movement. I think you and I were part actually were part of a different conversation and I was mentioning, you know, I think it's also about a dance, it's a choreography. I remember working in local government and we would say, oh my god, it's budget season and it's time for the budget dance. But <laugh> all that to say to what you're, you know, pointing out yearly leeway is that when you move, you activate being start to shit your antennas, your different antennas are gonna go up. So I'm speaking in a metaphor here, but movement, it's so important actually. Sometimes you just have to move, sometimes you just have to take an action step and that can sometimes in certain cases and policy making can be like half the battle.
Speaker 1 00:28:12 I wanna zoom out from the Roanoke example and from what we've talked about to really talk about, um, change lab and your broader strategy to address inequity or, or health inequity. How do you think it's relevant to meet the, the power of the moment or the crisis that we're
Speaker 2 00:28:28 In? Our mission is to create healthier communities for all through equitable laws and policies and central to achieving this. Our focus is on demystifying law and policy. We work to dismantle unjust laws, policies, systems and practices and replace them with equitable ones. We collaborate across disciplines and sectors as well as create trainings and tools to facilitate equitable policy development and implementation. We believe that change lab, that the most powerful risk factors in health, our laws and policies that have perpetuated the legacy of racism, discrimination, and segregation throughout our nation's history. And that the deliberate intervention through the tools of law and policies to address the distribution of money, power, and resources can undo the fundamental drivers of inequity and in hopes increase health equity. The reason why we want to demystify law and policies that we need people to have the knowledge base to operate in spaces where they may not have the power to have the language of that particular space.
Speaker 2 00:29:52 And I think it helps to catalyze people to come off the sidelines like, oh you know what, here's actually a model policy for something that I really care about. Let's just say school discipline policies. And you might be an individual who's been like directly impacted by that. You may have a child in the system, a child that you care about, you yourself. So I'm thinking about our youth, oh well here's this model policy and here are all the things that would need to be a part of said policy in order to make a change here. Cause sometimes policy makers or decision makers are oftentimes the conversation can play out in this way. I hear you, yes, this is a problem, we need to do something about it. I'm gonna think about different ways and huddle or you know what, I don't know if this is like possible because is it legal? Is it feasible? Is it politically feasible? Is it financially feasible? But when you can go into a conversation with like a baseline of that kind of figured out, that totally can change the orientation of that discussion and the experience that the participants have.
Speaker 1 00:31:24 Yeah, this is, this is a really fascinating and bold vision that Change lab solution is embarking on. I'm curious about, um, because you all are working with so many different types of stakeholders, right? You mentioned legal, you mentioned, um, you know, community residents and then like I think you had mentioned like public health professionals and, and city and state officials. You know, if, if we kind of envisioned, you know, change labs, solutions work, really taking off, you know, over the next 10 years, you know, what's an example of like the possibility of, of changing a specific law and policy and then how do you envision this framework kind of helping to bring different groups together or equip them to be able to sort of, or essentially organize to, to be able to, you know, make a difference on some of these laws and policies which have you, which as you said is a really important determinant of help. We don't oftentimes think about it that way. Mm-hmm.
Speaker 2 00:32:16 <affirmative>, you know, one I can point to I, I'll actually go back to the educational setting and school discipline policies. What I will attempt to do here is to illustrate what the health related issue is, like what the problem is and then how we've worked to like address that. There is data that shows that black Latinx and Native American and LGBTQ students as well as students with mental health conditions are disciplined more often in educational settings leading to a higher dropout rate and also stunting educational development and change lab has worked with civil rights and education academics to demonstrate the negative impacts of exclusionary disciplinary practices. So that's kind of step one, putting this around sound around the problem, but also starting to bridge to the solution. So calling out that not only is this problematic for the students that are representative of these different populations, but we actually have a bigger, broader issue here.
Speaker 2 00:33:27 And one might even argue that it's a public health crisis to that degree. And so to that end, thinking about the role also in which exclusionary disciplinary practices play in perpetuating those dropout rates. So we've been working to elevate the best practices and model policies that eliminate exclusionary disciplinary practices and institute a restorative justice or trauma informed support to promote health and educational opportunity in schools in a concrete way of what that can look like in tools that we have or, or points of entry where we could make change is thinking about ACEs and the role in which ACEs plays to think about adverse childhood experiences and how that impacts an individual over time. In that ACEs strata, it would be amazing when you're thinking through that checklist or that criteria, what role of, if any, did exclusionary disciplinary practices play? So that is a place in which we can make a tweak to something that is used to evaluate, that's part of a broader evaluation sort of package of a program or of a policy or really analyzing a broader issue at the population level.
Speaker 2 00:34:57 If we could see a change, an exclusionary disciplinary practices, here's some impacts that we hypothesize that we think that we would see, or in fact no, we would see in some cases having an impact on the school to prison pipeline, which for the drivers that I talk to about of inequities, you are now pushing up against reducing disparities and opportunity so that men, children are getting through school as they deserve to and need to means reducing disparities in income and wealth accumulation. We want our kids to graduate and have the opportunity to do so and high school graduation rates, there is a correlation to health outcomes, right? That is a criterion that, that we look at in public health. And then more so reducing structural discrimination as well when we can see that those who are most impacted by these different practices are students who are of marginalized communities, underrepresented communities, and the harm that that does that it's very difficult to like come back from you are altering that person's trajectory.
Speaker 1 00:36:19 Yeah. Well thank you so much Qua, I'm so inspired by the work of your colleagues at Change Lab and also your journey that kind of provided us into a window, into, um, you know, a connection into that work. And so thank you so much for joining me today and I look forward to talking more about it.
Speaker 2 00:36:39 And thanks for having me. This has been great.
Speaker 1 00:36:47 Qua ASU is the Chief Strategy Officer of Change Labs Solutions. You can find out more about their important work, demystifying laws and policies in the description. This podcast would not be possible without the talents of Bobby Millstein, Jane Erickson, Brad Gerard, and Jessica Estelle Huggins, I'm your host ey. So from Rethink Health, a Ripple Foundation initiative, and you're listening to unsung Stewards.
