Centering community voices: Reflections on King County’s pandemic response

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Note: The COVID-19 pandemic has magnified the inequities faced by Black, Indigenous and People of Color (BIPOC). Public Health recognized early in 2020 that this would happen, because it is what always happens when diseases intersect with structural racism. From that recognition — plus the need for feedback and to address impacts across sectors — a Pandemic Community Advisory Group was born. The group’s structure reflects previous experience in King County.  It includes leaders from not only community, business, education and corporate sectors, but also communities that have been marginalized by institutions, particularly immigrants and Black, Indigenous and People of Color. With last year’s declaration of Racism as a Public Health Crisis, they share a commitment to a racially equitable COVID-19 response and to addressing root causes of racism as part of what became the Pandemic and Racism Community Advisory Group (PARCAG). 

This is one of several blogs featuring voices from the PARCAG.

by Tara Lawal and Jodilyn Owen of Rainier Valley Midwives, with Gabriel Spitzer of Public Health – Seattle & King County

When COVID-19 hit our region last year, we saw immediately just how dangerous it could be for our clients. Rainier Valley Midwives (RVM) works with pregnant people and their families to improve parent and infant health outcomes in the Seattle area. We knew this disease would exacerbate the racial inequities that we confront every day — the same glaring disparities that lead to less accessible prenatal care and more preterm births in the populations we serve.

One sobering example: Black and Indigenous pregnant people in King County experience infant mortality rates two and three times as high as the county at large. 

Photo of the authors, Tara Lawal and Jodilyn Owen, of Rainier Valley Midwives. The woman on the left is dark skinned, with glasses on her head, and is embracing another woman with lighter skin and glasses that is wearing a head wrap. The woman on the right is cradling a tiny little baby that is wrapped in purple fabric.
The authors, Tara Lawal and Jodilyn Owen, of Rainier Valley Midwives.

Our origin story — who we are and what we are about — is inextricably connected to traditionally marginalized people in the Rainier Valley. We have a deep, personal understanding, based on lived experience, of the ways in which racism and misogyny have shaped the struggles and disparities that women of color experience, especially around reproductive health. We have the personal experience of facing limited options around birth and reproductive health. We have the experience of seeing our family members and friends confront barriers to health access and coverage. We have personal experience of redlining, prohibitive and predatory lending practices, exclusionary hiring practices and other instruments of institutional racism.

The extent of those inequities had never been laid out more starkly than in 2020. When COVID appeared, we jumped into action to make sure birthing families still had options for care and birth during COVID, switching breastfeeding groups to virtual Lactation Lounges, delivering supplies directly to families, and navigating a health care system in turmoil. As we love to say, we are not about thinking in the box — we are about pulling it apart to find real solutions for families and community.

As we hustled to figure out how to support pregnant people during a pandemic, Public Health — Seattle & King County was recognizing that addressing COVID-19 was inextricable from confronting the health disparities that disadvantage BIPOC communities. By the time they approached Rainier Valley Midwives to join the effort in May, Public Health had already been engaging with community-based groups all over King County and standing up organizations and task forces to bring them in to the pandemic response.

Pandemic and Racism – Spring and Summer, 2020

Much of that work had coalesced into the Pandemic Community Advisory Group, which started meeting weekly in March 2020, made up of a quilt of grassroots organizations across King County, along with institutional partners.

It began as a way for Public Health to get the word out into communities about how to fight the spread: wear masks, avoid gathering and wash your hands. But over the course of the pandemic, this group has undergone a profound evolution.

In June, when people across the country rose up in disgust over systemic racism and police brutality, the Pandemic Community Advisory Group decided to formally incorporate the public health crisis of racism into its mission: PCAG became PARCAG — the Pandemic and Racism Community Advisory Group.

Over time, the emphasis in PARCAG shifted to an increasingly community-driven approach. The circle expanded to include voices that had been left out before.

Those meetings were energetic, and they only got more so. We were particularly moved by the Alliance of People with disAbilities. Watching their executive director, Kimberly Meck, champion her communities and diagnose public health shortfalls was like a master class in advocacy.

We saw all the ways in which our work intersects with hers, and with the Ethiopian community in King County, the Community Health Board Coalition, Casa Latina, American Indian Health Commission and many other community organizations.

At PARCAG meetings, they articulated the hardships and disenfranchisement we’d lament in meetings at RVM, but here they were, saying it right out loud! It was an extraordinary connection and amplification of so many issues vital to communities across King County.

Who steers? – Fall, 2020

In the Fall, PARCAG underwent another transformation: King County basically handed over leadership of this organization to its members. A new steering committee, made up of five representatives of community-based organizations and one from Public Health, would lead the work.

In the beginning, the community-based organizations had followed along while King County led the meetings. Just being asked to show up was progress. Now, we were being asked to show up with power. We would lead the meetings. We would direct the agenda. We would, when possible, lead on policy. With the county’s support, we evolved the Pandemic and Racism Community Advisory Group into a muscular, dynamic, community-led organization, with teeth.

At the first meeting led by advisory group members, we could feel the difference. It felt familiar. In multicultural spaces, we tend to check in on each other first, elevate the needs and problems of community and individuals, and work in creative ways to find solutions. The steering committee made alterations to the typical agenda, giving more time to fewer topics per meeting to allow for full exploration of the issues. Those first member-led meetings, and the shift in thinking they signaled, were a healing experience for us.

This new format awakened us to the multiple intersectionalities that underlie our superficial differences. We got better at addressing all those layers, referring people to PARCAG partners for support for parenting with a disability, or food assistance, or housing insecurity.

We know that our fractured and historically racist system impacts people’s and communities’ health in profound and numerous ways. Our experience in PARCAG has made us better at seeing those impacts and providing more attuned healthcare for the people who face them.

Our organization’s and our county’s community-based response to this pandemic is constantly maturing — there’s no rest from the evolution. It is a brutal iterative process: You have to wake up every day ready to learn. It’s hard work and challenges concepts we hold about ourselves, but it can also be transformative to systems small and large. We are committed to continuous learning and we are so lucky to be at the table with other organizations who are also doing this work and want to dig into those hard conversations and see results together.

There are barriers to this work — any demand on the time and creative energy from organizations that are often led by people subject to whatever they are fighting against and for is a big ask. The large, institutional organizations represented on PARCAG have to double-down their commitment to show up, listen, learn and engage. 

No institution is immune from this work. At RVM we have made drastic changes in 2021 to hold ourselves accountable to building an equitable workplace. We have learned that it starts from the inside out with leadership development, ongoing training for staff and the board, and community engagement.

This is delicate, time-consuming work that requires sharing of resources, lifting and centering of community without ego and contributing because it is the right thing to do. PARCAG is a table where that work can be tackled together, as long as we all show up.

For the large funders in our county, it is a time to ask themselves: What work do we need to be doing to build capacity in the community? How can we work to help our employees and communities achieve their goals? Are we showing up in ways that promote the health of community-driven organizations, and pouring resources into them instead of trying to overlay our own values and design on their actual needs?  How can we contribute and create instead of consume? 

PARCAG has allowed us to humanize one another — Zoom breakout rooms are a great equalizer — with leadership from large institutions present with children and pets and doorbells and exhaustion, just like leadership from the community-based organizations. 

We hope these moments will help open us up to learning with, from, and about each other and lead to internal and external changes so desperately needed in our society right now.

The hard work is just beginning – 2021

What does it really mean to center Black, Asian, Pacific Islander and Indigenous voices and community-based organizations? It means an ongoing commitment to keeping the power and funding in community.  It means taking action on community ideas and providing the tools and resources needed for community-driven and led programs and services.

We have often been the recipients of carrots held out to community organizations in King County that turn out to require so much time and work that it costs us more to accept the carrot than it does to walk past it. This is a common experience among small community-based organizations and why we are so often left behind, despite being the ones doing so much of the work in the ways that matter to community.

As Public Health — Seattle & King County starts the shift toward a much bigger role for the community in policymaking, there is the potential for true restructuring of power that political and health systems can learn from. We are honored to put our time into the co-creation of this model with so many other beloved and vital organizations and the staff and leadership of Public Health — Seattle & King County and look forward to shared ongoing efforts in 2021.

About this blog:

This blog post is part of a series of stories from members of the Pandemic and Racism Community Advisory Group (PARCAG). The focus on PARCAG reflects its central role in defining an equitable response to the COVID-19 pandemic. In the process of making this blog, we sought to highlight equity and social justice values, anti-racism commitments and community resiliency. We also are committed to showing lessons learned and what approaches have been effective during an emergency response. To that end, Public Health has paired a communications specialist with a PARCAG member, to craft each story collaboratively. And PARCAG members receive a stipend in recognition of the time they are spending on the co-creation process. As the process of co-creation intersected with real-life difficulties from the pandemic, we recognized that being rigid about artificial timelines can itself be a reflection of white supremacy culture, and we adjusted the creation process.

Originally published on September 1, 2021