Conversations on Healing

Renee Canady

Breaking Bias to Improve Health Disparities

Featuring
Dr. Renee Canady
Chief Executive Officer of MPHI

Dr. Renee Canady is the CEO of the Michigan Public Health Institute (MPHI), leading a team dedicated to promoting health equity and well-being for all. Before MPHI, she served as Health Officer and Director of the Ingham County Health Department in Lansing, where she pioneered the Ingham County Health Equity Social Justice program. She is the author of the best-selling book “Room at the Table: A Leader’s Guide to Advancing Health Equity and Justice.” She is nationally recognized as a thought leader in health disparities, cultural competence, and social justice, with numerous publications and presentations on these topics. Dr. Canady has had significant influence on health equity discussions through her participation in national boards and advisory groups.

In today’s episode, host Shay Beider welcomes Dr. Canady to discuss a range of topics from public health equity to epigenetics. They delve into Renee’s own journey towards racial healing and breaking down biases she experienced from an early age. She shares the importance of recognizing and embracing differences, and understanding how they manifest differently across cultures. The pair talks about some of the physical impacts of racism and how these can transcend into different aspects of public health policy. Dr. Canady discusses the significance of being a leader that uses their privilege to empower others and how small differences can contribute to a more equitable future.

Show Notes:

  • Reach more about Dr. Canady’s background here
  • Check out the Michigan Public Health Institute
  • Read the best selling book “Room at the Table: A Leader’s Guide to Advancing Health Equity and Justice”
  • Look into Resmaa Menakem’s work here

Introduction (00:02) Welcome to the Conversations on Healing podcast, where host Shay Bider speaks with renowned healthcare leaders, practitioners, and thought leaders to explore the world of wellness, the incredible powers of self-care, and what it truly means to heal today. Join us on this journey to become more whole healed and connected.

Shay Beider (00:31) Hello, lovely listeners and welcome to the Conversations on Healing Podcast. I am your host, Shay Bider, and today we are joined by Dr. Renee Branch Kennedy. Dr. Kennedy is the Chief Executive Officer of the Michigan Public Health Institute. She’s recognized as a national thought leader in the areas of health inequities and disparities, cultural competence and social justice, and we discuss these topics in our conversation, and she also addresses them in her newly released Amazon bestselling book Room At the Table, a leader’s guide to Advancing Health Equity and Justice. Dr. Kennedy earned her PhD in medical sociology from Michigan State University where she’s held faculty and administrative positions. Dr. Kennedy has been highly influential in broadening the discussion of health equity and social justice while serving on numerous boards, review panels and advisory groups. We had a delightful and stimulating conversation on healing where we discussed the drive towards racial healing, breaking free of social expectations, and how to really incorporate this in being a good leader. This episode will absolutely broaden your view on how we heal in communities and dismantle some of the structures we’ve built around racism and inequity. So let’s dive in and get the conversation started. Oh, well, I’m so happy to have you on the Conversations on Healing podcast. Welcome to the show!

Renee Canady (02:23) Thank you so much, Shay.

Shay (02:25) It’s a delight to talk with you, and I know we’re going to go into lots of different areas today, but certainly one of the things that I want to talk about is your book Room At the Table, and I actually thought I would start the conversation with a story. It’s a story that you share in the book that I think is a beautiful illustration of how racism still is embedded in the world in which we live, and then how it plays out across a lifetime or can play out across a lifetime, but really does, I think is more accurate. So you talk about when you were a little girl that your best friend had a slumber party and that everybody was invited to that party except you, and that that was the first time that your parents had the talk with you about racism. You say that that moment obviously was very important and shaped you. Here you are today writing a book room at the table where you talk about health, equity and justice, and I want to begin our dialogue with the voice of that little girl and how that is fueling you in your work today.

Renee (03:48) Thank you, Shay. It was transformative and certainly there was something about the way I was parented that caused me to hold that moment in compassion and not hatred. I think I say in the book, like it’s too bad. I was going to be really fun at that party.

Shay (04:08) I loved that when you said that they were missing out.

Renee (04:12) So how do we continue to drive toward racial healing because it’s not complete without our voices instead of anger raising up or just all of the negative spectrum of the feelings and emotional ranges that we get deeply quiet to have compassion, to be loving, to figure out how can I be a source of healing in this rather than adding oil to the fire and continuing to allow this to continue to ferment. It’s really reassuring because there is something about the pure hearts of children that says, this is my best friend and we know we’re best friends. And I often think about what was that conversation for her with her parents?

Shay (05:10) Right. Great question. That’s a great question to ask. I’d also love for you to share, you have a photograph in the book related to this. I want you to share about that photograph because I think for our listeners hearing it in your words, it’s a really interesting moment as well.

Renee (05:26) Yeah, it was just sort of a happenstance picture. We were on the playground and I was seated on the footstool of the water fountain and she was in front of me and we were playing sort of patty cake, just the clapping hands together and singing a little rhyme together. And I love that the journalist, this was our local newspaper, a very small newspaper. I was living in Gila Bend, Arizona at that time, and the byline was no news value at all. And the suggestion that there’s something about the purity of this little black girl and this little white girl just enjoying relationship that is so much more appealing, so much more hopeful than they say in the narrative, than the smoke bomb and the riots that were happening in all of the very divisive things that were happening at that time in the sixties, that here’s a moment of hope and I would say an aspirational moment that we could look to.

Shay (06:41) And it is extraordinary how often you see children obviously expressing if we catch ’em early enough, they are still before all this gets sort of instilled in a firm way. So I’m going to share a little bit about a different but parallel perhaps story. So I work a lot in the field of disabilities and we work with a lot of children that have physical differences as a result of different medical health and health challenges that they face. And many years ago we did a healing retreat week and there were two girls that were physically conjoined twins, so they were still connected head to head and they could not actually be separated because there was so much brain involvement. And at the beginning of the retreat, we had some children that were there and at first many of them were very uncertain and a little scared about how you come to understand being with two girls that their heads are connected to one another that was so new and different. But by the end of the week we have video that’s very similar to just a normal moment in life where they’re brushing their hair, just kids being kids. It had all the fear and uncertainty. It just was gone, right? Because once they came to know one another, whatever that was, that was already in their mind that was holding them back, it was completely erased within a week it was erased. And so it’s interesting to understand how, especially when we’re young, and this is why in our programs with integrative touch, we always include very young children because in this work we want to address disability and the ways that people can create stigma and kind of bias against people that have physical differences, how you can actually educate really early so that as young people grow up, they’re not living with that for years to come. And I’m interested on your thoughts of also how this correlates with racism.

Renee (08:53) The operative term in the story that you’re telling and in the story that I lived is this odd little word called difference. When you think about the word diversity, oh, let’s value diversity, celebrate diversity, it boils down to difference. And I developed a practice of asking students or asking audiences when I was speaking to think of a time when they were keenly aware of their difference. And it didn’t have to be anything extreme. It could be something as easy as I went to an event, I thought it was sort of casual, and I got there and it was cocktail and I was standing out like a sore thumb. As the saying says, we talk about valuing difference, but there’s something inherently uncomfortable with us in the face of difference. And I kept thinking certainly as a sociologist, what is that about? I’m not a psychologist, I’m not a therapist, I’m not a clinician, but what made meaning for me was there is this deep desire for collectively sharing identity and experiences and difference seems to be a threat to that. But what’s gratifying is that we can overcome our discomfort with differences. And before you know it, the differences become value added. They become unique and special. And look, these girls are so special because they’re able to figure out how to do these very unique things or when we sort of argue we’re colorblind, that’s an aversion to talking about who we truly are. No, no, no, just act like you don’t see that she’s beautifully and uniquely and wonderfully different than you are, but how do we get to a place where we truly celebrate difference and we only will get there if we wave through the discomfort just as those young children did at the camp as you described.

Shay (11:09) Yeah, racism is so deep. It’s like the fish in the water analogy where you’re in it at times, obviously you can see it or you’re living it or you’re dealing with all the consequences of it. But there’s also an element of it’s so a part of our whole world and system. There are elements that can be missed, especially by people in power. And so many, many, many years ago, Renee, I had a dream and it’s the best sense I ever got of what the world would be like if we didn’t have institutional racism. And it was just in the dream, a man that I know and love, he was relating to another man that it was clear he knew and loved, and the man that I know has white skin, the other man in the dream had black skin and the entire dynamic between them was absent of racism. And the only way I can say it, I wish I could explain this better, it was the most powerful experience I ever had of really understanding it. But all the little pieces that we hold in our minds through what we’ve learned that separate us even just a little bit, they were all gone in the way those two men were interacting with one. And it was subtle, but it was also total, it was totalizing. It affected the entire relationship. And I think I saw to a degree in that dream, I had a glimpse into, oh my God, this is how different it would feel. It really was. It felt so different if we didn’t grow up in a world where this is what we all absorbed if this wasn’t the water in which we lived.

Renee (12:55) Absolutely. I love that story and what a hope and aspiration for us to get there. It continues to amaze me even that as I travel internationally, that while it is about skin color and this odd box called race in the United States, difference manifests in other ways in other nations, and there’s something about our inclination to other, I’m better because I’m not like you, as opposed to I’m wonderful and you are wonderful. I mean, that is sort of the point I’m trying to make in the book with this title. There is room at the table. I don’t have to be the king of the hill or the mountain, actually, the mountaintop is very broad and you can come up to the same level as I, and we can be there together affirmed in our own strengths and buoyed by the differences instead of separated by the differences.

Shay (14:01) Absolutely. Yeah, it’s a very powerful point that you make in the book. Your life path is so interesting. I do want to touch on it a little bit because initially you had a desire to go to medical school and in part I know you’ve shared with me part of that was because you felt like you wanted to be the one making the decisions, and it’s good to be the doctor and be in charge, very understandable. But as you actually got into it, you realized that wasn’t quite the right role for you. It wasn’t exactly what you wanted to be doing, and so you made a pivot into public health. But it was quite an interesting historical moment because this was in the eighties when the AIDS epidemic was really something, and I remember that I was also alive, well and conscious and impacted by that at that time. And so I’m very interested how you think being involved in that moment in history and seeing what you saw as someone in public health during that whole time of misunderstanding and trying to understand what was going on with HIV and aids, what how that impacted you in your career.

Renee (15:10): Career. Yeah, I love that. Let me offer this also early contextualizing, right? Yeah. I wanted to be the doctor because society had told me the doctors were in charge and I wanted to be the doctor also because I continually got the message of, you are good in science and math and we don’t have enough black physicians and we don’t have enough women physicians, so you need to go to medical school. And so there was all this sort of social pressure that I’m internalizing, not sort of having the autonomy of, I might be good in math, but I don’t think I really like it. So how do we break free from social expectations to be our best self? And you’re right, my best self landed me right in the middle of this space of complete. We don’t know what’s going on and this is a new disease. What do you mean it’s a new disease? We discovered all of the diseases, and what was clear to me was not the frustrations that clinicians had about how do I manage these symptoms, but what was clear to me was much like the threat of racism. I saw groups of people in their humanity being alienated, ostracized, stigmatized simply because of who they were and assumptions about what they do or what they did. And at that time, we were doing these horrible things like innocent victims. If you happen to be a child with hemophilia or someone that got a transfusion, a tainted transfusion, then you’re sort of in the not guilty group. But if you’re one of those that chooses to love people that are your same gender or do drugs, illicit illegal drugs, then oh, you’re in the bad category. So even this just drive to other people and determine who was affirmed though they had the same disease and who was alienated to me is the same mechanism of action that we see around racism. And that hierarchy, that tendency to have a hierarchy that values some people more than others was just horrendous to me. I just saw the hurt and the pain of people. I mean, to this day, I can drive down a street and see the apartment complex, just a little corner apartment where I knew this young woman suffered alone in silence and ultimately died alone as a consequence of aids because people, I would say weren’t so much afraid of her, but they had judged her and decided that she made these terrible choices. And so choices, you reap what you sow, here are the consequences of your actions. She was a beautiful soul who didn’t want to die prematurely, who loved people who had a child that she loved, and somehow or another, we allowed ourselves to look past her humanity. And so that was the fuel I think that continued to push me. Where do we continue to see people most othered thinking back on my journey as a child, and it always brought me back to racism, classism, and really even gender oppression as things that disrupt and damage relationships that also disrupt and damage the health and wellbeing of people that happen to check those social identity boxes.

Shay (19:19) Yeah, that’s why it seems the understanding that you share about Otherizing. I know James Baldwin used to look at this in terms of tribalism, how we create those barriers, how we create separation from self and other, and then create understandings of who is higher up or who you favor in that system is so critical. And many, many years ago, I worked not long after this period when you were in public health, I worked for an organization, a nonprofit that was founded actually to bring volunteers in to do massage, to touch and massage people that were HIV positive or had developed aids, and we would go in and volunteer and provide hands-on care and treatment. And it was because there had been so much stigma and fear that had built up as a result of initially not understanding how the virus was spread. But then once there was an understanding, it was perfectly safe to be able to touch and massage people. You just had to know what you were doing. And so it was fascinating that this whole organization was created in response and it was a beautiful gift because so many people still were living the life experience of being isolated and people still didn’t want to touch them. There was still this inherent fear that just didn’t go away quickly. And so it was a beautiful sort of counterpoint to what was going on with that and creating a lot of fear.

Renee (20:57) I think fear begets fear, and we tend to learn our fears from people that we love deeply, that we respect. It’s our parents, it’s our grandparents. I think about another little example that when I was pregnant with my first child, I was an aerobics instructor and my grandmother, who I loved dearly would say, now, don’t stretch your arm up over your head because the umbilical cord could wrap around the baby’s neck and you don’t want to risk the wellbeing of your baby. Now, I’m a public health professional. I’m thinking to myself, that makes no sense at all. That is not true. It’s not true. And I tried to have that conversation with her and she’s like, you better listen to me. And I found myself the next time I was teaching my class, instead of stretching my arm up over my head, I kind of was like, well, maybe we’ll just go shoulder level with the arms today. It gets deeply rooted and there’s a level of intentionality that we have to use to unlearn the flawed messages about ourselves and about each other to bring us to that place of wholeness and healing.

Shay (22:19) That’s so true, and it takes so much awareness and then feedback and then just making mistakes and then learning about what those, it’s a constant, I feel like it’s a feedback loop and cycle as well that helps us to get closer to where we may choose or want to be. I’m glad you brought up your pregnancy. This was a topic that I did want to discuss with you because after you were involved in some of the work with the AIDS epidemic, you actually shifted your focus towards adolescent health and in particular teen pregnancy. And you focused your research on infant mortality and pregnancy outcomes of black women yourself when you were personally pregnant, you had preeclampsia and that had a very significant impact on your life. I think maybe I just give space for you first to just share to whatever degree you would like about your own story and then how you understand this in the context of how black women are treated differently in our healthcare system regarding pregnancy and birth.

Renee (23:33) Yeah. It’s so hard still in this day and age to think that people do still see color first. So many people do still see color first, and I remember very clearly as my pregnancy progressed and weight gain ensued and my rings were getting a little tight, my wedding ring, and I was thinking, I am not taking this ring off because people will assume I’m a single unwed mother. Well, so what if I was a single unwed mother? But again, the stereotypes and the other ring, and it really took my friends saying, they’re going to have to cut your ring off. Just put some soap and water, get that ring off now while you can because of that concern. And here I am, this very confident black woman, highly educated, but recognizing the other ring that I was not safe from. And so we try to figure out, and there’s a whole body of research that looks at the physical impact of racism, that type of stressor chronically impacts you, not just emotionally, not just mentally, but literally physically. Your hormones do different things and are at higher levels than they should be and impact your own organs as well as the baby that is growing inside of your body. And so that is, once I got to this point of preeclampsia, having this very premature delivery, loving my son here on earth for six months before his death due to complications of his prematurity. I began thinking you know how do, what was purpose in this horribly painful experience for me? And so purpose for me was aligning my professional work in that direction. If I, who was a woman, black woman, who’s well resourced, lots of social support, lots of education and access, if I could be one to contribute to those numbers, how much more at risk of those things are women who don’t have all the support that I had? And so it really became a way to honor this short life that remains a part of my life. He made me a mother and continued to shape how I mother, but it’s been really, really gratifying. And now at that time, I mean, we knew that black women had disproportionately higher experiences with infant mortality, but now we’re beginning to see not only the complications for babies, but the complications for the mothers in terms of maternal death and how often needing something and even expressing the need gets discounted. We have a number of celebrity stories where that was the case. I remember in my own situation, the doctor coming in saying, okay, we’re going to deliver the baby today. And I’m like, wait, I thought we were going to keep me on my left side and I was going to take some medication and we’re going to try to stretch this out and well, no, we’re going to go ahead and deliver, well, is anyone going to talk to me about this? And my physician said, well, we already talked to your husband, so we’re going to get moving on this. I’m pretty sure it’s not him on the gurney, but you’re overwhelmed and you’re afraid and you’re worried about yourself and you’re worried about your baby, and you just decide you have no other choice but to trust the system. And we’re now seeing that the systems aren’t always trustworthy,

Shay (27:51) Yeah, and there’s such a huge power differential in that moment too. I mean, oh my God, so many layers you’re trying to navigate. You also, I mean just a human in a vulnerable medical state, right? The last thing you want to do is try to buck the system. You don’t want to offend the very people that are going to be doing surgery on, you don’t want to. So you’re like in this inherently really imbalanced power dynamic, and now you’ve got multiple layers to that because not only are you physically not well and trying to take care of an unborn, but you’re also dealing with racism. And now I’m a woman and now I’m, it’s like layer upon layer upon layer. Let me just talk to your husband and you’re trying to navigate all of that and keep yourself and your baby safe without offending or doing the wrong thing that could then have a negative health outcome. And it’s like it’s any wonder that people don’t just, of course, just say yes because you’re just trying to figure out is that the best? Is that my safest and best opportunity under this incredibly challenging set of circumstances?
Renee (29:01) Yes, it is additive, and you’re right, additive. It’s like, which part of this onion can I unpeel in this moment? I think I can’t unpeel any of it, I just have to

Shay (29:13) You just have to roll with it right? I think sometimes that’s the decision that is made. And so I want to continue as we look at the trajectory of your life because a beautiful life story that’s continuing to unfold. And I’m certain we’ll go in many, many continued beautiful directions from here forward, but now you’re serving as the CEO of the Michigan Public Health Institute, and you’re very committed to your work around justice and health equity. And I want to get some of your today “ISM” around what your priorities are in the field of public health and in this role as A CEO. I know you talk a lot in your book about leadership. We can go into that, but I just want to give you a chance to catch up to the present and share how you’re currently utilizing the position of power that you’re in to make a difference.

Renee (30:08) Thank you, Shay. I absolutely love my job, but I’ve really actually loved every job that I had. I just put myself all in to it. And prior to coming to MPH, I was the county health officer and director of our health department, that same health department where I got my first job as the AIDS educator and figured I would just retire in that job. But then opportunities come forward and it’s like, yeah, I’m supposed to lean in. But this position at Michigan Public Health Institute has a wonderful balance of governmental and academic partnerships. Those are spaces where I’ve lived all of my primary career areas in the local health department and at the university where I thought I would also just retire as a tenured professor. And so the marriage of these two worlds into this sort of quasigovernmental academic space has been really a place where I’ve been given the freedom to use who I am, both as a person and also as a professional to drive forward a trajectory of passion and of healing. I mean, public health right now, having just come out of a worldwide pandemic, still dealing with the residual consequences of that pandemic is in deep need of healing. And so I’m really grateful having learned things in the AIDS epidemic to now this broader worldwide pandemic. And for me, it is always about healing and wholeness. How do we keep people whole, do keep them at the table because we need all of us for solutions in society and public health mission is to assure the conditions necessary for good health. Making sure you’ll see an example where people might criticize, why is this mom feeding her three-year-old french fries? Oh, they go to McDonald’s and get french fries every day? Well, because the french fries are 99 cents or whatever. And so she’s concerned about her baby going to bed hungry, and it might not be the healthiest thing, but it is the satisfying thing. And right now, I would submit that the healthy choice is not the easy choice. It’s not the accessible choice in so many spaces and places and societies. And so how do we in public health not just preach at people, make better choices? How do we make sure better choices are available? And so I have found leadership in a space where my job now is not doing the work as I did when I was AIDS educator or adolescent health coordinator. My work now is supporting the team who does the work, making sure they have everything they need to succeed. And sometimes that’s a tough role, maybe even a tougher role for leaders. And so I’ve been pushing my colleagues to be courageous, to be bold, to be audacious, to speak up so that we don’t just keep spinning our wheels in the same space. There will be plenty of black infants dying if we just stay business as usual. Yep, that’s going to happen. Isn’t that terrible? Just admiring the problem, but instead saying, enough is enough. We are so frustrated by this and we’re going to take that frustration to drive change.

Shay (34:06) And it’s interesting, some of the research that’s been done, and certainly any research that you want to share, but around the access that people have to fruits and vegetables and in a lot of low income urban communities, you can’t even get fruits and you have to go miles and miles. It’s really when you see the analysis and the data around that, it’s like, well, of course you’re feeding your baby french fries because how the heck are you going to go when the fruits and vegetables are so far away from you? It becomes unrealistic. So that’s a huge part of it, and I still always go back to that your zip code is still the single most important determinant of your health. And because it tells you so much about your socioeconomic status, what you do have access to the air you breathe, we put industry in a lot of low income communities. You see asthma rates go sky high, all this data, you’re living this data. So for our listeners, if there’s different aspects of this that you want to highlight because you’re passionate about it and you see the importance, feel free, this has such an impact on our health and healing too.

Renee (35:12) Well you know, it is so true, and as you were describing that, I was thinking about some communities that are so walkable and jogable. You’ll be driving through and you see the people and their fitness gear and they’re looking so great. You can drive through another neighborhood. They’re also running in that neighborhood, but not for their health. They’re running for their lives. They’re trying to get home from school without being attacked or chased or any other type of negative consequence for being in that particular zip code. And so that’s not their choice. They didn’t say, let’s live in a high crime neighborhood. Wouldn’t that be fun? It was the only community available to them for the resources that they have. And so a lot of times we like to sort of put all the weight on personal responsibility and people feel very, very strongly about that. And I have just really, I’ve stopped trying to argue against personal responsibility, but I do say if you’re deeply committed to personal responsibility, then you have to be committed to social responsibility. It is our responsibility then to see that more than the bruised up bananas in the corner market are the only fruit option. And that comes from a policy decision that comes from a business decision. And those are all high level, highly educated, highly employed, highly salaried decision makers. So we indeed create the society that we want to live in. And just because it’s not been done before does not mean that it can’t or won’t be done now or in the future. It’s all about policies, actions, programs, and priorities.

Shay (37:18) Absolutely. This feels to me like it connects to a term that you share and discuss in your work that I would love for you to share with our listeners. I think it’s powerful, this idea of productive outrage. And so if you could share what that means and how outrage can be productive, just tell us more.

Renee (37:40) Thank you. Because that is absolutely my bandwagon right now. I remember sitting in a conference room having a conversation with a colleague of mine who is also a woman and is a white woman. And we were just talking about how frustrating it is that we both were longtime public health professionals. How frustrating is that we’re still in this space having this dialogue. And she said, happened to say, I mean, it’s just outrageous that a mother could die in 2020 simply because she wants to have a baby that is outrageous. And I said, it is outrageous, but we tend to be inclined when we experience outrage to just want to tear up a thing and turn over a table and drive through a wall or something. I’m like, how can we take that outrage and be productive? And this was just all this sort of brainstorming, frustration, venting sort of a conversation. And so I started talking to my team, what if we played around with this idea of productive outrage? What would that look like? I mean, there’s so many holy scriptures and writings that talk about using anger for good and not for bad. You can be angry, but don’t do terrible things when you’re angry. And so this idea of productive outrage, we define as that indignation that drives sustained change. And we were very particular about that because we want to bring and allow the affect into the space. We are also oftentimes in our professional spaces, oh, it’s not about your feelings and separated and be this objective professional colleague. No, no, no. We’re saying, let’s let indignation come into the room because we believe that when we feel deeply and strongly emotionally, then intellectually we will come up with solutions that are sustainable. This is not check the box. Oh yes, that was so terrible. We’re so mad. We did this thing for these moms that live in this block, in this community, and now we’re moving on. Nope, we want productive change that is sustained. So it’s not quite like righteous indignation, which sort of agitates us and get us riled up. It’s not like political will that maybe motivates us to do something but then flips with the next election cycle. It is this unique space of allowing the emotions to be authentic and raw, but being productive about it both individually and collectively. That’s where I’m trying to drive leaders to be. We tend to just sort of sit on our laurels, and some of us aren’t even sitting on our own laurels. We’re sitting on the laurels of the generation before us. We sort of drop the ball. But I’m always saying to colleagues, how can you look at this and not be outraged by it and not be willing to use your power and your authority to drive change?

Shay (41:16) Yeah, that’s beautifully said. And the impetus of it being the feeling, but then to create that sustained change. Also, as you said, you involve the intellect, but there’s got to be a lot of strategic thinking around that. If you’re going to create a sustained change, you need strategy and sort of a plan too in terms of how you do that long term. So I love the idea of that the outrage is part of the fuel, but then also it’s more than just that. And in a way that’s kind of the yin yang model or the bringing together of different aspects of self, right? It’s the emotional and the intellectual. It’s the bringing together of these different aspects so that they’re working collaboratively, which seems very useful in terms of how you would create positive change in the world. So I love that. And you talked quite a bit in your book and in your work about leadership, and you’ve even come up with this idea of leadering, and so I want you to share more about that as well. Let’s talk about that too.

Renee (42:13) Yeah, absolutely. I do think Leadering is about, it’s the antithesis to sitting on our laurels that somehow or another we’ve lost. Not that I’m an English major, but we’ve lost the jar in that the doing and the action we all learned that ING means we’re just continuing to do a thing. And somehow or another in my thinking and just agitating with colleagues leading seemed definitive like I did this thing and now it’s done. But the leader ring for me is this continual? Yep. We don’t get to stop. We might get to take a break, but we’re still moving slowly. So instead of jogging at five on the treadmill, I’m going to back off to 1.5, but I’m still actively moving forward. That is about our privilege as leaders. We do have privilege and how are we going to use that to strengthen the wellbeing of others? I think often and talk often about the leadering of a historical figure, a woman named Lillian Wald who was considered the founder of public health nursing, and this woman, a white woman, Jewish background, very wealthy background, but she decided that when she got her nursing degree, she was going to work in the tenement housings of Harlem, New York. She was from upstate New York, something in who this woman was. Her humanness understood that she had to align herself with change for this family. And so she began agitating, again, a term my organizing colleagues have taught me to say we have to do things differently. Why would we ask moms after a six week delivery to struggle to get back into the clinic? Why wouldn’t we go to them? And I can just imagine her archives don’t talk about this, but I can just imagine that her colleagues were saying, well, we don’t do that. Well, why would we do that? No, that’s not a thing. If you don’t know about Lillian Wall, you would think that home visiting public health, nursing home visits was ever not a thing. Of course, we go to the mom’s home, well, we didn’t go to the mom’s homes until we went to the mom’s homes. And so what is that disruptive change that we can implement because of our power, because of our passion, because of our outrage that we’ll make for productive and sustainable change? I mean, unless you’re a public health nurse, you probably don’t even know who Lillian Wald is. So her memory may have passed, but the impact of change of this woman goes without stating,

Shay (45:14) That’s a beautiful story. I love that. And it’s amazing how many gigantic stories are like that. The Mayo Clinic was really founded by a small group of nuns, and then they got a doctor involved, but it was really the passion. One woman in particular, a nun who just had a vision, literally had a vision of what would become the Mayo Clinic, and she just held to it like a force of nature and got a lot of people around her to do it, and really started in a very religious way and then became something very different over time. But something remarkable, truly remarkable. And a fierceness, I think in her and the other people that were involved in the inception of the Mayo Clinic, it was something in the fierceness in their spirit, just like in what you’re describing as well in public health nursing, it’s like there’s something in the fierceness of a spirit that just wants something to be a little bit different than it is and recognizes that in that moment, that individual has a capacity somehow is somehow positioned where they can make change. It might be hard, it might take a lot of drive and collaboration, but there’s a moment in time where it can be done. And it’s interesting, the human beings to me that see that, embrace it and then do it, execute on it. It’s really absolutely beautiful. Well, I wanted to just touch a little bit on epigenetics and some of the research because we are seeing, obviously, as you were saying earlier in our conversation about some people say, oh, just be colorblind. You don’t have to see that. Well, that doesn’t work. We do. And there’s still a legacy that we’re living with that’s all over our world. And the epigenetics research is showing us this in another way, how we’re literally having different genetic expression based on things that are happening. So some of the data that I’m aware of, for example, around families that have gone through the Holocaust would be an example. And then the ancestors, they have different genetic expression based on that experience of what their parents or grandparents went through. And so we see there are legacies even at that level that are carried down. And obviously if you think of something as extreme as slavery, we know, I mean, you can see right that there’s obviously epigenetic implications here. And so I’m interested in how you see this field of epigenetics as impacting public health, as impacting our understanding of racism and what we still need to do to address things that happened in the past, but that are still continuing to impact millions and millions of people today.

Renee (48:04) Thank you for that because so often we want to describe racism as sort of this just emotional thing, and you should just get over it. And here we are all in the same restaurants now and isn’t this beautiful, but we do recognize from two, what we call hard science fields, the epigenetics work, but also the brain science work. There’s a whole body of neuro behavioral work that is now demonstrating that there were actually tangible physical consequences for this level of sustained and repeated stress, and even down to the woman’s ovum, the egg that we’re carrying. So we’re now the girls that we’re taking care of the young girls that’s really making for the consequences of pregnancy outcomes, not only for that girl, but the eggs that she carries. And so we understand that there’s not just this emotional psychological component, but that is significant. There’s also this biological physiological component, and we don’t have to understand it, right? This is a whole deep field of research, but understanding that there is more to this than my feelings got hurt because you didn’t invite me to the birthday party. There’s much more to this, and the consequences are generational, and we’re not that many generations beyond. If I can talk to my father, who is now 89, soon to be 90 in a couple of months, prayerfully and he can talk about his grandparents and the things they dealt with and the stories they told him about their parents, that’s not historical. That is current events because these are people still living and still in our lives. And when those would say, well, you should just get over it and move past it, let’s see. You try getting over actions that have completely changed who you are as a person and then who you are physically and physiologically. And you’re right, it is the same thing that we see in the consequences of the Holocaust and the same type of racism that people of Jewish heritage also experienced.

Shay (50:44) And you think about legacies of trauma, and fortunately we’re in a time that’s building increasing awareness around the effects of trauma in the body and then what some of the legacies of that are. I think we have a tremendous amount still to learn, but we are kind of in a period where I see increased and heightened awareness around the impact of trauma and how that also plays out even now looking at collective traumas. So things like war. So for example, what’s going on in the Ukraine right now? What’s going on in the Middle East? There’s a bunch of different opportunities of where there’s such severe conflict and war and strife that inevitably there’s a collective trauma that’s emerging from that. And then the longer societal implications, both physiologically but also psychologically, even spiritually, you could identify this across multiple domains. You could really take the bio-psychosocial spiritual model and look at how that impacts every single aspect. And so I was thinking about that too because in addition to racism, in addition to all this, there’s just the legacy of trauma that when you’re otherized, when you’re oppressed, you inevitably at some point become a victim of trauma of some sort. There’s lots of different kinds of trauma, psychological, physiological, right and when that occurs, there’s also a legacy to that too. So it’s like, gosh, there’s such a, again, layer upon layer, that additive piece that we were talking about. There’s just a lot to unpack here in all of it.

Renee (52:29) I feel like there might be a very, very small minority of folk who have never experienced trauma in their life, but I would invite your listeners to think about maybe the trauma was short-lived. Maybe it was that horrific dog bite that you got or that you observed. I think about being in a movie theater as a child. We were watching Pinocchio, my two brothers and my mother and I, and all of a sudden they turned off the movie and they said, we ask everyone to exit the theater right now and we leave the theater. And when we get out, it was the old wooden theater. The theater was in flames. The whole top of the roof was in flames. And I think I was maybe seven at the time, and I remember that from that time on for I don’t know how long as I’m saying, my prayers at night, and God bless mommy, daddy, and please don’t let our house catch fire. Now, I realize that was a manifestation of trauma, like, oh my gosh, if the movie theater can, so is that something somewhat simple? Yes. But if you can think about the trauma that we as a society, white women being told to tell false narratives about black men who were then killed, lynched, murdered, that trauma lives on in the heart of that black woman. And I would dare say the white people who encourage that false narrative, whatever, the lack of truth being replaced by hatred and anger is traumatizing. We might not be living in a wart tone zone, but if we can be traumatized at that deep level, how much more are others being traumatized? As you said, the history of slavery and the consequences of slavery, the genocides that are happening all around our world, how do we as humanity choose to stand up for healing and hope and just put a stop? These are all socially constructed. The way we live race is socially constructed. We decided, speaking of genetics, we finally, the scientists completed the human genome study several decades ago and learned that genetically across race we’re more alike. You and I are more likely to be similar genetically than I am with another woman who checks the black box. So this idea that we’re genetically some people are genetically flawed and we’re different is not true. It’s a social construction where we’ve built this hierarchy of human value that if you look this way, you’re more valuable. And those messages even get indoctrinated within cultures. Colorism in the black American community is a real thing. So how do we put a stop by saying, whoa, whoa, whoa. I’m no longer going to be a victim. We are no longer going to be a victim, and one of us has to be the one to stand up and speak truth to power, as we say.

Shay (55:54) And that I think too, is why the title of your book, A Room at the Table, it’s such a great title because the visual of that, I mean, I tend to see it as a circular table just in the context of what you’ve described, but that it’s about creating that space for everyone. But it’s also about there’s fundamental equity in it, right? Because all sitting at the same table or depending on how you visualize it, but I see at a circular table sitting together and trying to figure out how to work things out together. It’s a collective of sorts. And ensuring also that there’s room enough for everyone to be represented that this is an inclusive table, not an exclusive table. And obviously one of the greatest challenges, which I think is still something that’s going to take a lot of time to figure out the secret sauce behind how all of this changes in profound ways, is that even though in the dynamic that you’re just describing the person of color and the person of let’s say, who has white skin, even though in different ways, they’re both experiencing something negative. So you think of the Emmett Till story, right? Oh my God, Emmett Till’s family and that boy, what awful. But there is still an impact too of all of the layers of that, all the people that were totally involved in allowing what happened to happen. And so when you think about, okay, so yes, there is the trauma, the negative impact of all of that, yes, that’s real, but the person who’s in the more otherized position has a much worse impact if we were to try to balance it on some kind of scale by far. And so how do you get it to shift? Not totally like this. It’s like, yeah, both are harmed, but obviously one is harmed much more than the other. And so what is the persuasive path to create change so that when somebody is still in a position of benefit?

Renee (58:14) Yeah, it’s such an important question. I have a friend that uses the term, the oppression Olympics. My oppression’s bigger than yours, my oppression’s worse than yours, I win. I don’t try to sort of split hairs on that. Absolutely. The context, the history, if we were trying to quantify the occurrences and the very tangible outcomes for blacks in America, they are deep and they are wide. But for every black person that is negatively impacted, there is a white person perpetrating that. And what we try to get our white allies and colleagues to see is that whites are also negatively impacted by racism. It’s easier to pretend like you’re not, but you are. And some of it is that what we’re talking about, the epigenetics and the psychological wellbeing and the safety and all of that, it is so complex. It is going to take all of us to fix this. If racism was only a black problem that black people would fix, we would’ve long before done that. The fact that we can’t change systems independently, it is requiring all of us to own this problem. And I will tell you my mantra around that whole idea of room at the table, I would always tell my team, my facilitators, my trainers, we are going to do equity, anti-racism and justice work in a way that keeps people whole and that keeps them at the table. And I say that because privilege for white people allows them to leave the table. Well, I feel like you’re calling me a racist. Well, this is really uncomfortable. I don’t have to do this. I’m not going to do this. And they’ll leave the table. And I need them, as I said, to stay at the table. I also though want to keep people whole. I don’t want bipoc folk, black indigenous people of color to have to keep telling their story of pain because it is that, and I got through a couple of painful stories for myself today in a pretty whole way. But there are days when I could tell either of those stories about that moment of being excluded from the party or my son’s death and be deeply broken emotionally. And so how are we going to do the work that doesn’t require some groups of people to rip off the bandaid again and again for the benefit of the people that don’t have a bandaid to rip off? How do we keep each other at that table together and keep each other whole as we’re doing the work? And so out of that sort of philosophy or mantra is where I’ll say that my publishers said, Hey, can we pitch a title to you? You seem to be talking about this very, very broad, open, inclusive table. I do love Shirley Chisholm’s quote, the first black woman to run for president of the United States. And she said, if there’s not a chair for you at the table, bring a folding chair. And yes, absolutely she was correct. I’m arguing that if we’re still having to bring folding chairs and force our way into the table, then leaders are missing the mark because we should be setting a table that makes space for all of the voices, all of the experiences, all of the perspectives, all of the talents and strengths, so that we can indeed build a society that is equitable, that emanates justice, that we are truly seeking justice, that we’re merciful, we’re loving mercy, and that we’re walking humbly in our way of doing that. Not the I’m the boss, but I’m the one building the table for other voices, particularly voices unlike mine, even if the voices are outraged so that we can come together for healing.

Shay (01:02:38) And it’s interesting to think about this too in the context of healing because that’s where I’ve dedicated a lot of my kind of career and life work is on healing, particularly for children, but with a lot of adults too. And one of the first things in order for healing to happen is on some level, the truth has to come out and it comes out in a lot of different ways. It doesn’t always come out in words. Sometimes it comes out through the body. It can come out through story. It can come out in so many ways. But in order for healing to happen, somehow the truth has to come out. And just in thinking about this conversation today, I feel like that’s such an important element of that, of how we heal not only the history and legacy of racism, but all the infrastructure that we’ve built around this thing that now we have to deconstruct and rebuild something entirely different that I think most of us don’t even know totally what that looks like yet, because we’re still, at least I feel I am still very indoctrinated in ways of thinking that I’ve grown up with that I’m still trying to unwind and undo, and I don’t imagine I’m going to solve that in my lifetime, but hopefully it will continue on and there will be others that will be leadering and helping to break that and deconstruct and reconstruct essentially. But when I think about, as you shared, you have shared some personal stories with us today, and what do you think in your life and in your work, you’ve come to understand about what healing is?

Renee (01:04:26) Such an important, powerful question. I hate to say that healing is aspirational, but it is sort of the goal right now. We’re not there, but I think that when we are healed, when we are whole, it’s almost like your dream shea that we see the difference between us and it makes us love each other more. We see the strengths that are our weaknesses, and it makes us love each other more. It is about love, which is not a word we into professional spaces, but it’s why I talk a little bit about not the professional self and the personal self, but the proper self professional and personal, all merged into one, allowing us to feel all of the feelings. We are cognitive, we are affective, we have beliefs, we have behaviors, and there’s a whole body again, of science that does evaluations around what we call cab studies, cognitive affective beliefs and behaviors. So in some spaces of science, we affirm that that’s important when we’re planning for how to change systems, but we don’t allow ourselves to be purveyors of that as long as I’m just studying it, but don’t ask me to be it. When I was a core course that I developed them was teaching to masters of public health students on equity and justice. And I would spend the first half of the semester having them journal and over and over again as I read their journal entries, I would say, you’ve told me a lot about what you know, have not told me about what you think. I want to know what you think about this. I want to know what you believe and feel about this because that’s going to be the fuel that’s going to drive you to use these facts to change. And it was so hard for them. They’re like, yep, unlearn, relearn. I know. Yep. I’m going to say it again. You haven’t told me what you believe. And so getting ourselves to think very differently, to arrive at a space of healing, at a space of wholeness, at a space of community. I love that Martin Luther King used the adjective beloved before community, heartfelt like You are so important to me. My very heart depends on our connectedness. And the more we begin to value people, especially people that are different than us, then our society changes, our world shifts, and really we can, at least in America, try to be the things that our documents say. We hold these truths to be self-evident that all they say, men, people are created equally. Do we believe that if we believe it, we’re not acting on it. And so this is the time that I hope I used to say, I do this work so my children wouldn’t have to do it. But now my children are all solidly adults. They’re all knocking on the door of 30. One of them is in the 30 club. So now I have to say I do it so that my grandchildren won’t have to do it, but we know that change happens. My grandmother died as a 95-year-old woman that was born without the right to vote and ended up being able to vote for the first black president of the United States. Change does happen, and it happens rapidly if we allow it to. So I’m going to push back a little gentle pushback on your not in my lifetime. I think we all feel that when we feel it. It’s got to be the productive outright that drives us to say, well, if it doesn’t happen in my lifetime, I’m going to get us a little bit farther in my lifetime.

Shay (01:08:50) Well, I’ve read where Res Menke talks about nine generations. I’m like, I don’t know where he exactly got the nine generations, but that it’s in your body and it takes so long to move it out of the body. But with productive outrage, maybe we can speed up that timeline it to happen a lot faster.

Renee (01:09:10) I sometimes say to my staff, take your time, but hurry up.

Shay (01:09:15) Take your time, but hurry up. That’s great. Well, I just want to give you an opportunity if there’s anything that we did not have an opportunity to touch on today that feels important to you in the context of healing, and I want to give you free reign to go wherever you would like to go, sort of in closing for our conversation today.

Renee (01:09:38) Thank you, Shay. I think if I were to throw down one gauntlet to us right now, it would be to do a hard thing. We can do hard things. We have been doing hard things and not giving ourselves credit for it. It is not good enough. So when I think we have a temptation to say, well, we’re good enough. Things are good enough, no good enough is not good enough. So whatever the fuel for your engine is, it might be gun violence. And you see how it’s disproportionately affecting certain communities. In certain societies, it might be infant mortality, it might be maternal death, it might be disabilities, and the alienation of people who are differently abled than you. Whatever that fuel assignment and calling is, as we make change in our particular areas to which we’ve been assigned, it has ripple effects. It does have ripple effects. And so I’m just hopeful and prayerful that we will decide as a society, and dare I say as a world that good enough is not good enough. I can do hard things and I can do even harder things when I link my arms with you and we drive forward together.

Shay (01:11:11): Well said, my goodness. What an honor and a privilege to have this conversation with you today. Renee, thank you so much for taking the time to share so much of who you are. And you certainly embodied what you described with us, of bringing in your feeling, your productive outrage, like all of who you are, your intellect, the beautiful intelligence that’s helped you to get to be in the position of power that you’re in today, but bringing it all in, not separating the personal and professional, but integrating. And I think you’re a lovely and powerful and incredible example of someone who’s doing all of that. So thank you so much for being a guest on the show. Appreciate you.

Renee (01:11:55) My pleasure. And I would just say that everyone who has listened, no matter what part of the earth you’re sitting in, you are now deputized to go forward and help us evoke some change in healing.

Shay (01:12:08) That’s right. They have received that mandate, so make some change right today. Alright, thanks so much.

Renee (01:12:17) Thank you, Shay.

Conclusion (01:12:21)We hope you enjoyed this episode of The Conversations on Healing Podcast. If you haven’t yet, please go to Apple Podcasts, Spotify, or your preferred podcast platform and subscribe, rate, and review. This podcast, it helps so you won’t miss an episode. See you next time.