Lab Matters Summer 2023 | Page 15

FEATURE

People in positions of leadership can extend privilege to their staff through access to education and professional development . And importantly , they can create an environment where people can speak freely without a fear of retribution and with the expectation that their words will be heard and considered . As a starting place , the DEI Task Force has compiled several resources and strategies to help support inclusion efforts in laboratories .

That ’ s how you learn — by being uncomfortable , by being out of your comfort space ,” Magaña added . “ We need to expose our students to develop these other competencies .”

Laura Magaña , PhD said Mighty Fine , MPH , CHES , director of the Center for Public Health Practice and Professional Development at the American Public Health Association ( APHA ). “ And it ’ s important for us to acknowledge that and call it out so we can shift that paradigm .”

That will require open , honest conversations about privilege and its impacts to help make them visible to everyone . Such conversations can be hard and uncomfortable at times , “ but it ’ s okay to be uncomfortable , as long as we ’ re respectful ,” said Michelle Rodemeyer , chief financial officer of the Missouri State Public Health Laboratory .

Too often , mentions of privilege evoke shame and defensiveness , which get in the way of open communication . Much of that stigma arises from two myths , Fine said .

First , acknowledging privilege “ does not mean that you didn ’ t work hard or that you don ’ t deserve what you have ,” Fine said . That idea is rooted in the myth of meritocracy — that equal effort and ability will result in equal success . But in fact , social systems are built on biases and assumptions that preference and reward some identities over others .

Nor does extending privilege to others diminish one ’ s own . That ’ s the myth of the zero-sum game — by giving to or supporting others , ground is lost or something important is given up . But that is not how success works . Supporting a multitude of identities results in a stronger system that benefits everyone more fully . ( For more on these myths , see the work of Camara Jones , MD , a social epidemiologist and physician at Morehouse School of Medicine .)

Productive conversations about privilege and its impacts will require debunking these myths and shifting the narrative toward a recognition that equitable practices work toward a collective benefit . Creating space for these conversations in the laboratory empowers individuals to ask questions , share their experiences and speak up about injustices they see or feel .

Hearing other peoples ’ experiences can be a powerful way of starting to see your own privilege as well . “ There ’ s a lot of misconceptions ,” said Rodemeyer , who is also a member of the APHL Diversity , Equity and Inclusion ( DEI ) Task Force . “ Ten years ago , I didn ’ t feel like I had a privileged upbringing . But as I ’ ve met people and heard their stories , I see how I did .”

“ These open and honest conversations are so necessary because they create an opportunity to build a shared understanding of our varied experiences , which can engender empathy and are a foundation for healing ,” Fine said . “ My grandmother used to always say , ‘ Change is on the other side of a conversation .’ I really believe that .”

Moving Toward Health Equity

As with privilege itself , addressing the resulting inequities in care first requires being able to see them . By providing services at no cost to patients , public health laboratories offer the most equitable testing possible — and often the only option for many individuals and populations who are underprivileged . In that “ safety net ” role , Rodemeyer sees for laboratories an unwritten mandate in health equity .

“ We level the scale a little bit .”

Public health laboratories offer a unique service to their communities , Salerno agrees . He encourages laboratorians to lean into that role .

“ From my point of view ,” he said , “ I think the most important message for public health laboratories is that they have a responsibility to engage their communities to determine where medically underserved populations live , and how they gain access to testing services .”

That requires the willingness and the ability to really understand the community and its needs . What role does the laboratory fill in community healthcare ? What services are being provided that people might not be able to access elsewhere , and are they being offered in an accessible and socially relevant way ?

At the laboratory level , that might mean having programs and staff dedicated to identifying underserved communities in their jurisdictions and enhancing access to the specific testing services needed in those communities — whether it is measles or sexually transmitted infections . It might also mean developing partnerships with existing organizations , or extending services to meet people where they are . For example , during the height of the COVID-19 pandemic , many public health laboratories created mobile laboratories to bring testing services to communities that lacked access to testing locations .