Unless power and privilege are being explored and addressed at the top levels systems, there will not be a significant change. Inclusion and diversity will be in appearance without substance, without systemic change.

While many of us strive to partner or “share power” with people with lived experiences, we often fall short. And as much as we all might think we want this partnership, it is difficult to implement successfully.

Medicaid helps set kids on a path to be successful adults. Research shows that compared with their uninsured peers, children enrolled in Medicaid are more likely to 1) miss fewer days of school; 2) perform better in school; 3) graduate high school and go to college; 4) earn higher wages and become tax-paying adults. By covering important health services that set children on a path to healthy adulthood, Medicaid supports the long-term financial stability of our health care system.

If we know mothers are having significant levels of stress and trauma before their children are born, we must begin community supports prenatally. If we know parental ACEs can influence maternal and child health, we must begin supporting moms prenatally. If we know that historical trauma, implicit bias, and systemic bias are negatively impacting maternal and child health, we must address bias and better support mothers of color prenatally.

Years of local land use and zoning policies have excluded our poorer residents and communities of color from many locations that they would otherwise have chosen to live.

Al Éxito has conducted focus groups about youth mental health with 60 middle and high school students across Iowa along with a mental health survey with 120 respondents. In the focus groups, students discussed barriers to receiving help or medical treatment when dealing with traumatic events or mental illness. One consistent issue for youth was lack of access to care due to their financial means and/or lack of health insurance and stigma from peers and parents.