For the past two decades I have been working to address health disparities among lesbian, gay, bisexual, transgender, and queer people in Wisconsin. The organization I started, Diverse and Resilient, Inc., has been successful in important and measureable ways. But the social conditions that put parameters around how healthy we can be are largely out of the control of an agency. It takes a community to eliminate health disparities.

Much is known about health disparities. Genetic differences among us are important, but are relatively small contributors to the different rates of mental health, substance abuse, or violence experienced by LGBT people, women, African American people, and others. The risk behaviors in which people engage also contribute to their different rates of health disorders and their reduced sense of well-being. Limited exercise, high calorie/high fat diets, tobacco use, alcohol abuse — these are building blocks of health disparities.

While huge sums are devoted to the research and drugs to address genetic factors associated with illness, even more is spent on advertising products and services that keep people sedentary, overweight, and addicted. But relatively little government or private money is devoted to addressing the social issues of racism, classism, sexism, and anti-LGBT discrimination that are powerful contributors to the conditions in which health disparities develop and flourish. While there are many advocates who seek to change this scenario — the disproportionate efforts to change the impact of genetics and while maintaining profit-based arrangements that cement health disparities in place — very little consistent support exists at the community level to shift our structural supports to keep us healthier longer.

As I have had the great privilege to do work that I love, I have also recognized that this case for public health also exists for issues of joblessness, education, and other apparently intractable social problems we face in the US and elsewhere. The reactions to grand jury decisions in 2014 in Missouri and New York reflect, I believe, some similar underpinnings. Decades of resources have gone to arming police forces, building prison infrastructure, and bailing out corporations while education budgets, job readiness programs, and supports for families and individuals have plummeted.

What I want to know now, what I will devote more of my energy and thinking to, is

1. how we can build community so people will vote in their own best interest and in the interest of their fellow community members;
2. how we can move beyond the contacts afforded us through our interactions with computers to engagement possible through personal connection with people face-to-face;
3. how can we activate empathy, social interest, and the desire for resolution; and,
4. how can we together confront and shift endemic discouragement, disinterest, and disillusionment.

As I look toward my next two decades, I plan to be a student and teacher of community building. Empathy, humility, reconciliation, and perspective all come into play.

This is exciting.