‘We Need to Acknowledge Both Resilience and Oppression’.
Savannah graduated with her MPH in 2020 and is now working as a project coordinator at the Mailman School of Public Health at Columbia University. During her time at BUSPH, she participated in the Activist Bucks program and shared her experience of how it gave her the opportunity to explore her passions and the vast opportunities in the field of public health.
Q&A
What was your Activist Bucks project? Why did you choose to decide to focus on this specific population?
Over the past year, I have been working as a research coordinator for an exploratory study that aims to understand how we can expand the work of a medical-financial partnership called StreetCred to dismantle economic oppression that contributes to racial inequity. StreetCred offers a truly innovative model that has enormous potential to mitigate child poverty, one of the most powerful social determinants of health. Most social determinants of health interventions that are situated in the healthcare setting have a downstream focus on addressing the most urgent hardships with community resource referral (e.g., food pantry to address current food insecurity) and ignore historical, systemic, and structural social determinants of health. In essence, these referrals allow families to subsist within systems of poverty without also working to mitigate poverty. Since 2016, StreetCred has been responding to this insufficiency by empowering families to build assets and income with financial services that are co-located within Boston Medical Center (BMC) Pediatrics. StreetCred focuses on ensuring receipt of the Earned Income Tax Credit and Child Tax Credit, the largest anti-poverty programs in the U.S. that are associated with improved maternal-child health. Since 2016, StreetCred has expanded beyond BMC to include six other clinic sites across four states and has returned $5.3 million to families.
This year, StreetCred expanded beyond the clinic by implementing a tax site at Epiphany School, a not-for-profit, community-based Early Learning Center and Middle School for children of economically disadvantaged families in Dorchester that provides a variety of supportive wrap-around services. We are evaluating the feasibility, acceptability, and community health impact of the Epiphany tax service. This evaluation is subsumed within the exploratory study as we try to understand where and how to best co-locate which types of financial services to achieve sustainable economic empowerment in the community. I am ecstatic about the potential of this work and was thrilled to go into the community and engage with diverse people on the ground. My PI allowed me the incredible opportunity to take ownership of the work and be the first author of this study’s manuscript.
Did the COVID-19 pandemic impact your work?
Unfortunately, we had to stop on-site data collection and go through a difficult transition to a virtual tax prep site beginning in mid-March. Thankfully, my consistent presence at Epiphany School from December through March helped foster community trust that has enabled me to continue to collect quantitative and qualitative follow-up data via email, phone, and Zoom. However, my collaboration with participants has been hampered as they grapple with the stress induced by COVID-19 and salience of racially inequitable violence and are unable to engage with me in the trusted Epiphany School environment. We paused the study for a time in June, letting participants know, “The StreetCred team wants to mourn the loss of black lives at the hands of police brutality and racism. We are committed to using our platform to dismantle structural racism through fighting economic oppression. In solidarity, we will pause our study.” I have been able to conduct 18 baseline interviews and 9 follow-up interviews thus far and will be analyzing the quantitative data soon.
What have you learned from working with your community partners?
Navigating difficult conversations around the intersection of racial inequity and economic oppression with folks of color has been so eye opening and humbling. I have learned (and am continuing to learn) how to foster open dialogue with those who have such diverse lived experiences. This skill is crucial, and this work has reinforced how imperative it is that I continue to grow in it. Sometimes academic circles can morph into comfortable echo chambers. But effective change is not born from echo chambers. Effective change is born from difficult conversations that explore seemingly intractable problems. Problems like child poverty and its litany of life course repercussions. We need innovation if we are to progress, and we cannot innovate about things we do not know fully and deeply. The parents I have interviewed have provided so much insight about economic oppression, and in so doing, economic liberation. That balance is key. In public health circles, I have heard people say that focusing on resilience unduly downplays oppression. Others have said that focusing on oppression unduly disempowers people and disregards their genuine strength. We need to acknowledge both resilience and oppression. Families experiencing poverty are doing amazing things, and they have important insights about how we can build on those amazing things. We need to consistently seek out this on-the-ground knowledge, pair it with the literature, find the areas of innovation, and get to work. There are so many powerful quotes that I wish I could share here, but I will have to save those for the manuscript.
How has being a part of the Activist Bucks program impacted your experience at BUSPH?
The Activist Bucks Program has been an incredibly important complement to my academics at BUSPH. Certainly, all my courses were practice-based with unquestionable relevance to my career as a public health professional, but the Activist Bucks Program offered a crucial outlet to do some extensive work on the ground. This work allowed me to integrate and apply all that I have learned throughout my coursework and to develop a deepened appreciation for the necessity of qualitative research when grappling with complex public health problems.
Do you have any advice for other students interested in Activist Bucks?
Seek out opportunities that are outside of your comfort zone, and explore new areas of interest! I came to BUSPH with a primary interest in refugee mental health, and I now have a newfound passion for community economic development that I may pursue as a career. Public health is vast, so take this opportunity to explore!