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Friday, November 24, 2017
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“Go to the Mountains,” Diane Bielak, from Visualize Health Equity:

On November 9 the National Academy of Medicine unveiled its Visualize Health Equity Project, an online gallery of 40 visual and verbal artworks. Artists from around the country submitted works illustrating what health equity means to them, expressing the opportunities and challenges surrounding the health of their communities.

The gallery demonstrates an impressive diversity of imagination that gives me hope for humans.

I’m happy to say that my prose poem “Health Equity as a Stand of Quaking Aspen: Sangre de Cristo Mountains” is among those on display. Even though I live in Brooklyn, my poetry is centered in the U.S. Southwest, where the great paradoxes of endangerment and beauty, brutality and tenderness are displayed in its many damaged ecosystems and in its high rates of health disparities.

I wrote in a brief essay accompanying my poem:

“New Mexico is a bellwether of how changes in climate, agriculture, and regulation affect public health, as well as the recovery possible through strategies designed to improve care access for Native residents and to restore aspen to mountainsides they’ve inhabited for millennia.

Aspen clones act as a living symbol of communal strength in biodiversity. But they’re more than metaphors: their health and ours are inseparable.”

Such ideas aren’t new, and poetry has deep ties to both environmentalism and social justice. But it’s a prose writer I think of as the poet laureate of 20th-century American conservation. Aldo Leopold’s rhythms and eloquence made clear what human greed had already imperiled by 1910, and in his prose he adopted two of poetry’s oldest traditions, the pastoral and the elegy, in crafting his argument for a “land ethic”—a philosophy in which any definition of community must also include nonhuman life.

Phrase by phrase and species by species, Leopold made his poetic case for “interdependence.”

By the turn of the 21st century, poets began using terms such as ecopoetry, ecocriticism, and ecopoetics to define how they would grapple with environmental crisis. They asked: How might the entire poetic enterprise—the composition, publication, reading, and performance of poems—inform an environmental ethic? Melissa Tuckey uses the term ecojustice poetry to describe poetry “at the intersection of culture, social justice, and the environment,” a poetry “of interconnection.”

I’m seeing more and more interconnections in contemporary poems between health disparities and ecological disaster. Of the many poets illuminating such issues, I’d like to point to one whose work provides a very moving example of lyric possibility.

William Brewer’s first full-length collection of poems, I Know Your Kind, reveals the opioid crisis as an outgrowth of the environmental and economic devastation afflicting his native West Virginia, the state with the highest death rate from opiate overdose.

Brewer conjures a world we can’t turn away from. “Like timber, like anthracite, death is a natural resource,” Brewer writes in “West Virginia.” These poems break and mourn and collapse; they brave the muted stillness remaining after tragic death; and ultimately they risk the claim that these hidden lives and that blasted landscape merit saving.

In “In the Room of the Overdosed, an Ember” the speaker addresses the body of a departed friend:

“You are still here. Each second of late-winter dark is a feather stitching the wings of your ghost.
The coal is almost gone, and soon the mountain tops, and fresh water, after which
this will be the cellar of how many centuries, locked away?
Snow wrapping the hills like caul fat.
Cattle on the hills, drops of soot.
The sky is blind and open for the snow.”

Blind and open . . . Isn’t that sky like so many us, our human eyes open but not seeing? Isn’t that how we’ve responded, as a culture, to the opioid epidemic, to health disparities overall, and to our changing climate?

Leopold wrote that the poet’s motivation is “the thrill to beauty.” Brewer’s work and the Visualize Health Equity Project are important efforts in helping us recognize the beauty and connections that endure in the midst of ruin. Policymakers will do well to study these and other artworks as they strategize to avert catastrophe.

[caption id="attachment_13544" align="alignleft" width="300"] “Go to the

Since WWII, Americans have been sold the idea that more health care is better. But comparisons of the U.S. with other comparable nations teach us otherwise. While we spend more per person on health care than any other nation—a total of over $3 trillion per year—we rank last or next to the last in key indicators of health and quality of health care. We know that medical errors are the third leading cause of death in this country, evidence that our health care system is not safe. And we are overscreening and overtreating and mistreating and misdiagnosing health problems. About one-third of all healthcare spending is because of unnecessary, inefficient and ineffective care, as well as outright fraud. If we could reduce this waste and give it to communities to promote health and wellness, we wouldn’t need as much acute care.

There is a growing movement in the U.S. to move our attention and resources upstream, meaning to efforts that will promote healthy individuals, families and communities so that they can avoid preventable, costly health problems. One of the leading organizations behind this movement is the Robert Wood Johnson Foundation (RWJF) through an initiative called Culture of Health. The focus is on what works to build healthier communities.

But where does one start in trying to build healthier communities for the individuals and families who live and work there?

One place to start is understanding whether your community is healthy or not. Some years ago, David Kindig initiated a project at the University of Wisconsin called County Health Rankings and Roadmaps that provides county-level data on key health indicators and ranks counties in a state based upon a composite score. You can go to the website and look up your county and see what the major health problems are and which of these are contributing to a poorer state of health in your community. The website also provides background on the indicators, resources that speak to addressing specific health issues, and examples of successful local initiatives that communities have launched to address key health problems. The Action Model shown above provides a guide for communities to think about doing the work of building a healthier place to live, work and play. In addition, the RWJF has funded the University of Wisconsin to help counties to interpret their data and be coached in developing initiatives that can prevent leading health problems.

On September 27, I interviewed Jerry Spegman, a Community Coach at the County Health Rankings & Roadmaps initiative at the University of Wisconsin, on my radio program, HealthCetera in the Catskills, to talk about the health indicators for Delaware County. HealthCetera in the Catskills airs on WIOX Radio in Roxbury, NY, located in Delaware County. Our discussion could be used to spur conversations about how to improve health in your own community.

Image source: County Health Rankings Action Model

Since WWII, Americans have been sold the idea

Carolyn Jones, Sally Welsh CEO HPNA, Barbara Glickstein

On Thursday, November 2, in honor of National Hospice and Palliative Care Month, a Congressional Hearing was held –  Advance Care Planning: Honoring Patient’s Wishes at the Cannon House Office Building. It was co-hosted by Congressman David P. Joyce (R-OH)  and Congresswoman Tulsi Gabbard, (D-HI), co-chairs of the Congressional Nursing Caucus.

Congresswoman Eddie Bernice Johnson (D-TX) attended the hearing and spoke about the importance of nursing’s role in Palliative Care and Hospice.

This hearing was organized by Hospice and Palliative Nurses Association (HPNA)Hospice and Palliative Nurses Foundation and Hospice and Palliative Credentialing Center.
Carolyn Jones, Director of the documentary, Defining Hope, screened select segments of her documentary highlighting nurses’ critical role supporting people at the most fragile junctures in life when facing serious illness.
Barbara Glickstein, RN, MPH, MS, is Nurse Advisor and Consultant to Carolyn Jones Productions, spent the last two years working with the production team on the documentary, Defining Hope and attended the hearing.  She is also Director, Communications, Media Projects, at the George Washington University School of Nursing, Center for Health Policy and Media Engagement.

Congresswoman Gabbard issued this press release about the hearing.

[caption id="attachment_13501" align="aligncenter" width="3000"] Carolyn Jones, Sally