Civility in Times of Social Polarization

Welcome to 2024 at the Johns Hopkins Center for Health Equity! I hope the year is off to a bright start for you. The Center wrapped up 2023 with several achievements, activities, and milestones.

 We had 78 members in attendance (in-person and virtual combined) at our December 2023 Community Advisory Board (CAB) meeting. Those who were able to attend in person enjoyed lively and productive discussions about our CAB’s engagement processes and the connections among members and about four current research projects:

• DASH-LIFE - This project will pilot a Food-is-Medicine intervention for adults with hypertension and type 2 diabetes residing in Healthy Food Priority Areas in Baltimore (`food deserts)—a population at high risk for adverse cardiometabolic health outcomes.

• LINKED Hearts – This program focuses on addressing structural issues of access and includes a self-measured blood pressure BP and blood glucose telemonitoring platform, team-based care including a pharmacist and community health worker, and provider-level interventions.

• BUILDing Leaders and Developing Power for Health Through Food—This research program is a collaboration between Johns Hopkins, Morgan State University, and BUILD (Baltimoreans United in Leadership Development), which seeks to understand better the impact of BUILD’s community processes and its food delivery program on food security, health, and well-being among participants.  

• UNLOAD- Heart Failure  – This project aims to adapt an evidence-based multi-level intervention (problem-solving training, use of community exercise facilities, and support from community health workers) for persons with low socio-economic status, diabetes, obesity, and early cardiac dysfunction, with input and feedback from community partners to increase acceptability and practicality.

In November, our beloved CAB member and community partner, Rhonda Ford Chatmon, retired from her role as Vice President at the American Heart Association (AHA) after 36 years. Rhonda has been instrumental in so many efforts and collaborations with the Center through her role at AHA, and we are excited to continue to work with her through the CAB.

Several faculty members received prestigious recognitions or promotions in the final quarter of 2023!  

• Deidra Crews was named the 2024 president of the American Society of Nephrology.
• Nakiya N. Showell was named a Baltimore Magazine Top Doc.
• Jessica Yeh was promoted to Professor in the Department of General Internal Medicine.
• Tanjala Purnell received the Community Champion Award from the Johns Hopkins Alumni Association.
• Yvonne Commodore-Mensah advanced in rank to Associate Professor and received the Global Achievement Award from the Johns Hopkins Alumni Association.

We bade a fond farewell to the Center’s biostatistical powerhouse, Kathryn “Kit” Carson, who has retired from Johns Hopkins after a distinguished 46-year career! At her retirement party, Kit received the inaugural Nancy E. Fink Faculty Award for Service and Scholarship from the Welch Center in recognition of her exceptional contributions to the design, conduct, and analysis of epidemiological studies. We will miss Kit so much.

The camaraderie and fellowship that we enjoy among researchers, faculty, students, staff, community members, and nonprofit and faith leaders affiliated with the Center for Health Equity strengthens our collective efforts. Sadly, it’s not this way with everyone and in every community.

Recently, I came across the book Choosing Civility: The 25 Rules of Considerate Conduct by the late P. M. Forni. Dr. Forni was a long-time professor at Johns Hopkins University and founded the Civility Initiative at Johns Hopkins in 2000. Civility initiatives have spread around the country since then.  

The concept of civility has an important role to play in fostering positive relationships and communities. But at times, when I am out in public, and especially when I watch or read the news or scroll through social media, I feel humanity has lost sight of this key concept. Reflecting on the rules described by Dr. Forni can do much to advance our understanding of one another. In fact, these rules are like the relationship-centered attitudes and behaviors that my colleagues and I described more than 15 years ago, as part of our work in the Fetzer Relationship-Centered Care Initiative. Civility is not sufficient, but it is the first step in creating safe spaces for relationships to develop and thrive. One wish I have for 2024 is that we can all look to these rules as guiding principles for how we engage both professionally and personally. Here are a few rules I found particularly relevant to the advancement of health equity.

Pay Attention:

Paying attention to issues and to one another is crucial to reducing health disparities. We must first recognize the existence of problems to address and eliminate them. With greater awareness, we can drive positive change in health care.

Acknowledge Others:

Acknowledging everyone, regardless of their role in the healthcare system or our communities, contributes to a more inclusive and supportive environment. We must strive to emphasize the significance of recognizing the contributions of all individuals in our society.

Think the Best:

How many times have you defaulted to thinking the worst of someone or the worst-case scenario in a situation? If we assume the best intentions of our friends, colleagues, and neighbors, we can make progress in so many aspects of society, including in healthcare. Remember that individuals within the healthcare system are working towards the common goal of improving health outcomes. Addressing challenges with a positive mindset can lead to more effective solutions.

Listen:

 We can learn so much from just listening. I have devoted decades of research to helping improve communication between patients and physicians. The skill of “active listening” is critical in health care and in community-engaged research and practice. By understanding diverse perspectives, especially from communities marginalized due to race, socioeconomic status, or other identities or life circumstances, health and public health professionals, researchers, and policymakers can better address specific health needs. Listening can lead to more tailored and effective programs and policies.

Be Inclusive:

These days, diversity, equity, and inclusion have become buzzwords that have lost their meaning and impact in many settings. In other situations, policy and politics have made it nearly impossible to exercise our hopes for a diverse, equitable and inclusive society. But we must not lose sight of the importance of inclusivity in healthcare policies and practices. Think about the ways you can break down barriers and expand access to healthcare services for all, irrespective of socioeconomic status, race, or other factors.

Speak Kindly:

Words have the power to heal or destroy. Yet, I find that people can be so cavalier about what they say online and sometimes even in person to the people they interact with. How can you create a supportive and empathetic environment for patients and their families, healthcare personnel, researchers, research participants, and community partners alike, fostering trust and collaboration with your words?

Respect Others' Opinions:

Decisions that impact the lives of people in our communities must reflect the ideas and wishes of diverse perspectives. This is especially true in health and healthcare decision-making. Respecting and considering different opinions can lead to more comprehensive and equitable practices and policies.

These are just a few of the rules on civility put forth in Dr. Forni’s book. And they align with the Center’s core values and practices. I hope this will be the beginning of an ongoing discussion of this topic among the faculty, staff, and trainees of the Center for Health Equity, our research participants, and the community members and patient advocates who work with us every day to advance health equity.

Happy New Year to all of you!