Remembering Thembi Ngubane

Thembi Ngubane was a brave 24 year-old HIV positive young South African woman who passed away last week. She recorded an AIDS diary in 2006 that was broadcast by NPR to over 50 million listeners in the U.S., Canada, Australia, U.K. and her native South Africa. The themes she touched on in the diary are about profoundly common human experiences. "She was smart and perceptive and self-reflective in a way that many people aren't," says Mr. Richman, who won an Overseas Press Club Award for the broadcast. Her story galvanized many to act in the service of others in South Africa and around the world. She is a great example of how one person's story can inspire others to serve. For more about her, please check out the WSJ article "Young South African Women's AIDS Diary Touched Millions of Listeners", 6/13/09.

Health and Human Rights

Come learn about health and human rights this Friday, June 5, 2009 at the First South Los Angeles Health and Human Rights conference. TruthAIDS will be presenting on the housing and health panel.

Check out the website for details:

http://www.southlahealthandhumanrights.org/index.html

Zip Code Matters More for Health Than Genetic Code

There was great article posted last week from the Senior Vice President of the Robert Wood Johnson Foundation on the importance of place and context in the health. TruthAIDS supporters you know the story but just in case you missed this article. Check it out below:


Why Your ZIP Code May Be More Important to Your Health Than Your Genetic Code
This commentary by James Marks, M.D., M.P.H., originally appeared April 23, 2009, on The Huffington Post.

How you see a problem drives how you create the solution.

We are not a healthy country. And while health reform focuses on coverage, cost, access and care, this is simply triage to a system that fails to ask the question "Why aren't we healthier in the first place?" Our health reform debate is focusing on where health ends (with medical care) and not on where our health begins (where we live, learn, work and play).

This month, the Robert Wood Johnson Foundation Commission to Build a Healthier America released a report about all of those other things. This report comes out of a bi-partisan commission created to look at the factors that affect Americans' health in our homes, our work environments, and our communities. In wonky terms, we call these factors "social determinants of health." In plain English, the Commission's purpose was to look for ways beyond medical care that could improve our health.

What do we mean by "beyond medical care?" There is a ton of evidence that shows where and how people live, learn, work and play has a tremendous impact on our health. And while this link may seem intuitive to most, the extent of the relationship is not reflected in either the way we consider our own health or the way we go about creating solutions to make us a healthier nation as a whole.

Let us consider just a few facts:

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Evidence now suggests that medical care accounts for only 10 to 15 percent of preventable early deaths.
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Some Americans will die 20 years earlier than others who live just a few miles away because of differences in education, income, race, ethnicity and where and how they live.
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College graduates can expect to live five years longer than those who do not complete high school.
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Middle-income people can expect to live shorter lives than higher income people, even if they are insured.
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And people who are poor are three times more like to suffer physical limitations from a chronic illness.

In other words, as it relates to our health, our ZIP code may be more important than our genetic code, our school files may be more telling than our medical files, the time spent in our office at work may be more relevant than the time spent at our doctor's office and the places we play may be more crucial than those where we get treated.

Even when we do consider these social factors, we too often place an unfair burden on personal responsibility and ignore the obstacles that stand in the way for some to make healthier choices. Consider that Detroit, an area of 139 square miles and over 900,000 citizens has just five grocery stores. An apple a day may help keep the doctor away but that assumes you can find an apple in your neighborhood.

As we begin to explore new ways to improve this country's health, we should look for inspiration from innovative programs around the country that are finding sensible, sustainable solutions at the intersection of health and daily life.

Take for example a program like Bonnie CLAC (Car Loans and Counseling), which is built on the premise that how you get around affects your ability to live a healthier lifestyle. Reliable transportation can mean the difference between keeping and losing your job, being able to take your kids to the doctor and make it to a grocery store that sells healthier food. Bonnie CLAC is helping the working poor purchase fuel-efficient cars at great prices and low interest rates, while providing them with crucial financial counseling. This counseling not only helps them make the payments but also show how changes, like quitting smoking, can help their financial bottom line and be good for their health. If only our banks had taken a similarly responsible approach to home lending, we could have avoided the sub-prime mess that has had a devastating domino effect in creating more Americans who are vulnerable to financial difficulties and subsequent poor health.

As we consider health reform in 2009, let's think about the neighborhoods and towns in which we all live, and ask ourselves: What are the barriers standing in the way to better health and how can health reform change the places we spend our lives to make them healthier places in which to live?

Take a look around you and ask yourself "where does health really start?" Is it in the hospital or the home? Is it with insurance company or your employer? Is it with an ambulance driver or an urban planner?

Only when we answer these questions honestly and see our health problems more clearly in this broader context, will we begin the real work to create and invest in solutions that help us all live as long and as healthy as we can.

James Marks, M.D., M.P.H., is currently the senior vice president, director of the Health Group at the Robert Wood Johnson Foundation and is former assistant surgeon general, director of the Centers for Disease Control's National Center for Chronic Disease Prevention and Health Promotion.

David the Piano Player

The trailer for David the Piano Player screened at the New York Academy of Medicine's conference on housing, health and serial displacement yesterday. It was very well received. David's story teaches volumes about dignity and how to heal from trauma. Many thanks to the talented editor and co-producer Sabrina Gordon, of Vespertine Media and Film Productions, DP/post-production supervisor Amir Ebrahimi of Metric Nine Productions, and Tiona McClodden (second camera) for signing on to make this project possible.

Please stay tuned for updates on this project which will be complete by Summer of 2009. I can't wait to share it with all of you.

TruthCircle Los Angeles

The Los Angeles-based TruthAIDS team, spearheaded by the poet Lily, recently held a TruthCircle for National Women and Girls HIV/AIDS Awareness day. Lily wrote the following about the event on her blog (lilyliketheflower.blogspot.com):


I recently hosted a TruthCircle event at Mecca Hair Studios in Los Angeles. To provide some background, the TruthCircle is designed to promote honest communication and offer the opportunity for women to share their stories and learn from others experiences. Ultimately, the goal is to identify alternative ways to address the HIV/AIDS epidemic and its effect on the population most vulnerable to it - women. Ideally a TruthCircle would take place with an all female audience, but the first TruthCircle Los Angeles was different to say the least. Firstly, it was coed with men outnumbering women. Secondly, because it was hosted at a local beauty salon and community hub, we actually had walk-in participants! Overall, it was an enlightening experience and offered the chance the hear answers to controversial TruthCircle questions such as "Are you sexually satisfied" and "Have you ever had sex when you did not want to?" from a man's perspective. Ladies, I must tell you these are questions that we should not only be answering ourselves but asking the men in our lives. The vast difference in the answers can be mind boggling. My key takeaways from the event are as follows:
1) As women, with our emotional and physiological vulnerabilities, we (when I say we I mean me too!) have to be more aware of the choices that we make and their potential outcomes
2) Men think very differently than women, especially when it comes to sex. Relying on a man to put our safety and feelings on any list of priorities is not likely in a casual dating situation and many times not even in what a woman would consider a "committed relationship"
3) We absolutely have to keep up the open and honest communications! I learned so much and look forward to the next opportunity to share! Have a TruthCircle with your girlfriends or visit http://www.truthaids.org/ to find a TruthCircle near you.

Social vulnerabilities and HIV prevention

I have been getting a lot of questions lately about who is responsible for addressing social vulnerabilities. This is a big question. My answer, in short, is everybody! Professionals, researchers, concerned citizens, advocates, and infected communities all have a stake to claim.

Poverty, homelessness, racism, sexism, violence and homophobia are all forms of social vulnerability that predispose communities to ill health. These problems are not specific to HIV prevention and are rooted in long histories of oppression. So then the question becomes, how do we get free? We start by not repeating mistakes from the past and focusing future efforts on collective emancipation. The operative word being collective. You don't need to be an expert to start addressing social vulnerabilities. In the words of Arthur Ashe: "Start where you are. Use what you have. Do what you can."

I touched on these issues while speaking on a CHAMP community forum panel last fall that was focused on HIV prevention. Check it out below. If you still have questions... you know where to find me.

Welcome Ebon!

TruthAIDS artisans are a group of artists we collaborate with to help us communicate community-based health lessons. Our newest member to the team is Ebon Heath.

Ebon Heath lives and works in Brooklyn New York and received his BFA, in Graphic Design, from Rhode Island School of Design. In 1993 he founded (((stereotype))) , a design studio focused on music packaging, magazine layout, and fashion advertising. Clients varied from the urban fashion pioneer Tripe 5 Soul, Puffy’s Bad Boy Records, to independent magazine Stress, as well as cultural institutions like the African Burial Ground, Take Your Daughter to Work Day, and promotions for the Nike NYC Swoosh Campaign.
He subsequently co-founded Cell Out in 2003, a consultancy that develops issue-based media strategies for non-profits, NGO's and brands. He is currently a adjunct professor in Graphic Design at Lehman College in the Bronx, New York.

Ebon will also be joining our advisory board and bringing his expertise in design to advise on all TruthAIDS projects. We are incredibly lucky to have him.

Please check out his incredible work: www.listeningwithmyeyes.com