Drash by Dr. Jeannette Ickovics on Healing in our Communities – Delivered Friday evening, August 23th 2013

Approximately six years ago next month, I was teaching in Winslow Auditorium at the Yale School of Public Health. It was the second day of my class on the Social and Behavioral Foundations of Health, and we were discussing the impact of race and social class on health. There were nearly 120 students present – and it was only the second day of class – so I didn’t have much credibility yet.

About one-third of the way through my lecture, an African American woman sitting in the third row, fourth seat from the right, raised her hand – and with a good deal of contempt in her voice – asked me what I knew of these things as “a white woman of privilege”?

At that time, after almost two decades of teaching, no one had ever confronted me like that. And for the first – and only – time in my life, I had a full sympathetic nervous system response – my heart rate and blood pressure accelerated, I got tunnel vision, and I thought I was going to pass out.

I took a deep breath, and steadied myself on the podium. Then I replied – totally unprepared: “You are right, I am privileged. And so are all of you – having the opportunity to be graduate students at one of the finest universities in the world. … But I didn’t come from privilege.”

And for the first time professionally and publically, I revealed to this class of 120 students, whom I didn’t know, that I was a child of Holocaust survivors.

It was a defining moment for me professionally. It was very personal and emotional. And it opened up an opportunity for me to discuss with the class – the tragic impact of stigma, discrimination and persecution on health and mental health. It opened up an opportunity to discuss assumptions we make all too quickly – and as burgeoning professionals, how important it is to be non-judgmental to best promote the health of the public. And it opened up an opportunity to discuss public health as social justice. The idea here is that health is a moral imperative. According to the World Health Organization, while there are no guarantees for good health, society can and should design and build effective institutions and social systems to support all citizens in the fundamental pursuit of health and well-being.

And for me, it was an opportunity to redouble my commitment to this health and social justice approach.

Around the same time, my mother was dying of melanoma. So I was acutely aware of the legacy that I needed to carry forth as the daughter of Holocaust survivors – not just for me, but for Tyler and our children: Ethan and Sam. A legacy of not just surviving, but thriving. And a legacy of tikkun olam – repairing or healing the world. I knew that I could not be a bystander to the injustices I witnessed daily in health and public health. To the social inequities that I saw in race and social class – and about which this student had confronted me.

Now some of you may even be wondering, what exactly is Public Health. [I get that question a lot.] Public health refers to organized measures to prevent disease, promote health, and prolong life among the population as a whole. We are concerned with the total system and not only the health of an individual or the eradication of a particular disease. Public health functions to monitor health of communities, formulate public policies to address health priorities, and assure that populations have access to appropriate and cost-effective care.

My own research is in two main areas, spanning the developmental lifespan: maternal and child health and chronic disease prevention.

First, for nearly my entire career (I arrived at Yale in 1989), I have worked in maternal and child health – particularly with urban teens and young women. Over the last decade, I have been running large randomized controlled trials on a model of group prenatal care that results in better birth outcomes for women and their babies: for example, we have documented a 33% reduction in preterm delivery (the leading cause of infant morbidity and mortality) and a 50% reduction in rapid repeat pregnancy (I say with full respect to the young women I work with, that the only thing more challenging than a 15 year old with one child, is a 16 year old with two). We are now conducting a study with United Health Foundation in Detroit, Nashville and McAllen TX in advance of a planned national scale up of this model of group prenatal care in 2016.

Second, six years ago, on the heels of that confrontation in the classroom, I started CARE: Community Alliance for Research and Engagement. Our goal is to improve health in New Haven with a specific focus on the prevention of chronic diseases – such as obesity, diabetes, heart disease and cancers – which account for 75% of our nation’s $2.5 trillion dollar healthcare expenditures – and have tremendous human costs in terms of illness and premature death. Our work in New Haven is deep in the neighborhoods and schools and we use a community organizing approach with a strong social justice foundation.
What these two seemingly disparate areas of research have in common are the inclusion of those traditionally vulnerable and underserved, dedication to scientific rigor and community engagement principles, and a commitment to tikkun olam – healing the world, in whatever small ways we are able.
Finally, I’d like to close with some connection of my work to this week’s Torah portion and the impending High Holy Days.

Ki Tavo: When You Enter

When you enter the land that the Eternal your God is giving you as a heritage, and you possess it and settle in it, you shall take some of every first fruit of the soil, which you harvest from the land that the Eternal your God is giving to you, put it in a basket and go to the place where the Eternal your God will choose to establish the divine name. [Deuteronomy 26:1-2]

The Israelites are instructed to express their gratitude to God for their bountiful harvests and freedom from slavery by tithing 10% of their crops for the Levite, the stranger, the orphan, and the widow (verse 26) (ReformJudaism.org).

In this parsha, we are told to tithe crops. But one may also tithe other things of value to help the Levite, the stranger, the orphan and the widow – notably our time and our money. Of course, the upcoming High Holidays are a time of personal reflection and repentance, when together with Jews throughout the world, we examine the year past and envision the year ahead. For me – and for us — this provides an opportunity to reflect on our privilege, while reaffirming our Jewish tradition’s longstanding commitment to tikkun olam – healing the world.

I will continue to redouble my efforts in the hospitals, health centers, neighborhoods and schools where my team and I work. And I hope that you, too, will make your own commitment to health and healing personally, for your family, our congregation, and the broader community in which we live. If we move forward with passion and compassion, courage, integrity and excellence – then I believe that we can face confrontation with strength, we can stand up to injustice (don’t be a bystander, be an “upstander”), we can learn from our history and leave a legacy for our children, we can be generous in our tithing – and we can indeed begin to heal the world.