WELCOME TO THE STRATEGY TO REACH INCLUSION AND ACHIEVE. A LOOK ACROSS POPULATIONS ACROSS LIFE SPANS AND GENERATIONS. I AM SAMANTHA AND I AM CO-HOSTING THIS WORKSHOP. I AM AT THE NATIONAL INSTITUTION FOR CHILD HEALTH DEVELOPMENT. OR NICHD, OUR GOALS ARE TO UNDERSTAND HOW SOCIAL IDENTITIES, INTERSECTIONALLITY AND IDENTITY BIASES CAN BE LEVERAGED ACKNOWLEDGED AND ADDRESSED. ALL TO PROMOTE HEALTH AND REDUCE DISPARITIES ACROSS POPULATIONS, LIFE SPANS AND GENERATIONS. I WOULD LIKE TO THANK THE PLANNING COMMITTEE WHO HELPED TO MAKE THIS WORKSHOP POSSIBLE, DR. DENISE HANEY, DR. WHITTINGTON AND MY CO-LEAD FOR THE WORKSHOP DR. PARSAFAR. IT IS NOW MY PLEASURE TO INTRODUCE DR. LAMAR, DIRECTOR OF HEALTH EQUITY AT THE EUNICE INSTITUTION LED BY NICHD, LED BY HEALTH EQUITY NICHD LAUNCHED STRIVE TO INCLUDE DIVERSITY AND INCLUSION IN ALL ASPECTS OF ITS RESEARCH AND WORKFORCE. I NOW PASS THE ZOOM FLOOR TO DR. LAMAR. >> GOOD MORNING EVERYONE. THANK YOU FOR THAT INTRODUCTION. I AM DELIGHTED EACH OF YOU HAS JOINED US TODAY, THIS IS A SECOND IN A 5 SERIES WORKSHOP THAT IS SPEARHEADED BY THE HEALTH DISPARITIES RESEARCH COMMITTEE OF THE STRIVE INITIATIVE. WE ARE LOOKING FORWARD TO HAVING YOUR INSIGHTS AS WE DEVELOP INNOVATIVE AND BOLD NEW IDEAS AS TO HOW IT IS AT NICHD CAN BELTER SERVE THE COMMUNITIES--IN WHICH WE SERVE. THE STRIVE INITIATIVE WAS LAUNCHED AS SAMANTHA MENTHED LAST SUMMER AND IS A VERY BROAD NICHD EFFORT. WE ARE WHAT'S VITAL TO THIS PROCESS OF DEVELOPING THIS INITIATIVE AND IMPLEMENTING THIS INITIATIVE IS THAT WE REALLY ENGAGE BOTH INTERNALLY AND EXTERNALLY WITH OUR STAKEHOLDERS. SO THE STRIVE INITIATIVE CONSISTS OF 3 COMMITTEES, THERE ARE 50 NICHD STAFF MEMBERS REPRESENTED ON EACH OF THESE 3 COMMITTEES. THE 3 COMMITTEES, THE FIRST, THE EQUITY, DIVERSITY AND INCLUSION COMMITTEE IS LOOKING INTERNALLY AT NICHD AND WHAT CAN WE DO TO ENHANCE DIVERSITY EEQUUT I AND INCLUSION AMONG OUR WORKFORCE. THE SECOND COMMITTEE IS FOCUSING ON SCIENTIFIC WORKFORCE DIVERSITY WHO WE FUND, WHO WE TRAIN, HOW CAN WE ENHANCE THE DIVERSITY OF THOSE INDIVIDUALS AND SUSTAIN THE WORKFORCE DIVERSITY. AND THE HEALTH DISPARITIES RESEARCH COMMITTEE IS LOOKING AT KEY DRIVERS AND HOW CAN WE LOOK AT THOSE KEY DRIVERS AND IMPROVE THE HEALTH AND THE EQUITABLE HEALTH OUTCOMES. THERE'S VIEW POINTS, PERSPECTIVES, WE HAVE ADMINISTRATIVE STAFF, SCIENTIFIC STAFF, AND WE REALLY HAVE TRAINEES AND FELLOWS. WE REALLY ARE LOOKING FOR EVERYONE TO GIVE US PERSPECTIVE BECAUSE WE REALIZE IN HIGHSOLATION WE MIGHT NOT HAVE THE BREDTH OF THE IDEAS AND PERSPECTIVES ON LIVED EXPERIENCES. SO WE ARE VERY ENCOURAGED THAT YOU'VE JOINED US HERE TODAY AND WE LOOK FORWARD TO YOUR INPUT. THE STRIVE INITIATIVE AGAIN IS BEING SPEARHEADED OUT OF THIS OFFICE ON BEHALF OF DR. DIANNA BIANCI, SO I WOULD LIKE TO THANK HER BECAUSE THIS IS NOT POSSIBLE, THANK THE CO-LEADS DR. CALABRESE, AND DR. P A RSAFAR AND WITH THAT I WILL END MY REMARKS AND TURN IT BACK OVER TO SAN FRANCISCO MAJTA BECAUSE WE HAVE A VERY ROBUST AGENDA FOR TODAY AND I WANT TO MAKE SURE THERE'S PLENTY OF TIME FOR THE PRESENTATIONS AND DISCUSSIONS BUT AS SAMANTHA MENTIONED, PLEASE ENGAGE WITH US. WE WOULD LIKE TO HEAR YOUR PERSPECTIVES, THERE ARE MANY OPPORTUNITIES BOAGHTS THE IDEA SCALE, E-MAILS US, TWITTER, THERE ARE JUST MANY OPPORTUNITIES AND IT'S NOT JUST TODAY, WE REALLY WANT YOU TO THINK ABOUT THIS AS WE GO THROUGH THIS PROCESS AND DEVELOP ACTION PLANS THAT WILL INFORM AND BE IMPLEMENTED INTO THE 2020 NICHD STRATEGIC PLAN. SO AGAIN, THANK YOU ALL AND WELCOME AND SAMANTHA, I WILL TURN IT BACK TO YOU. >> THANK YOU DR. LAMAR. IT IS NOW MY PLEASURE TO INTRODUCE DR. [INDISCERNIBLE] IS A DOCTOR FROM GUATEMALA IN DEVELOPMENT PSYCHOLOGY AT THE UNIVERSITY OF CALIFORNIA SANTA CRUZ. SHE INVESTIGATES THE ROLES OF IMMIGRATION, SCHOOL, FAMILY, ADOLESCENTS, COLLEGE STUDENT, PEERS AND EDUCATIONAL AND CAREER PATHWAYS. DR. [INDISCERNIBLE] I PASS THE ZOOM FOR TO YOU FOR MEETING INTRODUCTIONS. >> OKAY, GOOD MORNING, EVERYBODY. LET ME START. HOPEFULLY IT'S WORKING, GOOD MORNING FROM CALIFORNIA. I AM SO EXCITED FOR THIS OPPORTUNITY BUT I ONLY HAVE 10 MINUTES SO I WILL BE QUICK. I WANT US TO THINK TODAY IN THIS VERY SETTING WORKSHOP, NOT AS CHALLENGES AND DEFICITS BUT I WANT TO USE IDEAS OF OPPORTUNITY GAPS. SO WHAT WE'RE HOPING FOR IS INCREASE THE OPPORTUNITIES FOR OUR DIVERSE POINT OF VIEWS AND I WILL TALK ABOUT SOCIAL IDENTITIES, BIAS, RESISTANCE AND RESILIENCE AND HOW TO DISRUPT THE SYSTEMIC AND INTERRACIAL DISPARITY. SO WE START EARLY TO THINK ABOUT WHO AM I? WHO ARE WE? WHY DOES IT MATTER TO ME WHO I AM OR WHAT GROUPS I BELONG TO AND TODAY, I WILL JUST BE TALKING ABOUT SOCIAL IDENTITY AND I WANT TO START BY SAYING THAT IT'S MY ROADMAP THAT IDENTITY IS A LIFE LONG INTERGENERATIONAL JOURNEY BECAUSE WE PASS ON OUR IDEAS OF BEINGS AND BELONGINGS TO OUR CHILDREN, OUR STUDENTS, TO OUR COMMUNITIES. ALSO, IDENTITY DEVELOPMENT INCLUDES AWARENESS OF BELONGING, POWER AND INEQUALITIES AND ESPECIALLY IN ELEMENTARY SCHOOL AND ADOLESCENCE WE HAVE THE COGNITIVE SKILLS TO DO THIS, TO UNDERSTAND PRIVILEGE AND OPPRESSION, DISCRIMINATION AND I WANT TO EMPHASIZE THAT THE PANDEMIC INCREASED ALREADY EXISTING HELT DISPARITIES AND MENTAL HEALTH CHALLENGES IN MINORITIZED YOUTH. SO LET'S TAKE ADOLESCENCE, BECAUSE I LOVE ADOLESCENTS AND I HAVE 2 OF THEM. WHAT DOES THE PANDEMIC DO IN TERMS OF INCREASING CHALLENGES? WELL IT SEPARATES THEM FROM FRIENDS AT AN IMPORTANT TIME FOR FRIENDSHIP. IT DISRUPTS SCHOOL AND RELATIONSHIPS, AND CAUSED AN ACUTE STRESSOR WHEN EVERYONE WAS SENT HOME AND LESSONS FOR YOUNG ADULTS AND WE WEREN'T PREPARED TO TEACH THEM BAH BI ALSO IN OUR COMMUNITY AND THAT STRESS HAS BECOME CHRONIC FOR ADOLESC EPTS AND ADULTS, INCREASES WORRIES ABOUT FAMILY AND HEALTH, LESS ACCESS AND A LOT OF SCHOOLS PROVIDE ACCESS AS A SCHOOL SIGHT BUT ALSO THEY COULD NOT SEE THEIR PROVIDER AND GRIEF BECAUSE MINORITIZED POPULATIONS WERE MORE LIKELY TO GET ILL AND ALSO BECAUSE THEY TEND TO BE FRONT AND SERVICE RESPONDERS. ADOLESCENTS INCREASED WORRYFAMILY AND COUNTRY ECONOMICS. MANY PARENTS AND ADOLESCENTS LOST THEIR JOBS, LOST THEIR HOMES, FOOD INSECURE, RIGHT NOW WE'RE IN THE DEBATE ABOUT MORATORIUM ON EVIKSS AND OF COURSEA'RE ADOLESCENTS AND CHILDREN, AND COPE, MOST OF US DO USING SOCIAL MEDIA AND ELECTRONIC ACCESS. I'MING ABOUT HEJT CARE AND MENTAL HEALTHCARE BECAUSE WE'RE TALKING ABOUT DISPARITIES AND ILLNESSES AND I WON'T GIVE YOU THE STATISTICS SO SOCIAL IDENTITY, WHAT IS IT? WELL IT'S A LENS THAT WE USE TO SEE OURSELVES AND OTHERS. SOME OF THESE GENDERS AND EXAMPLES BECAUSE IT STARTS EARLIER THAN OTHERS BUT WHEN I AM AROUND, TOO, I'M A GIRL AND I REALIZE, OH I'M A GIRL, SO ONCE I DO THAT, THAT'S MY LEADS, SO IF I'M A GIRL, WHO DO GIRLS DO, SO I ENGAGE IN SOCIAL COMPARISON, I LOOK AT GIRLS, I LOOK AT BOYS, I LOOK AT NONBINARY, I LOOK AT EVERYBODY IN THE COMMUNITY TO BEGIN TO THINK ABOUT HOW CAN I BE A REALLY GOOD MEMBER OF THIS GROUP BECAUSE I WANT TO BELONG, SO YAY! BELONGS TO A GROUP DOES IS THAT WE OTHER--HONOR PEOPLE NOT IN OUR GROUP. SO GIRLS RULE BUT WHAT DOES THAT DO? BOYS ARE GROSS? BOYS ARE STINKY? AND SO AS WE GET OLDER, WE START TO UNDERSTAND NONBINARY PEOPLE, IF I'M A NONBINARY PERSON I'M NEGOTIATING AND STRADDLING 2 AND I MIGHT WANT TO CALL MYSELF A GENDER BUT AGAIN ALL THESE THINGS MIGHT BE GREAT FOR ME BECAUSE I BELONG BUT AT THE SAME TIME THEY'RE NOT SO GOOD TO OTHER PEOPLE THAT I CONTRAST AND THIS IS WHAT WE TALK ABOUT IN TERMS OF BIAS AND DISCRIMINATION AND OPPRESSION. SOCIAL IDENTITY ARE ABOUT PRIVILEGE, WHO HAS IT AND WHO DOESN'T? MINORITY INDIVIDUALS, MINORITIZED INDIVIDUALS ARE LESS LIKELY TO HAVE ACCESS TO HEALTHCARE, EDUCATION, HOUSING FOOD AND SAFETY, WE ALL KNOW ABOUT THE PROBLEM OF RED LINING BUT ALSO SCHOOLS WE DON'T HAVE AS MANY RESOURCES AND 1 OF THE THINGS I BEGAN TO DO IN MIDDLE CHILDHOOD, SO ELEMENTARY SCHOOL WAS TO ASK MYSELF, IS MY GROUP REPRESENTED IN LEADERSHIP, EDUCATION AND HEALTH SERVICE. DOES MY TEACHER SHARE MY GENDER OR RACE OR MY SEXUALITY, WHATEVER, MY CLASS. AND HOW ABOUT MY COMMUNITY. HOW ABOUT THE PEOPLE THAT I GO TO, MY DOCTORS, MY MEDICAL SERVICE, MY COUNSELOR AT SCHOOL AND I BEGAN TO REALIZE THAT SOME PEOPLE ARE MORE REPRESENTATIVE THAN OTHERS BUT ALSO I BEGAN TO UNDERSTAND IN ADOLESCENCE THAT OH MY GOODNESS, I HAVE A POSITION IN SOCIETY EVEN WITHIN MY OWN GROUP. THERE ARE SOME FEMALES THAT ARE MORE POWERFUL THAN OTHERS. SO THERE'S SEXISM, ABLEISM, CLASSISM, AND IT'S NOT JUST IN OTHERS BUT IT'S IN THE POLARIZEDEE AND PRACTICES WE HAVE. I TALKED ABOUT RACE LINING AND THEN WE HAVE THE SYSTEM JUSTIFICATION, IF YOU SUCCEED IT'S BECAUSE YOU'RE NOT WORKING HARD ENOUGH, OR DISRUPTIVE BUT I DO IT MYSELF, I'M A COLLEGE PROFESSOR, I MIGHT SAY WELL, YOU KNOW OTHER IMMIGRANTS, I GOT THIS PLACE BECAUSE I WORKED REALLY HARD. OTHERS NOT SO MUCH. SO I JUSTIFY THE SYSTEM, BUT ACTUALLY OPPRESSS MY PEOPLE. BUT NOW I'M GOING TO GET TO INTERSECTIONALLITY BECAUSE I'VE BEEN ONLY TALKING ABOUT GENDER BUT KIMBERLY CRENSHAW, A BLACK ACTIVIST AND SCHOLAR USED THE WORD INTERSECTIONALLITY FOR THE FIRST TIME, SHE STUDIES THE LEGAL SYSTEM AND SHE WAS LOOKING AT DOMESTIC ABUSE. AND SHE WROTE A BEAUTIFUL PAPER AND IF YOU LOOK AT THE COURTS SYSTEM, IT TALKS ABOUT ABUSE, IT DISCRIMINATES AGAINST WOMEN OF COLOR, LOW INCOME WOMEN, WELL IF YOU HAVE POOR, YOU HAVE MORE VIOLENCE IN YOUR GENES ANYWAY, SO THE LAWS ARE DIFFERENT IN TERMS OF RESOURCES. PATRICIA HILL COLLINS IS A SOCIOLOGIST THAT REALLY ALLOWS US TO SEE HOW THE SOCIETY IS REALLY HIERARCHICAL WHETHER WE WANT TO OR NOT, SO HOPEFULLY IN THIS WORKSHOP, WE CAN TALK ABOUT WAYS TO BREAK THE HIERARCHY AND ANGELLA DAVIS WHO HAS LONG ARGUED AND MADE EVIDENCE TO THE SCHOOL TO PRISON PIPELINE, THAT IS MORE ABOUT BROWN PEOPLE, BROWN BIAS BUT ALSO ABOUT BLACK AND BROWN BOYS AND MEN. AND SO THIS SHOWS INTERSECTIONALLITY IN THAT MALES MIGHT BE MORE PRIVILEGED BUT NOT IF YOU'RE BLACK AND BROWN. AND I'M GETTING TO THE END, NO WORRIES, AND WHAT INTERSECTIONALLITY ALLOWS US TO UNDERSTAND IS STIGMA AND INEQUALITYYS AND HEALTH AND OPPORTUNITY GAPS AND SO I WANT TO START WITH GLORIA SALD UA, WHO DID MEXICAN CHICANO SCHOLAR WHO WROTE THESE BEAUTIFUL PIECES OF--BORDER IN MEXICO, 1 IN TEXAS, BUT ALSO THE [INDISCERNIBLE] TODAY ABOUT IMMIGRATION AND UNDOCUMENTATION AND HER POINT OF NOBODY TOLD ME, NOBODY. WE'RE ALL HUMAN. THE PANDEMIC AND HEALTH DISPARITIES FOREVER HAVE BEEN REALLY CHALLENGE FOR NATIVE AMERICAN YOUTH AND PEOPLES WHO ARE NOT REALLY IN THE NEWS BUT WE HAVE A LOT OF WOMEN WHO HAVE DISAPPEARED WHO HAVE BEEN--A LOT OF VIOLENCE, BUT ALSO, HEALTH DISPARITIES. THINK ABOUT PEOPLE WHO ARE NATIVE AMERICANS THAT TEND TO HAVE LOWER SOCIOECONOMIC STATUS AND SO FORTH. THEN WE HAVE PEOPLE WHO ARE [INDISCERNIBLE] ARE REALLY GOOD, ASIAN AMERICANS BECAUSE THEY'RE THE MODEL MINORITY, SMART, WELL-BEHAVED, POTENTIAL LEADERS BUT NOT SO MUCH BECAUSE WE WON'T VOTE FOR THEM, SO THERE'S A LOT OF PRESSURE TO OVERACHIEVE, AND EMBARRASSMENT IF YOU DON'T. AND OF COURSE THE VIRUS HAS BEEN AN ISSUE THAT HAS INCREASED PREJUDICE AGAINST NATION HERITAGE PEOPLES BECAUSE IT'S ASSUMED THAT THERE'S A CHINESE VIRUS AND SO HATE CRIMES HAVE INCREASED AND I WANT TO LEAVE YOU WITH MY LAST 32ndS WITH THE IDEA THAT 1 OF THE REASONS WE NEED MULTICULTURAL COMPETENT SCHOOL COUNSELORS, COMMUNITIES, THERAPISTS, BECAUSE IF YOU ARE A MINORITIZED PERSON, YOU WANT TO HAVE THAT REPRESENTATION AND THE NEW YORK TIMES RECENTLY DID AN ARTICLE ON A WEBSITE, THERAPY FOR BLACK GIRLS BECAUSE CALIFORNIA 30% ARE BLACK PEOPLE, IMAGINE GETTING A THERAPIST IF YOU WANT 1 WHO HAS A LONG WAITING LIST IF YOU WANT 1, BECAUSE EVERYBODY NEEDS MORE THERAPY IN THE PANDEMIC. I HAVE A BLACK DAUGHTER AND 1 LATINA AND I WISH THERE WAS 1 FOR LATINA, AND SO WE WANT TO THINK ABOUT HOW DO WE CLOSE THE OPPORTUNITY GAPS AND THAT WAS MY LAST SLIDE. THANK YOU VERY MUCH. I WILL STOP. >> THANK YOU DR. AZMITIA. IT IS MY PLEASURE TO INTRODUCE THE NEXT DOCTOR, SHE DISCUSSING RACIAL ADOLESCENTS AND YOUNG ADULTS, DOCTOR, I PASS IT FORWARD TO YOU FOR SESSION 1 IDENTITY PROCESSES AND HEALTH OUTCOMES. >> THANK YOU. WELCOME EVERYBODY IS THANK YOU TO THE NICHD AND THE STRIVE TEAM FOR HOSTING THIS CONVERSATION TODAY. I WILL BE MODERATING SESSION 1, FOCUSED ON IDENTITY PROCESSES AND HEALTH OUTCOMES. NEXT SLIDE, PLEASE. AND THE PRESENTERS FOR TODAY'S FIRST SESSION INCLUDE DR. LOPEZ WHO WILL BE SPEAKING ABOUT INTERSECTIONALLITY, RACE AND THE DIFFERENCE BETWEEN RACE AND ETHNICITY, PARTICULARLY WITH RESPECT TO LATIN X COMMUNITY. DR. RIVAS-DRAKE WILL TALK ABOUT RACIAL, ETHNIC IDENTITY. DR. SCHWARTZ WILL TALK ABOUT CULTURAL IDENTITY AMONG IMMIGRANT YOUTH AND DR. KATZ-WISE WILL TALK ABOUT FAMILY AND GENDER DIVERSITY. NEXT SLIDE, PLEASE. SO JUST PIGGYBACKING OFF DR. AZMITIA'S PRESENTATION, WHAT ARE SOCIAL IDENTITIES AND WHY DO THEY MATTER? NEXT SLIDE, PLEASE. SO AS A DEVELOPMENTAL PSYCHOLOGIST A LOT OF MY WORK FOCUSES ON THE ROLE OF CONTEXT AND SO IN THINKING ABOUT THE IMPORTANCE AND THE RELEVANCE OF SOCIAL IDENTITIES IN THE UNITED STATES, IT'S IMPORTANT TO UNDERSTAND THAT THESE IDENTITIES ARE DEVELOPED AND CONSTRUCTED AGAINST THIS LARGER BACK DROP OF INCREASING DIVERSITY IN THIS COUNTRY. SO DIVERSITY WITH RESPECT TO ETHNICITY, RACE, LANGUAGE, IMMIGRATION STATUS, GENDER IDEBTITIES AND MANY, MANY OTHER SOCIAL CATEGORIES. NEXT SLIDE, PLEASE. SO WHY SO MUCH INTEREST IN THE CONSTRUCT OF IDENTITY, RIGHT? IT'S BECAUSE WE AS HUMAN BEINGS ARE FUNDAMENTALLY SOCIAL, RIGHT? WE IN THE PANDEMIC HAS REALLY HIGHLIGHTED THIS LIKE OUR INABILITY TO TO BE SOCIAL HAS HIGHLIGHTED THE IMPORTANCE OF NEEDING TO BE WITH OTHER PEOPLE, RIGHT? AND THE IMPORTANCE OF SORT OF RESPECTING THAT AGES SPECT OF WHO WE ARE. SO THIS QUESTION IS NOT JUST AN EXSTENTIAL QUESTION BUT IT'S A DEVELOPMENTAL 1, RIGHT? AND AS A DEVELOPMENTAL 1 THAT TAKES PLACE AGAINST THE BACK DROP OF BOTH PHYSICAL CONTEXT SO NEIGHBORHOODS, SCHOOLS, COMMUNITIES, STATES, URBAN SETTINGS, RURAL SETTINGS AS WELL AS SOCIAL CONTEXTS, RIGHT? SO LOOKING AT HOMES, YOU KNOW SCHOOL SETTINGS, PLACES OF WORSHIP AND WORK SETTINGS AND PHYSICAL AND SOCIAL CONTEXT THAT WE AS SOCIAL BEINGS INTERACT WITH THAT WE INTERACT WITH ON A DAILY BASIS. SO FROM A DEVELOPMENTAL PERSPECTIVE--I WOULD ARGUE THAT WE NEED TO MOVE FORWARD, DEPICTIONS OF INTERSECTIONALLITY THAT ARE NOT JUST FLAT, RIGHT, SO WE NEED A LAYERED APPROACH, SO THINKING ABOUT IDENTITY HIERARCHYS, ARE SOME OF THESE SOCIAL IDEBTITYS MORE IMPORTANT, MORE SALIENT IN A PARTICULAR TIME, AGAIN, NOW, BUT ALSO OVER TIME DEVELOPMENTALLY, SO IN THE DISCUSSION, I WILL PUSH US TO THINK MORE ABOUT HOW WE CAN DEPICT INTERSECTIONALLITY MAYBE FROM A 3 DIMENSIONAL, 4 DIMENSIONAL PERSPECTIVE BECAUSE THE SOCIAL IDENTITIES ARE NOT ONLY UPON TIED TO SOCIALLY CONSTRUCTED CATEGORIES SUCH AS RACE AND ABILITY STATUS BUT THEY'RE ALSO TIED TO SOCIAL ROLES SO YOU MAY HAVE IDENTITIES AS A SOCIAL SCIENTIST OR BIOMEDICAL SCIENTIST OR AS A MOTHER OR AS A SISTER, RIGHT? SO THESE ARE IMPORTANT WAYS TO THINK ABOUT REALLY BROAD CATEGORIES OF SOCIAL IDENTITY AND TOGETHER THESE IDENTITIES COME TO FORM A WHOLE PERSON THAT HAVE BOTH UNIQUE AND SHARED AND INTERSECTIONALLITY THAT EITHER PUTS PEOPLE AT MULTIPLE AREAS OF RISK, RIGHT, SO AND AREAS OF MARGINALIZATION--AND I THINK THIS IS WHAT MAKES IT SO IMPORTANT FOR US TO THINK ABOUT THE CONNECTIONS BETWEEN THESE INTERSECTIONS OR LAYERED WAYS OF THINKING ABOUT SOCIAL IDENTITY AND HOW THEY'RE RELATED TO--LINKED TO PREDICTIVE OF AND SORT OF PERSPECTIVELY PREDICTIVE OF HEALTH. AND SO WITH THAT I WILL TURN THE FLOOR OVER TO OUR FIRST SPEAKER, DR. LOPEZ AND WE WILL REZOOM OUR SESSION AT THE END OF THE TALKS, THANK YOU. >> I HAVE A 50 POWER POINT SLIDE I WANT TO MAKE SURE YOU GET A COPY OF, BUT I WANTED TO USE THIS TIME TO TELL STORIES, I WILL CUT TO THE CHASE. THE GAPS IN CURRENT DEMOGRAPHIC DATA GATHERING LED SOME ACADEMICS AND EVEN POLICY MAKERS TO BELIEVE THAT IT WOULD BE BETTER TO INCLUDE HISPANIC AS A RACIAL CATEGORY IN OUR OFFICIAL DATA COLLECTION THAN COLLECTING HISPANIC ORIGIN AS A SEPARATE REASON FOR RACE,--AND RIGOROUS METRICS FOR EQUITY. I WILL ILLUSTRATE WITH A STORY AND RESEARCH EVIDENCE. WHEN I LIVED IN NEW YORK CITY, I HAD 3 FRIENDS THAT WERE ALL HISPANIC MEN, 1 WAS A DID MIN KAN--KANA BASEBALL PLAYER WHO WAS RACIALIZED AS BLACK, ANOTHER LOOKED LIKE RICKY MARTIN WHO WOULD BE LIGHT SKINNED AND WOULD BE RACIALIZED AS WHITE AND TAN NOT WITHSTANDING, AND ANOTHER WHO LOOKED LIKE GEORGE LOPEZ WHO WOULD BE RACIALIZED AS BROWN. SO WHEN THEY WENT TO SEE AN APARTMENT, 1 WAS SHOWN AN APARTMENT AND THE OTHER 2 WERE NOT. A FAIR HOUSING AUDIT STUDY ALSO FOUND DISCRIMINATION AGAINST "VISIBLE MINORITIES ACROSS 28 CITIES WITH 8000 TESTERS," IT'S NO SURPRISE THEN THAT HOGAN WHO WORKED FOR THE CENSUS BUREAU AND USED THE AMERICAN COMMUNITY SURVEY AND FOUND THAT LATINOS THAT IDENTIFY AS WHITE HOUSE HOLDS EXPERIENCE LOWER LEVELS OF POVERTY THAN THOSE WHO IDENTIFY AS BLACK AND SOME OTHER RACE. THE CENSUS CLAIMS THAT LATINOS HAVE A HARD TIME ANSWERING THAT RACE QUESTION BECAUSE CLOSE TO 40% CHECK OTHER AND MARK SOME OTHER RACE. BUT A DEEP DIVE BY NATIONAL ORIGIN TELLS A VERY DIFFERENT STORY FOR INSTANCE, 85% OF CUBANS IDENTIFY AS WHITE COMPARED TO DOMINICANS LIKE MYSELF WHERE IT'S ONLY 30%. FOR SOUTH AMERICANS IT'S ABOUT 66%, 2/3RDS WHO IDENTIFY AS WHITE. THAT DOESN'T SOUND LIKE CONFUSION TO ME. IF YOU WANT TO CONSIDER THE NUMBER OF LATIN X, DO CHECK SOME OTHER RACE. COULD IT BE THAT THEY'RE TRYING TO TELL US THAT THEY'RE BROWN? THAT MEANS THAT THEY'RE NOT RACIALIZED AS WHITE OR BLACK BODIES AND IN THE WAKE OF OUR NATIONAL RACIAL RECONNING AND GROWING CALLS FOR RACIAL JUSTICE, WE CONSTANTLY HEAR ABOUT BROWN AND BLACK PEOPLE YET IT'S PARADOXICAL THAT WE DON'T HAVE INFORMATION ON EXPERIENCES OF BROWN PEOPLE LIKE MY HUSBAND AND DEEP FAMILY ROOTS HERE IN NEW MEXICO WHERE WE LIVE NOW AND CONSTANTLY ASKED TO PRODUCE PAPERS WHEREVER HE WALKS DOWN THE STREET BECAUSE HE LOOKS BROWN. RIGHT? THINK ABOUT WHY PRECISELY WHEN THE CIVIL RIGHTS MOVEMENT ESTABLISHED FAIR HOUSING LAWS, WE ERASE THE WORD COLOR FROM THE CENSUS AND SUBSEQUENTLY CONFLATED NATIONAL ORIGIN WITH RACE. WE WOULD BT USE MEASURES FOR RACE AND GENDER AND SEXUALITY SO WHY SHOULD WE USE 1 QUESTION TO MEASURE HISPANIC ORIGIN IS RACE, WE WOULDN'T BASE THE DECISION ON HOW TO COLLECT RACE AND ETHNICITY ON 2 STUDIES CONDUCTED BY THE SENSE ISOTOPE BUREAU WHILE DISMISSING NUMEROUS SCIENTIFIC PEERY REVIEWED STUDIES ON SOCIAL EQUALITIES THAT CLEARLY SHOW THAT RACE AND ETHNICITY ARE NOT EQUIVALENTENTIOUS SPECIALLY WHEN STUDYING SOCIAL INEQUALITIES AND STRUCTURAL RACISM. AT SOME POINT WE HAVE TO WONDER IS THIS A BATTLE, BATTLE OVER OVER THEORY OF WHAT RACE OR ORIGIN MEANS? SORE IS THIS PART AND PARCEL ON RULING RELATIONS IN THE POSSESSIVE INVESTMENT IN THE STATUS QUO OR POST RACIAL [INDISCERNIBLE]. WHO BENEFITS FROM THE DATA COLLECTION? WHY IS COLOR BLINDNESS AND INSTITUTIONAL COLLECTION AN ISSUE DISM WHAT WOULD ETHICAL ANTIRACIVE DATA COLLECTION LOOK LIKE, COULD INTERSECTIONAL INQUIRIES BRING ATTENTION TO THE SIEM ULTIMATELY TENAITY OF RACIAL, SEX, GENDER, CITIZENSHIP STATUS, ALL OF THAT CULTIVATE RIGOROUS ADMINISTRATIVE DIRECTION FOR LIBERATION, SOME MAY CALL TO ATTENTION WHAT I CALL STREET RACE. IF YOU WERE WALKING DOWN THE STREET WHAT RACE DO YOU THINK OTHERS WHO DON'T KNOW YOU WOULD AUTOMATICALLY ASSUME YOU ARE BASED ON WHAT YOU LOOK LIKE AND THAT WOULD INCLUDE A CONGLOMERATION OF YOUR SKIN TONE, FACIAL FEATURES AND EVEN HAIR TEXTURE. CALLING ATTENTION TO THE RELATIONAL POSITIONALLITY OF BLACK, BROWN AND WHITE LATINOS, AS WELL AS ASIANS, LATINOS, IS NOT--IS NOT AN ISSUE OF FRAGMENT TO THE COMMUNITY. IT'S A ISSUE OF PRACTICING SOLIDARITY, MAKE A PLAIN--I QUOTE THAT WE CAUTION THAT LATINO/LATINA AS A SOCIAL CONSTRUCT MUST BE PROBLEMATTIZED, IT IS COMPLICATED BY DIFFERENCES IN NATIONAL ORIGIN, CITIZENSHIP, RACE, CLASS, ETHNICITY AND BY THE CONFLUENCE OF THESE FACTORS AND INTERSECTIONS--IN UNDERSTANDING MY RELATIONSHIP TO RACE AND ETHNICITY IS SOMETHING I AM BEGINNING TO GRAPPLE WITH AND CAUSED A FAIR AMOUNT OF DISCOMFORT AS WELL AS EXCITEMENT. I WAS WONDERING IF YOU HAD ANY BOOK RECOMMENDATIONS FOR SOMEONE JUST BEGINNING TO EXPLORE THESE ISSUES IN HER OWN LIFE. WHAT WOULD YOU ANSWER TO THE FOLLOWING QUESTION. WHAT'S YOUR STREET RACE, IF YOU WERE WALKING DOWN THE STREET, WHAT RACE DO YOU THINK STRANGERS WOULD AUTOMATICALLY ASSUME YOU ARE BASED ON WHAT YOU LOOK LIKE. THE BEAUTY OF THIS QUESTION IS THAT IT CHALLENGES THE MYTH OF RACE, GENERATED ETICSICS, NATIONALITY, ETHNICITY, CULTURE OR AS A LOT OF PEOPLE LIKE TO SAY, I'M PART OF THE HUMAN RACE WE'RE ALL THE SAME WITHOUT RECOGNIZING THE THAT SOCIAL MEANS THAT ARE ASSIGNED TO US DO SHAPE OUR EXPERIENCES WITH EXPERIENCE, SO COLOR BLINDNESS MIGHT SAVE US, IN MOST SOCIAL CIRCUMSTANCES, RACE, LIFE GENDER SHAPES YOUR TREATMENT. ACROSS A VARIETY OF SOCIAL INSTITUTIONS, RACE IS NOT JUST ABOUT YOUR PERSONAL IDENTITY, IT'S ABOUT HOW OTHERS DESCRIBE SOCIAL MEANINGS TO YOUR APPEARANCE, HAIR, COLOR, FACIAL, FEATURES. --MULTIPLE ETHNIC ORIGES AND U.S. BORN LIKE ME SHOW THAT WHEN YOU USE AIAN MEASURE, YOU MAKE VISIBLE INEQUALITIES THAT WOULD REMAIN HIDDEN, AS WELL AS CRITICAL PUBLIC HEALTH JOURNAL. IT'S ALWAYS IMPORTANT TO INCLUDE AT LEAST 2 QUESTIONS FIRST, SELF-IDENTITY, THAT'S BEAUTIFUL, HOW DO YOU IDENTIFY, MARK EVERYTHING YOU WANT TO, THAT'S FINE, BUT THE NEXT QUESTION THAT WE NEED FOR IS WHAT'S YOUR STREET RACE. AND HERE WE ASK THAT YOU MARK ONLY 1 BOX. THINK ABOUT WHY PRESIDENT OBOOM BOOM BOOM BOOMA THE SON OF A--PRESIDENT OBAMA, THE SON OF A BLACKMAN FROM KENYA AND THEY ONLY MARKED 1 BLACK BOX IN THE 2010 CENSUS AND THE USE OF CIVIL RIGHT DATA TO DETECT HOUSING, ACCESS AND VOTING DISCRIMINATION, ET CETERA. ASK YOURSELF, IF PRESIDENT OBAMA WERE WALKING DOWN THE STREET LOOKING FOR AN AAPARTMENT OR A MORTGAGE OR SHOWED UP IN THE ER WOULD ANYONE THINK HE'S WHITE? WHAT DOES THIS MEAN FOR LAW ENFORCEMENT, HEALTHCARE, I WILL END BY MAKING RECOMMENDATIONS, FIRST PRACTICE DEEP REFLECTION ABOUT YOUR OWN STREET RACE AS WELL AS GENDER BACKGROUND, SEXUALITY, CLASS BACKGROUND, AS MEASURED AND EVEN YOUR CLASS ORIGIN AS MEASURED BY THE HIGHEST LEVEL OF EDUCATION THAT YOUR PARENTS HAD WHEN YOU WERE AN ADOLESCENT WHEN YOU WERE 16. THE AGGREGATED DATA IS IMPORTANT, BUT IT'S NOT ENOUGH. ONLY WHEN WE CRITICALLY ASSESS OUR STREET RACE WITH OTHER INTERACCESSAL POSITIONS AND SYSTEMS OF INEQUALITY CAN WE BEGIN THE JOURNEY OF UNDERSTANDING OURSELVES AND SHIFTING TO UNDERSTAND THE EXPERIENCES OF OTHERS WHO ARE DIFFERENT FROM US. SECOND, WE NEED TO KEEP SEPARATE QUESTIONS ON HISPANIC ORIGIN AND RACE, THE SCIENCE IS CLEAR, ETHNICITY, ORIGIN ARE NOT THE SAME THING AS RACE. --AND FINALLY CULTIVATE A COMMUNITY OF PRACTICE. A CONSORTIUM OF SORTS TOWARD INTERSECTIONALLITY. WHO BENEFITS? HOW CAN WE PRACTICE SOLIDARITY IN OUR ADMINISTRATIVE DATA COLLECTION, WHAT KNEW KNOWLEDGE CAN WE GAIN FOR REDUCING INEQUALITY. I INVITE TO YOU THINK ABOUT 1 OR 2 THINGS THAT YOU CAN DO, WHAT IS YOUR DOMAIN OF INFLUENCE, HOW CAN YOU CATALYZE INSTITUTIONAL RESPONSIBILITY FOR DATA COLLECTION AND ANALYSIS, POLICY MAKING, AND PRACTICE THE REDISTRIBUTION OF RESOURCES TO HELP US ADVANCE HUMAN RIGHTS, NOT ONLY FOR OURSELVES, BUT FOR OUR CHILDREN. OUR FAMILIES AND COMMUNITIES FOR GENERATIONS TO COME, I INVITE YOU TO CHECK IT OUT. THANK YOU SO MUCH AND I LOOK FORWARD TO THE CONVERSATION. >> THANK YOU TO EVERYONE AT NICHD AND THE STRIVE TEAM AND NANCY FOR THAT REALLY EXCITING PERSPECTIVE. I AM EAGER TO GET TO THE PRESENTATION BUT I WILL GIVE A LITTLE BIT OF PERSPECTIVE ON RACIAL AND ETHNIC IDENTITY AND YOUTH DEVELOPMENT AND IF POSSIBLE, IMPLICATIONS FOR HEALTH DISPARITIES TO HELP FURTHER ADVANCE OUR CONVERSATION TODAY. WONDERFUL TO HEAR YOUR INTRODUCTION AS WELL. AND SO WHEN WE THINK ABOUT THIS, I WANTED TO START MY PRESENTATION BY HAVING YOU THINK A LITTLE BIT ABOUT THE METAPHOR AND THINKING OF ABOUT IDENTITY OF MOSAIC OVER THE COURSE OF THEIR YOUNG "LIKE" US ON FACEBOOK LIVES. AND SO OKAY, WHEN YOU THINK ABOUT YOUR OWN RACIAL OR ETHNIC IDENTITY HOW IMPORTANT IS RACE OR ETHNICITY TO HOW YOU DEFINE YOURSELF. HOW WOULD YOU SAY THAT YOU FEEL ABOUT IT. YOU KNOW WHAT ARE THE FEELINGS THAT YOU HAVE ABOUT BEING A MEMBER OF YOUR RACIAL ETHNIC GROUP. HOW DOES RACE OR ETHNICITY FASTER OR ETHNICITY COME IN YOUR DAILY LIFE EXPERIENCE AND WHAT OPPORTUNITIES ARE AFFORDED TO YOU AND LIFE CHANCES, SO SPEAKING ABOUT WHAT NANCY WAS JUST DESCRIBING, WHAT ROLES HAVE FAMILIES HEAR, TEACHERS AND OTHER COMMUNITY MEMBERS PLAYED IN THE DEVELOPMENT OF THIS UNDERSTANDING. AND IF I ASK YOU TO THINK ABOUT THE ANSWERS TO THESE QUESTIONS, NOW, THE PERSON THAT YOU ARE NOW, I'M ASSUMING MOST OF US ARE ADULTS ON THE CALL, HOW WOULD THEY BE DIFFERENT OR THE SAME FROM THE ANSWERS YOU WOULD HAVE WHEN YOU WERE 14 AND THEN THINKING EVEN FURTHER BACK TO WHEN YOU WERE 7. AND IN MY FIELD, WHAT WE'VE BEEN--WHAT WE--WE--YOU INTERESTED IN IS REALLY UNDERSTANDING THE WAY OF THESE MEANING OF DIFFERENT CONCEPTS AND THE ASPECTS OF THEIR IDENTITY OVER THE COURSE OF CHILDHOOD ADOLESCENTS AND WE KNOW THAT IT INVOLVED ANSWERING THESE QUESTIONS, A DIFFERENT POINTS IN THE LIFE COURSE, NOT ONLY IN TERMS OF HOW THEY SEE THEMSELVES BUT THAT IS PART OF THE PSYCHOLOGICAL EXPERIENCE IS AN IMPORTANT PIECE OF IT, LIKE YOU HO YOU SEE YOURSELF BUT ALSO AS NANCY DESCRIBED, HOW THEY ARE IN THE WORLD AND BY THE WORLD. AND JUST TO GIVE YOU AN EXAMPLE OF WHAT THIS SOUNDS LIKE FROM 1 OF OUR STUDIES, WE ASKED ADOLESCENTS, THESE ARE JUST A 15 YEAR-OLD. I WANTED TO BRING IN THE VOICE OF YOUTH AS WELL INTO THIS DISCUSSION TODAY. WE ASKED THEM WHAT DOES YOUR ETHNICITY MEAN TO YOU. AND THIS YOUNG PERSON SAYS, I AM PROUD TO BE MEXICAN EVEN IF WHITE PEOPLE, SOME, NOT ALL, MIGHT THINK WE ARE NOT AS SMART OR AS EQUAL TO THEM. I LOVE MY ETHNICITY, I LOVE THE FOODS, CULTURE, PEOPLE. SOME WHITE PEOPLE OUT THERE WANT US TO GO BACK TO OUR COUNTRY, I AM PROUD OF MY ETHNICITY AND I WOULDN'T CHANGE. IT IS THE BEST. I WANT TO DRAW YOUR ATTENTION TO A FEW THINGS. YOU KNOW 1 IS THAT THE LOVE THAT SHE HAS FOR HER THE MEXICAN PEOPLE AND THE CULTURE THAT SHE IDENTIFIES AS HER OWN AND YOU CAN SEE TEST TEST. TEST TEST. --FOSTER CONDITIONS IN YOUTH ENVIRONMENT THAT HELP TO DISRUPT THE STATUS QUO OF CULTURAL LAWS OF A MESSAGE THAT IS YOU KNOW ASSIMILATION, COLOR OR EVASIVENESS AND TO PROMOTE AGENCY AND IN ORDER TO DO THAT, TO DO IT IN A WAY THAT ULTIMATELY IS PREPARING THEM TO RECOGNIZE INTERPERSONAL AND INSTITUTIONAL RACISM TO RETAIN A CONNECTION OF THOSE EXPERIENCES AND THESE THAT ARE IMPORTANT TO GROUNDING WHO THEY ARE AND IN TURN PROMOTING A SENSE OF BELONGING AND I WOULD ARGUE COMMUNITY HEALTH AND ULTIMATELY TO ROUGH ATOM MOTE AGENCY AND ENGAGEMENT AND CIVIC LIFE, WHEN I THINK IS THE LONGER TERM OUTCOME FOR ME AND THAT I THINK WOULD BE IMPORTANT TO LOOK AT. AND WITH THAT I WILL WIND DOWN HERE AND LOOK FORWARD TO THE CONVERSATION, THANK YOU VERY MUCH FOR YOUR ATTENTION AND TIME. >> THANK YOU SO MUCH DOCTOR, UP NEXT WE HAVE DR. SCHWARTZ, PLEASE GO AHEAD AND SHARE YOUR SCREEN. >> ROOK, I WILL TRY-HF IN THE LAST 50 YEARS UP TO 45 MILLION PEOPLE, 15% OF THE U.S. POPULATION AND THESE MEMBER NUMBERS ARE EXPECTED TO CONTINUE TO INCREASE SO THIS IS A VERY, VERY IMPORTANT POPULATION FOR US TO BE STUDYING AND WORKING WITH. SO ONCE AGAIN THIS IS A REALLY, REALLY IMPORTANT POPULATION FOR US TO WORK WITH AND WHEN I SAY, IMMIGRANT YOUTH, I'M INCLUDING PEOPLE WHO WERE BORN IN THE U.S. AND RAISED BY AT LEAST 1 PARENT WHO WAS BORN OUTSIDE THE U.S. SO I WILL SWITCH A BIT AND I WILL TALK ABOUT SPECIFIC IDENTITY CHALLENGES IN THE U.S. AND OTHER WESTERN SOCIETIES THAT FACE MOST YOUTH AND THEN I WILL BRING IT BACK TO THE ISSUE OF IMMIGRATION. IN THE U.S. AND OTHER WESTERN SOCIETIES, YOUNG PEOPLE BASICALLY EXPECT TO FIND THEIR OWN WAY INTO ADULTHOOD WITH LITTLE HELP FROM SOCIETY. YES, FAMILY MEMBERS LIKE THE HEALTH BUT THERE ISN'T--IN TERMS OF HOW DO I BECOME AN ADULT. SO WE BASICALLY HAVE TO DO IT OURSELVES AND THE WAY THAT WE DO IT IS THROUGH A SENSE OF IDENTITY, HERE I'M REFERRING LARGELY TO PERSONAL IDENTITY WHICH IS BASICALLY THINGS LIKE FUTURE PLANS, CAREER, VALUES AND RELATIONSHIPS ET CETERA, BUT THIS IS THE WAY THAT WE ACTUALLY MAP OUR PATH TO ADULTHOOD. WE SAY OKAY, SO WHO AM I, WHERE DO I WANT TO BE, WHO DO I WANT TO BE? AND THAT HELPS US TO MAKE THE CHOICES THAT WILL HOPEFULLY LEAD US TO WHERE WE WOULD LIKE TO GO. AND JIM KOTE, WHO IS A HIGHLY PROMINENT SOCIOLOGIST AND WITH OTHER WESTERN NATIONS WITH IDEBTITY SOCIETIES BECAUSE THERE IS SO MUCH FOCUS ON IDENTITY. SO, ACCORDINGLY AS SOME OF THE OTHER FOLKS HAVE SAID THIS MORNING, ALMOST ALL YOUTH HAVE TO CONSIDER ANSWERS TO QUESTIONS LIKE WHO AM I, AND WHO ARE WE AND WE CAN MEAN VARIOUS THINGS, IT CAN MEAN MY GENDER EMY ETHNIC GROUP, MY COUNTRY, MY HERITAGE, ET CETERA. AND AS I SAID, MOST ADOLESCENTS AND YOUNG ADULTS ACROSS GROUPS CONSIDER THESE ISSUES IN AREAS SUCH AS CAREER RELATIONSHIPS, VALUES, FAMILY. WHAT'S IMPORTANT TO NOTE IS THAT BECAUSE YOUNG PEOPLE HAVE TO DO THIS LARGELY ON THEIR OWN, THERE IS LIKELY TO BE AN EXPERIENCE THAT SOMETHING IS NOT WORKING. I'M NOT ABLE TO FIND A SATISFYING ANSWER TO THE QUESTION OF WHO AM I AND WHERE AM I GOING AND THIS CAN BE EXPERIENCED AS HIGHLY CONFUSING, FRUSTRATING, DESTABILIZING, UPSITING AND AND FER TO TO THIS AS A SENSE OF IDENTITY CONFUSION, THERE IS ANOTHER SUBSET OF YOUNG PEOPLE WHO BASICALLY OPT OUT OF THE TASK OF IBE IDENTITY INSTRUCTION AND SAY I JUST DON'T CARE ABOUT THAT AND THESE FOLKS ARE MORE LIKELY TO HAVE ISSUES WITH SUBSTANCE USE AND ANTISOCIAL BEHAVIOR. SO SO MORE OR LESS IF WE'RE NOT ABLE TO SUCCESSFULLY ENGAGE WITH IDENTITY ISSUES THERE ARE LIKELY TO BE NEG5 CONSEQUENCES. NOW WHAT I'M GOING TO SAY HERE IS THAT BASICALLY IMMIGRANTS HAVE TO DO ALL OF THIS AND MORE. SO MOST YOUTH HAVE TO ENGAGE IN THESE IN CONSIDERATION OF WHO DO I WANT TO BE? WHAT SORT OF WORK DO I WANT TO DO? WHAT SORT OF RELATIONSHIPS DO I WANT TO HAVE? IMMIGRANTS ALSO HAVE TO FOCUS ON CULTURAL IDENTITY, WHO AM I AS AN IMMIGRANT, WHO AM I AS AN ETHNIC GROUP, AS AN AMERICAN OR SOMEONE WHO LIVES IN THE U.S.? AND THESE ISSUES HAVE TO BE RECONCILED WITH THE IDENTITY ISSUES AS WELL, SO IT'S A LOT MORE COMPLEX. WHAT WE FIND IN OUR WORK IS THAT THE CULTURAL AND PERSONAL ASPECT OF IDENTITY ARE PRETTY MUCH REINFORCING OF EACH OTHER WHERE IF, IF I HAVE A GOOD SENSE OF WHO I AM AS A MEMBER OF MY ETHNIC GROUP AND WHO I AM AS A MEMBER OF U.S., I'M LIKELY TO ALSO BE PRETTY COMFORTABLE WITH MYSELF IN GENERAL IN TERMS OF WHERE I'M GOING AND THESE ASPECTS OF IDENTITY OVER TIME HAVE BEEN SHOWN TO BE PREDICTIVE OF OPTIMISM, RULE BREAKING AND AGGRESSION, INVERSELY OR NEGATIVELY, AND DEPRESSIVE SYMPTOMS, ALSO INVERSELY OR NEGATIVELY. IDENTITY CONFUSION AS I MENTIONED JUST A MINUTE AGO, IT'S A SENSE OF FEELING OF WHERE I DON'T KNOW WHERE MY LIFE IS GOING, I DON'T KNOW WHERE I FIT IN WITH MY FAMILY, MY GROUP OF FRIENDS, MY COMMUNITY, MY SOCIETY AS A WHOLE. I FEEL STUCK AND I'M NOTA ABLE TO MOVE FORWARD AND WHAT WE FIND IN IMMIGRANT--CAN BE HARMFUL FOR 1'S SELF-ESTEEM AND LIFE AND POSITIVE--AND POSITIVELY PREDICTS--I'M SORRY--DEPRESSIVE SYMPTOMS, RULE BREAKING, AGGRESSION, ALCOHOL USE AND SEXUAL RISK TAKING. I'M GOING TO ACTUALLY EXTEND THE CONCEPT OF IDENTITY CONFUSION BUT ALSO REFER TO CULTURAL IDENTITY CONFUSION AND WHAT WE MEAN BY THAT, IS DIFFICULTIES INTEGRATING 1'S HERITAGE IN U.S. CULTURAL IDENTITIES, THEY JUST DON'T SEEM TO FIT TOGETHER, THEY DON'T GO TOGETHER, I HAVE A HARD TIME BEING BOTH A MEMBER OF MY ETHNIC GROUP AND AN AMERICAN. WHAT HAS BEEN FOUND IN THE LITERATURE IS THAT IN MOST CASES, YOUNG PEOPLE BETWEEN ADLEASE ENSEL AND YOUNG ADULTHOOD--[INDISCERNIBLE] HAS DONE A LOT OF THIS IN HIS WORK. PEOPLE TEND GO OVER A LOT OVER TIME IN TERMS OF THEIR HERITAGE IDENTITY AND U.S. IDENTITY, IF THIS DOESN'T HAPPEN THAT BE CAN A SENSE OF CULTURAL IDENTITY CONFUSION. AND IF I SEE A WHOLE LOT OF CONTRADICTIONS BETWEEN MY HERITAGE AND MY U.S. IDENTITY THAT CAN ALSO INDICATE THAT I'M HAVING TROUBLE IN THIS AREA, SO NOT SURPRISINGLY IN OUR WORK WITH IMMIGRANT SAMPLES, CULTURAL IDENTITY CONFUSION, NEGATIVELY PREDICTS SELF-ESTEEM AND OPTIMISM, POSITIVELY PREDICTS DEPRESSIVE SYMPTOMS AND RULE BREAKING AND AGGRESSION AND BECAUSE CULTURAL IDENTITY IS OFTEN PASSED DOWN WITHIN FAMILY, YOUNG PEOPLE WHO FEEL WHO FEEL CONFUSED ABOUT THEMSELVES CULTURALLY OFTEN HAVE FRICTION IN THEIR FAMILY. SO NOW I WANT TO TALK A LITTLE BIT ABOUT HOW THIS PLAYS OUT ACROSS GENERATIONS OF IMMIGRANTS AND HERE I'M GOING TO REFER TO 3 GENERAL GENERATIONS. FIRST GENERATION 1.5 GENERATION AND SECOND GENERATION. FIRST GENERATION PEOPLE ARE BORN OUTSIDE OF THE U.S., THEY GET HERE ROUGHLY AFTER ABOUT THE AGE OF 10. THEIR ENGLISH IS OFTEN SPOKEN WITH AN ACCENT AND THEY HAVE PRETTY GOOD MEMORIES OF WHAT IT WAS LIKE TO LIVE IN THE COUNTRY OF ORIGIN. 1.5 GENERATION ACTUALLY IS ALSO BORN OUTSIDE THE U.S. BUT THEY GET HERE FAIRLY EARLY IN LIFE, THEY OFTEN SPEAK ENGLISH WITHOUT AN ACCENT BUT THEIR MEMORIES OF LIVING IN THE COUNTRY OF ORIGIN ARE NOT QUITE AS VIVID BECAUSE THEY DID GET HERE AT YOUNGER AGING. SECOND GENERATION YOUTH ARE ACTUALLY BORN IN THE U.S., RAISED BY FOREIGN-BORNE PARENTS AND THEIR ENGLISH AND OFTEN SPOKEN WITHOUT AN ACCENT BUT THEIR EXPOSURE TO THE HERITAGE CULTURE IS LARGELY INDIRECT THROUGH FOR EXAMPLE, STORIES, TRIPS, AND SOCIAL MEDIA. SO LOOKING AT THE IDENTITY CHALLENGES BY GENERATION AND I'M ACTUALLY GOING TO BORROW IT FROM THE FIRST 2 PRESENTATIONS IN TERMS OF RECOMMENDATIONS FOR FUTURE WORK THAT SHOULD BE DONE. FOR THE FIRST GENERATION IT APPEARS THAT THESE FOLKS HAVE A PRETTY GOOD SENSE OF THEMSELVES IN TERMS OF THEIR CULTURAL HERITAGE AND THE MAIN CHALLENGE IS ACQUIRING U.S. CULTURAL IDENTITY AND INTEGRATING THAT WITH THE HERITAGE CULTURAL SELF. FOR THE 1.5 GENERATION, THEY MAY HAVE SOME SENSE OF THEMSELVES IN TERMS OF THEIR HERITAGE CULTURE DEPENDING ON HOW HOLD THEY WERE WHEN THEY GOT HERE BUT THEY--THEY PRETTY MUCH HAVE TO REACQUIRE THAT BECAUSE IT'S PROBABLY NOT COMPLETE. AND THEY ALSO HAVE TO ACQUIRE U.S. CULTURAL IDENTITY AND INTEGRATE, SECOND GENERATION HAS--HAVE TO ACQUIRE BOTH AND FIGURE OUT HOW TO INTEGRATE THAT. SO I WILL TALK ABOUT SOME TARGETS HERE FOR RESEARCH AND INTERVENTION HERE. YOU NOTICE THAT I'VE HIGHLIGHTED PERSONAL IDENTITY CONFUSION FOR BASICALLY EVERYBODY BECAUSE THIS IS A PROBLEM FOR YOUTH IN GENERAL BUT FOR THE FIRST GENERATION IT APPEARS THAT U.S. IDENTITY AFFIRMATION AND INTEGRATING THAT WITH 1'S SENSE OF 1'S SELF-AS A MEMBER OF 1'S ETHNIC GROUP ARE THE MAIN CHALLENGES THAT WOULD NEED TO BE STUDIED AND ADDRESSED. FOR 1.5 AND SECOND GENERATION THERE ARE MORE AREAS IN WHICH THESE FOLKS MIGHT NEED SOME HELP. HERE WE'RE TALKING ABOUT BOTH AND U.S. IDENTITY AFFIRMATION AND HOW THEY'RE INTEGRATED AS WELL AS A SENSE OF CULTURAL IDENTITY CONFUSION. >> DR. SCHWARTZ, SORRY FOR THE INTERRUPTION, BUT YOU'RE AT TIME. I DON'T KNOW IF YOU CAN SEE THE MESSAGES I HAVE BEEN SENDING. >> I CANNOT. WOULD YOU LIKE ME TO WRAP UP HERE? >> IF YOU COULD TAKE A FEW MINUES JUST TO WRAP UP, THAT WOULD BE GREAT. THANK YOU. >> SURE. SO I ONLY HAVE A LITTLE BIT MORE, SUMMARY AND SUGGESTIONS. 1.5 AND SECOND GENERATION YOUTH MAY EXPERIENCE MORE CHALLENGES IN TERMS OF IDENTITY FOR THESE YOUTH, WE NEED TO PROMOTE HERITAGE CULTURE RETENTION AND BY CULTURALLISM, WE NEED TO ALLEVIATE CULTURAL IDENTITY AND HELP THEM SITUATE THEMSELVES WITHIN MULTIPLE GROUPS. WE ALSO HAVE TO ALLEVIATE PERSONAL IDENTITY CONFUSION WHICH IS FAIRLY COMMON AMONG YOUTH. OR FIRST GENERATION, WE MAINLY NEED TO PROMOTE U.S. IDEBTITY AFFIRMATION AND TO,A LEAVEIATE PERSONAL IDENTITY CONFUSION SOME FIRST GENERATION YOUTH MAY ALSO HAVE CULTURAL IDENTITY CONFUSION IF THEY'RE NOT INCREASING OVER TIME. AND I WILL STOP THERE, THANK YOU VERY MUCH. >> THANK YOU DR. SCHWARTZ. THE NEXT SPEAKER IS DR. KATZ-WISE, ZOOM FLOOR IS YOURS. >> GREAT. THANK YOU. ALL RIGHT CAN EVERYONE SEE MY SLIDES? >> YES. >> GREAT. HI, EVERYONE, THANKS SO MUCH FOR HAVING ME, I AM VERY HONORED TO FOLLOW THE PRESENTATIONS OF MY FELLOW PANELISTS WHICH WERE REALLY EXCELLENT AND I THINK HELPED US SET THE STAGE FOR A REALLY INTERESTING DISCUSSION. SO I'M GOING TO TAKE US IN A LITTLE BIT OF A DIFFERENT DIRECTION TODAY, TALKING ABOUT FAMILY PROCESSES, GENDER DIVERSITY AND YOUTH HEALTH OUTCOMES. SO AS I KIND OF BRIEF OUTLINE ABOUT WHERE I'M GOING, I'M GOING TO GIVE AN OVERVIEW OF SOME KEY CONCEPTS AND THEN TALK SPECIFICALLY ABOUT THE BODY OF RESEARCH WITH TRANSGENDER AND GENDER DIVERSE YOUTH, WHICH YOU WILL SEE ABBREVIATED BY TGED IN THIS PRESENTATION AND THEIR FAMILIES IN TERMS OF WHAT WE KNOW, WHAT WE DON'T YET KNOW AND SOME INNOVATIONS IN FUTURE DIRECTIONS FOR THIS WORK. SO AS A BRIEF OVERVIEW, TRANSGENDER AND GENDER DIVERSITY YOUTH HAVE A DIFFERENT IDENTITY THAN THEIR SEX ASSIGNED AT BIRTH. THEY HAVE A GENDER IDEBTITY THAT MAY BE BINARY OR NONBINARY O EXAMPLES OF NONBINARY IDENTITY ARE TRANSGENDER GIRL OR BOY AND NONBINARY MIGHT INCLUDE IDENTITIES SUCH AS NONBINARY, GENDER QUEER, A-GENDER AND MANY MORE IDEBTITYS PARTICULARLY AMONG YOUTH WHO CAN BE QUITE CREATIVE WITH THEIR LANGUAGE AND TERMS. FOR TRANSGENDER AND GENDER DIVERSE YOUTH, THEIR GENDER IDENTITY SO HOW THEY UNDERSTAND THEIR GENDER INTERNAL FOR THEMSELVES AND THE PRONOUNS TO ADDRESS OTHER PEOPLE IN THE WORLD. AND IN ADDITION BOTH GENDER IDENTITY AND THEIR GENDER EXPRESSION MAY BE FLUID OVER TIME SO THEY MIGHT USE DIFFERENT TERMS TO DESCRIBE THEIR IDENTITIES OVER TIME, THEIR EXPRESSION MIGHT LOOK DIFFERENT AS WELL. TRANSGENDER AND GENDER DIVERSITY YOUTH MAY UNDERGO 1 OR MORE FORMS OF GENDER TRANSITION INCLUDING SOCIAL TRANSITION WHICH MIGHT INVOLVE CHANGES IN THEIR GENDER EXPRESSION, THE NAME THEY USE OR THEIR PRONOUNS, LEGAL TRANSITION WHICH MIGHT INCLUDE CHANGING IDENTITY DOCUMENTS OR INSURANCE SEX AND THEN MEDICAL TRANSITION WHICH MAY INCLUDE GENDER [INDISCERNIBLE] MEDICAL TREATMENTS. AND I THINK IT'S IMPORTANT TO RECOGNIZE THAT MANY AND NOT ALL GENDER YOUTH DESIRE GENDER AFFIRMING MEDICAL TREATMENT AND THESE DIFFERENT TREATMENTS MIGHT INCLUDE PIEWBITTAL BLOCKERS TO SORT OF PREVENT PUBERTY ALIGNED WITH THEIR ASSIGNED SEX FOR MOVING FORWARD. HORMONES TO HELP AFFIRM THEIR GENDER AND SURGICAL PROCEDURES. SO I ALSO WANT TO TALK A LITTLE BIT ABOUT THIS IMPORTANT CONCEPT OF THE FAMILY CONTEXT AND OTHER PRESENTERS HAVE MENTIONED THIS BRIEFLY BUT I'M GOING TO GO INTO A LITTLE BIT MORE DEPTH HERE AND WHAT THE BODY OF RESEARCH THAT I'M TALKING ABOUT TODAY IS REALLY ABOUT TRANSGENDER AND GENDER DIVERSE YOUTH WITHIN THEIR FAMILY CONTEXT, AND I LIKE TO USE FAMILY SYSTEMS THEORY IN MY WORK TO HELP CONCEPTUALIZE WHAT'S HAPPENING IN THESE FAMILIES. AND THIS THEORY PROPOSES THAT FAMILY MEMBERS ARE INTERDEPENDENT THAT INDIVIDUAL FAMILY MEMBERS EXPERIENCES MUST BE CONSIDERED WITHIN THE FUNCTIONING OF THE LARGER FAMILY SYSTEM AND THAT A TRANSITION FOR 1 FAMILY MEMBER CHALLENGES THE ENTIRE FAMILY SYSTEM AND WHEN THIS THEORY WAS FIRST DEVELOPED, THEY WERE NOT TALKING ABOUT GENDER TRANSITION, BUT IT'S--IT'S QUITE APPLICABLE TO THE EXPERIENCES OF FAMILIES THAT OF TRANSGENDER YOUTH IN THINKING ABOUT HOW A YOUTH'S GENDER, IDENTITY AND TRANSITION CAN REALLY AFFECT THE ENTIRE FAMILY SYSTEM. AND IT'S ALSO IMPORTANT TO THINK ABOUT THE FAMILY CONTEXT WITHIN THE LARGER ECOLOGICAL SYSTEM IN TERMS OF BEING WITHIN THE LARGER COMMUNITY CONTEXT, THE LARGER SOCIETAL INSTITUTIONAL AND HISTORICAL CONTEXTS, AND WHEN WE'RE THINKING SPECIFICALLY ABOUT TRANSGENDER YOUTH, TRANSGENDER AND--SORRY TRANSGENDER AND GENDER DIVERSE YOUTH, WE ARE ALSO THINKING ABOUT THE LARGER CONTEXT IN TERMS OF ATTITUDES TOWARDS TRANSGENDER PEOPLE, VISIBILITY OF TRANSGENDER PEOPLE, HOW POLICIES AND PROCEDURES MIGHT BE AFFECTING THEM, LAWS, AS WELL AS THE HISTORICAL CONTEXT OF HOW THESE ATTITUDES AND POLICIES AND LANGUAGE MIGHT BE CHANGING AND SHIFTING OVER TIME. AND I ALSO WANTED TO BRING IN THIS CONCEPT OF GENDER MINORITY STRESS WHICH IS USED A LOT IN THE FIELD OF TRANSGENDER, YOUTH AND FAMILIES TO THINK ABOUT YOUTH, YOUTH'S AND THEIR FAMILY'S EXPERIENCES, THIS THEORY PROPOSES THAT DISTAL STRESSORS SO STRESSORS THAT ARE EXTERNAL TO AN INDIVIDUAL SUCH AS EXPERIENCES OF OF ANTITRANSGENDER, PREJUDICE, AND DISCRIMINATION, AS WELL AS PROXIMAL STRESSORS WHICH ARE THE INTERNALIZED VERSION OF THOSE FORMS OF PREJUDICE AND STIGMA, ADVERSELY EFFECT INDIVIDUALS, PHYSICAL AND MENTAL HEALTH OUTCOMES IN PART THROUGH PSYCHOLOGY STRESS RESPONSE. AND FOLLOWING FROM MY PRESENTERS, THE PRESENTERS THAT PRESENTED BEFORE ME, RELATED TO INTERSECTIONALLITY ALSO REALLY CRITICAL TO BE BRINGING INTO THE PICTURE OTHER FORMS OF PREJUDICE AND DISCRIMINATION AND STIGMA, RELATED TO RACE, RELATED TO CLASS, SEXUAL ORIENTATION AND ALSO THE INTERNALIZED VERSIONS OF THESE AND HOW THEY MIGHT INTERSECT WITH GENDER MINORITY STRESS TO ADVERSELY AFFECT PHYSICAL AND MENTAL HEALTH. SO NOW SHIFTING SPECIFICALLY TO RESEARCH WITH TRANSGENDER AND GENDER DIVERSE YOUTH AND FAMILIES, WHAT DO WE ALREADY KNOW. THE BODY OF RESEARCH THAT CURRENTLY EXISTS, SUGGESTS THAT TRANSGENDER AND GENDER IDENTITY AFFECTS THE WHOLE FAMILY, SO THIS IS THE WHOLE FAMILY SYSTEM'S PERSPECTIVE I WAS TALKING ABOUT EARLIER. AND THE WAYS IN WHICH TRANSGENDER AND IDENTITY, AFFECTS THEIR DAY-TO-DAY LEVEL AS FAR AS COMMUNICATION, RELATED TO SATISFACTION WITH EACH OTHER, AND ALSO IN TERMS OF THE RELATIONSHIPS AMONG FAMILY MEMBERS, RELATIONSHIP QUALITY, RELATIONSHIP SATISFACTION. AND THEIR GENDER IDENTITY AND TRANSITION MAY ALSO AFFECT THE WHOLE FAMILY IN TERMS OF MENTAL HEALTH OF THE FAMILY MEMBERS IN PSYCHOSOCIAL FUNCTIONING. WE ALSO KNOW FROM CURRENT BODY OF RESEARCH THAT TRANSGENDER AND GENDER DIVERSITIES ARE AT GREATER RISK THAN THEIR CIS GENDER OR NONTRANSGENDER PEERS FOR ADVERSE MENTAL AND PHYSICAL HEALTH OUTCOMES. AND THESE ARE LARGELY UNDERSTOOD TO BE RELATED TO GENDER MINORITY STRESS, THE FRAMEWORK THAT I TALKED ABOUT EARLIER. AND THIS IS--THIS HEALTH AND EQUITY HAS BEEN DEMONSTRATED ACROSS MANY, MANY DIFFERENT MENTAL AND PHYSICAL HEALTH OUTCOMES. WE ALSO KNOW FROM THIS BODY OF WORK THAT FAMILY SUPPORT AND FUNCTIONING ARE LINKED PRETTY DIRECTLY TO TRANSGENDER AND GENDER DIVERSITY MENTAL AND PHYSICAL HEALTH. WE KNOW THAT FAMILY SUPPORT IS INCREDIBLY PROTECTIVE FOR ALL YOUTH THAT'S ALSO TRUE AND ESPECIALLY TRUE FOR TRANSGENDER AND GENDER DIVERSE YOUTH. AND CONVERSELY FAMILY REJECTION CAN ACT AS A RISK FACTDOR FOR TRANSGENDER YOUTH MENTAL HEALTH. SO OTHER--OOPS SORRY--ADVANCED A LITTLE FAR. SO OTHER THINGS WE KNOW ARE TRANSGENDER, GENDER DIVERSE YOUTH WHO DESIRE GENDER AFFIRMING MEDICAL TREATMENT FACE NUMEROUS BARRIERS. THESE MIGHT BE RELATED TO A LACK OF FAMILY SUPPORT, GEOGRAPHIC BARRIERS, WHERE THEY ARE NOT GEOGRAPHICALLY LOCATED CLOSE TO PROVIDERS, THAT PROVIDE GENDER AFFIRMING MEDICAL TREATMENT, THEY MIGHT FACE FINANCIAL BARRIERS OR LACK OF INSURANCE COVERAGE FOR THESE TREATMENTS AND ALSO PROVIDE OUR LACK OF KNOWLEDGE BOTH AMONG MEDICAL AND MENTAL HEALTH PROVIDERS. WE ALSO KNOW THAT FAMILIES WHO ARE WHITE HIGH INCOME, POLITICALLY LIBERAL AND LIVE IN URBAN SETTINGS HAVE BETTER ACCESS TO SUPPORT AND GENDER AFFIRMING MEDICAL TREATMENT FOR THEIR TRANSGENDER AND GENDER DIVERSE YOUTH, THEY ARE MORE LIKELY TO UTILIZE IN PERSON AND ONLINE SUPPORT--EXCUSE ME--AND THEY'RE MORE LIKELY TO PARTICIPATE IN RESEARCH. WE ALSO KNOW THAT FAMILIES WHO ARE SUPPORTIVE OF THEIR TRANSGENDER AND GENDER DIVERSE YOUTH ARE ALSO MORE LIKELY TO PARTICIPATE IN RESEARCH. SO WHAT DON'T WE KNOW, WHAT ARE THE GAPS IN THE RESEARCH? WE DON'T KNOW AS MUCH ABOUT THE EXPERIENCES AND SUPPORT NEEDS OF OTHER PEOPLE IN TRANSGENDER AND GENDER DIVERSE YOUTH SLIDES. THIS INCLUDES SIBLINGS OF WHICH WE--SOME EVERYONE INCLUDING SOME FROM MY TEAM BUT NOT MUCH WE DON'T KNOW VERY MUCH ABOUT EXTENDED FAMILY MEMBERS, GRAND PARENTS, AUNTS, UNCLES AND FOSTER FAMILIES. AND WE ALSO NEED MORE RESEARCHOT EXPERIENCES AND SUPPORT NEEDS OF FAMILIES WITH ADDITIONAL MARGINALIZED IDENTITIES AND EXPERIENCES. OKAY, SO I WILL SPEED UP A LITTLE BIT, I SEE A HAVE A COUPLE MINUTES REMAINING. SO WE ALSO DON'T KNOW ABOUT PARENTS AND CAREGIVERS WHO ARE NOT SUPPORTIVE OF THEIR YOUTH, WHO ARE POLITICALLY CONSERVATIVE AND WHO ARE RELIGIOUS AND HOW BEST TO SUPPORT NONBINARY YOUTH AND THEIR FAMILIES SPECIFICALLY REFERRING TO MEDICAL TREATMENT AND HOW BEST TO SUPPORT GENDER DIVERSE PIEWBITTAL CHILDREN AND THEIR FAMILIES. SO THINKING ABOUT CHILDREN WHO ARE NOT YET GOING THROUGH GENDER AFFIRMING MEDICAL TREATMENT. SO WHAT'S NEXT? HERE ARE INNOVATIVE METHODOLOGIES AND APPROACHES THAT ARE STARTING TO BE USED IN THIS RESEARCH THAT CAN BE REALLY USEFUL FOR HELPING US UNDERSTAND THE EXPERIENCES OF TRANSGENDER YOUTH AND FAMILIES. THE FIRST IS COMMUNITY ENGAGED RESEARCH, SO THIS INVOLVES--INVOLVING COMMUNITIES IN MULTIPLE STAGES OF THE RESEARCH PROCESS, ALLOWING COMMUNITY MEMBERS TO PROVIDE THE LIVED EXPERIENCE TO HELP GUIDE THE RESEARCH AND THIS APPROACH CAN BE PARTICULARLY USEFUL FOR MARGINALIZED COMMUNITIES AND I'VE JUST HIGHLIGHTED HERE THE TRANSGENDER TEEN AND FAMILY NARRATIVES PROJECT, 1 OF MY PROJECTS THAT USES THIS APPROACH THAT WAS FUNDED BY NICHD. OORLGT INNOVATIVE METHOD LOGICAL APPROACHES IS THE DELPHI AWHOACH WHICH IS USED TO HELP CREATE EXPERT CONSENSUS GUIDELINES FOR HELT RELATED TOPICS SUCH AS PARENTING TRANSGENDER AND GENDER DIVERSE YOUTH. ANOTHER INNOVATIVE METHOD LOGICAL APPROACH IS THE USE OF ASYNCHROUS AND DIGITAL APPROACH AND FINALLY STORY TELLING CAN WITH USED TO HELP COMMUNITIES SHARE LIVED EXPERIENCE THROUGH STORIES THAT CAN HELP OTHER PEOPLE UNDERSTAND THEIR PERSPECTIVES AND IN MY WORK WE'VE BEEN USING THIS TO DESIGN AN INTERVENTION FOR FAMILIES WITH TRANSGENDER YOUTH TO HELP IMPROVE COMMUNICATION AND CONVERSATIONS RELATED TO THE TRANSYOUTH GENDER RELATED IDENTITY. AND 1 INNOVATIVE TOPIC THAT I WANT TO HIGHLIGHT IS THE EFFECTS OF POLITICAL CLIMATE AND POLICIES ON TRANSGENDER AND GENDER DIVERSE YOUTH AND FAMILIES WHICH MY OWN TEAM HAS DONE SOME WORK ON AS WELL AS DR. [INDISCERNIBLE] AND HER TEAM. SO WHAT'S NEXT? I THINK THAT NICHD SHOULD BE PRIORITIZING FUNDING FOR RESEARCH ON EXPERIENCES OF MARGINALIZED COMMUNITIES AND THIS INCLUDES PEOPLE OF COLOR, PEOPLE FROM LOW INCOME BACKGROUNDS, RURAL GEOGRAPHIC REGIONS, IMMIGRANTS, THERE NEEDS TO BE MORE RESEARCH ON DEVELOPMENT OF INTERVENTIONS TO SUPPORT TRANSGENDER AND GENDER DIVERSE YOUTH AND THEIR FAMILIES, COMMUNITY ENGAGED RESEARCH, LONGITUDINAL RESEARCH TO REALLY CAPITALIZE ON THE DEVELOPMENT OF GENDER IDENTITY OVER TIME AND HOW TRANSGENDER AND GENDER DIVERSE YOUTH EXPERIENCES WITH THEIR FAMILIES AND MY EBB AND FLOW OVER TIME. SOME OF THE INNOVATIVE METHODOLOGIES AND TOPICS THAT I TALK ABOUT, WE ALSO NEED MORE WORK ON NATIONALLY REPRESENTATIVE SURVEY DATA ON EXPERIENCES OF TRANSGENDER YOUTH AND FAMILIES SINCE MUCH OF OUR RESEARCH SO FAR IS BASED ON SMALL CONVENIENCE SAMPLES OR CLINIC-BASED SAMPLES. AND WE ALSO NEED MORE WORK ON THE INTEGRATION OF GENDER FIRMING CARE INTO MEDICAL AND MENTAL HEALTH TRAINING AND PRACTICE. I WILL END THERE. THANK AND YOU LOOKING FORWARD TO THE DISCUSSION. >> THANK YOU, DOCTOR. NOW DR. YIP, I OPEN THE FLOOR FOR THE QUESTION-ANSWER AND DISCUSSION PORTION OF THIS SESSION. THANK YOU. >> CAN EVERYONE HEAR ME? >> YES. >> APOLOGIES FOR THAT. SO I WANT TO THANK OW PANELISTS FOR A VERY STIMULATING AND THOUGHTFUL PRESENTATION AND I'M GOING TO HIGHLIGHT A COUPLE OF THEMES, CROSS CUTTING THEMES THAT I OBSERVED IN THE PRESENTATION AND THEN, I WILL OPEN IT UP FOR QUESTION AND ANSWER. SO IF YOU WOULD LIKE TO START SENDING ME QUESTIONS FOR OUR PANELISTS IN THE CHAT, I WILL INTEGRATE THOSE AND IMPOSE THEM TO THE PANEL. SO NEXT SLIDE, PLEASE. SO SOME SYNTHETIC THEMES ACROSS THE PRESENTATION. SOCIAL IDENTITIES ARE DEVELOPMENTAL, ALL RIGHT? SO WE SAW A PRESENTATION THAT COVERED ADOLESCENCE, EARLY CHILDHOOD, ADULTHOOD, AND AS THE INTRODUCTION MENTIONED THAT IT'S REALLY A LIFE LONG PROCESS, SO YOU DON'T DEVELOP AN IDENTITY, ARISE AND BE DONE, RIGHT? THIS IS AN ONGOING PROCESS THAT CONTINUES ACROSS THE LIFE SPAN. INTERSECTIONALLITY IS A REALLY LARGE THEME FOR MANY OF OUR PAPERS. AND I WOULD ADD TO THAT, THAT OUR IDENTITIES ARE ALSO LAYERED IN THEIR HIERARCHICAL, RIGHT? SO THAT'S SOME IDENTITIES HAVE MUCH MORE PROMINENCE FOR SIGNIFICANCE FOR OUR LIVED EXPERIENCES, THAN OTHERS AND THAT'S BECAUSE THESE IDENTITIES ARE SITUATED IN TIME THAT ARE SITUATED IN PLACE AND THEY'RE SITUATED IN SPACE, SO IF YOU THINK ABOUT THESE DIMENSIONS, AND YOU ADD THEM TO OUR CONCEPTUALIZATION, OF IDENTITIES, YOU START TO SEE WHERE SOME IDENTITIES ARE MUCH MORE PROMINENT. THAT PROBABLY OCCUPY A LITTLE MORE SPACE IN THE CONSTRUCTION OF SELF-THAN MAYBE OCCUPATIONAL IDENTITY, RIGHT? SOCIAL IDENTITIES ARE SOCIAL, SO THAT MAY SOUND REDUNDANT BUT IT'S REALLY INTERSECTIONS WITH SIMILAR OTHERS, WITH DIFFERENT OTHERS, WITH FAMILIES, WITH PEERS, WITH TEACHERS, COWORKERS, BUT IT'S THROUGH THESE INTERACTIONS THAT OUR IDENTITY--IDENTITIES BECOME RELEVANT, RIGHT? IF YOU'RE JUST SITTING IN A ROOM BY YOURSELF, NOT ENGAGING WITH ANYONE, YOUR IDENTITY IS VERY DIFFERENT THAN IT IS WHEN YOU ARE INTERACTING WITH OTHER PEOPLE AND SO FROM THAT SENSE, SOCIAL IDENTITIES ARE INFORMED BY AND THEY ALSO INFORM OUR EVERYDAY SOCIAL INTERACTIONS, OUR LIVED EXPERIENCES, OUR DAILY LIVES AND AGAIN IN THE MOMENT RIGHT. SO THINK ABOUT WHICH IDENTITIES ARE SALIENT TO YOU NOW AND OVER TIME, RIGHT, SO DEVELOPMENTALLY WHICH ARE MORE OR LESS PROMINENT OVER TIME. AND I WOULD ARGUE THAT SOCIAL IDENTITIES ARE ACTUALLY PATHWAYS THROUGH WHICH RELATIVE PRIVILEGE AND MARGINALIZATION IMPACT HEALTH, SO IF YOU THINK ABOUT THE SOCIAL CONSTRUCTION AND IDENTITY IT'S THROUGH HAVING AND EMBRACING AN IDENTITY THAT MESSAGES A PRIVILEGE AND MARGINALIZATION ARE COMMUNICATED TO YOU AND ABOUT YOU AND IT'S THAT PATHWAY THROUGH WHICH HEALTH IS IMPACTED. NEXT SLIDE, PLEASE. FINALLY, THINKING ABOUT SOME FUTURE DIRECTIONS FOR SOCIAL IDENTITY SCIENCE. AS MANY OF OUR PANELISTS DISCUSS, THEORIES OF INTERSECTIONS, BUT I REALLY THINK WE'RE AT A PLACE WHERE WE PRETTY MUCH UNDERSTAND THEORETICALLY THE IMPORTANCE OF INTERSECTIONALLITY BUT WE'RE WOEFULLY UNDERDEVELOPED IN THE AREA OF MEASUREMENT CONSTRUCTION. SO THERE ARE A HANDFUL OF MEASURES THAT LOOK AT INTERSECTIONAL IDENTITIES, BUT THEY DON'T QUITE CAPTURE THE NUANCE AND THE DYNAMIC NATURE OF INTERSECTIONALLITY AND ON TOP OF THAT, THIS NOTION OF HIERARCHY OR LAYERS THAT ALSO CONSIDER TIME, PHYSICAL AND SOCIAL SPACES. AND SO, THE WAY WE SORT OF MEASURE IDENTITY, SOCIAL IDENTITIES IS MISSING THIS COMPLEX INTERPLAY. SECOND, HOW ARE SOCIAL IDENTITIES BIOBEHAVIORAL INDICATED IN SOCIAL AND EQUITY PROMOTION? SO WHEN ARE WHICH SOCIAL IDENTITIES ACTIVATED, RIGHT? OR MADE SALIENT? WHICH DOES THAT HAPPEN AND WHICH IDENTITY IS THAT TRUE FOR AND HOW CAN WE THINK ABOUT THAT, HOW THAT HAS A DIRECT IMPACT, OR IMPLICATIONS FOR HEALTH, AGAIN IN THE MOMENT AND OVER TIME. SO I THINK IT'S QUITE CLEAR FROM LOOKING AT THE COLLECTION OF PRESENTATIONS TODAY THAT SOCIAL IDENTITY IS A REALLY IMPORTANT SOCIAL DETERMINANT OF HEALTH AND DEVELOPMENT. AND AS A COMMUNITY, WE NEED TO START THINKING ABOUT HOW SOCIAL IDENTITY SCIENCE CAN BE LEVERAGED TO 1, MITIGATE DISPARITIES BUT ALSO PROMOTE HEALTH EQUITY. FINAL SLIDE AND WITH THAT, I WILL TURN IT OVER TO OUR PANELISTS WHAT SORT OF QUESTIONS YOU HAVE FOR THE PANEL, PLEASE FEEL FREE TO SEND THOSE TO ME IN A CHAT AND I WILL POSE THEM TO OUR PANELISTS. THANK YOU VERY MUCH. ALL RIGHT. LET'S SEE. I HAVE A QUESTION HERE, OKAY. SO, HERE'S THE FIRST QUESTION FOR OUR PANEL: IF WE EXTEND THE CONCEPT OF STREET RACE TO OTHER INTERSECTING IDENTITIES, HOW CAN WE HELP PARENTS INCLUDING OURSELVES ADVOCATE AND UNDERSTAND THE LIVED EXPERIENCES OF THEIR CHILDREN WHEN THEY PRESENT AS PRIVILEGE FOR EXAMPLE, LIGHT SKIN, CISGENDER, UPPER MIDDLE CLASS BUT THEIR CHILDREN PRESENT AS BLACK, BROWN, GENDER AND SEXUALLY FLUID. SO THE IDEA IS HOW CAN PARENTS BE ACTIVE OR EFFECTIVE ADVOCATE WHEN IS THEY MAY PHENOTYPICALLY PRESENT DIFFERENT FROM PARENT AND THEREFORE HAVE A COMPLETELY DIFFERENT LIVED EXPERIENCE FROM THEIR PARENT? >> I GUESS THAT'S FOR ME. SO, I THINK 1 OF THE THINGS I WANT TO DO IF IT'S OKAY IS JUST SHARE A SCREEN AND SHARE 1 SLIDE THAT WILL HELP ADDRESS THAT QUESTION. IF THAT'S OKAY? SO THIS WAS PART OF THE POWER POINT I MENTIONED IS ABOUT 50 SLIDES--VERY DIFFERENTLY AND THIS COMES FROM DAVIS' BOOK ON INTERSECTIONALLITY AND DOMAINS OF BELONGING AND WHAT SHE SAYS IS YOU CAN HELP THAT CHILD, UNDERSTAND, YES, AND IN FACT THAT HAPPENS IN MANY LATINO FAMILIES. IF YOU LOOK AT EVERYONE ON MY FATHER'S SIDE, THEY'RE VERY FAIR SKINNED SOME ARE BLOND AND BLUE EYED AND MY MOM'S SIDE IS DARK SKIN, BLACK HAIR, DOMAIN MIN KAN--KANA, ALL THE KIDS WERE ALL DIFFERENT COLORS THAT EACH THOUGH WE MAY OCCUPY DIFFERENT STREET RACES, SOME OF US MAY BE OF DIFFERENT CLASS BACKGROUNDS, RIGHT NOW, MAYBE THE SAME CLASS ORIGIN THAT WE MAY SRO DIFFERENT NARRATIVES OF IDENTITY, SOME--I IDENTIFY AS A BLACK LATINA, NOT ALL MY SIBLINGS IDENTIFY, THEY MAY LOOK LIKE ME, THEY HAVE A DIFFERENT NARRATIVE OF IDENTITY AND THEY DEFINITELY DON'T HAVE THE SAME COMMITMENT. SO I THINK THE PATH CAN HELP US UNDERSTAND THAT YES, YOUR SOCIAL LOCATION IN GRIDS OF POWER MAY BE DIFFERENT, YOUR NARRATIVE OF IDENTITY MAY BE DIFFERENT, YOUR ETHICAL AND POLITICAL EFFORTS MAY BE DIFFERENT BUT WE'RE ALL IN SOLIDARITY. THERE'S IMPLICIT SOLIDARITY. SO THAT IS A REAL REALITY FOR MANY THAT ARE GROWING UP IN HOUSEHOLD WHERE THE PARENTS ARE PHENOTYPICALLY VERY DIFFERENT AND EVERY OTHER SIBLING IS, SO I THINK THIS IS A VISUAL TOOL REALLY DOES HELP UNPACK THAT. THAT IT IS ABOUT PRACTICING SOLIDARITY SO I WILL STOP SHARING. --FROM THE PERSPECTIVE OF FAMILIES WITH TRANSGENDER AND GENDER DIVERSE YOUTH. IF WE DO WHAT THE QUESTION ASKS IN TERMS OF EXTENDING STREET RACE TO HAVE IDEBTITYS WE CAN THINK ABOUT HOW CISGENDER PARENTS MIGHT HAVE CHALLENGES RELATED TO PARENTING TRANSGENDER AND GENDER DIVERSE YOUTH IN PART BECAUSE THEY DON'T HAVE THAT LIVED EXPERIENCE AND THEY DON'T KNOW WHAT IT MIGHT BE LIKE TO EXPERIENCE PREJUDICE AND DISCRIMINATION RELATED TO GENDER IDENTITY AND GENDER EXPRESSION. THE AND I THINK FROM MY WORK IN THE OTHER WORK OF PEOPLE IN THE FIELD THAT'S REALLY CRITICAL FOR PARENTS TO TAKE THE TIME TO LISTEN TO THEIR CHILDREN AND LISTEN TO THEIR YOUTH ABOUT WHAT THEIR EXPERIENCES IS LIKE AND DEFER TO THEM ABOUT WHAT DO THEY NEED TO BE SUPPORTED? WHAT DOES SUPPORT LOOK LIKE FOR THEM AND I CAN JUST SAY IN THE FIELD THAT I WORK IN, YOUTH OFTEN REALLY HAVE A DIFFERENT PERCEPTION OF SUPPORT THAN PARENTS DO ABOUT THE SUPPORT THAT THEY THINK THEY'RE GETTING KIDS. SO I THINK THAT THAT COULD--I WOULD IMAGINE THAT MIGHT ALSO EXTEND TO OTHER TYPES OF FAMILIES WHERE PARENTS AND YOUTH HAVE DIFFERENT TYPES OF VISUAL IDENTITIES. >> EXCELLENT. THANK YOU. ANYONE ELSE WANT TO WEIGH IN? I HAVE ANOTHER QUESTION HERE IN THE CHAT THAT IS DIRECTED SPECIFICALLY AT DR. SCHWARTZ'S PRESENTATION, THE RECOMMENDATION THAT IMMIGRANTS NEED TO ACQUIRE A U.S. IDENTITY OR TO ASSIMILATE, THE QUESTION SAYS THE U.S. WAS FOUNDED ON PURISM AND SLIEFRY WHY WOULD NOT WHITES WANT TO ACQUIRE THIS IDENTITY? >> I THINK I WOULD SAY IT'S NOT THAT THEY WOULD WANT TO IT'S THAT RESEARCH HAS SHOWN THAT IT'S ACTUALLY BENEFICIAL FOR THEIR WELL BEING AND THEIR HEALTH WHEN THEY DO, WOULD ACTUALLY PREDICT HIGHER WELL BEING LOWER DEPRESSIVE SYMPTOMS, LESS ALCOHOL USE, ESTROGEN. SO THIS IS NOTED A VALUE JUDGMENT ABOUT A COUNTRY, THIS IS A FIND BEING SPECIFICALLY ABOUT THE HEALTH OF THESE YOUTH. >> CAN I ALSO JUST JUMP IN? >> ABSOLUTELY, GO AHEAD. >> I'M SORRY, I'M SURE HAVE YOU SOMETHING INSIGHTFUL BUT I WAS THINKING ABOUT THIS IN TERMS OF LIKE, YOU COULD ARRIVE AT A U.S. IDENTITY AND I KNOW THERE ARE IN SOCIOLOGY THERE ARE DIFFERENT WAY TOTION THINK ABOUT LIKE THE CONCEPT OF ASSIMILATION FOR EXAMPLE AND IF WE THINK ABOUT U.S. IDENTITY AS INVOLVING, A REJECTION OR CIS-IDENTIFICATION WITH WHAT CAN ASSIMILATION LOOK LOOK AND FOR ME IT'S CRITICAL THAT WE LOOK AT OUR SOCIAL INSTITUTIONS AND EVERY ASPECT OF YOUTH, WHAT ARE WAYS THEY CAN BE INVITED INTO THIS U.S. CONTEXT IN A WAY THAT DOESN'T NEGATE THE HISTORY THAT THIS PERSON IS POINTING OUT TO YOU RIGHTFULLY, AND IT'S, YOU KNOW CONSCIOUS OF IT, AND IS ALSO--IS NOT ASKING THEM TO FORFEIT A WHOLE ASPECT OF WHO THEY ARE AND THEIR LIVED EXPERIENCES SO I THINK IT'S AN INTERESTING FINDING BUT I AUSWANT TO UNPACK, WHAT DOES THAT LOOK LIKE, YOU BE AND ARE THERE EXPERIENCES LIKE YOUTH ARE HAVING, WHAT'S THE CONTEXT IN WHICH THAT RESEARCH IS DONE, LIKE IS THERE SOMETHING ABOUT WHAT'S HAPPENING THERE, THAT IS--YOU KNOW HAPPENING SO THAT THE U.S. IDENTITY IS NOT COMING AT THE EXPENSE OF THE OTHER. BECAUSE WE KNOW AND YOU MENTIONED THAT MULTIPLE IDENTITY, RIGHT? LIKE HAVING THE HERITAGE AND THE U.S. IDENTITY TOGETHER WOULD BE IDEAL BUT WE DON'T WANT THE U.S. IDENTITY TO GET A NAIVE 1, RIGHT? SO THINK ABOUT OTHER WAYS TO FORM THAT. YEAH. >> I THINK THAT'S A REALLY IMPORTANT CONSIDERATION. AND I THINK I WOULD ADD TO THAT THAT SORT OF INTEGRATING THE FIRST QUESTION ABOUT HOW 1 PRESENTS AND THE SECOND QUESTION ABOUT ADOPTING AN AMERICAN IDENTITY, WE ALSO HAVE TO UNDERSTAND THAT IDENTITY IS NOT JUST WHO WE SAY WE ARE BUT WHO OTHER PEOPLE SEE US AS, RIGHT? SO THERE'S A LOT OF RESEARCH AND SOCIAL PSYCHOLOGY THAT FINDS THAT ASIAN AMERICANS IN PARTICULAR ARE NOT SEEN AS AMERICANS, THEY'RE SEEN AS ASIAN BUT THEY'RE DEFINITELY NOT SEEN AS AMERICAN, AND WHEN THEY ASSERT THEIR AMERICAN IDENTITY IT GETS REJECTED BY "-UNQUOTE AMERICANS. SO I THINK IT'S REALLY IMPORTANT WHEN WE THINK ABOUT IDENTITY AND IT'S CONTRIBUTIONS TO HEALTH TO THINK ABOUT NOT ONLY WHO I SAY I AM BUT WHO OTHER PEOPLE SEE ME AS, AND I THINK THAT'S A SORT OF LIKE AN INTEGRATION OF THAT FIRST QUESTION WITH RESENTING 1 WAY AND ALSO THINKING ABOUT HOW WE CONSTRUCT THIS ITSELF. OKAY, LET'S SEE, OTHER CONVERSATIONS, SO THERE'S A QUESTION HERE ABOUT, YOUTH WITH DISABILITIES, AND HOW WE THINK ABOUT DISABILITIES AS INTERSECTING WITH RACE, CULTURE, SOCIAL IDENTITY AND THINKING ABOUT IT IN THE CONTEXT OF HEALTH EQUITY DOES ANY OF YOUR WORK INCLUDE YOUNG PEOPLE WITH DISABILITIES, THIS IS IMPORTANT BECAUSE MOST WILL TRANSITION INTO THE WORLD OF WORK AND SUPPORTS POLICY CHANGES AND INCLUSION IN THESE DISCUSSIONS, COMMUNITIES OF COLOR WILL REMAIN AT AN EXTREME DISADVANTAGE AND WILL CONTINUE TO DRAMATICALLY IMPACT PARTICULARLY COMMUNITIES OF COLORS WHO ALSO STRUGGLE WITH DISABILITIES. WOULD ANY OF THE PANEL LIKE TO SPEAK TO THAT. >> I WILL MENTION BRIEFLY, ABSOLUTELY. MAPPING THE MARGINS OF DISABILITY IS PART OF INTERSECTIONAL INQUIRY. SO FOR EXAMPLE, ARE WHITE MALES WITH DISABILITIES WHO COME FROM HOUSEHOLDS WHERE MOW PARENT EARNED COLLEGE DEGREE OVERREPRESENTED AN OUT OF SCHOOL SUSPENSION AND DROP OUT WHEN COMCOMPARED TO THEIR BLACK, NATIVE, ASIAN AND INDIGENOUS COUNTERPARTS, ET CETERA. INTERSECTIONAL INQUIRY IS KEY. THE CHALLENGE IS THAT THERE'S LITTLE IF ANY ADMINISTRATIVE DATA ON DISABILITY THAT'S READILY ACCESSIBLE FOR THAT ANALYSIS. AND THERE'S NO DATA, ON PARENTAL EDUCATIONAL ATTAINMENT. THIS IS WHY INTERSECTIONALLITY IS KEY. WE ABSOLUTELY NEED TO LOOK AT THAT SOCIAL LOCATION, THAT LIVED POSITION, RIGHT? AND THAT RELATIVE EXPERIENCE WITH DISPARITIES HEALTH, EDUCATION AND SO ON, EMPLOYMENT. BUT WITHOUT THE ADMINISTRATIVE DATA WE CANNOT. >> I CAN ADD THAT IN MY AREA OF WORK, DISABILITY OFTEN COMES IN WHEN PARTICIPANTS AND FAMILIES ARE TALKING ABOUT ACCESSING GENDER FIRMING CARE, ESPECIALLY IF THEY HAVE CHRONIC ILLNESS OR CONDITION THAT REQUIRES ENGAGEMENT WITH MEDICAL CARE LONG-TERM THAT OFTEN TIMES, THERE'S A LOT OF SILOING THAT THEY ARE GOING TO 1 BRO VIEDER FOR GENDER AFFIRMING CARE AND ANOTHER PROVIDER FOR CARE RELATED TO THEIR DISABILITY OR CHRONIC ILLNESS, AND THE PROVIDERS FOR CHRONIC ILLNESS AND DISABILITY, TRANSGENDER AND GENDER DIVERSE PEOPLE, AND YOU KNOW CONVERSELY THE GENDER CARE SPECIALIST MIGHT NOT BE KNOWLEDGEABLE ABOUT THEIR PARTICULAR CONDITION, SO IT ENDS UP BEING REALLY COMPLICATED TO ENGAGE IN THE HEALTHCARE SYSTEM FOR THOSE INDIVIDUALS. >> THANK YOU. WE HAVE A QUESTION HERE SORT OF PIGGYBACKING ON AN EARLIER COMMUNITY LOOKING AT THE INTERSECTION OF RACE AS A SOCIAL CONSTRUCT AND HOW IT INTERSECTS WITH SEXUAL GENDER MINORITY, LGBTQI AND SO-[INDISCERNIBLE] YOUTH AND HOW CONSIDERING THESE INTERRELATED ASPECTS AMONG ADOLESCENTS AND YOUNG ADULTS, WILL BE--IS RELATED TO HEALTH AND HOW WE CAN SORT OF LEVERAGE THAT TO DEVELOP A MORE INCLUSIVE AND RESPECTFUL DEVELOPMENTAL CONTEXT FOR THESE YOUTH THAT STRUGGLE WITH THAT PARTICULAR INTERSECTION. >> AGAIN WE DON'T HAVE THE DATA SO MAPPING, WHETHER IT'S EDUCATIONAL OUTCOME, DISCIPLINE OR HEALTH, IF WE DON'T HAVE [INDISCERNIBLE] DATA WE ARE NOT ABLE TO LOOK AT THAT INTERSECTIONAL LOCATION, MY GUESS IS THAT OF COURSE WHETHER THE STUDENT IS SOCIALIZED AS A BROWN OR BLACK BODY OR ASIAN OR NATIVE AMERICAN, THAT LIVED EXPERIENCE WILL VARY DRAMATICALLY, WHEN THERE'S INTERACTION WITH LAW ENFORCEMENT OR SCHOOL OFFICIAL OR WHATEVER THE CASE MAY BE. THE OTHER COMPLICATION IS THAT EXPERIENCE COULD ALSO BE VERY DIFFERENT DEPENDING ON WHAT THAT STUDENT CLASS ORIGIN IS, ALL RIGHT? SO IF THEY HAVE RESOURCES AND ACCESS TO HEALTHCARE, HAVE TRANSPORTATION, RIGHT? IF THEY COME FROM A HOUSEHOLD WHERE A PARENT AS A COLLEGE DEGREE, THAT'S NOT A PREDICTOR OF WEALTH BUT IT'S A PRETTY RELIABLE PREDICTOR OF AT LEAST THE LEVEL OF SOCIAL NETWORKS THAT THAT PERSON MIGHT HAVE ACCESS TO AND ALSO YES, RESOURCES. SO, I ASK MYSELF WHAT IS THE FEAR OF COLLECTING PARENTAL EDUCATIONAL ATTAINMENT IN ALL OF OUR SCHOOLS? AS A DATA, A POINT FOR EQUITY RESOURCE DISTRIBUTION, WHY DON'T WE COLLECT THAT? FREE LUNCH IS NOT ENOUGH. AND SO ABSOLUTELY, WE NEED SOGI DATA WITH AN ETHICAL COMMITMENT TO DO NO HARM BECAUSE PEOPLE ARE AFRAID TO COLLECT THE DATA BECAUSE IT MAY BE USED INAPPROPRIATELY. >> THANK YOU DR. LOPEZ, I HAVE 1 FOLLOW UP QUESTION AND THEN PERHAPS WE CAN SQUEEZE IN THIS LAST QUESTION THAT'S IN THE CHAT AS WELL. SO THE FOLLOW UP QUESTION IS WHAT CAN BE DONE ABOUT GATHERING THIS REALLY IMPORTANT ADMINISTRATIVE DATA THAT YOU TALK ABOUT? >> CREATE A CONSORTIUM, A COMMUNITY OF PRACTICE, ON DATA COLLECTION AND THAT WOULD INCLUDE K12, HOSPITALS, LAW ENFORCEMENT, YOU NAME IT, HOUSING AND THE REASON I SAY THAT IS THAT A LOT OF PEOPLE BELIEVE THAT WE ARE WEDDED TO THE OMB OFFICE OF MANAGEMENT AND BUDGET GUIDELINES, THAT IS TRUE, WE DO ARE TO COLLECT THE DATA IN A WAY THAT AGGREGATES TO THEIR CATEGORIES BUT WE CAN CONTEXTUALIZE THAT DATA, THEY KNOW THAT IT'S NECESSARY FOR EQUITY, HEALTHCARE, EDUCATION, HOUSING, ET CETERA WE CAN ADD A STREET RACE QUESTION, THERE'S NOTHING SAYING THAT WE CAN'T. WE CAN ADD A SOGI QUESTION, A DISABILITY QUESTION WITH THE UNDERSTANDING THAT THAT DATA IS FOR EQUITY USE AND RESOURCE DISTRIBUTION. THAT IT'S NOT FOR YOU KNOW IDENTIFYING AND MARGINALIZING. THE 1 DATA POINT THAT ALSO IS IMPORTANT THAT I WOULD NOT ADVISE THAT WE COLLECT BECAUSE OF COURSE SO MANY THINGS ARE HAPPENING, IS IMMIGRATION STATUS, RIGHT? SO STUDENTS WHO ARE UNDOCUMENTED HAVE A COMPLETELY DIFFERENT LIVED REALITY, RIGHT? NOW DEPENDING ON THE CLASS BACKGROUND AND WHAT THEY LOOK LIKE BEING STOPPED AND ASKED FOR PAPERS MIGHT LOOK DIFFERENT FOR 1 STUDENT VERSUS ANOTHER, SO ALL OF THOSE THINGS, START A CONSORTIUM, YOU CAN ADD THESE QUESTIONS TO ANY ADMINISTRATIVE DATA, TOO. >> THANK YOU DR. LOPEZ, YOU MUST HAVE YOUR EYE ON THE CHAT BECAUSE THE NEXT 2 QUESTIONS ARE ABOUT IMMIGRATION, THEY'RE DIRECTED TO DR. SCHWARTZ, SO 1 QUESTION SAYS INTERESTING DEFINITIONS FOR GENERATIONAL DIFFERENCES BASED ON A CULTERATION LEVEL, PRIMARY LANGUAGE AND ACCENT AND EXPOSURE TO HERITAGE CULTURE. WHAT ARE THE LIMITATIONS OF IGNORING OTHER DOMAINS OF ACCULTURATION, SUCH AS BEHAVIOR AND CUSTOMS? >> I THINK THAT'S A FASCINATING QUESTION AND WHAT I WAS TRYING TO DO WAS TO GIVE A BROAD OVERVIEW WITHIN THE CONTEXT OF I SHORT PRESENTATION, BASICALLY WHAT THESE--3 GENERATIONS ARE. I DO AGREE THAT THERE'S A HUGE AMOUNT OF DIVERSITY WITHIN EACH OF THESE GROUPS AND THERE'S--THERE'S ANOTHER COMMENT THAT I SEE THERE, ABOUT FIRST GENERATION IMMIGRANTS WHO ARE--WHO ARE UNDOCUMENTED AND OF COURSE THAT WILL PLAY AN IMPORTANT ROLE IN TERMS OF IDENTITY. I'M GOING TO SAY THAT, THE SORTS OF DATA THAT WE WOULD NEED TO DEFINITIVELY ANSWER A QUESTION LIKE THIS, STILL NEED TO BE COLLECTED AND I'M GOING TO SAY THAT THIS SHOULD BE AN IMPORTANT AREA FOR THE NICHD TO LOOK AT HOW DOES BEING UNDOCUMENTED FOR EXAMPLE, AFFECT VARIOUS AREAS OF HEALTH OVER TIME. ARE THERE DIFFERENCES ACROSS DIFFERENT ETHNIC GROUPS. IS IT THE SAME FOR SOMEBODY WHOSE FAMILY IS LET'S SAY FROM MEXICO VERSUS FROM CENTRAL AMERICA, VERSUS FROM ASIA, VERSUS FROM AFRICA. ARE THERE DIFFERENCES--ARE THERE DIFFERENCES TO PIGGYBACK ACTUALLY FROM DR. LOPEZ'S COMMENT, ARE THERE DIFFERENCES IN TERMS OF WHO THE PARENTS ARE? HOW EDUCATED THEY ARE? WHAT WE'VE--WHAT WE'VE SEEN ACTUALLY SINCE THE BEGINNING OF THE YEAR HAS BEEN A LOT OF PEOPLE ACROSSING THE BORDER WHO HAVE COLLEGE DEGREES. SO, WHAT DIFFERENCE DOES THAT MAKE. DOES IT MATTER WHETHER THE PARENTS HAVE MORE EDUCATION? DOES IT MATTER WHETHER THEY'VE GOT OTHER FAMILY HERE IN THE U.S.? I THINK A LOT OF THESE THINGS STILL NEED TO BE LOOKED AT, SO I'M GOING TO CALL FOR SOME MORE RESEARCH IN THIS AREA. I THINK THIS IS AN ABSOLUTELY WONDERFUL QUESTION. >> THANK YOU DR. SCHWARTZ, SO WE HAVE TIME FOR 1 FINAL QUESTION. YOU SORT OF ALLUDED TO IT A LITTLE BIT BUT I THINK IT'S WORTH SORT OF UNDERSCORING A LITTLE BIT MORE, WHICH ARE THE UNIQUE CHALLENGES OF FIRST GENERATION IMMIGRANTS, RIGHT? THEY'RE AT RISK FOR MARGINALIZATION, IN TERMS OF ECONOMIC STATUS, YOU MENTIONED UNDOCUMENTATION, POVERTY, ACCESS TO FEDERAL BENEFITS, LANGUAGE BARRIERS, EDUCATION, EMPLOYMENT BENEFITS, SO WHAT DOES THE PUBLIC HEALTH VALUE OF IDENTIFYING 1.5 AND SECOND GENERATION IMMIGRANTS WHO MIGHT HAVE ADDITIONAL BARRIERS OF THAT THEN TRANSLATE INTO HEALTH DISPARITIES? >> I THINK THERE'S--THERE'S A COUPLE OF ISSUES. FIRST OF ALL THERE'S--THERE'S A BIT OF A MIXED BLESSING, I THINK IN BEING 1.5 AND SECOND GENERATION BECAUSE YOU DON'T HAVE AN ACCENT BECAUSE PEOPLE DON'T--PEOPLE MAY NOT REALIZE THAT YOU'RE AN IMMIGRANT, PEOPLE MAY NOT SEE THAT YOU MAY BE FACING CHALLENGES. THE PUBLIC HEALTH VALUE, I THINK LIES IN THE IMMIGRANT PARADOX IN THE SENSE THAT THE LONGER THAT SOMEONE HAS LIVED IN THE U.S., THE WORSE CERTAIN MENTAL AND PHYSICAL HEALTH INDICATORS SEEM TO GET. AND PEOPLE WHO ARE BORN IN THE U.S. AND RAISED BY IMMIGRANT PARENTS, I. E. SECOND GENERATION VERY OFTEN HAVE WORSE MENTAL AND PHYSICAL HEALTH COMPARED TO THE FIRST GENERATION IMMIGRANTS. AND I THINK WE NEED TO KNOW WHY. I THINK THAT--WELL DOCUMENTED THAT IF WE DON'T UNDERSTAND IT, TELL BE VERY, VERY HARD TO ACTUALLY PREVENT IT SO IF WE DON'T UNDERSTAND WHAT'S CAUSING IT, WHAT ARE THE SPECIFIC MECHANISMS, IS THERE AN ASPECT OF IDENTITY THAT ACTUALLY FITS IN THERE WHERE I'M NOT QUITE SURE WHO AND WHAT I AM BECAUSE I DON'T FEEL COMPLETELY AMERICAN, BUT I DON'T FEEL COMPLETELY WHATEVER MY FAMILY WAS. SO I'M KIND OF STUCK IN THE MIDDLE AND I DON'T FEEL LIKE I'M EITHER 1 AND DOES THAT HAVE MENTAL AND PHYSICAL HEALTH CONSEQUENCES SO WHAT ARE THEY? ARE THERE SPECIFIC THINGS THAT WE CAN INTERVENE INTO, WE OBVIOUSLY CAN'T TAKE SOMEBODY WHO WAS BORN HERE AND SOMEHOW MAKE THEM NOT HAVING BEEN BORN HERE BUT WE CAN LOOK FOR THE MECHANISMS THAT CAN BE INTERVENED AND EXCHANGED, THAT CAN HELP TO OFFSET THE PARADOX THAT APPEARS TO MOSTLY AFFECT 1.5 AND SECOND GENERATION YOUTH. >> THANK YOU DR. SCHWARTZ-- >> CAN I JUST SAY 1 THING-- >> REALLY QUICK. >> OKAY. I DON'T WANT THE POINT TO BE LOST SO IF NOTHING ELSE, REMEMBER, I SAID THIS, IT'S THAT WE OBVIOUSLY WITH ALL OF THESE DIFFERENT QUESTIONS, WE NEED ALL SORTS OF DATA AND THERE ARE MORE GAPS AND SOME KINDS OF DATA THAN OTHERS BUT AT THE END OF THE DAY, WE REALLY WANT THE WHOLE PICTURE FROM TOP TO BOTTOM AND BOTTOM UP TO ADMINISTRATIVE DATA SO I DON'T WANT TO GET LOST IN THE IDEA THAT PEOPLE'S LIVED EXPERIENCES ARE REALLY IMPORTANT IN TERMS OF HOW THESE INTERSECTIONS PLAY OUT AND SORT OF THEIR DAILY LIFE AND BEHAVIORS, YOU KNOW FROM OTHER--LOTS OF HEALTH RESEARCH THAT THOSE MATTER, THAT LIVED EXPERIENCE AND HOW THEY INTERFACE WITH SOCIAL INSTITUTIONS, HEALTH PROVIDER, EDUCATORS, YOU KNOW ET CETERA AND COMMUNITY MEMBERS AND SO I WOULD JUST SAY THAT FOR ALL THESE QUESTIONS, THERE'S NO SIMPLE ANSWER, OBVIOUSLY, WE NEED ALL OF THE DATA ALL THE WAY THROUGH AT MULTIPLE LEVELS AND OVER TIME WHEN WE'RE TALKING ABOUT KIDS, YOU WANT TO KNOW FROM BIRTH, ALL THE WAY THROUGH. >> OKAY, AND WITH THAT I DO WANT TO RESPECT EVERYBODY'S TIME. THERE ARE GREAT QUESTIONS IN HERE, I KNOW YOU HAVE A PACKED AND EXCITING DAY AHEAD OF YOU. THE ONLY OTHER EXCLAMATION POINT PUT HERE IS THAT THE DATA ARE CLEAR, THE RACISMISMS IMPACT HEALTH, WE KNOW THAT'S TRUE. THERE WAS ALSO A REALLY IMPORTANT QUESTION IN THE CHAT THAT WE DIDN'T GET TO TOUCH UPON AND HOW--AND THAT IS: IS THERE RESEARCH ON HOW IDENTITY DEVELOPMENT IS INFORMED BY INTERSECTIONS AND UNFORTUNATELY, I THINK THE ANSWER TO THAT IS NO, IT'S LIMITED IN THAT SORT OF RELATES TO AN EARLIER POINT ABOUT WE FLEED TO BE BETTER ABOUT MEASURING THESE EXPERIENCES. SO THANK TO YOU OUR PANELISTS, THANK YOU FOR THESE EXCELLENT QUESTIONS AND THANK YOU AGAIN TO THE NIH AND THE STRIVE TEAM FOR HOSTING AND I HOPE YOU ENJOY THE REST OF THE PROGRAM TODAY. TAKE CARE. WELCOME BACK. IT'S NOW MY PLEASURE TO INTRODUCE DR. AERIKA BRITTIAN LLOYD. DR. LLOYD IS AN INTERDISCIPLINARY ENGAGED DEVELOPMENTAL SCIENTIST AND ASSOCIATE PROFESSOR IN THE DEPARTMENT OF PSYCHOLOGY AT THE UNIVERSITY OF CALIFORNIA RIVERSIDE. . DR. LLOYD'S CURRENT LINE OF RESEARCH INVESTIGATES SOCIAL STRESSORS AND PROTECTIVE FACTORS AMONG AFRICAN AMERICAN AND LATINX YOUTH AND FAMILIES. DR. LLOYD, I PASS THE ZOOM FORWARD TO YOU FOR SESSION TWO FOR HEARING FROM THE COMMUNITY PANEL. >> THANKS, SAMANTHA. HELLO, EVERYONE, CAN YOU HEAR ME? GREAT. IT'S MY PLEASURE TO MODERATE TODAY'S PANEL FEATURING TWO ORGANIZATIONS THAT ARE DOING CRITICAL WORK WITH YOUTH. AS WE.LEARNED IN SESSION ONE, IT'S IMPORTANT TO CONSIDER IDENTITY IN HEALTH DISPARITIES FOR SURGE BECAUSE OF ITS IMPORTANCE IN PEOPLE'S LIVES, BOTH IN TERMS OF THE MEANING MAKING AND HOW IT AFFECTS OUR BEHAVIORS. . BUT ALSO HOW IT SHAPES OUR EXPERIENCES IN BOTH POSITIVE AND NEGATIVE WAYS. SO I LOOK FORWARD TO BEING A MODERATOR AND STUDENT TODAY. OFTENTIMES RESEARCH IS CONDUCTED ON OR FOR COMMUNITIES AND NOT IN PARTNERSHIP WITH COMMUNITIES. AND THIS APPROACH SOMETIMES LEADS TO MISREPRESENTATIONS OF DIVERSE COMMUNITIES AND MAY FAIL TO AUTHENTICALLY REPRESENT THE COMMUNITIES WE SEEK TO SERVE. AND IN SOME CASES THIS RESEARCH CAN CAUSE MORE HARM. SO I'M PERSONALLY EXCITED TO HEAR FROM BOTH OF THESE ORGANIZATIONS PARTICULARLY FROM THE YOUTH WHO HAVE VALUABLE INSIGHT AND WISDOM TO SHARE TODAY. >> OUR TIME HERE TODAY IS DIVIDED IN TWO PARTS, FIRST HEARING FROM YOUTH FROM TWO ORGANIZATIONS. THEN WE'LL HEAR FROM REPRESENTATIVES FROM THE TWO ORGANIZATIONS AND WE'LL OPEN IT UP TO AUDIENCE QUESTIONS. IF QUESTIONS COME UP DURING THE PANELISTS AS THEY'RE SPEAKING FEEL FREE TO POST THOSE IN THE CHAT. OR CHAT ME PRIVATELY AND I'LL ASK THOSE QUESTIONS TOWARDS TEND OF OUR SESSION. WITH THAT SAID, WE'LL BEGIN WITH INTRODUCTIONS STARTING WITH YOUTH AND THEN THE REPRESENTATIVES FROM YOUTH COLLABORATORY AND IDENTITY INNING. LET'S START WITH OUR YOUTH COLLABORATIVES. PLEASE INTRODUCE YOURSELF BY SHARING YOUR NAME, WHERE YOU'RE FROM, IF YOU WOULD LIKE TO SHARE, AND YOUR AGE. >> HELLO, DR. LLOYD. >> HI EVERYONE, MY NAME IS DIAMOND DUMAS. I'M CURRENTLY LOCATED IN JACKSONVILLE, FLORIDA. I'M WITH YOUTH COLLABORATORY ON THEIR YOUTH CATALYST TEAM. I AM PRESENTLY 24. >> NEXT. >> HI, EVERYONE MY NAME IS MADDOX I USE HE HIM, THEY THEM PRONOUNS LOCATED IN NEW YORK CITY AND I'M 25. >> HI, EVERYONE. I'M ANDRE THOMAS. I'M WITH THE YOUTH CATALYST TEAM. I'M LOCATED IN PHILADELPHIA PENNSYLVANIA, 21 YEARS OLD. AND HE HIS PRONOUNS. >> GREAT. THANK YOU. >> AND OUR YOUTH PANELIST FROM IDENTITY INK. >> I'M PRECIOUS AGYEKUM, 19 YEARS OLD FROM GATHERSBURG FROM IDENTITY INC. >> I'M KATHRYN, I'M 18 I'M REPRESENTING IDENTITY TODAY. >> MY NAME IS EMMANUEL CRUZ I'M 19 YEARS OLD FROM HONDURAS I'M A PARTICIPANT IN THE IDENTITY PROGRAMS. >> GREAT. THANK YOU FOR BEING HERE TODAY. AND OUR PANELIST FROM EACH ORGANIZATION, LET'S START WITH YOUTH COLLABORATORY IF YOU COULD SHARE YOUR NAME AND YOUR ROLE IN THAT ORGANIZATION. >> HI, SURE. I'M KEN DON ELLIOTT. USE HE THEY THEM PRONOUNS AND I'M BASED IN MISSOURI, A TRAINER IN YOUTH COLLABORATORY SUPPORTING THE YOUTH CATALYST TEAM. >> AND THE PANELIST FROM IDENTITY INC. >> GOOD AFTERNOON I'M CAROLYN COMACHO I'M WITH IDENTITY LOCATED IN MONTGOMERY COUNTY MARYLAND. >> MY NAME IS ERIC BARROS REPRESENTING IDENTITY TODAY. HERE IN MONTGOMERY COUNTY, MARYLAND. >> GREAT, THANK YOU ALL FOR BEING HERE WITH US TODAY. SO I KNOW WE SENT YOU A LIST OF QUESTIONS AND SO I'LL DO MY BEST TO ASK THE INDIVIDUALS THAT WERE GIVEN THOSE SPECIFIC QUESTIONS THAT THEY WANTED TO WEIGH IN ON THOSE QUESTIONS. WE'LL START WITH OUR YOUTH QUESTION, AND THIS IS A QUESTION FOR DIAMOND AND PRECIOUS. WHAT DOES IDENTITY MEAN TO YOU? YOU CAN SPEAK TO YOUR IDENTITY OR IDENTITY GENERALLY, AND WHAT DO YOU THINK CONTRIBUTES TO SOMEONE'S IDENTITY? >> SO I IDENTIFY AS AN AFRICAN AMERICAN. MY PARENTS ARE FROM GHANA, I'M GHANIAN. AND IDENTITY TO ME SHAPES YOU WHO YOU ARE AS A PERSON. INCLUDES YOUR RACE AND ETHNICITY, OF COURSE, AND YOUR SEX AND YOUR SEXUAL PREFERENCE, ALL THAT. IT COMBINES INTO WHO YOU ARE AS A PERSON WHO YOU IDENTIFY AS. I DON'T LIKE TO THINK MYSELF AS A MINORITY BUT MAJORITY, THERE'S NOTHING ABOUT ME THAT'S MINOR. I LIKE TO STRESS AND ADVOCATE THAT MY PEERS ARE ALSO LIKE ME AS WELL THAT WE SHOULD BE PROUD OF WHO WE ARE AND WHO WE IDENTIFY AS. AND THAT WE SHOULD LOOK AT IT AS NOT AS A BURDEN BUT RATHER AS A BLESSING IN THAT WE SHOULDN'T REALLY SUBJECT OURSELVES TO THE STEREOTYPES THAT ARE PLACED ON US BUT IMPROVE AGAINST THEM. PROVE WHY WE'RE SUCCESSFUL, HARDWORKING AND COURAGEOUS AFRICAN-AMERICAN VIEWS AND WE HAVE THE POTENTIAL TO BE AND DO WHAT WE WANT AS MUCH AS WE -- AS MANY OPPORTUNITIES -- I'M SORRY, AND WE HAVE OPPORTUNITIES TO BE AS EMPOWERING AS POSSIBLE, AS LONG AS WE PUT OUR MINDS TO IT. AND WE CAN ACT ON THAT AS WELL. AND SO THAT'S WHO I IDENTIFY AS. >> GREAT. THANKS SO MUCH, PRECIOUS. >> YES, THANK YOU, PRECIOUS, I APPRECIATE THE REFRAMING CHALLENGING OF NARRATIVES. FOR ME TO GO OFF OF WHAT PRECIOUS SAID, AND IN ADDITION TO, IDENTITY AS MUCH AS IT IS WHAT YOU ARE AND WHO YOU ARE AND THE INFORMATION THAT YOU PUT ON YOURSELF -- IT'S ALSO A LOT ABOUT HOW THE SYSTEM AND OTHER INDIVIDUALS PERCEIVE YOU. SO I IDENTIFY IN A CERTAIN WAY, BUT IT'S KIND OF LIKE THAT DEBATE BETWEEN YOUTH EXPERIENCING HOUSING INSTABILITY AND YOUTH HOMELESSNESS. AND TYING THE IDENTITY WITH AN EXPERIENCE AND THEREFORE LABELING SOMEONE AS THEIR EXPERIENCE. YOUTH COLLABORATORY, AS WELL AS THE YOUTH CATALYST TEAM AND INDIVIDUALS ARE WORKING HARD TO PUSH AGAINST SEPARATING THE INDIVIDUAL FROM THE CIRCUMSTANCE. AND SO FOR ME IDENTITY IS A LOT AS PRECIOUS SAID. AND AS MUCH AS IT IS THE PERSONAL, IT'S ALSO ABOUT BREAKING SYSTEMS THAT TRY TO FORCE IDENTITY ON TO SOMEONE. >> WELL SAID, DIAMOND. SO, THIS NEXT QUESTION IS FOR DIAMOND AND KATHRYN. WHAT ROLE IS YOUR IDENTITY PLAY IN YOUR OVERALL WELL-BEING. SO YOU CAN ANSWER IN ANY WAY YOU FEEL COMFORTABLE ANSWERING. LET'S START WITH KATHRYN. >> CAN YOU HEAR ME. IT ALLOWS ME TO HAVE A GOOD MINDSET, SELF-AWARENESS AND SELF-WORTH. SO THIS QUALITY SUPPORTS MY WELL-BEING AND IT HELPS ME HAVE A GOOD INFLUENCE WITH OTHER PEOPLE. >> THANK YOU. >> THANK YOU. TO KATHERIN, TO ADD TO THAT THE IMPORTANCE OF SELF-CARE AND RADICAL SELF-CARE FOR THOSE WHO HAVE BEEN DENIED OR TOLD THAT SELF-CARE ISN'T AFFORDED TO THEM BECAUSE OF THEIR SKIN COLOR, OR SEXUAL ORIENTATION OR ANYTHING THAT WOULD DENY THEM THE ABILITY OR WILLINGNESS TO TAKE CARE OF THEMSELVES. SO FOR ME IDENTITY IS TIED WITH THE INDIVIDUAL AS WELL AS THE COMMUNITY. AND ACKNOWLEDGING THE SUPPORT SYSTEMS THAT COME FROM COMMUNITY THAT ARE BASED IN IDENTITY. I IDENTIFY AS AN AFRO LATINX WOMAN, AND I REALLY FIND COMMUNITY IN THE CULTURE THAT IS WITHIN THOSE GROUPS. AND THE SUPPORT THAT SURROUNDS INDIVIDUALS THAT IDENTIFY WITH THEM OR ALONGSIDE THEM. AND SO WELL-BEING COMES FROM THOSE SUPPORT SYSTEMS AND THOSE PROTECTIVE AND RESILIENCE FACTORS THAT ARE GIVEN TO YOU THROUGH YOUR CULTURE, THROUGH YOUR COMMUNITY, THROUGH THE PARTNERSHIPS THAT YOU FORM AND NETWORKS THAT YOU BUILD WITH ORGANIZATIONS LIKE IDENTITY AND YOUTH COLLABORATORY. AS WELL AS WITH ONE ANOTHER. >> THANKS, DIAMOND. A SIMILAR QUESTION FOR ANDRE AND PRECIOUS. WHAT ROLE DO YOU THINK IDENTITY HAS PLAYED IN YOUR MENTAL AND PHYSICAL HEALTH OR IN YOUR WELL-BEING. >> SO I THINK THAT WHEN IT COMES TO PHYSICAL AND MENTAL WELL-BEING, AS IT PERTAINS TO MY IDENTITY, IT OFTEN HAS TO DO WITH DIFFERENT EXPRESSIONS MORE SO THAN NECESSARILY DIFFERENCES LIKE PERCEIVING THINGS DIFFERENT. OBVIOUSLY THERE'S SOME THINGS THAT I'M MORE SENSITIVE TO BECAUSE OF MY IDENTITY BUT THERE'S ALSO THINGS THAT MAYBE THAT I'M SENSITIVE TO OR I HAVE BLINDERS FOR. AND I FEEL THAT IN EXPRESSING MYSELF, WHETHER THAT'S LIKE I'M AN ARTIST I LIKE TO DO THAT ARTISTICALLY. MY ART LOOKS VERY DIFFERENT THAN THE ART FROM SOMEONE FROM ANOTHER CULTURE WHETHER THAT'S AMERICAN OR SOMEONE WHO IS NOT BLACK LIKE I AM, AND I THINK THAT ALL PERTAINS TO WHO I AM AND WHAT I COME FROM. AS OPPOSED TO JUST BEING SORT OF LIKE THIS SORT OF MASS SPHERE OF JUST LIKE, OKAY, I'M DIFFERENT BECAUSE OF THAT IT'S LIKE ALL THESE THINGS ADDED ONTO ME AS A PERSON AND NOW CONTRIBUTE TO THAT. >> THANKS, ANDRE. PRECIOUS. >> I THOUGHT I ANSWERED THIS QUESTION BEFORE BUT I CAN ANSWER THIS ONE TOO. SO TO ME ORGANIZATIONS LIKE MY IDENTITY. SO MY IDENTITY, IT'S ACTUALLY HELPED ME TO, NOT HELPED ME, BUT IT CONTRIBUTED TO LIKE THE ROLES THAT I HAVE AT HOME AND LIKE WHAT MY JOBS ARE AS A WOMAN AND SOMEONE IN MY CULTURE TO BE LIKE THINGS IN THE HOUSEHOLD, WHAT THINGS I PLAY IN AS CONTRIBUTING TO LIKE THINGS -- THINGS IN MY HOUSE. AND IT'S MADE ME REALIZE THE IMPORTANCE OF, LIKE, SELF-CARE MAKING SURE I PUT MYSELF FIRST BECAUSE A LOT OF TIMES I DIP MY HANDS IN TOO MANY THINGS OR I THINK -- I SET ASIDE A LOT OF TIME TO HELP OTHERS. AND I DON'T TAKE ENOUGH TIME TO REGROUP AND FOCUS ON MYSELF AND TRYING TO REBUILD MYSELF AND GET MY ENERGY BACK. A LOT OF TIMES I END UP REALLY DRAINED AND REALLY TIRED. I'VE REALIZED THAT IT'S REALLY IMPORTANT TO TAKE SOME TIME, JUST LIKE HOW DIAMOND SAID EARLIER IT'S REALLY IMPORTANT TO TAKE TIME OUT FOR YOURSELF AND TO REFLECT ON WHAT DO YOU NEED TO DO FOR YOURSELF, WHAT THINGS DO YOU NEED TO DO? HOW MUCH SLEEP DO YOU NEED TO GET? BECAUSE YOU CAN ONLY DO SO MUCH AT A SMALL AMOUNT OF ENERGY. LIKE YOU NEED TO BE ABLE TO AT YOUR BEST SO YOU CAN DO YOUR BEST. AND SO I THINK THAT IS REALLY IMPORTANT TO NOT ONLY MAKE SURE WE SET ASIDE TIME FOR OURSELVES AND OUR HEALTHCARE, BUT ALSO TO TAKE CARE OF OUR MENTAL HEALTH AND SPREAD AND ADVOCATE FOR MENTAL HEALTH AWARENESS FOR OTHERS WHO THINK THEY SHOULDN'T HAVE IT. BECAUSE LIKE, OH, STEREOTYPES WILL BE YOU'RE BLACK, YOU DON'T HAVE TO CRY ABOUT IT. CERTAIN THINGS LIKE THAT, BECAUSE WE'RE AFRICAN-AMERICAN OR SOMETHING, THAT WE'RE TOO TOUGH TO HAVE EMOTIONS. IT'S OKAY TO HAVE EMOTIONS. IT'S OKAY TO TALK ABOUT THINGS AND IT'S OKAY TO TAKE CARE OF YOUR MENTAL AND SELF-HELP. >> THANK YOU, PRECIOUS. THAT WAS WELL-SAID. I LOVE THAT YOU ACKNOWLEDGED THE EXPERIENCES AND EXPECTATIONS THAT MAY BE IMPOSED, WITH IDENTITY AND STRUCTURAL AND SYSTEMIC THINGS THAT MAY BE IMPACTING YOU BASED ON YOUR IDENTITY. SO RELATED TO THAT, THIS IS A QUESTION FOR MADDOX AND KATHERIN, BUT I'LL REALLY OPEN IT UP TO ANYONE WHO WANTS TO ANSWER. HAVE YOU EVER BEEN TREATED BADLY BECAUSE OF YOUR IDENTITY? AND IF SO, HOW DID THAT IMPACT YOU? SO I HAVE EXPERIENCED PERCEPTION BIAS BEFORE BACK WHEN I WAS IN MIDDLE SCHOOL, I GOT CALLED COMCHI BECAUSE I ARRIVED TO THE COUNTRY AND DIDN'T SPEAK THE LANGUAGE. THIS IMPACTED ME BECAUSE THOSE WERE HURTFUL. AND IT PLAYED A ROLE IN MY SELF-CONFIDENCE WHEN I WAS TRYING TO LEARN THE LANGUAGE. AND ALSO IT MOTIVATED ME TO LEARN THE LANGUAGE BETTER AND STEREOTYPES ARE NOT TRUE AND PEOPLE SHOULDN'T JUDGE A BOOK BY ITS COVER. AND SO THIS EXPERIENCE TAUGHT ME THAT MY IDENTITY DOES NOT DEFINE WHAT OTHER PEOPLE THINK OF ME. >> WHAT PEOPLE THINK ABOUT ME, THIS QUESTION MAKES ME THINK ABOUT WHEN I WAS FIRST STARTING MY TRANSITION JOURNEY. I FEEL THERE'S A LOT OF PRESSURE FOR ANYBODY WHO HAS A MARGINALIZED ACCIDENT A LOT OF WORK BUT I WAS THINKING OF FLIPPING THE SCRIPT FOR ANYBODY. FOR ME THIS QUESTION MAKES ME THINK ABOUT SOCIETY AND HOW WE AS A SOCIETY HAVE TO DO BETTER BY PEOPLE, THAT'S BY THE WAY WE INTERACT WITH EACH OTHER. THE COMMENTS WE HAVE. THE WAY LIKE THE LITTLE THINGS PEOPLE SAY. LIKE, OH, THAT'S GAY. OH, THAT'S FOR GIRLS, THAT'S FOR BOYS. GENDER REVEAL PARTIES. WHEN I SEE PEOPLE HAVING GENDER REVEAL PARTIES TO THIS DAY I'M LIKE WHAT ARE YOU DOING? ALL OF THIS BEHAVIOR IS HARMFUL BECAUSE WE'RE ERASING A WHOLE COMMUNITY OF PEOPLE LIKE A WHOLE -- YOU KNOW WHAT I MEAN? A WHOLE GROUP OF PEOPLE BECAUSE THE MAINSTREAM DOESN'T ACCEPT IT. AND THAT CAUSES RIPPLE EFFECTS. WE KNOW THE SUICIDE RATES FOR TRANS PEOPLE AND QUEER PEOPLE. WE KNOW THE DETRIMENTAL EFFECT IT HAS ON PEOPLE. FOR ME, I THINK ABOUT AN INSTANCE WHEN I WAS YOUNGER WHERE I WAS DISCRIMINATED AT WHEN I WAS APPLYING FOR A JOB. AND THAT HAD A VERY HURTFUL FOR A LONG TIME I COULD NEVER WORK IN A RETAIL JOB. I COULD NEVER DO SOMETHING LIKE THAT. THAT PUT ME IN A STATE I HAD TO FIND ANOTHER WAY TO LIVE BECAUSE I JUST KNOW LIKE I DIDN'T WANT TO GO THROUGH THAT EXPERIENCE LIKE THAT AGAIN. SO FOR ME IT MAKES ME THINK HOW WE REALLY HAVE TO CHANGE THE NARRATIVE. EVEN WHEN I HEAR PEOPLE MAKE LITTLE COMMENTS ABOUT GIRLS AND BOYS. PEOPLE, PROGRESSIVE PEOPLE, LIKE WHAT ARE WE DOING? WE'RE NOT LIVING IN THAT WORLD ANYMORE. WE'RE TRYING TO AT LEAST FOR ME I'M TRYING TO GET RID OF GENDER. I HOPE EVERYBODY ELSE IS TRYING TO GET RID OF GENDER, TOO. BUT I THINK THAT'S SO LIMITING, LIMITS SO MANY PEOPLE, EVEN PEOPLE WHO ARE CIS. HOW MANY BOYS THAT WANT TO BE EXPRESSIVE, JUST EXPRESS THEMSELVES THEY CAN'T BECAUSE YOU'RE BEING TOO MUCH LIKE A GIRL. OR GIRLS THAT ARE MORE MASCULINE AND EXPRESS YOU CAN'T DO SOMETHING BECAUSE YOU'RE TRYING TO BE LIKE A BOY. ALL THIS RHETORIC, IT'S LIMITING US AS HUMANS. SO WE NEED TO MOVE TO A PLACE WHERE WE'RE DOING AWAY WITH THAT SO WE CAN BLOOM AND GROW INTO FULL CAPACITY THAT WE HAVEN'T EVEN SEEN YET. >> I LOVE THAT. THANK YOU FOR SHARING. DIAMOND. >> TO GO OFF WHAT MADDOX SAID THE PRESSURE SHOULD NOT BE PUT ON THE INDIVIDUAL TO BREAK OUT OF THE SYSTEM THAT THEY HAVE BEEN PUT IN. SO AS AN ALLY, EVERY SINGLE INDIVIDUAL THE WORK SHOULD BE PUT ON SELF-TO ACKNOWLEDGE AND IDENTIFY BIASES. THERE ARE SO MANY TESTS OUT THERE THAT HELP YOU IDENTIFY YOUR BIASES AGAINST RACE, GENDER, SEXUALITY, RELIGION. AND LIKE THAT SMALL ACT OF JUST TAKING THE TEST AND LIKE CHALLENGING YOURSELF TO UNDERSTAND HOW YOUR BRAIN IS WORKING AND WHAT ARE YOUR ORIGINAL THOUGHTS AND WHAT ARE THOUGHTS CONSTRUCTED FOR YOU BY MEDIA AND TELEVISION AND OTHER INDIVIDUALS, YOUR FAMILY, YOUR PAST, YOUR TRAUMA. ALL OF THOSE THINGS PLAY INTO BIAS AND ARE IMPACTING NOT ONLY THE PEOPLE THAT YOUR BIASES ARE BEING PUT UPON BUT YOURSELF BECAUSE AS MADDOX SAYS, LIKE YOU'RE LIMITING THE POTENTIAL TO CONNECT AND TO BUILD COMMUNITY. AND TO FORM A SOCIETY THAT IS HOLISTIC IN CARE AND SERVICE. >> SOMETHING REAL QUICK I WANTED TO SAY TO THIS QUESTION, TOO, THAT LIKE LIMITING PEOPLE TO THAT ALSO SOMETIMES YOU SEE SO MANY TRANS AND QUEER PEOPLE THAT ARE ADVOCATES THAT ARE ORGANIZERS, AND IT'S LIKE THAT'S EVEN LIMITING US. RIGHT THERE. BECAUSE WE'RE BEYOND THAT. THERE ARE PEOPLE THAT ARE POLITICIANS, HEALERS, ACTORS, DANCERS, ALL THAT KIND OF THING WE JUST DON'T HAVE TO DO THE WORK OF ORGANIZING AND ADVOCATING. LIKE, THERE ARE OTHER MULTITUDES OF THINGS WE COULD DO. AND I THINK PEOPLE KIND OF LIKE IMPOSING THAT DOES LIMIT YOU IN THAT WAY AS WELL. >> QUESTION FOR EMMANUEL FOR EVERYBODY AS WELL HOW HAS YOUTH COLLABORATORY OR IDENTITY INC. IMPACTED YOU. >> I THINK IDENTITY HAS HELPED ME A LOT. WHEN I CAME HERE TO THIS COUNTRY I WAS REALLY ALONE. I DIDN'T HAVE ANYONE TO HELP ME AND I I THINK THESE PROGRAMS HAVE MADE ME INTEGRATE TO MY SCHOOL AND KNOW MORE ABOUT, FOR EXAMPLE, THE LANGUAGE, ENGLISH, AND KNOW HOW TO MOVE IN THIS NEW COUNTRY WHEN I WAS YOUNG. >> ANYONE ELSE. >> FOR ME, PERSONALLY WHEN I WAS INTRODUCED TO IDENTITY, I DIDN'T KNOW MUCH ABOUT IT BUT THEY CAME TO ME AND OPENED UP WITH OPEN ARMS AND FELT ME FEEL LIKE FAMILY. I DIDN'T HAVE THE EASIEST CHILDHOOD, THINGS WERE GOING ON IN MY OWN HOUSEHOLD. TO BE ABLE TO GO TO SCHOOL AND HAVE A SENSE OF FAMILY IN SCHOOL, IT WAS SOMETHING THAT WAS SO PRECIOUS TO ME AND I CHERISHED IT A LOT. IDENTITY HAS GIVEN ME SO MANY OPPORTUNITIES EVALUATE MYSELF AND I FOUND THINGS IN MYSELF I NEVER KNEW I POSSESSED. AND THE IMMENSE AMOUNT OF GRATITUDE I HAVE FOR PEOPLE AND LIKE THE WAY I LIKE TO SHARE AND CARE FOR PEOPLE. I'VE GROWN IN IDENTITY. IDENTITY HAS GIVEN ME THE OPPORTUNITY TO EXPRESS AND SHARE LOVE AND SPREAD POSITIVITY AND HELP OTHERS. AND CHANGE LIVES, JUST LIKE HOW THEY CHANGED MINE. AND SO THROUGH THE VOLUNTEER ORGANIZATIONS THAT WE WOULD DO, LIKE BEING ABLE TO FEED PEOPLE AND HELP THEM OUT, IT JUST GIVES YOU A SENSE OF LIKE, WOW, I ACCOMPLISHED SOMETHING. AND YOU LEAVE THERE FEELING I CAN GO CONQUER THE WORLD. IT'S REALLY CHANGED ME AS A PERSON. I EVEN SEE THINGS AT MY UNIVERSITY AS WELL. I SEE MYSELF WANTING TO HELP OTHERS. I SEE MYSELF WANTING TO BE IN VOLUNTEER ORGANIZATIONS AND SPREADING MORE POSITIVITY WITHIN MY COMMUNITY AND HELPING OTHERS JUST LIKE I DID IN IDENTITY. SO IDENTITY HAS ALLOWED ME TO BE MORE LIKE HELPFUL TO OTHERS. AND JUST SHARE WHAT I HAVE BEEN GIVEN AS WELL. AND I'VE ALSO ENJOYED RESOURCES THAT THEY'VE GIVEN ME, TOO, WITH THE CLUBS AND THE AFTER SCHOOL ORGANIZATIONS AS WELL. THEY HAVE ALLOWED ME TO MEET NEW PEOPLE AND FOLKS AND STORIES FIND THINGS I SEE SIMILAR IN THEM. JUST HOW THEY DO IT IN OTHER CLUBS AS WELL. SO I DON'T KNOW, IT'S HELPED ME HERE AT HOME. AND IT'S HELPED ME AT SCHOOL AS WELL. AND I KNOW I'LL BE EVER GRATEFUL FOR THE OPPORTUNITIES THAT IDENTITY HAS GIVEN ME THAT THEY THEY DO FOR ME. BECAUSE IT'S LIFE-CHANGING. I FEEL EVERYONE SHOULD HAVE AN OPPORTUNITY TO BE PART OF IDENTITY. THEY ARE GIVING US AN OPPORTUNITY AND YOU DON'T REALIZE IT. AND SO I'M GRATEFUL. >> I TALK ABOUT THIS, BUT JUST ORGANIZATIONS IN GENERAL I THINK PLAY A KEY ROLE IN OUR SOCIETY. ESPECIALLY FOR PEOPLE WHO, LIKE, YOU KNOW, FALL THROUGH THE CRACKS ARE ON THE MARGINS THAT THEY COULD KIND OF, THEY SET THIS AS A PLACE THAT WE STABILIZE THOSE FOLKS. SO FOR ME, I HAD ORGANIZATIONS INTERNSHIPS PLAYED A HUGE PART IN MY LIFE AND DEVELOPMENT, AND I'M A HUGE ADVOCATE FOR THEM BECAUSE FOR SOMEBODY WHO IS EXPERIENCING INSTABILITY IN THEIR LIFE AND WHATEVER AREA TO HAVE A PLACE WHERE THEY CAN GO TO CONSISTENTLY AT LEAST ONCE A WEEK, PERSON VIRTUAL, I SAY PRE-COVID TIMES, THIS HAD A HUGE EFFECT ON ME. I'M NOT JUST TALKING ABOUT THIS ORGANIZATION, BUT I'M SAYING IN GENERAL MY EXPERIENCE WHEN I WAS THERE, WHEN I WAS IN A PLACE EXPERIENCING HOUSING INSTABILITY AND JUSTICE INSTABILITY IN MY LIFE, JUST TO HAVE A PLACE I WAS GOING EVERY WEEK CONSISTENTLY. SHOWING ME WHAT CONSISTENCY IS LIKE, BEING CONSISTENT WAS SOMETHING IN YOUR LIFE WHAT THAT COULD LEAD YOU TO, HAVING PEOPLE SUPPORT YOU IN DIFFERENT AREAS THAT ARE NOT THE MAINSTREAM. OR THAT COULD LEAD YOU TO. FOR ME I'M A HUGE ADVOCATE FOR THAT THAT SAVES A LOT OF PEOPLE'S LIVES YOU HAVE A PLACE YOU CAN GO TO IT'S GUARANTEED THAT YOU'RE GOING TO TALK TO SOMEBODY. YOU JUST HAVE SOMETHING TO DO. WHEN I WAS A PERSON, I LITERALLY HAD NOTHING TO DO. I WAS ON THE STREETS. WHEN I STARTED TO GO TO A PLACE THAT I WAS THERE EVERY WEEK. I STARTED TO SEE, LIKE, IF I COME HERE EVERY WEEK AND I GAINED THIS EXPERIENCE, AND THIS SKILL, WHAT ELSE COULD I DO CONSISTENTLY AND GAIN LIKE SOMETHING FROM. SO, I'M A HUGE ADVOCATE FOR ORGANIZATIONS. I KNOW THAT SOMETIMES ALL ORGANIZATIONS HAVE WORK TO DO. WE'RE WORKING WITH PEOPLE, WORKING IN A SYSTEM. AND I DO THINK THAT THAT'S THE INTERFERING, THE INTERVENTION, WHEN YOU'RE GOING THROUGH IT IN LIFE. MAYBE SCHOOL WASN'T THE PLACE FOR YOU, HOME WASN'T THE PLACE FOR YOU. AN ORGANIZATION IS LIKE THAT, COULD SUPPORT YOU IN SOCIETY AND GET YOU TO ANOTHER PLACE. >> THANK YOU, MADDOX. ANYONE ELSE? >> I'D LIKE TO ADD IT HELPS TO CREATE ORDER IN MY LIFE AS WELL. AND LIKE WHEN YOU'RE CONSTANTLY DOING SOMETHING JUST LIKE HOW MADDOX WAS SAYING, IT SUSTAINS ORDER IN YOUR LIFE. WHEN YOU'RE DOING SOMETHING CONSISTENTLY, BECOME ORGANIZED, YOU BECOME MORE SELF-SUFFICIENT, AND IT HELPS YOU TO REALLY COLLECT THINGS AND DO THINGS IN LIKE A CERTAIN ORDER SO YOU'RE NOT AS LIKE -- YOU'RE NOT DOING TOO MANY ACTIVITIES AT ONE TIME OR THINGS ARE NOT IN PLACE OR WHATEVER. IT HELPED ME AS WELL. AND COVID, BEING ABLE TO -- I WAS ALSO STRUGGLING A LOT DURING COVID. BUT BEING ABLE TO EXTEND MY HAND TO OTHERS, TOO. WE'RE ALL GETTING OURSELVES PICKING OURSELVES BACK UP ON OUR FEET. SO THAT HELPS AS WELL. >> I'M GOING TO ASK A QUESTION TO EVERYONE, EVEN THOUGH THIS WAS SPECIFICALLY FOR MADDOX, DIAMOND AND EMMANUEL. I'M GOING TO OPEN IT UP TO EVERYONE. WHAT SHOULD WE RESEARCHERS, WHAT SHOULD RESEARCHERS BE DOING TO AFFIRM AND BETTER SUPPORT THE DEVELOPMENT OF POSITIVE IDENTITY AMONG YOUNG PEOPLE? SO WHAT DO YOU THINK RESEARCHERS, WHAT DO YOU THINK SCIENTISTS SHOULD BE DOING BETTER TO SUPPORT POSITIVE IDENTITY DEVELOPMENT? >> >> JUST TALKING TO PEOPLE. LIKE TALKING TO THE COMMUNITIES THEY'RE RESEARCHING, MAKING SURE THEY'RE DOING RESEARCH WITH THAT COMMUNITY. BECAUSE NO ONE KNOWS LIKE ANDRE SAID IT BEST, THE PEOPLE CLOSEST TO THE QUESTION HAVE THE BEST ANSWER. MAKES SENSE, FOREIGNERS, WE ASK PEOPLE NOT IN THE COMMUNITY TO COME IN IF IT'S NOT A PROBLEM. ESPECIALLY WITH RESEARCHERS, BECAUSE I THINK RESEARCHERS BRING A LEVEL OF EXPERTISE MAYBE I WASN'T AWARE OF. BUT WITH MY LIVED EXPERIENCE AND PLUS YOUR EXPERTISE WHERE COULD WE GET TO. I'M IN NEW YORK CITY WHERE CURRENTLY THIS YEAR WE'RE VOTING ON A LOT OF INITIATIVES. WE JUST DID A DIRECT -- WE'RE VOTING DIRECT TRANS PILOT. EVERY TIME I GOT ON A CALL, I REMIND EVERYBODY I'VE BEEN PART OF THE PROCESS SINCE THE IDEA OF LIKE -- THERE WAS PROBABLY A FOCUS GROUP THAT I WENT TO THAT WHAT WERE SOME THINGS, JUST GIVE PEOPLE MONEY BECAUSE I LITERALLY REMEMBER FOUR OR FIVE YEARS AGO WHEN I WAS A WOMAN. I WAS SAYING MAYBE I'M NOT GOING TO BENEFIT FROM THIS BECAUSE IT'S GOING TO TAKE FOREVER FOR THIS TO HAPPEN BUT FOUR YEARS LATER NOW I'M STILL SUPPORTING WITH IT, I THINK THAT THAT'S A GREAT EXPERIENCE AND I DO OTHER WORK FOR RESEARCHERS WHERE I'M LOOKING AT THINGS THAT I HAVE IDENTIFIED AS AN ISSUE AND THEY'RE LIKE, OKAY, THEY'RE LETTING ME KNOW ABOUT THE RB PROCESS. ALL OF THIS STUFF. AND I'M LEARNING ABOUT THIS WHOLE OTHER WORLD AND IT'S WITH ME. IT'S INCLUSIVE. IT'S ANYTHING THAT'S PROBLEMATIC OR NOT AFFIRMING, LIKE WE COULD TALK ABOUT IT AND SAY THIS THING IS HARMFUL. SO WE HAVE THOSE CONVERSATIONS, AND I THINK EVEN BEFORE ALL OF THIS THERE'S PARTICIPATORY ACTION RESEARCH WHERE IT'S LED BY COMMUNITY AND LIKE WHAT I'M SAYING COMMUNITY GETS TO CHOOSE THE ISSUE WHATEVER AREA THEY WANT TO WORK ON. AND THEY WORK WITH RESEARCHERS TO GET THE DATA THAT THEY NEED. SO IN AN IDEAL WORLD, THAT'S WHAT I IMAGINE. THE RESEARCHERS AND THE COMMUNITY EXPERTS WORKING TOGETHER TO MAKE THAT THE BETTER WORLD WE WANT TO SEE. >> AS LIKE COMMUNITY AND AS ORGANIZATIONS, WE OFTEN THINK ABOUT OUR GOAL FOR THE YOUTH. WE HAVE CLIENTS, THIS IS WHAT WE NEED TO GET THEM TO DO. THEY'RE AT THIS POINT A RIGHT NOW AND HERE'S THE POINT CI NEED THEM TO BE AT. I THINK WE OFTEN, ESPECIALLY LIKE WITH PEOPLE WHO ARE YOUNGER, WE JUST DON'T EVEN THINK ABOUT LIKE WHAT THEY WANT OR WHAT THAT SUITS THEM AND WE TRY TO SORT OF LIKE PIGEONHOLE THEM INTO WHAT IT IS WE NEED OR WE WANT FROM THEM FOR LIKE A FEDERAL REQUIREMENT STANDPOINT. THAT CAUSES A LOT OF CHAOS AND MISSED RESULTS BECAUSE HEY, LIKE, YOU DIDN'T REALLY ASK AND WE SEE IT AS A HOLE ACROSS THE SYSTEM. PEOPLE DON'T REALLY ASK SOME OF THE SIMPLE QUESTIONS. DOES OUR COMMUNITY EVEN WANT THIS? DOES YOUR CLIENTELE NEED THIS? NO ONE REALLY THOUGHT TO ASK BUT WE WERE RIGHT LIKE FOR MONTHS WE WERE WRITING REQUIREMENTS. WE WERE LIKE DOING ALL OF THESE THINGS AROUND POLICY. AND NEVER EVEN REALLY IMAGINED WHAT BROUGHT THESE PEOPLE TO THE TABLE TO ASK THEIR THOUGHTS ON IT. AND THE RESULTS OF COURSE. WE GET A LOT OF PEOPLE TURNED AWAY, PEOPLE DON'T WANT TO ENGAGE, THAT'S BECAUSE WE DIDN'T EVEN THINK THE SYSTEM IS SUPPOSED TO REVOLVE AROUND THEM MORE THAN IT IS US. >> EMMANUEL. >> I THINK THE RESEARCHERS NEED TO FOCUS THE DIFFERENCE, FOR EXAMPLE, EVERY COMMUNITY HAS DIFFERENT PROBLEMS AND I THINK RESEARCHERS NEED TO FOCUS ON THAT. EVERY COMMUNITY NEEDS DIFFERENT THINGS. AND YES RESEARCHERS NEED TO FOCUS ON THAT TO BE A BETTER COMMUNITY. I THINK ALSO THAT THE RESEARCHERS SHOULD TRY TO WORK IN EVERY COMMUNITY AND TRY TO PUT IT TOGETHER ALL THE COMMUNITIES TO MAKE A STRONGER COMMUNITY. >> DIAMOND, GO AHEAD. >> I'M GOING TO SAY SOMETHING THAT MIGHT SOUND CRAZY BUT I THINK RESEARCHERS NEED TO STOP BEING RESEARCHERS. YOU KNOW, NOT EVERYTHING CAN FIT INTO A SCIENTIFIC METHOD. AND THE HUMANISTATION ELEMENT OF WORK IS WHERE REAL CHANGE HAPPENS. AND SO IDENTITY, YOUTH COLLABORATORY, THE YOUTH HERE ON THIS PANEL HAVE WORKED TO BE TRAUMA INFORMED AND REFRAME OUR IDENTITIES THAT HAVE BEEN PUT ON US BY SOCIETIES AND STEREOTYPES. AND ALL THIS WORK HAS GONE INTO LIKE MAKING OURSELVES BETTER INDIVIDUAL AS THEY PUT WORK INTO MAKING THEMSELVES A BETTER RESEARCHER. BUT HOW MUCH OF THAT SAME TIME AND ENERGY IS LIKE PUT INTO LIKE BEING A BETTER HUMAN AND MAKING THE WORK THAT YOU'RE DOING MORE IMPACTFUL TO HUMANS BECAUSE THE HUMAN ELEMENT IS THERE. LIKE THE HUMANISTATION OF RESEARCH TO TAG ALONG WITH WHAT MADDOX SAID ABOUT PARTICIPATORY RESEARCH, IS THAT IF A RESEARCHER IS GOING TO BE FOCUSING ON IDENTITY FOR YOUTH THEN I ALSO WANT THAT RESEARCHER TO BE TRAUMA INFORMED, KNOW HOW NOT TO RETRAUMATIZE INDIVIDUALS WHO ARE PARTICIPATING. AND HOW TO LOOK AT ME AS A PERSON INSTEAD OF LIKE A TOKEN OR A SUBJECT MATTER. AND THAT WOULD BE THE LAST THING I SAY ABOUT THAT. >> WELL SAID, DIAMOND. I APPRECIATE THAT. ANYTHING ELSE YOU ALL WANT TO SHARE SPECIFICALLY ABOUT HOW RESEARCHERS CAN DO A BETTER JOB. >> ONE THING I WILL SAY, TOO, IS I THINK IN RELATION TO THAT POINT ALSO UPLIFTING HOW SOME OF THE RESEARCH INITIATIVES THAT THEY'VE COME UP WITH DOES COME FROM COMMUNITY. NOT TRYING TO BE A BROKEN RECORD ABOUT THIS BUT IN NEW YORK I TRY TO PUSH THE NARRATIVE WITH DIRECT TRANSFER. THAT FOR ME THIS IS LIKE MODELED OFF OF COMMUNITY MUTUAL AID. SO LIKE USING THAT AS A NARRATIVE BECAUSE BASICALLY WHAT THEY DID IS INSTITUTIONALIZE MUTUAL AID. WE HAVE COMMUNITIES ARE ALREADY SENDING EACH OTHER MONEY. LIKE FUNDRAISING MONEY, SENDING IT TO EACH OTHER, NO STRINGS ATTACHED. BEING ABLE TO SOLVE. FOLKS SAW THE MODEL, HEY THAT SEEMS TO BE WORKING WITH PEOPLE, BRING IT TO AN INSTITUTIONAL LEVEL. WE DON'T REALLY HEAR THAT NARRATIVE. WE DON'T HEAR THAT'S COME FROM COMMUNITY. WE DON'T HEAR. THERE'S PROBABLY SO MUCH RESEARCH, THE HISTORY OF RESEARCH PROBABLY COMES FROM LANGUAGE BEING STOLEN FROM INDIGENOUS PEOPLE AND KNOWLEDGE BEING STOLEN AND PUT IN AN INSTITUTIONAL LEVEL. I THINK NAMING THAT SO THAT WE CAN SHIFT THAT CULTURE. >> WE'LL SWITCH GEARS A BIT TO OUR SECOND PART IN THE INTEREST OF TIME BECAUSE I WANT TO MAKE SURE WE GET THROUGH ALL OF THE QUESTIONS. BUT WE WILL ASK MORE QUESTIONS. IF YOU ALL HAVE QUESTIONS FOR OUR YOUTH PANELISTS PLEASE POST THOSE IN THE CHAT SO WE CAN ASK THEM LATER. SO WE'LL GO TO THE REPRESENTATIVES FROM OUR ORGANIZATIONS. REALLY, I'LL OPEN IT UP TO ANY OF YOU. WHAT COMPONENTS OF YOUR ORGANIZATION OR NETWORK HELP TO AFFIRM AND SUPPORT YOUTH IDENTITY THAT COULD BE LEVERAGED IN RESEARCH OR IN WORK TO EITHER REDUCE HEALTH DISPARITIES OR PROMOTE YOUTH THRIVING MORE BROADLY. >> I'LL BE HAPPY TO JUMP IN. FIRST I WANT TO SAY WHAT A TREMENDOUS HONOR IT IS TO BE HERE WITH THE YOUNG PEOPLE ON THIS PANEL. AND JUST VERY APPRECIATIVE FOR THIS OPPORTUNITY TO BE HERE WITH YOU. SO IDENTITY WORKS WITH AFTER SCHOOL PROGRAMS AND IN THE COMMUNITY AS WELL AS ON THE PLAYING FIELDS TO SUPPORT LATINO AND OTHER HISTORICALLY UNDERSERVED YOUTH TO GROW INTO ADULTHOOD. AND WE OFFER PROGRAMS AND SERVICES AND ADVOCACY TO STRENGTHEN THEIR SOCIAL EMOTIONAL WELL-BEING AND ALSO SUPPORT THEIR ACADEMIC AND HELP THEM DEVELOP THEIR WORKFORCE SKILLS AND TO STABILIZE THEIR FAMILIES. SO I THINK, IN PARTICULAR, FOR THIS QUESTION I REALLY WANTED TO HIGHLIGHT THE WORK THAT WE'RE DOING AT THE SCHOOL-BASED HEALTH AND WELLNESS CENTERS. WE MANAGE AT THREE MONTGOMERY COUNTY PUBLIC HIGH SCHOOLS. AND I'D INVITE MY COLLEAGUE ERIC TO SHARE MORE ABOUT HOW WE'RE PROVIDING PROGRAMS AND SERVICES ON THE GROUND TO SERVE A DIVERSE GROUP OF YOUTH. ERIK. >> THANK YOU CAROLINA. AS WAS MENTIONED THE SCHOOL-BASED WELLNESS CENTERS THAT WE HAVE ACROSS MONTGOMERY COUNTY PUBLIC SCHOOLS, HAS A VARIETY OF SERVICES. THAT INCLUDES HEALTH SERVICES, MENTAL HEALTH SERVICES. WE DO CASE MANAGEMENT. AND AFTER SCHOOL YOUTH GROUPS. BUT I THINK THAT TO HIGHLIGHT THE FACT THAT WE ARE IN SCHOOLS AND THAT WE HAVE THOSE HEALTH SERVICES HAS BENEFITED THE STUDENTS, ESPECIALLY OUR COMMUNITY, BECAUSE IT GIVES THEM EASIER ACCESS TO STI OR HIV SCREENINGS. IMMUNIZATIONS. WHETHER THAT'S ANY VACCINES THAT THEY MIGHT BE MISSING THAT THEY MIGHT HAVE NOT GOTTEN FROM HOME COUNTRIES. PERHAPS WE PROVIDE THAT -- WE DO OFFER REFERRALS. WHETHER IT'S DENTAL SCREENINGS AND OTHER PRIMARY PREVENTIVE CARE. I THINK ONE OF THE MONTHEST IMPORTANT THINGS THAT WE OFFER AT THOSE CENTERS ALSO THE MENTAL HEALTH SERVICES. RIGHT NOW DURING THIS PANDEMIC, WE ARE GOING TO SEE PROBABLY AN INCREASE IN REFERRALS FOR MENTAL HEALTH SERVICES BECAUSE OF COVID AND HOW IT'S BEEN A COMMUNITYIVE ACTUALLY A GLOBAL ISSUE. WHERE THAT WHERE STUDENTS ARE GOING TO COME IN TALKING ABOUT INDIVIDUAL NEEDS, FAMILY PROBLEMS THAT ARE HAPPENING. AND EVEN THE WELLNESS CENTER WILL BE PREPARED AND IDENTITY HAS BEEN PREPARING ITS STAFF MEMBERS FOR CRISIS INTERVENTION. AND WE ARE BECOMING A TRAUMA INFORMED ORGANIZATION WITH OUR AFTER SCHOOL YOUTH PROGRAMS. SO I THINK THAT IN REGARDS TO OUR AFTER SCHOOL YOUTH PROGRAMS, WE HAVE BEEN OFFERING PROGRAMS TO A LOT OF THE STUDENTS IN OUR COMMUNITY ABOUT GOAL SETTING, ABOUT BUILDING POSITIVE RELATIONSHIPS AND EDUCATING THEM ABOUT THE DIFFERENT THINGS THAT ARE HAPPENING IN THE COMMUNITY. WHETHER THAT'S SEXUAL EDUCATION PREVENTION. SUBSTANCE ABUSE EDUCATION AND SUCH. SO A LOT TO -- >> I WOULD JUST ADD THAT PRECIOUS EMMANUEL AND KATHERIN ARE AMAZING REPRESENTATIVES FOR THE PROGRAMS AND SERVICES THAT WE OFFER. >> I CAN JUMP IN QUICKLY JUST TO TALK A LITTLE MORE ABOUT YOUTH COLLABORATORY AND YOUTH CATALYST TEAM. OUR WORK IS A LITTLE BIT DIFFERENT. I'M PRIVILEGED TO SHARE THIS OPPORTUNITY WITH IDENTITY INC. OF COURSE WITH THE YOUNG PEOPLE ON THE PANEL. SO OUR WORK IS FOCUSED ON WE ARE A NATIONAL NETWORK FOCUSED ON TRAINING AND CAPACITY BUILDING OF NONPROFITS, NONPROFIT ORGANIZATIONS ACROSS SEVERAL KEY FOCUS AREAS, YOUTH HOUSING JUSTICE INCREASING SAFETY AND WELL-BEING AND BUILDING COMMUNITY AND COLLECTIVE RELATIONAL CONNECTIONS WITH YOUNG PEOPLE TO STRENGTHEN THEIR DEVELOPMENT. SO OUR YOUTH CATALYST TEAM, FOLKS ACTUALLY PAY EMPLOYEES PARTNERS COLLABORATE TERSE IN THIS WORK, AND IT IS MORE OF A JOB AND LESS OF A PROGRAM. BUT IN THE SAME TOKEN, I THINK A LOT OF WHAT YOUTH COLLABORATORY BRINGS TO THIS SPACE IS THAT YOUNG PEOPLE ARE INVOLVED IN OUR ORGANIZATION AT ALL LEVELS. SO THAT INCLUDES A LOT OF THE EQUITY WORK THAT WE'RE DOING, AND THEY'RE BOTH GUIDING THAT AND BEING IN COMMUNITY WITH OUR STAFF. WITH OUR BOARD. AND AS WELL SO THAT MULTI-GENERATIONAL, I THINK, LEARNING, SHARING, COMMUNITY BUILDING AROUND WHO WE ARE AS INDIVIDUALS AND HOW DOES THAT IMPACT HOW WE WORK TOGETHER, HOW WE INTERACT AND HOW WE JUST -- AS SEVERAL OF THE PANELISTS MENTION JUST CARE FOR ONE ANOTHER IN A HUMAN WAY. AND I ALSO THINK THAT A LOT OF OUR WORK FOCUSES ON YOUNG PEOPLE BUILDING POWER AMONGST THEMSELVES AND US LIKE JUST GETTING OUT OF THE WAY OF THAT AND WHAT ARE WAYS THAT THEY CAN BUILD COMMUNITY AROUND THAT SHARED IDENTITY OF AGE AS WELL AS THINGS LIKE RACE AND SEXUAL ORIENTATION AND GENDER AND ALL OF THOSE MYRIAD OF LAYERS. BUT REALLY IT'S ABOUT THAT SUPPORT AND THAT COMMUNITY THAT GETS CREATED IN THE PROCESS. >> GREAT. I'M GOING TO THROW A QUESTION OUT TO THE REPRESENTATIVES FROM THE ORGANIZATION, BUT DEFINITELY IF OUR YOUTH PANELISTS HAVE ANYTHING TO SHARE ON THIS PARTICULAR QUESTION, PLEASE FEEL FREE TO JUMP IN. SO THE QUESTION IS WHAT TYPE OF RESEARCH DO YOU WISH EXISTED OR WAS OUT THERE THAT WOULD REALLY SUPPORT THE WORK THAT YOU'RE DOING? >> I WOULD SAY EVALUATION HAS ALWAYS BEEN A PILLAR OF IDENTITY SINCE THE VERY BEGINNING OF OUR ORGANIZATION. AND WHERE WE DEVELOPED PROGRAMS AND SERVICES BASED ON THE PARTICULAR COMMUNITY AND ALSO WITH INPUT FROM THE COMMUNITY TO MADDOX AND THE PANEL HAS BEEN ADVOCATING FOR ASKING THE YOUTH, INVOLVING THEM IN THROUGH MULTIPLE, WHETHER IT'S ONE-ON-ONE DISCUSSIONS OR FOCUS GROUPS. AND DESIGNING PROGRAMS THAT MEET THEIR NEEDS. WE'VE ALSO -- SO WE DO THAT WITHIN OUR ORGANIZATION AND AS WELL AS WE PARTNER WITH OTHER RESEARCH BASED ORGANIZATIONS, UNIVERSITIES, AS WELL. AND SO I WOULD SAY THAT PARTICULAR PARTNERSHIP OR COLLABORATION BETWEEN YOUTH SERVING ORGANIZATIONS THAT ARE ON THE GROUND IMPLEMENTING PROGRAMS. WITH UNIVERSITIES OR OTHER ORGANIZATIONS REALLY HELPS TO PROMOTE THE DEVELOPMENT OF PROGRAMS AND SERVICES THAT ARE CUSTOMLY LINGUISTICALLY COMPETENT AND ALSO SUPPORT THE HEALTHY DEVELOPMENT OF ALL YOUTH, IN ALL THE THEIR IDENTITIES. >> FOR ME IT'S LESS ABOUT THE RESEARCH THAT I WISH EXISTED AND MORE ABOUT THE RESEARCH THAT I WISH WAS MORE UPLIFTED. THERE'S SEVERAL AND TONS OF RESEARCH DONE THAT IS ABOUT YOUTH HEALTH AND YOUTH WELL-BEING WHERE RESOURCES AND SUPPLIES AND FUNDING SHOULD GO IN TERMS OF YOUTH. BUT THAT INFORMATION IS OFTEN LOST BECAUSE A LOT OF IT IS YOUTH LED. AND YOUTH BASED. AND SO FOR ME IT'S UPLIFTING LIKE THE INFORMATION THAT SAYS YOU KNOW WHAT, IF GIVEN THE RIGHT TOOLS AND RESOURCES, YOUTH ARE 100% GOING TO TAKE CARE OF THEMSELVES, WHICH IS SOME OF THE RESEARCH THAT LED TO THE DIRECT CASH TRANSFER THAT MADDOX HAS BEEN TALKING ABOUT. I REALLY APPRECIATE JUST THE WORK OF LIKE ONE SMALL COMMUNITY AND HEARING ERIC TALK. LIKE THE GAPS THAT EXIST IN SOME OF THE COMMUNITY AND LIKE HOW IDENTITY HAS WORKED TO FILL THAT IS GREATLY APPRECIATED. AND THEN LIKE THE EXISTENCE OF LIKE A YOUTH ACTION BOARD OR A YOUTH CATALYST TEAM TO HELP FURTHER IDENTIFY WHERE THOSE GAPS ARE BY THE YOUTH WHO ARE IN THOSE SYSTEMS. >> IF I COULD ALSO JUMP IN TO ADD, DIAMOND WAS MAKING ME THINK OF SOMETHING. ACTUALLY, PRECIOUS AND EMANUEL AND KATHERIN WERE PART OF A PROGRAM THAT WE DEVELOPED DURING THE PANDEMIC CALLED SAFETY AMBASSADORS, WHERE THEY WERE SHARING INFORMATION WITH THEIR OWN NETWORK. WITH THEIR PEERS, WITH THEIR FAMILY. WITH THEIR COMMUNITY. ABOUT RESOURCES AND SERVICES THAT WOULD SUPPORT THEM DURING THIS TIME, ABOUT COVID SAFETY. COVID TESTING, VACCINES. THEY THEMSELVES WERE SHARING THIS INFORMATION AND HELPING SPREAD WITHIN THEIR OWN NETWORK IN THE COMMUNITY AND CONNECT FOLKS WHO WERE HARDEST HIT BY THE PANDEMIC TO IS SERVICES THEY NEED. SO WE'RE JUST INCREDIBLY PROUD OF THE WORK THAT THEY'VE DONE. AND COLLECTING -- ASKING YOUNG PEOPLE ABOUT THEIR ATTITUDE TO THE VACCINE. AND SPEAKING AND GATHERING THAT INFORMATION AND HELPING TO SHAPE HOW THE COUNTY IS PUTTING RESOURCES INTO SUPPORTING THE HEALTH OF THE COMMUNITY. SO WE'RE JUST IN AWE AND TREMENDOUSLY PROUD OF OUR YOUNG PEOPLE. >> EXCUSE ME, DR. LLOYD, DO YOU MIND IF I POSE A QUESTION TO THEM BASED OFF OF WHAT CAROLINA HAS SAID? I'M INTERESTED TO SEE WHAT YOUNG ADULTS DID AND HOW THEY THEMSELVES BECAME RESEARCHERS IN THIS MOMENT AND WHAT THAT LOOKED LIKE FOR THEM, IF THAT'S POSSIBLE. >> YOU ABSOLUTELY -- >> WE'RE HAPPY TO TALK OFF LINE, TOO. SO WE CAN MAYBE -- I DON'T KNOW ABOUT DR. LLOYD. I KNOW YOU HAVE AN AGENDA, BUT WE'RE HAPPY TO FOLLOW UP THIS CONVERSATION ONLINE, OFF LINE, RATHER. >> ACTUALLY, DIAMOND TOOK THE QUESTION OUT OF MY MOUTH I WANTED TO FOLLOW UP WITH PRECIOUS AND MA MADDOX AND KATHERIN TO SHARE THAT EXPERIENCE. >> AS A SAFETY AMBASSADOR IT WAS TO OUTREACH COMMUNITY, CONTACT AS MANY PEOPLE AS POSSIBLE AND LET THEM KNOW THE RESOURCES THAT ARE IN MONTGOMERY COUNTY THAT OFFER RENTAL ASSISTANCE AND FOOD ASSISTANCE. AND INFORMATION ON COVID VACCINES HOW TO PREVENT THEMSELVES FROM GETTING COVID AS WELL. YOU WOULD BE SURPRISED HOW MANY PEOPLE WERE MISINFORMED WITH THE INFORMATION THAT WAS SURROUNDING COVID. A LOT OF PEOPLE DIDN'T KNOW WHERE TO GO. SO TO BE ABLE TO PROVIDE THEM AN OPPORTUNITY TO SHOW THEM A LIST OF RESOURCES AND WAYS WHERE THEY CAN FIND THIS HELP WAS AMAZING AND IT WAS REALLY INTERESTING TO SEE HOW MANY PEOPLE WERE LIKE ALSO MISLED ON INFORMATION SURROUNDING THE VACCINE AND WHETHER OR NOT IT WAS SOMETHING THAT WAS SAFE TO TAKE. WAS IT OKAY FOR YOUR BODY. IT WAS COOL HOW TO TRAIN THEM AND WHAT EXACTLY TO INFORM THEM ABOUT. AND HOW THEY COULD BETTER PROTECT THEMSELVES AND THEIR FAMILIES AS WELL FROM COVID. SO IT WAS A LONG PROCESS. I'M SO GRATEFUL BECAUSE I LEARNED SO MANY THINGS THAT I DIDN'T EVEN KNOW, TOO. NOT ONLY WAS I EDUCATING OTHERS BUT EDUCATING MYSELF AND EDUCATING MYSELF TO BE ABLE TO SPREAD THAT KNOWLEDGE AND HELP OTHERS TOO. AND IT WAS REALLY COOL, LIKE, IDENTITY PROVIDED US WITH THE OPPORTUNITY TO LIKE MEET NEW PEOPLE AND TELL THEM, EVEN WHEN WE'RE GIVING THEM FOOD, HEY, THERE'S ALSO THIS AT MONTGOMERY COUNTY FOR YOU TOO, AND A LOT OF PEOPLE IN DIFFERENT COMMUNITIES LINKED TO WERE NOT AWARE OF THIS. SO IT WAS REALLY IMPORTANT TO SPREAD MORE INFORMATION. TO ADVOCATE FOR, HEY, LIKE, YOU HAVE THESE RESOURCES AVAILABLE SO UTILIZE THEM. SO, YEAH. >> GREAT. THANKS SO MUCH, PRECIOUS. >> EMANUEL. >> I LEARNED MANY THINGS BEING A AMBASSADOR. I REALLY LEARNED HOW OUR COMMUNITY THERE IS A LOT OF NECESSITIES AND PROGRAMS LIKE IDENTITY HELP A LOT. AND I REALLY LEARNED A LOT FROM LIKE EVERYONE THAT I HELPED. AND I THINK THIS WAS A GREAT EXPERIENCE. >> I HAVE LIKE AN INTERNAL QUESTION FOR YOU ALL. ON IDENTITY. SO THE FOLKS IN THE PROGRAM. THIS SEEMS LIKE IT'S INTERNATIONAL. DO YOU ALWAYS WORK WITH INTERNATIONAL -- ACTUALLY, I DON'T KNOW IF YOU'RE INTERNATIONAL. I'M JUST SAYING -- YOU SAID YOU'RE FROM HONDURAS OR CURRENTLY IN HONDURAS. I WAS CURIOUS IF YOU OPERATE INTERNATIONAL OR IS THAT SOMETHING BECAUSE OF COVID WE'RE ABLE TO REACH A -- >> ACTUALLY, WE'RE IN MONTGOMERY COUNTY, MARYLAND, BUT WE WORK WITH YOUNG PEOPLE WHO LIVE IN THE COUNTY BUT WHO ARE FROM MANY DIFFERENT AREAS. AND EMANUEL IS FROM HONDURAS. AND PRECIOUS' FAMILY IS FROM GHANA, BUT WE'RE HERE IN MONTGOMERY COUNTY, MARYLAND. >> I ALSO WANTED TO ADD IN A TIME LIKE COVID PANDEMIC A LOT OF FAMILIES WERE ON THEIR LAST THREAD OF THINGS. SO BEING ABLE TO HELP IDENTITY, BEING ABLE TO HELP THROUGH IDENTITY HAS SAVED MANY LIVES. MANY PEOPLE WERE LIKE DIDN'T KNOW HOW THEY WERE GOING TO GET THEIR NEXT MEAL OR HOW THEY WERE GOING TO BE ABLE TO PAY FOR CERTAIN THINGS BECAUSE THINGS WERE BEING THREATENED NOT BEING ABLE TO PAY RENT LOST THEIR JOBS DURING THE PANDEMIC. A LOT OF THINGS WERE GOING ON AT THE TIME. SO HAVING THIS REALLY BIG RESOURCE IN MONTGOMERY COUNTY SAVED MANY LIVES AND FAMILIES DURING THE PANDEMIC IN THE WINTERTIME AROUND THAT TIME. SO SAVED MANY LIVES. >> AND YOU ALL HAD A BIG ROLE TO PLAY BECAUSE YOU WERE PART OF THIS EFFORT TO REACH THE COMMUNITY. AND YOU'RE A TRUSTED VOICE IN THE COMMUNITY. SO IT WAS A COLLABORATION BETWEEN THE YOUNG PEOPLE AND THE ORGANIZATION. >> SO IN OUR LAST FEW MINUTES TOGETHER, WHAT I'D LIKE TO DO IS THERE'S A QUESTION IN THE CHAT THAT I'M GOING TO POSE TO EVERYONE AND THEN MY LAST QUESTION WILL BE SPECIFICALLY FOR OUR YOUTH PANELIST BECAUSE I WOULD LIKE TO CENTER THEIR VOICES AT THE END OF OUR CONVERSATION. THE QUESTION FOR EVERYONE IS, AND IT'S IN THE CHAT, WHAT DO YOU THINK WOULD BE KEY IN GETTING THE ATTENTION OF POLICYMAKERS TO CHANGE HOW RESOURCES ARE DISTRIBUTED AND/OR HOW PROGRAMS ARE SUPPORTED? >> WELL, ONE THING I ALWAYS ASK YOU FOR IS KIND OF LIKE A LATERAL APPROACH. SO WE KNOW THAT ON THE GROUNDS, FOR THE MOST PART, DID THEIR JOB OF GETTING YOUTH INPUT AND VOICE. AND I WOULD LIKE TO SEE THAT AT A MORE FEDERAL LEVEL. ALWAYS IN LOCAL AND NATIONALLY, BUT I WANT TO SEE YOUTH PRESENCE AND VOICE REALLY LIKE HONORED AT THAT LEVEL. FOR ME, NEW YORK CITY, I WANT TO SEE PEOPLE WITH LIVED EXPERIENCE, COMMITTEE THAT'S WORKING DIRECTLY WITH THE MAYOR'S OFFICE OF NEW YORK CITY. AND OTHER -- I DON'T KNOW WHAT THE POLITICAL ECOSYSTEM IS IN OTHER STATES. BUT LIKE THAT LEVEL. THAT YOUNG PEOPLE HAVE THOSE TYPE OF ROLES. AND THEY COULD INFORM HOW THINGS GET DISSEMINATED. THEY GET A CHANCE TO FOR REQUEST FOR PROPOSALS, THEY GET A CHANCE TO OUTLINE REQUIREMENTS, CRITERIA, WHO GETS FUNDING. MAKING SURE THAT YOUNG PEOPLE ARE PART OF THAT DECISION-MAKING STUFF, THAT YOUNG PEOPLE ARE NOT JUST, OH, WE NEED YOU -- LIKE YOU'RE TOKENS. SO REALLY WANT TO SEE, LIKE, YOUNG PEOPLE AT THAT LEVEL BOTH LOCALLY AND NATIONALLY, BECAUSE I THINK THEN WE WOULD HAVE MORE OF A CHANCE TO REALLY BE ABLE TO DISSEMINATE HOW THINGS GET SPREAD. AND BE LIKE IN THE EARS OF LIKE THE TOP POLICYMAKERS IN OUR RESPECTIVE AREAS. >> SO AGAIN I WOULD JUST REITERATE THEN, FOR EXAMPLE, THIS SAFETY AMBASSADOR PROGRAM THAT WE WERE TALKING ABOUT WAS A LOCAL PROGRAM HERE AT THE COUNTY LEVEL. AND WHICH WHERE THE YOUNG PEOPLE WERE DOING OUTREACH IN THEIR OWN COMMUNITY WITHIN THEIR OWN NETWORK AROUND COVID. COVID SAFETY, COVID TESTING, THE COVID VACCINE. AND BASED ON THE INPUT THAT THEY WERE GETTING BACK AROUND VACCINE HESITANCY AMONG YOUTH, WE WERE ABLE TO SHARE THAT INFORMATION WITH THE DECISION MAKERS HERE IN THE COUNTY. AND SO BASED ON THE INPUT OF THE YOUTH, THEY HAVE BEEN MAKING DECISIONS ABOUT THEIR FOCUS AND HOW THEY'RE GOING TO TAILOR A COMMUNICATION AND OUTREACH CAMPAIGN TO INCREASE VACCINE IN THE COMMUNITIES THAT WERE HARDEST HIT BY COVID. SO I THINK THIS IS AN EXAMPLE. AND JUST LIKE AS PRECIOUS SAID, WE REALLY TRIED TO CONNECT YOUTH TO OPPORTUNITIES, REAL AUTHENTIC OPPORTUNITIES, TO GIVE THEIR VOICE AND SPEAK UP, WHETHER IT BE AT THE SCHOOL LEVEL OR AT THE COUNTY. AND THEN TAKE IT TO THE NEXT LEVEL AS MADDOX SAID. >> THE ONE THING I WOULD ADD IS I THINK THERE'S FOLKS DOING GOOD THINGS IN THIS SPACE, THE YOUTH PARTNER, UNIVERSITY OF CHICAGO IS ONE EXAMPLE, BUT I THINK FOLKS, THE MORE THAT RESEARCHERS CAN ALIGN THEMSELVES ON THE FRONT END WITH WHAT ARE SOME OF THE GOALS AND THE CRITICAL ISSUES. THAT THE FIELD AND WHATEVER THE FIELD IN THAT PARTICULAR FOCUS AREA IS, IF THAT'S IDENTITY DEVELOPMENT AROUND HEALTH OR HOUSING OR OTHER HEALTH ISSUES. BUT MAKING SURE THAT LIKE THAT PARTNERSHIP STARTS ON THE FRONT END AND LIKE HEARING FROM THE COMMUNITY AND THEN THAT CAN CARRY THROUGH. SO BECAUSE OF THAT PARTNERSHIP THEN ALL OF THE FINDINGS THAT COME OUT OF RESEARCH OR COME OUT OF THAT WE'RE PROMOTING IT WITHIN OUR NETWORKS AND THEN IT'S ALSO FEDERAL PARTNERS ARE AT THE TABLE WHO HOLD DOLLARS. THINGS LIKE THAT. SO I THINK UNDERSTANDING WHO THOSE NETWORKS ARE AND WHO THEY CAN BE IS LIKE ONE WAY TO LIFT UP SOME OF THE RESEARCH AT THAT LEVEL. >> GREAT, THANKS, KENDON. THE LAST QUESTION I'M GOING TO POSE TO OUR YOUTH PANELIST, ANYONE CAN FEEL FREE TO RESPOND. YOU CAN FEEL FREE TO PASS. I KNOW OUR PANEL OUR WORKSHOP TODAY IS ABOUT IDENTITY, INTERSECTIONALITIES, HEALTH DISPARITIES, ANYTHING YOU'D LIKE TO SHARE THAT YOU THINK IS IMPORTANT FOR OUR DISCUSSION TODAY? ARE WE MISSING THE MARK ON SOMETHING? IS THERE SOMETHING REALLY IMPORTANT TO YOU THAT WE HAVEN'T TALKED ABOUT TODAY? >> I'LL JUST SAY THEN I'LL LEAVE FOR THE REST I'LL BE QUIET. BUT I THINK IT'S REALLY IMPORTANT TO TRUST AND BELIEVE IN YOUTH AND SELF-AUTONOMY, BECAUSE A LOT OF YOUNG PEOPLE HAVE AMAZING IDEAS THERE'S THINGS THEY WANT TO DO AND SOMETIMES THOSE THINGS INVOLVE THEM BEING INDEPENDENT. BUT I THINK IT'S A BIT SELFISH AT TIMES FROM ALLIES WHEN THEY DON'T SUPPORT YOUNG PEOPLE WITH THOSE THINGS. LIKE OH THAT'S TOO BIG OF A GOAL, RIGHT? FOR ME IN NEW YORK CITY WE HAVE A YOUTH ACTION BOARD I WANT US TO BE INDEPENDENT. I DON'T WANT US TO BE THE CITY OWNS US, BECAUSE WE FOUNDED THAT. WE CREATED IT. SO IT DOESN'T MAKE FOR US TO BE UNDER THE CITY WHEN IT'S SOMETHING THAT WE CREATED. SO I'VE ALWAYS KIND OF BEEN UP AGAINST THAT WHEN I BRING THIS UP. AND I'M A PERSON WHO HAS MADE MY OWN BUSINESS AND STUFF. I KNOW IT'S VERY POSSIBLE FOR A YOUNG PERSON TO DO THIS. LIKE INCORPORATE. IT'S NOT AN EASY THING BUT IT IS VERY POSSIBLE. SO I ALWAYS ADVOCATE FOR THAT. FOR JUST TO TRUST YOUNG PEOPLE AND LET THEM GIVE THEM THE RESOURCES, SHOW THEM HOW TO WRITE GRANTS. SHOW THEM HOW TO DO THINGS. DON'T TAKE THAT AWAY FROM THEM BECAUSE YOU WANT TO KEEP THEM UNDER YOUR BELT. LIKE LET PEOPLE BE FREE. HAVE AUTONOMY AND CREATE THEIR OWN SELF-SUSTAINABILITY, THEIR OWN SELF-DETERMINATION FOR WHAT THEY WANT THEIR FUTURE TO LOOK LIKE. NOT IMPOSE WHAT YOU WANT BECAUSE YOU WANT TO HAVE THAT PERSON UNDER YOUR OR NEAR YOU OR YOU'RE AFRAID THEY MIGHT BE BIGGER THAN YOU. JUST KIND OF LIKE REALLY TRUSTING YOUNG PEOPLE AND NOT BEING AFRAID OF THEIR LIFE. >> I WOULD ADD ONE THAT I'M SUPER GRATEFUL TO BE A PART OF THIS CONVERSATION AND TO HAVE MET THE PEOPLE AT IDENTITY. AND ESPECIALLY THE YOUTH. A LOT OF THEM INSETS I'M GOING TO TAKE WITH ME. FOR ME HIGHLIGHTING THE IMPORTANCE OF PEER TO PEER. PEER TO PE-TO-PEER STRENGTH AND IDENTITY AND WHAT THAT CAN LOOK LIKE AS WELL AS MORE ABOUT THE SELF-. NOT IN TERMS OF IDENTITY BUT EMPOWERING ONE'S SELF. AND, LIKE, THERE ARE OPPORTUNITIES THAT ARE AFFORDED TO YOUTH ARE OPPORTUNITIES, YES, BUT HAVE BEEN EARNED. AND HAVE BEEN WORKED FOR AND HAVE BEEN INTERVIEWED FOR AND HAVE BEEN COMPETED WITH. AND SO THE STRENGTH THAT YOUTH HAVE IS WITHIN THEM. AND SOMETIMES IT TAKES LIKE THAT OPPORTUNITY FOR THAT RECOGNIZING, BUT THAT AS MUCH AS LIKE SUPPORT COMES FROM OUTSIDE, LIKE THE REAL POWER, THE REAL IT IS ALREADY WITHIN THE YOUTH. AND IT IS ABOUT LIKE MAKING SPACE FOR THAT POWER TO BE SEEN OR NOT TRYING TO OVERPOWER THAT POWER OR DIMINISH IT IN ORDER TO REMAIN IN THE STATUS OR POSITION THAT OTHERS HAVE BEEN IN. LIKE THAT HIERARCHY. SO MORE COLLABORATION IS ALWAYS KEY IN MY PRO-UTOPIA MADDOX. >> AND ALSO DO MORE TO LIKE HAVE OUR VOICE MORE PROMINENT IN CERTAIN THINGS IN ESTABLISHMENTS. THAT WE SHOULD JUST BE GIVEN THE OPPORTUNITY TO SPEAK UP ABOUT WHAT IS GOING ON MORE SO YOU GET A BETTER INSIGHT ON WHAT NEEDS TO GO ON. BECAUSE WE ARE THE FUTURE. WE ARE THE YOUTH. WE ARE THE FUTURE. SO WHAT'S TO HAPPEN FROM 10 TO 15 YEARS NOW IS IT'S GOING TO IMPACT US, BECAUSE WE'RE THE NEXT GENERATION. TO GIVE US A CHANCE TO BE ABLE TO ADVOCATE MORE FOR OUR VOICE AND HAVE OUR VOICE IN CERTAIN THINGS THAT YOU GUYS ARE DECIDING ON OR MAKING RULES ON AND EVERYTHING. WE SHOULD PROBABLY HAVE A VOICE AND SAY IN WHAT GOES ON AND HOW YOU GUYS CAN BETTER HELP US. >> ANDRE EMANUEL OR KATHERIN. YOU CAN ALSO FEEL FREE TO PASS. OKAY. GREAT. SO THANK YOU EVERYONE FOR JOINING US TODAY. THANK YOU SO MUCH TO OUR YOUTH PANELISTS FOR SHARING YOUR WISDOM AND INSIGHTS WITH US. I HOPE THAT -- I KNOW I ABSORBED QUITE A LOT TODAY. I HOPE YOU ALL REALLY LISTENED TO THE WISDOM THAT OUR PANELISTS SHARED TODAY AND THANK YOU SO MUCH TO IDENTITY, INC. AND YOUTH COLLABORATORY FOR BEING HERE TODAY. I THINK WE HAVE LUNCH NEXT. IS THAT CORRECT? >> YES, THAT IS CORRECT, DR. LLOYD. I WANT TO EXTEND FROM THE WHOLE NICHD FAMILY TO OUR SPEAKERS OUR MODERATORS AND THE YOUTH FOR OPENING UP DURING YOUR PANEL. SO WE'RE GOING TO BREAK NOW AND RETURN BACK AT 1:30 FOR SESSION THREE. THANK YOU EVERYBODY AND WE'LL TALK AGAIN SOON. WELCOME BACK, EVERYONE. IT'S MY PLEASURE TO INTRODUCE DR. SMITH BYNUM, EXPERT IN AFRICAN-AMERICAN MENTAL HEALTH AND ADOLESCENT MENTAL HEALTH PARENTING AND FAMILY COMMUNICATION ABOUT RACIAL ISSUES. DR. SMITH BYNUM, I PASS THE ZOOM FORWARD TO YOU FOR SESSION THREE THE ROLE IN BIAS AND HEALTH DISPARITIES. >> GOOD AFTERNOON EVERYONE AND THANK YOU SO MUCH FOR JOINING US. TALKING ABOUT IDENTITY AND HEALTH IS ONE OF THE TOPICS THAT IS NEAR AND DEAR TO MY HEART. SO I'M PLEASED TO MODERATE TODAY'S SESSION. WE HAVE A SET OF FOUR VERY ENGAGING TALKS THAT I'M DELIGHTED TO BRING TO YOU TODAY. THE FIRST ONE WILL BE GIVEN BY DR. AMANDA CALHOUN, WHO WILL BE PRESENTING ON HOW MEDICAL RACISM IMPACTS YOUTH HEALTH DISPARITIES. IN THE NEXT TALK WE'LL HEAR FROM DR. IEZZONI, EXPERIENCES OF WOMEN WITH DISPARITIES AND THE THIRD TALK BY NIA HEARD-GARRIS SHE'LL BE TALKING ABOUT RACIAL DISPARITIES IN HEALTH. AND FINALLY WE'LL BE TALKING FROM DANIEL DICKERSON. A DOCTOR OF OSTEOPATHIC MEDICINE. HE'LL BE SPEAKING TO US ON HEALTH RESEARCH DISPARITIES IN AMERICAN INDIAN, ALASKA NATIVE YOUTH, CHALLENGES AND SOLUTIONS. JUST AS A REMINDER, THIS SESSION IS ONE HOUR LONG. AND THE PRESENTATIONS SHOULD BE ABOUT SEVEN MINUTES. I WILL SEND ALL OF OUR PRESENTERS A TWO-MINUTE CHAT-BASED WARNING AND A ONE MINUTE VERBAL WARNING AT THE END OF YOUR TIME SLOT SO WE CAN HAVE TIME FOR A COUPLE OF QUESTIONS. AND I BELIEVE THERE WILL BE AN OPPORTUNITY FOR OUR GUESTS FOLKS WHO ARE ATTENDING TODAY'S SESSION TO PRESENT YOUR QUESTIONS THROUGH THE CHAT NEAR THE END OF THE PRESENTATION THEY WILL SEND THEM TO ME AND I WILL PRESENT THEM TO OUR GREAT PANEL TODAY. SO WITH THAT BEING SAID, WHY DON'T WE TAKE IT AWAY. LET'S HEAR FROM DR. CALHOUN. >> HELLO EVERYONE, THANKS FOR HAVING ME. SO I GOT THE MEMO IT WAS TEN MINUTES SO HOPEFULLY WE CAN GET THROUGH IT QUICKLY. SO WE'LL SEE WHAT WE CAN DO, OKAY. LET ME SHARE MY SCREEN. GOOD AFTERNOON, EVERYONE, MY NAME IS AMANDA CALHOUN, I'M A THIRD YEAR PSYCHIATRY RESIDENT AT YALE I'LL TALK ABOUT HOW MEDICAL RACISM AFFECTS YOUTH. AND I DEFINE IT AS WIDESPREAD IN THE MEDICAL SYSTEM INCLUDING HEALTHCARE BY PROVIDERS AND EFFECTS OF RACISM ON HEALTH. FIRST, LET'S TALK ABOUT TERMINOLOGY. I BELIEVE THAT A NUMBER OF TERMS THAT ARE WIDELY USED WHEN DISCUSSING RACISM ARE NOT ONLY EUPHEMISTIC BUT CONFUSING AND SHOULD BE REPLACED WITH ALTERNATIVE TERMINOLOGY THAT IS MORE EFFECTIVE AND TARGETED. SO INSTEAD OF IMPLICIT BIAS, I USE ANTI-BLACK RACISM. I USE IT BECAUSE ANTI-BLACK RACISM IS IMPORTANT TO ACKNOWLEDGE AND TO TARGET. AND THE WORD IMPLICIT BIAS IS HONESTLY INSUFFICIENT TO TARGET ANTI-BLACK RACISM, BECAUSE IMPLICIT BIAS AND ANTI-BLACK RACISM ARE NOT SYNONYMS, SOME WOULD SAY THAT IMPLICIT BIAS OPENS THE DOOR TO MORE CONVERSATIONS AROUND RACE. THAT COULD BE TRUE. BUT TO TACKLE IT YOU MUST NAME IT AS SUCH. IMPLICIT BIAS IS BROAD AND MAY APPLY TO ANYTHING FROM WEIGHT BIAS TO GENDER BIAS, IN ADDITION IMPLICIT BIAS ASSUMES THAT ACTIONS BELIEFS ARE SUBCONSCIOUS UNINTENTIONAL. RACIST IDEA AND BEHAVIOR MAY OR MAY NOT BE SUBCONSCIOUS AND UNINTENTIONAL. MANY PEOPLE EXIST TODAY WHO HAVE CONSCIOUSLY RACIST BELIEFS. NOW, TO BE FAIR, THERE ARE MANY DIFFERENT DEFINITIONS OF RACISM. MY WORKING DEFINITION OF RACISM IS ANTI-BLACK RACISM SPECIFICALLY. PREJUDICE AGAINST INDIVIDUALS RACIALIZED AS BLACK DUE TO THE APPEARANCE OF A PERSON'S SKIN AND OTHER PHYSICAL CHARACTERISTICS, LIKE HAIR, TEXTURE OR FACIAL FEATURES, FOR EXAMPLE. IT MUST BE BACKED BY SOCIAL INSTITUTIONAL AND POLITICAL POWER. NOW YOU MAY HAVE NOTICED I SAID PEOPLE RACIALIZED AS BLACK. WHY? BECAUSE RACE IS A SOCIAL CONSTRUCT. IT WAS MADE UP. AND HAS NO BIOLOGICAL BASIS CREATED BY THE PORTUGUESE IN THE 1400S TO DESCRIBE INDIVIDUALS LIVING ON THE CONTINENT OF AFRICA WHOM THEY WANTED TO INFLATE. BLACKNESS WAS SYNONYM NOW'S. AND IT WAS TO HAVE BLACKNESS DECENT. I'LL REFER TO PEOPLE AS BLACK AND WHITE BUT UNDERSTAND THAT IT IS MADE UP AND THE CORRECT PHRASING IS PEOPLE RACIALIZED AS BLACK OR PEOPLE RACIALIZED AS WHITE. MY QUESTION TO YOU IS, CAN -- [BUFFERING] OR YOU MIGHT HAVE COME ACROSS A DEBATE WITH INDIVIDUALS ABOUT ANYONE COULD BE RACIST. MY ANSWER IS IT DEPENDS [BUFFERING] IF YOU DEFINE RACISM AS PREJUDICE THEN SURE ANYONE COULD BE RACIST. HOWEVER, THAT IS NOT HOW I AND MANY OTHERS DEFINE RACISM I DEFINE IT AS PREJUDICE PLUS POWER. SO NO NOT EVERYONE CAN BE RACIST. YOU MUST HAVE THE POWER. IN THIS COUNTRY, WHITE PEOPLE HOLD THAT POWER. WHAT DO I MEAN? WELL, LET'S TAKE MEDICINE. THE MAJORITY OF FULL PROFESSOR POSITIONS ARE OCCUPIED BY WHITE PEOPLE. THE MAJORITY OF HOSPITAL CEOS ARE WHITE PEOPLE. THE MAJORITY OF PEOPLE IN POSITIONS OF LEADERSHIP IN RESEARCH AND IN MEDICINE ARE, YOU GUESSED IT, WHITE PEOPLE. SO ONLY WHITE PEOPLE CAN BE RACIST, NO ONE ELSE. ANYONE CAN BE PREJUDICE AND BLACK PEOPLE CAN CERTAINLY PERPETUATE RACISM AND INTERNALIZE IT A CONCEPT KNOWN AS INTERNAL RACISM BUT NO BLACK PEOPLE CANNOT BE RACIST BECAUSE THEY DO NOT HOLD THE POWER. NOW, THERE'S A LOT MORE TO UNPACK HERE REGARDING RACE PRIVILEGE. AND DIFFERENCES BETWEEN PEOPLE OF COLOR, BUT LET'S LEAVE IT AT THAT. THE INSTEAD OF MICROAGGRESSIONS I USE EVERYDAY ANTIBLACK RACISM OR RACISM EXPERIENCED BY BLACK PEOPLE. EVERY DAY ANTI-BLACK RACISM CUTS IN SLIGHT BY BLACK PEOPLE. MICRO AGGRESSION TERMED BY DR. CHESTER PIERCE TO DESCRIBE THE EXPERIENCE OF BLACK AMERICANS. IT IS NOW A BROAD AND VAGUE TERM USED TO DESCRIBE MANY DIFFERENT STRUGGLES FROM RACISM TO XENOPHOBIA, AND IT ASSUMES THE AGGRESSOR ACTING SUBCONSCIOUSLY AGAIN MAY NOT OR MAY NOT BE TRUE. DOES INTENTION REALLY MATTER MORE THAN IMPACT. I'D SAY NO. DO I REALLY CARE WHY THE WHITE WOMAN IN THE GROCERY STORE ASSUMED THAT I AT 10 YEARS OLD WAS THE MOTHER OF MY ONE-YEAR-OLD SISTER. NOT REALLY. IT IMPACKETSED ME NEGATIVELY NONETHELESS AND MY PARENTS WERE FURIOUS NONETHELESS. INSTEAD OF RACE RELATIONS I USE WHITE SUPREMACY. IT'S THE INTENTIONAL SOCIO POLITICAL POWER STRUCTURE THAT BENEFITS INDIVIDUALS WHITE OVER OTHERS. IN MEDICINE WHITE PEOPLE DON'T HOLD THE MAJORITY OF POSITIONS BY CHANCE. THEY HOLD THE MAJORITY OF POSITIONS DUE TO WHITE SUPREMACY AND AN INTENTIONAL POWER STRUCTURE THAT'S BEEN PERP PET WAITED FOR CENTURIES. HOLD THE MAJORITY OF POSITIONS FOR LONGEST TIME BLACK PEOPLE COULDN'T BECOME DOCTORS LET ALONE SERVE IN LEADERSHIP POSITIONS AND BLACK PEOPLE STILL EXPERIENCE UNFAIR DISADVANTAGES WHEN IT COMES TO PROMOTION TO LEADERSHIP POSITIONS. FOCUSING ON WHITE SUPREMACY INSTEAD OF RACE RELATIONS ANTI-JUSTICE POWER RESEARCH AND BEYOND. NOW YOU MAY ALSO NOTICE THAT WHITE SUPREMACY IS NOT CAPITALIZED THERE'S A MOVEMENT NOT TO CAPITALIZE THE WORD WHITE. BECAUSE THE CAPITALIZATION OF THE WORD WHITE IS USED AS A I SYMBOL AMONG WHITE SUPREME MASSIST GROUPS. INSTEAD OF RACISM, I SAY RACISM CONSCIOUS IT'S THE DILIGENT AWARENESS OF THE TREATMENT OF COLLEAGUES AND PATIENTS. NOTICE AGAIN I DON'T USE THE TERM MINORITY EITHER. FOR ONE, NONWHITE PEOPLE ARE NOT THE MINORITY GLOBALLY. AND FOR TWO, MINOR IMPLIES LESS IMPORTANCE. PEOPLE OF COLOR ARE NOT LESS IMPORTANT. THEY WERE MADE TO BE LESS IMPORTANT BY WHITE PEOPLE THROUGH WHITE SUPREMACY AND RACISM HENCE MINORTIZED FOCUSING ON BEING RACISM CONSCIOUS LEADS TO INITIATIVES LIKE THIS ONE TO UNDERSTAND MEDICAL RACISM HOW IT CAN BE ADEQUATELY REPRESENTED IN RESEARCH. AND FINALLY INSTEAD OF RACIAL EQUALITY I SAY RACIAL EQUITY. RACIAL EQUITY IS THE ACHIEVEMENT MAINTENANCE OF FAIRNESS AND JUSTICE BETWEEN RACIALIZED GROUPS BY TREATING THEM DIFFERENTLY DEPENDING ON THEIR NEEDS. NOT THE SAME. WHY? BECAUSE PEOPLE OF DIFFERENT RACIALIZED GROUPS ARE ON AN EQUAL FOOTING HAVE DIFFERENT NEEDS WHEN IT COMES TO ADVOCACY AND SUPPORT. YOU MAY HAVE ALSO NOTICED THAT THIS PRESENTATION IS SPECIFICALLY FOCUSED ON ANTI-BLACK RACISM BECAUSE TACKLING RACISM EXPERIENCED BY PEOPLE OF COLOR OR NONWHITE PEOPLE IS WAY TOO BROAD. PEOPLE OF COLOR HAVE DIFFERENT HISTORIES, DIFFERENT STRUGGLES DIFFERENT EXPERIENCES OF RACISM. THEY EACH DESERVE DIFFERENT TARGETED APPROACHES. NOT A ONE-SIZE-FITS-ALL APPROACH. MANY OF THE INEQUITIES WE'RE SEEING IN MEDICINE ARE NOT AFFECTING ALL PEOPLE OF COLOR. THEY'RE AFFECTING BLACK PEOPLE SPECIFICALLY OR OTHER GROUPS SPECIFICALLY. BLACK IS HETEROGENEOUS ENOUGH. A BLACK PERSON COULD BE AN IMMIGRANT FROM THE CARIBBEAN SPEAKING FRENCH OR DESCENDANT OF SLAVES OR BLACK PERSON WHO LIVED IN THE U.S.A. FOR GENERATION. THESE BLACK PEOPLE ARE DIFFERENT IN THEIR CULTURES AND EXPERIENCES. NOW LET'S TALK ABOUT HOW RACISM AFFECTS BLACK CHILDREN. I WAS NINE YEARS OLD WHEN I EXPERIENCED MY FIRST INSTANCE OF RACIAL PROFILING BY THE POLICE. I WAS RIDING MY NEW BIKE IN MY NEIGHBORHOOD. A POLICE CAR DROVE UP BESIDE ME. THE POLICE OFFICER ROLLED DOWN HIS WINDOW STARED AT ME WITH BLUE EYES WHOSE BIKE IS THAT HE ASKED ME SHARPLY. I WAS PRETTY CONFUSED, WELL, IT'S MY BIKE I SAID WITH A SMILE. HE DID NOT RETURN MY SMILE. WELL, DO YOU LIVE AROUND HERE, HE ASKED? I STATED MY ADDRESSED TOLD HIM I LIVED DOWN IN STREET HAD STRIPES LIKE A ZEBRA. HE SAID ALL RIGHT. DRIVING OFF. I WAS RACIALLY PROFILED I KNOW HE ASSUMED I STOLE THE BIKE AND BECAUSE OF MY SKIN COLOR I COULDN'T HAVE POSSIBLY LIVED AROUND THE AFFLUENT NEIGHBORHOOD. I KNEW THEN NO BLACK CHILD WAS IMMUNE FROM RACISM. I WAS SCARED BECAUSE THAT POLICEMAN HAD GUN AND GUNS KILL PEOPLE. BUT I WOULD SOON REALIZE THAT GUNS CAN BE LETHAL. THAT MEDICAL RACISM KILLS PEOPLE TOO. I WAS 11 YEARS OLD WHEN MY EXTENDED FAMILY LOST A CHILD DUE TO RACIST NEGLIGENCE IN THE MEDICAL SYSTEM AND WON THEIR MEDICAL MALPRACTICE CASE. DO YOU KNOW HOW MANY MEDICAL MALPRACTICE LAWSUITS REPORT MEDICAL RACISM? I DON'T. WHAT I DO KNOW IS THAT NO BLACK CHILDREN ARE IMMUNE FROM ANTI-BLACK RACISM. IN 2019 THE AMERICAN ACADEMY OF PEDIATRICS RELEASED AN AMAZING POLICY STATEMENT NAMING RACISM AS THE DRIVER OF HEALTH INEQUITIES IN CHILDREN. BLACK CHILDREN BEAR THE BRUNT OF ANTI-BLACK RACISM AND IT AFFECTS THEIR PHYSICAL AND MENTAL HEALTH EVEN BEFORE THEY'RE BORN. DID YOU KNOW THAT BLACK COLLEGE GRADUATE WOMEN ARE MORE LIKELY TO DIE FROM PREGNANCY DEATH THAN WHITE WOMEN WHO NEVER COMPLETED HIGH SCHOOL BECAUSE THE STRESS OF RACISM AFFECTS BIRTH OUTCOMES. BECAUSE RACISM AND HEALTHCARE PROVIDERS LEADS TO BLACK WOMEN NOT BEING BELIEVED WHEN THEY HAVE SYMPTOMS AND THIS MEDICAL RACISM IS KILLING US. AND AFTER BLACK BABIES ARE BORN STUDY THEY'RE MORE LIKELY TO DIE THAN WHITE NEWBORNS. AGAIN NO BLACK CHILDREN ARE IMMUNE FROM RACISM. NOW MEDICAL EDUCATION WILL TEACH YOU THAT BLACK WOMEN ARE LESS LIKELY TO BREASTFEED THAN WHITE WOMEN, BUT WE DON'T LEARN THAT BLACK WOMEN WERE FORCED TO BREASTFEED THE WHITE CHILDREN OF THEIR SLAVE OWNERS AND NEGLECT THEIR OWN CHILDREN. WE DON'T LEARN THAT FORMULA COMPANIES EXPLICITLY TARGETED BLACK COMMUNITIES BY USING BLACK CHILDREN LIKE THESE IN THEIR ADS AND PERFECTED THEIR FORMULA INGREDIENTS BY EXPERIMENTING ON POOR BLACK CHILDREN. READ THE BOOK SKINN"SKINNED" FOR MORE INFORMATION. BLACK PATIENTS ARE LESS LIKELY TO BE REFERRED FOR CLINICAL TESTING COMPARED TO WHITE PATIENTS WITH COMPARABLE DIAGNOSES AND COMPLAINTS. BLACK CHILDREN ARE UNDERTREATED FOR THEIR PAIN COMPARED TO WHITE CHILDREN. AND STUDIES SHOW TIME AND TIME AGAIN THAT DOCTORS HAVE MORE POSITIVE ATTITUDES ABOUT WHITE PATIENTS AND MORE NEGATIVE ATTITUDES TOWARDS BLACK PATIENTS WHICH AFFECTS THEIR CLINICAL CARE. MEDICAL EDUCATION WILL TEACH US THAT BLACK CHILDREN SUFFER FROM HIGHER AS MA RATES THAN WHITE CHILDREN BUT IT WILL NOT TEACH US THAT THESE HIGHER ASTHMA RATES INTERTWINE WITH ENVIRONMENTAL RACISM. MEDICAL EDUCATION WILL TEACH US THAT BLACK CHILDREN SUFFER FROM HIGHER OBESITY RATES THAN WHITE CHILDREN BUT IT WILL NOT TEACH US THAT HIGHER OBESITY RATES IN BLACK CHILDREN ARE TIED TO EXPERIENCES OF ANTI-BLACK RACISM, FOOD INSECURITY DUE TO INTENTIONAL ECONOMIC OPPRESSION OF BLACK AMERICANS ACROSS GENERATIONS AND THE RACIST MEASURE OF BMI WHICH WAS VALIDATED ON EUROPEAN DESCENDANT INDIVIDUALS WITH LOW MUSCLE MASS. FOR THE LONGEST TIME THE EXCUSE JUSTIFYING RACIAL DISPARITIES WITH LACK OF ACCESS TO HEALTHCARE AND EDUCATION. WE KNOW THAT EVEN WHEN BLACK AND WHITE PEOPLE HAVE EQUAL ACCESS TO HEALTHCARE, BLACK PEOPLE STILL FARE WORSE, WHY? BECAUSE THE ROOT OF BLACK WHITE HEALTHCARE DISPARITIES IS RACISM. ANTI-BLACK RACISM LEADS TO A MYRIAD OF ADVERSE HEALTH OUTCOMES IN CHILDREN, INCLUDING BUT NOT LIMITED TO DISORDERED EATING WORSENED SLEEP DEPRESSION IS YOUS ACCEPTABILITY TO ILLNESS. WHAT ARE MY SUGGESTIONS FOR NICHD? WELL, USE TARGETED NONEUPHEMISTIC TERMINOLOGY. THROW THAT TERM BI"BIAS" AWAY AND START TALKING ABOUT WHITE SUPREMACY AND RACISM IN ITS MANY FORMS. PRIORITIZE RESEARCH FOCUSING ON ANTI-BLACK RACISM AND RACISM AMONG OTHER GROUPS AS THE DRIVER OF HEALTH INEQUITIES. FUND BLACK RESEARCHERS IN LEADERSHIP POSITIONS LIKE ME. PUT YOUR MONEY WHERE YOUR MOUTH IS BECAUSE NOTHING ABOUT US WITHOUT US. THERE SHOULD BE NO RESEARCH INITIATIVES INVOLVING BLACK PARTICIPANTS WITHOUT BLACK RESEARCHERS IN LEADERSHIP POSITIONS WELL COMPENSATED. FINALLY, STOP ATTRIBUTING YOUTH HEALTHCARE DISPARITIES EXCLUSIVELY TO SOCIOECONOMICS OR LACK OF ACCESS TO CARE. CITE ANTI-BLACK RACISM. CITE THE INTENTIONAL ECONOMIC OPPRESSION OF BLACK AMERICANS. THANK YOU. >> AWESOME. WONDERFUL. THANK YOU FOR THAT. AND NOW WE WILL HAVE NEXT SPEAKER TOGGLING OUR VARIOUS SCREENS HERE. WE WILL HEAR FROM DR. LISA IEZZONI TO TALK ABOUT THE MUCH NEEDED TOPIC, NEED OF DISCUSSION, REPRODUCTIVE HEALTH EXPERIENCES OF WOMEN WITH DISABILITY. >> THANK YOU. IT'S AN HONOR TO BE HERE AND FOLLOW THAT INCREDIBLE TALK WE JUST HAD. I WANT TO SAY I SELF-IDENTIFY AS A PERSON WITH A DISABILITY. I'VE USED A WHEELCHAIR FOR 33 YEARS. I'D LIKE TO START WITH A BRIEF HISTORY AND THAT IS THAT THE EUGENICS MOVEMENT WHICH STARTED IN THE UNITED STATES IN 1880, WENT THROUGH 1925, REALLY HAS COLORED THE WHOLE THINKING ABOUT REPRODUCTIVE HEALTHCARE AND PEOPLE WITH DISABILITIES. THE BELIEFS WERE THAT DISABILITY IS PASSED DOWN FROM PARENTS TO CHILDREN. ULTIMATELY DEGRADING THE HUMAN SPECIES. SOCIAL DARWINISM WAS A CONTEMPORARY NEOIST THOUGHT TO PROTECT THE COMMUNITY FROM ENCOURAGEABILITY OF THE PEOPLE WITH DISABILITY AND ISOLATION. THESE TWIN CONCEPTS LED TO THE FORCED STERLIZATION OF WOMEN WITH STERILITY AND MANY STATES BANNED THEM FROM MARRYING. AND THEY WERE COMPLICIT LED TO THESE POLICIES. IT LED TO THE INFAMOUS BUCK V BELL DECISION, THE SUPREME COURT RULED THAT COMMON WEALTH COULD STERILIZE CARRIE BUCK DEEMED FEEBLE DIDMINDED INSTITUTIONALIZED ALONG WITH HER MOTHER ALSO DEEMED FEEBLEMINDED AND JUSTICE HOLMES RULED THREE GENERATIONS OF IMBESILLS ARE ENOUGH. AND THEY'RE NOT OVERTURNED AND PEOPLE ARE DISTRUSTFUL CONCERNED THAT DOCTORS MAKE ERRONEOUS DECISIONS ESPECIALLY IN REPRODUCTIVE HEALTH. THE NEXT FEW QUOTES ARE FROM A STUDY I DID WITH NICHD FUNDING THEY COME FROM WOMEN I INTERVIEWED WHO ARE PREGNANT HAD MAJOR MOBILITY PROBLEMS. THIS IS MARGIE WHO IS DISABLED FROM ARTHRO GRYPOSISI GOT DIRTY LOOKS. HOW COULD I BRING A BABY IN WHEN I'M NOT FIT TO BE A MOTHER. WALMART SOME WERE THRILLED AND OTHER PEOPLE HAD THE NERVE TO SAY WHAT ARE YOU DOING? YOU'RE JUST A WASTE TO SOCIETY. HERE'S A COMMUNITY FROM NAN, WITH CEREBRAL PALSY, RECALLING WHAT A PHYSICIAN SAID ABOUT HER PREGNANCY. YOET YOET I DON'T EVEN KNOW WHY YOU'RE HERE AND YOU DON'T HAVE NO IDEA WHAT YOU'RE GETTING INTO. THERE ARE NOTED HEALTH CARE DISABILITIES WITH WOMEN WITH DISABILITIES. MAJOR LIMITATIONS 70% LESS LIKELY THAN OTHER WOMEN TO BE ASKED ABOUT CONTRACEPTION BY THEIR PHYSICIAN. IN TERMS OF PAP TESTS IN THE LAST THREE YEARS, 81% OF WOMEN WITHOUT DISABILITY, BUT ONLY 68% OF WOMEN WITH MOBILITY LIMITATIONS AND 72% OF WOMEN WITH COMPLEX ACTIVITY LIMITATIONS. THESE DATA COME FROM THE NATIONAL HEALTH INTERVIEW SURVEY. WE DON'T KNOW WHY THERE ARE THESE DISPARITIES, BUT IT COULD BE BECAUSE PRACTITIONERS DO NOT THINK THAT WOMEN WITH DISABILITY ARE LIKELY TO BE SEXUALLY ACTIVE. AND THEREFORE AT RISK OF HUMAN PAPILLOMA VIRUS, CAUSING MANY CERVICAL CANCERS. WE ALSO WITH NICHD FUNDING DID AN ADDITIONAL STUDY LOOKING AT WHETHER WOMEN WITH DISABILITY HAD HIGHER RATES OF CERVICAL CANCER THAN OTHER WOMEN. FORTUNATELY THEY'RE VERY LOW NONDISABLED WOMEN .6% BUT STATISTICALLY HIGHER RATES FOR WOMEN WITH DISABILITIES. MOBILITY LIMITATIONS .8% AND WITH COMPLEX ACTIVITY LIMITATIONS 1%. WE ALL KNOW THAT WE JUST CELEBRATED THE 31st ANNIVERSARY OF THE AMERICANS WITH DISABILITIES ACT. AND THE ADA ACTUALLY MANDATES THAT PEOPLE WITH DISABILITY GET EQUAL QUALITY OF CARE AS OTHER PEOPLE. TITLE 2 COVERS PRACTICES RUN BY PUBLIC ENTITIES AND TITLE 3 COVERS PRIVATE PRACTICES. BUT BOTH REQUIRE PROVISION OF REASONABLE ACCOMMODATIONS. AND THE WAY THAT YOU ESTABLISH WHAT REASONABLE ACCOMMODATIONS ARE IS BY COLLABORATIVE DISCUSSIONS BETWEEN PATIENTS AND CLINICIANS WITH THE GOAL TO PROVIDE EQUAL ACCESS TO CARE FOR PEOPLE WITH DISABILITIES. PATIENTS CANNOT BE REQUIRED UNDER THE LAW TO PROVIDE THEIR OWN ASSISTANCE OR TO PAY FOR THEIR ACCOMMODATIONS. HOWEVER, AGAIN, THIS COMES FROM MY STUDY WHERE I INTERVIEWED THESE WOMEN WITH MOBILITY PROBLEMS WHO WERE PREGNANT. THIS IS ABOUT WOMEN WHO ARE TALKING ABOUT THEIR PRENATAL CARE. THEY KEPT NOT TRANSFERRING ME FOR EXAMS BECAUSE THEY TOLD ME I HAD TO BRING SOMEBODY TO HELP TRANSFER. SO THEY SKIPPED SEVERAL EXAMS ON ME. THIS IS A WOMAN NAMED GABRIELLA ALSO WITH A SPINAL CORD INJURY. THEY WERE LIKE, WELL, YOU CAN GO TO THE POST OFFICE AND GET ON A CARGO SCALE. I WAS LIKE I'M NOT GOING TO BE DOING THAT. THE ONE TIME I WAS WEIGHED I WAS FIVE MONTHS PREGNANT AND WAS ON A HOSPITAL BED WITH A WEIGHT DEVICE. WE RECENTLY AGAIN WITHIN NICHD, THIS IS A COMMON REFRAIN, DID THE FIRST-EVER NATIONAL SURVEY OF PHYSICIAN'S ABOUT THEIR EXPERIENCE WITH AND PERCEPTIONS OF CARING FOR PEOPLE WITH DISABILITY. AND I'LL JUST SHOW YOU A FEW OF THE FINDINGS. OUR TOTAL SAMPLE WAS 714, 61% RESPONSE RATE CONSIDERED HIGH FOR PHYSICIANS. I'LL TALK ABOUT OB/GYN RESPONSE 62% RATE. WE HAVE 65 OF THEM. WE ASKED PHYSICIANS ABOUT WHETHER THEY USUALLY OR ALWAYS OR SOMETIMES RARELY OR NEVER USE ADJUSTABLE EXAM TABLES OR CHAIRS FOR THEIR PATIENTS WITH MAJOR MOBILITY LIMITATIONS. AND ACROSS U.S. PRACTICING PHYSICIANS, 40%, ONLY 40%, ALWAYS OR USUALLY USE ACCESSIBLE EXAM TABLES OR CHAIRS. WHEREAS OB/GYNS ARE BETTER THAN THE AVERAGE PHYSICIAN, 80% OF THEM. LOOK AT THESE NUMBERS FOR USE OF ACCESSIBLE WEIGHT SCALES. REMEMBERING THAT POOR WOMAN WHO WAS TOLD TO GO TO THE POST OFFICE. AMONG U.S. PRACTICING PHYSICIANS ONLY 23% ALWAYS OR USUALLY USE AN ACCESSIBLE WEIGHT SCALE FOR PEOPLE WITH MOBILITY LIMITATIONS. AND OB/GYN ARE A TICK HIGHER AT 24%. WE ALSO ASKED PHYSICIANS ABOUT THEIR ATTITUDES ABOUT PEOPLE WITH DISABILITY. 82% OF PHYSICIANS THINK THAT PEOPLE WITH SIGNIFICANT DISABILITY HAVE OVERALL WORSE QUALITY OF LIFE THAN OTHER PEOPLE. AND OB/GYNS THE SAME 82%. ONLY 41% OF PHYSICIANS FEEL VERY CONFIDENT. IN THEIR ABILITY TO PROVIDE EQUAL QUALITY OF CARE TO PATIENTS WITH DISABILITY. OB/GYNS ABOUT THE SAME WITH 40%. AND ONLY 56% OF PHYSICIANS STRONGLY WELCOME PATIENTS WITH DISABILITY INTO THEIR PRACTICE. OB/GYNS ARE 57%. SO MY SUGGESTIONS FOR NICHD ARE TO INVOLVE PEOPLE WITH DISABILITY. RESEARCHERS AND COMMUNITY PARTNERS AS APPROPRIATE. AND ALL COMMITTEE, ALL TRAINING, ALL RESEARCH OVERSIGHT ACTIVITIES AT NIH. IDENTIFY PEOPLE WITH DISABILITY AS A POPULATION THAT EXPERIENCE HEALTH AND HEALTHCARE DISPARITIES. WE NEED, THOUGH, TO CHANGE THE HEARTS AND MINDS OF PHYSICIANS ABOUT CARING FOR PATIENTS WITH DISABILITIES. WE NEED TO INCLUDE STRATEGIES THAT BOTH INCLUDE INDUCEMENTS. LIKE CARROTS. BUT WE MIGHT ALSO NEED STICKS SUCH AS REQUIREMENTS FOR CONTINUING MEDICAL EDUCATION AND TRAINING TO ENSURE THEY CAN PROVIDE EQUITABLE CARE TO PEOPLE WITH DISABILITY. WE ALSO NEED TO WORK WITH GENERAL EDITORS TO TRY TO DISSEMINATE RIGOROUS RESEARCH FOR PEOPLE WITH DISABILITY IN HIGH IMPACT JOURNALS SO PHYSICIANS CARING FOR PATIENTS IN THE UNITED STATES CAN KNOW ABOUT THESE STUDIES. I'D LIKE TO JUST CONCLUDE ANTICIPATING THAT THE PARALYMPIC GAMES ARE GOING TO HAPPEN IN TOKYO, JAPAN IN A FEW WEEKS TO REMEMBER WHAT HAPPENED IN LONDON BACK IN 2012. AND IN HONOR OF THIS, I'D LIKE TO SHOW THIS SCULPTURE OF A WOMAN NAMED ALLISON LAPER, BRITISH NO ARMS AND NO LEGS WAS SENT TO A RESIDENTIAL FACILITY. WHEN SHE WAS ONLY SIX WEEKS OLD. THIS SCULPTURE IS OF HER AT SEVEN MONTHS OF PREGNANCY IT'S BY THE QUINN TO BE PLACED IN TRAFLGAR SQUARE. AND AT THE TIME THIS WAS A CONTROVERSIAL THING TO HAVE THIS STATUE OF THIS NAKED DISABLED WOMAN SEVEN MONTHS PREGNANT IN THE SQUARE. HER VIEW IT PUTS DISABILITY FEMNITY MOTHERHOOD ON THE MAP. IT'S TIME TO CHALLENGE PEOPLE'S PERCEPTIONS I'M HOPEFUL IT CAN MAKE A DIFFERENCE. WHEN LONDON HOSTED THE PARALYMPIC GAMES AFTER THE OLYMPIC GAMES IN THE SUMMER OF 2012, THEY ACTUALLY CREATED 15-METER TALL VERSION OF THIS SCULPTURE, AND THEY SHOWED IT AT THE OPENING CEREMONIES OF THE PARALYMPIC GAMES. SO THIS IS ALLISON LAPER WITH HER SON, WHO WAS AT THE TIME 14 WHEN SHE AN ARTIST RECEIVED AN HONORARY DEGREE FROM THE UNIVERSITY OF BRISTOL IN THE UK. AND SHE DESCRIBED HER SON AS HER MAJOR WORK OF ART THAT SHE'D EVER CREATED. SO THAT'S A DROP IN THE BUCKET OF WHAT I COULD TELL YOU, BUT I LOOK FORWARD TO HEARING THE OTHER PRESENTATIONS. THANK YOU. >> THANK YOU SO MUCH. THAT WAS FANTASTIC. AND I LEARNED SO MUCH. SO THANK YOU FOR YOUR WORK. WE'RE NOW GOING TO HEAR OUR THIRD PRESENTATION FROM DR. NIA HEARD-GARRIS, WHO WILL BE SPEAKING TO US ABOUT MEDIA, RACIAL ETHNIC BIAS AND DISPARITIES IN YOUTH HEALTH. >> HI, EVERYONE. I HOPE YOU CAN SEE MY SCREEN AND SEE MY SLIDES. CAN I GET LIKE A THUMBS UP OR SOMETHING TO MAKE SURE IT'S COMING THROUGH OKAY? SO THERE'S BEEN A LOT OF BUT THERE'S BEEN LOTS OF FOCUS ON -- I LIKE THIS GRAPHIC BECAUSE (INAUDIBLE) SO LESS'S START BY DEFINING RACISM; STRUCTURAL RACISM TO SOCIETAL GOODS, SERVICES AND OPPORTUNITIES BY RACE, OR OTHER PHYSICAL PROPERTIES. EXPOE SHOWER TO RACISM IS ASSOCIATED WITH NEGATIVE PSYCHOLOGICAL AND BIOLOGICAL RESPONSES, WHICH THEN TRANSLATE INTO HEALTH OUTCOMES AND SUBSEQUENTLY DISPARITIES WHICH PERSISTS AT THE POPULATION LEVEL. SO SPECIFICALLY CHILDREN ARE EXPOSED TO RACIAL DISCRIMINATION AT THE MICROAND MACRO LEVELS. AND WE'LL GO INTO MORE DETAILS IN A SECONDS BUT THEN THAT EXPOSURE TRANSLATES TO PHYSIOLOGICAL AND PSYCHOLOGICAL RESPONSES. WITH SOME SIMILAR MECHANISMS AS FACES. YOU CAN SEE DEPRESSION HOMELESSNESS ANXIETY AND DECREASING FUNCTION IN COURT SOLVE, INCREASED BLOOD PRESSURE. THOUGH CHANGES TRANSLATE TO INCREASE RISK OF NEGATIVE HEALTH OUTCOMES AN DISEASE LIKE PREMATURE BIRTH, INFANT MORTALITY, RISKY BEHAVIOR AND DISEASE. WHAT ARE THOSE EXPOSURES THAT'S WHAT WE'LL TALK ABOUT TODAY. PAT THE MACRO LEVEL IS EXPOSURE TO NEEDS YUM SCHOOLS, POLICIES IS POLICE, AND OTHER AUTHORITY FIGURES. AND AT THE MICRO LEVEL EXPERIENCES LIKE WITH TEASING, LIKE CURIOUS OR SECOND HAND EXPOSURES AND SOCIALIZATION, HOW YOU COME TO UNDERSTAND WHAT THAT MEANS TO BE A BLACK, BROWN KID IN THE U.S. NOW SHIFTING TO TWO EXAM EXAMPLES OF STRUCTURAL RACISM AND HEALTH. ONE IN THREE. OOH A BLACK BOY BORN TODAY HAS ONE IN THREE GOING TO PRISON IN HIS LIFETIME. LATINO BOY ONE IN SIX CHANCE AND WHITE BOY ONE IN 17 CHANCE. AND GENERALLY WHILE THEY INCARCERATION OF PEOPLE ADHERENCE TENDS TO BE IN ORIGINAL, I WANT YOU TO UNDERSTAND THAT THIS SPECIFIC PIECE HAS A DISPROPORTIONATE EFFECT ON CHILDREN AND FAMILIES OF COLOR. SO HERE IS THE GREAT VISUAL FROM THE PRISON POLICY INITIATIVE THAT SHOWS ON THE LEFT THE MAKE UP OF WHITE, BLACK, LATINX AND NATIVE INDIGENOUS POPULATIONS IN THE US. AND ON THE RIGHT IS A REPRESENTATION OF THE SAME POPULATIONS IN PRISON. SO IF YOU SEE AT THE TOP LEFT OF THE GRAPH, 64% OF WHITE PEOPLE MAKE UP THE GENERAL POPULATION. BUT IN THE PRISON POPULATION ACCOUNT FOR LESS THAN 40%. AND ON THE CONTRARY, THE BLACK POPULATION REPRESENTS ABOUT 13% IN THE U.S. POPULATION, BUT 40% IN THE PRISON POPULATION. SET IN A SLIGHTLY DIFFERENT WAY, INCARCERATION IMPACTS BLACK AND LATINX FOLKS AT HIGHER RATES. SO HERE YOU SEE BLACK MEN ONE IN THREE, LATINO MEN ONE IN SIX, BLACK WOMEN ONE IN 18 AND LATINA WOMEN ONE IN 45 COMPARED TO WHITE COUNTER PARTS. AS I SAID THE MAJORITY EXPERIENCE INCARCERATION OF FATHERS, HOWEVER, MATERNAL INCARCERATION IS INCREASINGLY COMMON, DUE TO THE RISING INCARCERATION RATES OF WOMEN, THE NUMBER OF WOMEN IN PRISON HAS BEEN INCREASING AT A RATE 50% HIGHER THAN MEN SINCE THE 1980s. SO WHAT ABOUT THE DISTRICT AND DMV WHERE I THINK MOST PEOPLE MIGHT BE ZOOMING IN FROM. SO AS YOU CAN SEE, THE UNITED STATES INCARCERATES ABOUT 698 PEOPLE PER HUNDRED THOUSAND PEOPLE. IN THE DISTRICT. IT'S MUCH HIGHER. AT ABOUT 1100 PER 100,000 PEOPLE. THAT INCLUDES PRISONS AND JAILS IMMIGRATION DETENTION, AND JUVENILE JUSTICE FACILITIES. SO HOW DOES THIS TRANSLATE TO CHILDREN AND FAMILIES? SO FOR CHILDREN, ABOUT 5 MILLION LIKELY THAT'S AN UNDERCOUNT, OF U.S. CHILDREN HAVE HAD HAD AN INCARCERATED PARENT. ABOUT ONE IN EIGHT POOR CHILDREN, ONE IN NINE BLACK CHILDREN AND FOR JUST CHILDREN OVERALL, ABOUT ONE IN 14 ARE IMPACTED BY PARENTAL INCARCERATION. AND WHAT DOES THIS MEAN FOR THEIR HEALTH? SO ONE OF THE STUDIES THAT I DID WE LOOKED AT HEALTHCARE USE AND HEALTH BEHAVIORS AMONG YOUNG ADULTSES WITH HISTORY OF PARENT INCARCERATION. AND FOUND THAT YOUNG ADULTS THAT HAD A PARENT INCARCERATED WERE MORE LIKELY TO SKIP MEDICAL CARE, MORE LIKELY TO MISUSE OR ABUSE PRESCRIPTION DRUGS AND ENGAGE IN RISKY SEXUAL PRACTICES. THEY HAVE HIGHER PREVALENCE OF ASTHMA, OF HIV, AND MENTAL HEALTH CONDITIONS LIKE DEPRESSION ANXIETY AND PTSD. JUST AS WE THINK OF GENETIC MUTATIONS POTENTIALLY IMPACTING FUTURE GENERATIONS WE SHOULD TOO THINK ABOUT INCARCERATION IMPACTING FUTURE GENERATIONS AS WELCH THE SUBSEQUENT STUDY I FOUND THAT ONE IN EVERY 100 U.S. CHILDREN HAVE HAD A PARENT INCARCERATED AND LATER INVOLVED IN THE JUVENILE JUSTICE SYSTEM. SO ONE IN EVERY 100 CHILDREN. IN THAT SAME STUDY WE FOUND ULTIMATELY HAVING THOSE EXPOSURES DISPROPORTIONATELY IMPACTED NON-HISPANIC BLACKS, CHILDREN FROM ONE PARENT HOUSEHOLDS, THOSE RECEIVING PUBLIC ASSISTANCE, AND LIVING IN CITIES AND AGAIN, WE SAW THE ADVERSE MENTAL HEALTH OUTCOMES, DEPRESSION ANXIETY AND PTSD. SO THE SECOND EXAMPLE, I WANT TO TALK ABOUT IS VICARIOUS RACISM WHICH IS SECOND HAND RACISM SO NOT NECESSARILY BEING THE TARGET OR VICTIM OF RACISM BUT WITNESSING IT, SEEING IT OR OBSERVING IT IN SOME OTHER WAY. IT CAN BE A MICRO OR MACRO LEVEL EXPOSURE. IN A SYSTEMATIC REVIEW WE FOUND VICARIOUS RACISM IN CHILD HEALTH WERE LINKED. AND THAT THE LITERATURE SAID THAT CHILDREN THAT EXPERIENCE VICARIOUS RACISM WERE MORE LIKELY TO HAVE NEGATIVE PHYSICAL HEALTH, LOWER HEALTHCARE UTILIZATION, WORSE SOCIO EMOTIONAL HEALTH AND ADVERSE MENTAL HEALTH AS WELL. MY LAB WE DID A QUALITATIVE STUDY OF ADOLESCENTS TO UNDERSTAND VICARIOUS RACISM IN THE MEDIA AND WE FOUND MANY PARTICIPANTS READILY IDENTIFIED THEIR FEELINGS IN RESPONSE TO VICARIOUS RACISM. I'M GOING TO FOCUS ON SOME OF THEIR QUOTE THAT WERE RELATED TO THEIR NEGATIVE MOODS SYMPTOMS. SEVERAL TEENS WERE ABLE TO EXPAND ON VIE VICARIOUS IMPACT OF RACISM, TELLING AND RETELLING OF NEWS STORIES INVOLVING RACISM OR NOTED BY SOME TO PERPETUATE THEIR TRAUMA. ONE PARTICIPANT SAID THEY EVEN CREATED A SPECIFIC TERM TO DESCRIBE FEELINGS OF SADNESS AND RERESIGNATION RELATED TO VICARIOUS RACISM EXPERIENCE. THAT PERSON SAID SOME OF MY WHITE COUNTER PARTS WOULD LIKE HEY THIS THING HAPPENED. HOW DO YOU FEEL ABOUT IT? AND I'M LIKE I CREATED THE TERM MELANINCHOLY. ANOTHER TEEN SAID AFTER HEARING ABOUT RACISM IN THE NEWS OR ON SOCIAL MEDIA, FELT LIKE 100 BRICKS WERE JUST PUT ON MY SHOULDERS. SO THOSE TOGETHER WERE IMPORTANT TO SHOW THE IMPACT OF VICARIOUS RACISM THOUGH IT DOESN'T HAPPEN DIRECTLY TO THE VICTIM STILL IMPACTS THEIR SOCIO EMOTIONAL HEALTH. SO FINALLY, RECOMMENDATIONS. MOVING FORWARD I RECOMMEND FORMING APPROACHES ENSURING RECIPIENTS OF FUNDING, MEASURE AND USE COMPREHENSIVE CONCEPTUALIZATION OF RACISM, EXAMINING INTERSECTIONALITY, HOW DOES RACE AND ETHNICITY AND SOCIAL -- SEXUAL ORIENTATION OR GENDER ABILITY STATUS, SPECIAL HEALTHCARE NEEDS HOW DO THEY INTERSECT AND INFLUENCE HEALTH. I ALSO ENCOURAGE MULTI-GENERATIONAL MODELS MORE THAN ONE GENERATION BEING TESTED AND ALSO INTERVENTIONS. I'M REALLY MORE INTERESTED IN UNDERSTANDING HOW REDUCING STRUCTURAL RACISM IMPACTS HEALTH AND WELL BEING FOR BLACK AND LATINX YOUTH. THIS IS A CONCEPTUAL MODEL THAT WILL HOPEFULLY BE PUBLISHED THE NEXT COUPLE OF WEEKS THAT SAYS THAT STRUCTURAL RACISM IS THE FOUNDATION SO THAT'S SEGREGATION IN SCHOOLS AND RESIDENCES OCCUPATIONAL SEGREGATION, THAT UNDERLIES THE SOCIAL DETERMINANTS OF HEALTH THAT A LOT OF US HAVE FOCUSED ON SO THAT SOCIAL AND PHYSICAL ENVIRONMENT AND THAT IS THEN IMPORTANT FOR CARE GIVING FOR CHILD HEALTH OUTCOMES FOR SUBSEQUENT DISPARITIES THAT IS ACTUALLY VERY COMPLEX BUT UNDERLYING ALL THIS IS STRUCTURAL RACISM. AND I WANTED TO SHOW ONE EXAMPLE OF AN INTERVENTION THAT I SAW IN THE LITERATURE CALLED THE STRONG AFRICAN AMERICAN FAMILIES PREVENTION PROGRAM, IT'S AN INTERVENTION DONE BY -- >> WE ARE OVER TIME. IF YOU COULD WRAP UP, THANK YOU. >> OKAY. YEAH. JUST THIS RCT SHOWED THEY HAD LOWER LEVELS OF INFLAMMATION. SO FINALLY I'LL END AND SAY ONE OF OUR ADOLESCENTS SAID I FEEL LIKE IF WE HAVE THE RIGHT COPING SKILLS AND RIGHT WAYS TO DEAL WITH IT, WE CAN USE THOSE NEGATIVE EMOTIONS FOR GOOD BECAUSE THEN WE CAN BE MORE PASSIONATE. AND LIKE OUR ACTIONS TO SPREAD LOVING AWARENESS FOR THESE KINDS OF THINGS. THAT'S IT. I WOULD LIKE TO THANK ALL MY CO-AUTHORS AND HERE IS MY LAB AND MY CONTACT INFORMATION. THANK YOU. >> THANK YOU SO MUCH. LAST SPEAKER IS DR. DANIEL DICKERSON, HEALTH RESEARCH DISPARITIES IN AMERICAN INDIAN AN ACT ACHE NATIVE YOUTH, CHALLENGES AND SOLUTIONS. TAKE IT AWAY. >> YES. THANK YOU, CAN YOU HEAR ME OKAY, FIRST OF ALL? >> YOU SOUND GREAT AND THE FIRST SLIDE LOOKS GREAT. >> GREAT. OKAY. MY NAME IS DAN DICKERSON, ALASKA NATIVE TRIBAL ON MY MOTHER'S SIDE CAUCASIAN, ON MY FATHER'S SIDE I USE THE PRONOUNCE HE HIM AND HIS. AND I'M AN ASSOCIATE RESEARCH PSYCHIATRIST AT UCLA INTEGRATED SUBSTANCE ABUSE PROGRAMS. MY RESEARCH FOCUSES ON DEVELOPMENT ANALYSIS OF CULTURE CENTERED SUBSTANCE USE TREATMENT AND INTERVENTIONS. I WORK CLINICALLY AS ADDICTION PSYCHIATRIST. AND I REALLY LIKE TO THANK NICHD FOR THIS OPPORTUNITY AND NIH FOR PUTTING ON ON THIS AMAZING SERIES OF WORKSHOPS. AND MY -- I REALLY LIKE TO ACKNOWLEDGE MY CO-PRINCIPLE INVESTIGATOR ON MANY PROJECTS ELIZABETH FROM THE RAND CORPORATION AS WELL. SO JUST TO START OFF, NATIVE AMERICANS EXPERIENCE NUMEROUS HEALTH DISPARITIES UNFORTUNATELY. THESE INCLUDE HIGH RATES OF SUBSTANCE USE, HIGH RATES OF SUICIDE, OBESITY, DIABETES, MANY OTHER PSYCHOSOCIAL FACTORS AND IMPORTANT RELEVANT ISSUES SUCH AS HOMELESSNESS OR DISPROPORTIONATELY AFFECTED BY HOMELESSNESS, POVERTY AND UNEMPLOYMENT. AND AS A SIDE NOTE, NATIVE AMERICANS ARE VERY DIVERSE, THERE'S OVER 500 TRIBES FOR INSTANCE FEDERALLY RECOGNIZED ACROSS THE U.S. SO THERE'S DEFINITE DIFFERENCES IN RATES AMONG DIFFERENT TRIBES. ONE OF THE ROOT CAUSES MANY BELIEVE THAT HAVE CONTRIBUTED TO THESE HEALTH DISPARITIES ARE THE AFFECTS OF HISTORICAL BASED TRAUMAS THAT HAVE -- THAT NATIVE AMERICANS HAVE EXPERIENCED OVER THE PAST 500 YEARS DUE TO MANY SOCIAL INJUSTICES INCLUDING BUT NOT LIMITED TO FORCE RELOCATIONS FROM NATIVE LANDS, COERCED KISS SEMINATION INTO URBAN AREAS FORCED PLACEMENT OF O INDIAN KIDS IN BOARDING SCHOOLS, CHILDREN WHO ARE TAKEN AWAY FROM HOMES AND PUT IN BOARDING SCHOOLS. AND EVEN LAWS FEDERAL LAWS PROHIBITING MANY NATIVE AMERICANS SPIRITUAL PRACTICES. THESE HAVE ALL CONTRIBUTED TO AS MANY PRESENTERS HAVE TALKED ABOUT TODAY AFFECTS OR KIND OF SOME REAL TOUGH CULTURE IDENTITY RELATED ISSUES, FRAGMENTED COMMUNITIES, AND SUCH THAT MANY BELIEVE HAVE CONTRIBUTED TO THESE OVER HIGH RATES OF VARIOUS HEALTH ISSUES AFFECTING NATIVE PEOPLE. BECAUSE OF ALL THIS, THERE IS SOME DISTRUST OF RESEARCH PROJECT AMONG MANY NATIVE AMERICANS DUE TO SOME HISTORIES OF UNETHICALLY CONDUCTED RESEARCH CONDUCTED MANY THE PAST. BUT THIS IS A BIT OF A SHAME BECAUSE THERE'S A SHORTAGE OF RESEARCH FOR NATIVE PEOPLE AND WE NEED RESEARCH CONDUCTED APPROPRIATELY DONE OF COURSE, THAT COULD HELP HIGHLIGHT ISSUES AND BRING SOME USEFUL DATA THAT WE CAN USE TO HELP INFORM POLICY AND TREATMENT AND PREVENTION PROGRAMS. NATIVE AMERICANS AND MANY OTHER GROUPS REALLY EMPHASIZE THE NEED FOR COMMUNITY ENGAGEMENT, COMMUNITY BASED PARTICIPATORY APPROACH. SO THERE'S A NEED FOR THAT WITH NATIVE PEOPLE THAT COULD HELP BRING TRUST TO THE TABLE, HELP WITH IMPLEMENTATION BECAUSE THERE IS A SHORTAGE OF IMPLEMENTATION. PROMISING PRACTICES. SO MORE COMMUNITY ENGAGEMENT THAT COULD HELP FACILITATE BROADER IMPLEMENTATION OF PROMISING STUDIES. AND ALSO THERE IS A SHORTAGE OF NATIVE AMERICAN RESEARCHERS, AMERICAN INDIAN ALASKA NATIVE, NATIVE HAWAIIAN AND OTHER INDIGENOUS GROUPS THERE IS A SHORTAGE OF INDIGENOUS RESEARCHERS. THESE -- AND ALTHOUGH THERE ARE MANY RESEARCHERS OUT THERE THAT ARE NOT NATIVE WHO ARE JUST DOING GREAT WORK WE DO NEED MORE NATIVE RESEARCHERS AS WELL. SOME POTENTIAL SOLUTIONS AS I STATED NEED FOR COMMUNITY INVOLVEMENT, MORE COMMUNITY ENGAGEMENT, AND PERSPECTIVE. WE KNOW THE STEPS, WE KNOW SOME OF THE BACKGROUND INFO BUT WE DONE KNOW THE STORY AND PEOPLE NEED TO UNDERSTAND THE STORY OF NATIVE AMERICANS AND BOTH FROM THE PAST AND PRESENT. AND WITH THAT WE NEED MORE ELDER OVERSIGHT. ELDERS ARE HIGHLY RESPECTED INDIVIDUALS IN OUR POPULATIONS AND THEIR INVOLVEMENT IS VERY CRITICAL, WE HAVE ELDER ADVISORY BOARDS IN OUR PROJECTS WE BOUNCE EVERYTHING OFF OF AND THEY ARE ALSO USEFUL TO HAVE -- AS QUESTIONS COME UP. SITUATIONS AND CHALLENGES COME UP DURING RESEARCH PROGRAMS SO WE REALLY, IT IS REALLY GREAT TO HAVE THEM INVOLVED. THERE'S TOO MUCH IN MY OPINION TOO MUCH OF A DIVIDE BETWEEN CLINICAL WORLD AND RESEARCH WORLD. THERE NEEDS TO BE MORE COLLABORATION, MORE CROSS FERTILIZATION OF IDEAS, WITH THAT. I THINK WITH ANY WITHIN THE CLINICAL SETTING, IN MY EXPERIENCE MANY PROVIDERS ARE TRYING TO DO THEIR BEST TO DO WHAT IS EXPECTED OF THEM, AND THAT'S TO DELIVER EVIDENCE BASED PRACTICES AND THEIR SUPERVISORS REALLY AND THE BILLING DEPARTMENT REALLY WANTS THAT. SO THERE'S REALLY NOT ENOUGH ATTENTION IN MY OPINION OF PROMISING PRACTICES. HOW OFTEN DO WE HEAR IN THE TREATMENT MEETING, HERE IS A NEW PROMISING PRACTICE THAT SHOWS POTENTIAL BENEFIT FOR US, LETS'S USE THIS ONE, HERE IS A MANUAL, HERE IS SOME RESEARCH, HERE IS HOW WE DO IT. THAT'S GO FOR THIS NEW PROGRAM. VERY RARELY DO YOU HAVE THAT CONVERSATION AND MY EXPERIENCE AT LEAST WITHIN THE CLINICAL SETTING. SO WE NEED NEW QUICKER IMPLEMENTATION STRATEGIES, NOT TO SAY OF COURSE WE NEED RESEARCH THAT SHOWS THESE INTERVENTIONS WORK AND ARE USEFUL, BUT WE NEED SOME QUICKER TURN AROUND BECAUSE THERE'S BIG ISSUES THAT NEED TO REALLY BE ADDRESSED. JUST SOME BACK GROUND, I HAVE BEEN INVOLVED IN SOME SUBSTANCE USE INTERVENTION PREVENTION AND TREATMENT PROGRAMS THAT INTEGRATE TRADITIONAL PRACTICES. OVER AND OVER AGAIN NATIVE AMERICAN COMMUNE COMMUNITIES IF YOU CONDUCT FOCUS GROUPS ON WHAT IS NEEDED YOU ALWAYS HEAR WE NEED MORE TRADITIONAL PRACTICES MORE AMERICAN INDIAN SPIRITUALTY WORK. WE NEED SOME ROOM FOR THAT DISCUSSION WITHIN INTERVENTIONS. SO ONE OF OUR INTERVENTIONS WE INTEGRATE DRUMMING, WITH AA PRINCIPLES, THAT'S -- WE'VE CONDUCTED A FEASIBILITY CLINICAL TRIAL THAT SHOWS SOME POTENTIAL FOR THIS INTERVENTION. AND A COUPLE OF OTHER INVENTIONS FOR ADOLESCENTS WITH SUBSTANCE USE AN PREVENTION INTERVENTION TACUNA ONE WE ARE CURRENTLY CONDUCTING FOR YOUNG ADULTS THAT LOOKS HOW CAN WE ENHANCE SOCIAL CONNECTIONS AND TRADITIONAL PRACTICES AND MOTIVATIONAL INTERVIEWING TO HELP EMERGING YOUNG ADULTS NOT USE OPIOIDS. I THINK I'M AT ABOUT EIGHT MINUTES SO THANK YOU, VERY MUCH. >> THANK YOU SO MUCH FOR THAT. YES, YOU WERE AT ABOUT EIGHT MINUTES. SO THE ONE REGRET I HAVE ABOUT THIS SESSION IS I THINK WE COULD SPEND A FULL DAY ON EACH OF THE PRESENTATIONS THAT WERE GIVEN BUT WE WILL MAKE THE BEST OF IT WITH SOME HEALTHY QUESTION AND ANSWER. SO IF IT IS OKAY WITH THE NIH STAFF I WILL BEGIN THAT. AND I'VE GOT A MEETY QUESTION FOR THE PANELIST SO IF IT TAKES A MINUTE TO THINK THROUGH WHILE WAIT FOR THE AUDIENCE TO SEND QUESTIONS IN THE CHAT. ONE THING THAT STRIKES ME ABOUT THE THEME THAT CUTS THROUGH ALL THE PRESENTATIONS HAS TO DO WITH THIS ISSUE OF IDENTITY, SEVERAL PANELISTS TALKED ABOUT THEIR OWN LIVED IDENTITY AND ONE CAN READILY SEE THE CONNECTION OF THEIR LIVED EYETY WITH KINDS OF RESEARCH -- IDENTITY WITH THE KINDS OF RESEARCH THEY ARE DOING. AND I WANT TO SAY WITH RESPECT TO THE ISSUE OF THE LACK OF AVAILABLE SCIENCE ON EACH OF THE POPULATIONS THAT YOU PRESENTED ON TODAY AND THE ISSUES, HOW DO WE ADDRESS THIS ISSUE OF IDENTITY AND RESEARCH QUESTIONS? AND ALSO THE FUNDING OF SCIENTISTS BECAUSE THE REALITY OF BEING A MEMBER OF A MINOR MINORITIZED GROUP IS THAT THE BULK OF THE RESEARCH WILL OFTEN NOT BE CONDUCTED OR NOT BE CONDUCTED BY US. MEMBERS OF MINORITIZED COMMUNITIES. SO IF YOU COULD WHILE WE HAVE THE EARS OF NICHD AND NIH ON THE LISTENING LINE, TALK TO US ABOUT HOW CAN WE GET AT THE SYSTEM LEVEL ISSUES, SO IF YOU COULD [EXPLETIVE] AND -- EXPAND UPON THESE ISSUES, WE HAVE SOME MORE JUNIOR SCIENTISTS HERE ON THE PANEL, AND WE KNOW HOW COMPETITIVE IT IS TO GET THESE FUNDS. YET WE NEEDED THE SCIENCE YESTERDAY. SO IF YOU COULD SHARE A FEW REMARKS, I WILL CALL ON YOUR ONE BY ONE, IF YOU ARE NOT READY JUST ASK ME TO PASS THE MIKE BUT TO TALK ABOUT THAT AND SO THE FIRST PERSON ON MY SCREEN IS DR. IAZONI. IF YOU COULD TALK TO US ABOUT ADDRESSING THE SYSTEMS LEVEL ISSUES BECAUSE THAT'S GOING TO BE AT THE CORE. >> OKAY. WELL, THANK YOU SO MUCH AND YOU STARTED OFF BY TALKING ABOUT IDENTITY AND HOW EACH OF US ARE PURSUING RESEARCH WITHIN OUR SCOPE OF IDENTITY. LET ME JUST SAY THAT I AM PROBABLY THE OLDEST PERSON ON THIS ENTIRE CALL AND I AM PRE-ADA. I STARTED AT MEDICAL SCHOOL IN SEPTEMBER OF 1980 AT HARVARD, THAT'S WHEN I WAS FIRST DIAGNOSED WITH MULTIPLE SCLEROSIS. AND TO MAKE A LONG STORY VERY SHORT, WHEN I WENT TO APPLY FOR AN INTERNSHIP RESIDENCY THE INTERNSHIP AND RESIDENCY ADVISOR TOLD ME THAT THE POWERS THAT BE AT HARVARD MEDICAL SCHOOL DISCUSSED MY CASE AND HAD DECIDED THAT THEY WERE NOT GOING TO WRITE A LETTER OF RECOMMENDATION FOR ME. SO EVEN THOUGH I COMPLETED ALL MY MEDICAL SCHOOL COURSE WORK AND HAD DONE EVERYTHING THAT I NEEDED TO DO, I WAS NEVER ABLE TO GO ON TO TRAIN TO BECOME A PRACTITIONER. AND SO I HAVE NEVER BEEN A LICENSED PHYSICIAN, I HAVE NEVER PRACTICED A DAY IN MY LIFE AND WHAT I WAS TAUGHT AS A MEDICAL STUDENT THERE WAS WE CANNOT CURE YOU. YOU ARE A FAILURE. YOU REPRESENT A FAILURE OF MEDICINE. AND SO DON'T TALK TO US ABOUT DISABILITY, KEEP IT QUIET, KEEP IT -- DON'T SAY A WORD ABOUT IT. AND SO FOR THE FIRST DOZEN YEARS OF MY CAREER, I NEVER TALKED ABOUT DISABILITY, THERE WAS NEVER ANY THOUGHT I HAD IN DOING RESEARCH RELATING TO DISABILITY, AS A MATTER OF FACT I ALMOST DIDN'T IDENTIFY AS HAVING A DISABILITY BECAUSE I WAS IN MY OWN LITTLE SILO JUST TRYING TO SURVIVE. AND LET ME SAY THAT THE REASON THAT I DID BECOME A PROFESSOR AT HARVARD MEDICAL SCHOOL, IN 1998 IS BECAUSE OF CLASSIC OVERCOMPENSATION. I WORKED SO HARD AND WROTE SO MANY PAPERS BECAUSE I WAS TERRIFIED OF BEING FIRED AT EVERY MOMENT. AND SO LET ME JUST SAY THAT I NOW HAVE THE HONOR OF CO-CHAIRING A SUBGROUP THAT IS GOING TO BE ADVISING A GROUP THAT'S ADVISING NIH DIRECTORS SO WE ARE KIND OF DOWN IN THE TRENCHES A LITTLE BIT BUT IT IS A SUBGROUP OF PEOPLE WITH DISABILITY TRYING TO THINK ABOUT HOW TO INCREASE THE WORK FORCE OF PEOPLE WITH DISABILITY AND RESEARCH. IT'S GOING TO BE VERY, VERY HARD BECAUSE THERE ARE SUCH SUBTLE WAYS TO DISCRIMINATE AGAINST PEOPLE WITH DISABILITY THAT YOU JUST -- THAT IT'S HAPPENED TO ME THROUGHOUT MY CAREER EVEN AFTER BECOMING A PROFESSOR, THAT IT'S JUST SO HARD TO IDENTIFY, IT'S SO SUBTLE. AND IT'S HARD TO COMPLAIN ABOUT IT BECAUSE ARE YOU GOING TO SAY WELL THE PERSON DIDN'T LOOK ME IN THE EYE OR DIDN'T -- WASN'T POLITE TO ME. OR DIDN'T GO OUT TO DINNER WITH ME BECAUSE THEY COULDN'T FIND AN ACCESSIBLE RESTAURANT, WHEN I WAS INTERVIEWING FOR POSITION. SO IT'S GOING TO BE VERY, VERY CHALLENGING AND ONE OF THE PROBLEMS IS ALSO THAT WE DON'T HAVE DATA, WE DON'T KNOW HOW -- WHAT OUR DENOMINATOR IS. HOW MANY YOUNG SCIENTISTS WITH DISABILITY THERE ARE VERSUS HOW MANY ACTUAL SCIENTISTS WITH DISABILITY HAVE NIH FUNDING. SO LET ME STOP THERE. >> WONDERFUL COMMENTS. DR. HEARD GARRIS, YOU ARE NEXT ON MY SCREEN, IF YOU CAN TALK ABOUT THIS ISSUE HOW WE CUT INTO THESE SYSTEMIC ISSUES, THE TREE SCHEMATIC THAT YOU PUT UP ILLUSTRATES NICELY AND OUR DISCUSSION IS AROUND THE LEAVES AND HOW TO GET TO THE BRANCH BECAUSE THAT IS HOW WE'RE GOING TO INCREASE FUNDING FOR THESE TOPICS. >> ABSOLUTELY. I APPRECIATE THE QUESTION BECAUSE I THINK IT'S GOING TO BE MULTI-LEVEL. SO I THINK THE RESEARCHERS THAT CURRENTLY ARE FUNDED NEED TO BE PUSHED ENCOURAGED MANDATED HOWEVER YOU WANT TO SAY IT, TO LOOK AT THESE ISSUES BECAUSE YOU ARE RIGHT, THERE IS NOT THAT MANY OF US IN THIS SPACE. SO THE MORE PEOPLE THAT ARE ENGAGING IN THIS WORK, THE MORE PEOPLE THAT UNDERSTAND, THE SYSTEMIC ISSUES, THE BETTER BECAUSE THEY CAN APPLY TO ALL THE DIFFERENT FIELDS OF STUDY. AND IT IS NOT JUST A FEW PEOPLE TRYING TO DO IT ALL. WITH THAT BEING SAID, WE ALSO NEED PROGRAMS AND FUNDING THAT HELP INCREASE THAT MOUNT OF RESEARCHERS THAT COME FROM MINORITIZED BACKGROUNDS. BECAUSE WE ARE LIVING THIS EXPERIENCE, WE ARE IN COMMUNITIES THAT ARE IMPACTED BY THESE PROBLEMS AND CAN LOOK AT IT IN WAYS THAT OTHER PEOPLE MIGHT NOT BE ABLE TO. SO THERE ARE MULTIPLE LAYERS THAT NEED TO BE ADDRESSED WHEN THINKING ABOUT ISSUES OF RACE, ISSUES OF IDENTITY AND BIAS, BECAUSE WE BRING SOMETHING VERY IMPORTANT TO THE SCIENCE. SO I THINK MULTIPLE LEVELS. >> WONDERFUL. DR. DICKERSON, I TEACH ON RACE AND FAMILIES AND HEALTH AT THE UNIVERSITY OF MARYLAND AND ONE OF THE THINGS I ALWAYS TELL MY STUDENTS IS THAT IT'S ALMOST AS IF NATIVE AMERICAN YOUTH AND FAMILIES HAVE BEEN RENDERED INVISIBLE IN THE RESEARCH DATA. SO PLEASE TALK TO US ABOUT YOUR IDEAS HOW WE CUT INTO THIS ISSUE. >> I WOULD AGREE WITH THE OTHER PRESENTERS THAT WE NEED TO INCLUDE THAT WITHIN OUR RESEARCH DESIGN AND QUESTIONNAIRES AND SUCH. AND I THINK ALSO EMPHASIZING -- THERE IS SOME RESEARCH THAT DOES SHOW BENEFIT OF CULTURAL IDENTITY AND ENHANCEMENT OF CULTURE IDENTITY AND WITH NATIVE AMERICANS THAT KIND OF LINES IN WITH LEARNING ABOUT HEALTHY NATIVE TRADITIONAL WAYS OF LIVING WHICH EMPHASIZE A LIFE OF BALANCE, PHYSICALLY EMOTIONALLY SPIRITUALLY MENTALLY, SO SO BY PROVIDING THAT OPPORTUNITY WITHIN RESEARCH DESIGN AND INTERVENTIONS, POLICY MAKERS COULD FEEL REST ASSURED THEY ARE GETTING AN INTERVENTION THAT REALLY EMPHASIZES REALLY HEALTHY BEHAVIORS AND LIVING. THERE IS SOME RESEARCH THAT SHOWS THAT THERE ARE BENEFITS TO THAT, ALTHOUGH NOT A LOT OF IT YET BUT THERE IS PROMISING DATA ON THAT. >> THANK YOU SO MUCH FOR THAT. WE LOST ONE OF OUR PANELISTS, DR. CALHOUN, THIS IS THE LIFE OF PRACTICING PHYSICIAN RESEARCHERS, DR. CALHOUN HAD TO STEP AWAY TO TAKE CARE OF A PATIENT. SO WE HAVE TWO QUESTIONS THEY ADDRESSED TWO DIFFERENT ASPECTS OF INTERSECTIONALITY OF HEALTH BIAS SO I WILL TAKE TAKE THE FIRST ONE HERE LET ME SCROLL UP. WAS FOR DR. CALHOUN. THERE IS A QUESTION HERE ABOUT VICARIOUS RACISM. AND THE QUESTION ASKS COULD THIS TERM ENCOMPASS ANY PERSON WHO WITNESSES THIS? FOR EXAMPLE MY CHILDREN ARE WHITE AND YET THEY ARE DEEPLY DISTURBED BY WHAT THEY SEE WHEN THEY SEE OTHER CHILDREN TREATED IN WAYS THEY RECOGNIZE AS UNWARRANTED AN UNFAIR. SO IF YOU COULD EXPAND ON THAT. AND THEN I BELIEVE BECAUSE WE HAVE MULTIPLE FOLKS WHO CAN ADDRESS THIS ISSUE, THERE IS A QUESTION AROUND FRAMING THESE QUESTIONS TODAY IN THE ARENA OF MATERNAL AND CHILD HEALTH. SO DR. HEARD GARRIS I WILL POINT FIRST TO YOU ABOUT VICARIOUS RACISM. SO THIS IS INTERESTING, WE THINK ABOUT TYPICALLY IN TERMS OF OTHER CHILDREN OF COLOR WITNESSING VICARIOUS RACISM BUT THIS IS FRAMED FROM THE PERSPECTIVE OF WHITE CHILDREN SEEING THEIR PEERS OR CLASSMATES GO THROUGH THIS. >> ABSOLUTELY. I APPRECIATE THE QUESTION AND CAN PROVIDE CLARIFICATION. I THINK THERE IS DEBATE IN THE FIELD ABOUT WHO CAN ACTUALLY EXPERIENCE VICARIOUS RACISM, HOW I CONCEPTUALIZE IT IS THAT ANYONE CAN EXPERIENCE VICARIOUS RACISM, IF YOU ARE WHITE AND YOU ARE SEEING ESPECIALLY FOR CHILDREN AND THEY ARE SEEING SOME RACISM BIAS UNFAIR TREATMENT, ABSOLUTELY, THEY CAN INTERNALIZE IT AND THAT MIGHT IMPACT THEIR HEALTH. I WILL SAY THAT ALONG THAT SAME DEFINITION I DO THINK THERE IS SOMETHING TO IDENTITY. SO IF YOU ARE A BLACK MALE AND YOU SEE TREVON MARTIN, ANY OF THOSE PEOPLE GET KILLED AND YOU CAN SEE YOURSELF IN THAT SPACE, I DO THINK IT PROBABLY HAS A DIFFERENTIAL EFFECT ON YOU. WE DON'T KNOW AS MUCH AS WE SHOULD, THERE WAS ONE STUDY BY DAVID WILLIAMS AND THEIR GROUP THAT LOOKED AND SAW AFTER BLOOD PERSON WAS KILLED UNARMED BLACK PERSON WAS KILLED HOW THAT IMPACTED THEIR MENTAL HEALTH AND FOR BLACK AMERICANS, IT IMPACTED THEIR MENTAL HEALTH MUCH MORE THAN ANY OTHER AMERICANS. SO I DO THINK THAT THERE IS SOME GRADIENT THERE. >> AWESOME. YES. THAT PAPER WAS PUBLISHED IN THE LANSETT I BELIEVE IN 2019 IF WE CAN I'LL TRY TO PULL UP THE REFERENCE BECAUSE I THINK IT GOES TO THE POINT THAT THEY DID LOOK AT WHITE AMERICANS LIVING IN SAME PROXIMITY AND THEY FOUND THAT IT DIDN'T PENETRATE. JUST AS A CLINICAL PSYCHOLOGIST WHICH IS MY BACKGROUND, MS. -- SHE HER PRONOUNS, THAT YOUR CHILDREN HAVE EMPATHY FOR THIS, I THINK IS SOMETHING THAT YOU CAN CAPITALIZE ON AND SO THAT ANY TIME PEOPLE ARE EXPERIENCING THAT TRAUMA THAT THEY ARE WITNESSING, IT MAY PENETRATE IN A DIFFERENT WAY BUT I THINK ONE OF THE MAIN THINGS WE ARE MISSING IN THE OPEN ENDED COMMENTS FROM DR. IEZZONI'S TALK AND ALL THE PRESENTATIONS TODAY IS THAT PHYSICIANS ARE HUMAN BEINGS AND THEY BRING THEIR BIASES INTO THE PATIENT ROOM. SO TO THE EXTENT THAT YOU ARE TALKING WITH YOUR KIDS AN CONTINUING TO CULTIVATE THAT SENSE OF EMPATHY, AND THEY ARE GROWING AWARENESS OF THE UNFAIRNESS OF THE WORLD, THAT'S A GOOD THING ALTHOUGH IT IS STRESSFUL. SO GOING BACK TO THIS ISSUE OF MATERNAL AND CHILD HEALTH AND HOW WE THINK ABOUT IT IN TERMS OF THE ISMS, RACISM, SEXISM, THE WAY THEY COMBINE, ABLEISM, I'M GOING TO DIRECT THAT BROADLY TO THE PANEL WITH THE THREE MINUTES THAT WE HAVE LEFT. AND I'M GUESSING THAT FOLKS WHO WANT THE WEIGH IN ON THIS DR. IEZZONI AND DR. HEARD-GARRIS BUT DR. DICKERSON MAY HAVE A COMMENT AS WELL SO IF WE CAN FIT IT ALL IN FEEL FREE TO DO SO. WOULD ANYONE LIKE TO SPEAK FIRST? JUST GO AHEAD AND UNMUTE YOURSELF AND I'LL REFEREE AS NEEDED. >> I HAVE A QUICK COMMENT. WITH NATIVE AMERICANS WITH DIFFERENT LIFE EVENTS AND STAGES, THERE IS -- MANY OF THE GIVING BIRTH, BEING PREGNANT, HAVING A CHILD, THOSE ARE SACRED EVENTS AND OFTENTIMES WITH NATIVE AMERICANS THERE IS PLACE FOR CEREMONY, AND TRADITIONAL PRACTICES THAT TIE IN WITH THAT SO EMPHASIZING THOSE TO BE IMPORTANT IN THE CLINICAL SETTING. >> DR. IEZZONI, WOULD YOU LIKE THE WEIGH IN? >> I WANT TO MAKE ONE COMMENT, THAT IS THAT THERE IS EVIDENCE THAT PEOPLE WITH DISABILITY ARE AT RISK OF LOSING CUSTODY OF THEIR CHILDREN BECAUSE OF THEIR DISABILITY. ESPECIALLY IN DIVORCE OR SITUATIONS AND I ACTUALLY HEARD FROM SOME OF THE WOMEN THAT I INTERVIEWED THAT THEY WERE CONCERNED THAT THEIR NEIGHBORS WERE GOING TO REPORT THEM TO CHILD PROTECTIVE SERVICES BECAUSE THEIR NEIGHBORS WERE WATCHING THEM AND SAYING CAN THIS DISABLED WOMAN ACTUALLY CARE FOR HER CHILD. SO I THINK THAT IS STILL COUNTER NORMATIVE TO THINK OF A PERSON WITH A DISABILITY BEING A PARENT OF A SMALL CHILD. SO THERE'S JUST A LOT OF WORK AND THINKING AT A SOCIETAL LEVEL AND ALSO AMONG US AS SCIENTISTS TO FIGURE OUT HOW TO IMPROVE THIS SITUATION FOR PARENTS WITH DISABILITY. >> DR. HEARD-GARRIS, TAKE IT AWAY. >> ON THE FRAMING ISSUE THAT IS SUCH AN IMPORTANT QUESTION BECAUSE HOW YOU FRAME TO ONE AUDIENCE MAY NOT BE THE SAME WAY YOU FRAME THE EXTENT AND THE PROBLEM AS YOU MAY SEE IT. HOW YOU FRAME IT IN IN A GRANT APPLICATION OR TO POLICY MAKERS OR TO COMMUNITY, MIGHT BE VERY DIFFERENT LANGUAGE AND I THINK SOME OF THAT MIGHT DRAW INTO WHAT ARE THE VALUES OF THAT ORGANIZATION. SO NICHD MAKING SURE THAT CHILDREN AND MOTHERS LIVE THE HEALTHIEST LIVES THANK YOU TALK ABOUT HOW RACISM AND RACIAL IDENTITY AND THINGS THAT HOLD PEOPLE BACK PREVENT THEM OR PRECLUDE THEM FROM ACHIEVING THAT BEST LIFE THAT THEY CAN OR THE HEALTHIEST LIFE THEY CAN AND FOR POLICY MAKERS YOU TALK ABOUT THE VERY REAL STRAWING L WITH -- STRUGGLE THAT POLICY WITH STRUCTURAL RACISM COMES WITH AND HOW SOME ARE NOT ABLE TO ACCESS OPPORTUNITIES THAT WE SHOULD ALL BE ABLE TO ACCESS BECAUSE OF STRUCTURAL RACISM, WITH COMMUNITIES YOU TALK ABOUT THINGS IMPACTING THAT PARTICULAR COMMUNITY. SO I THINK IT IS AN IMPORTANT QUESTION BECAUSE FRAMING MATTERS. AND HOW YOU GET PEOPLE TO BUY IN MATTERS. I WOULD SAY TWO YEARS AGO ME GIVING THIS TALK I WOULD HAVE HAD TO DRIVE HOME THE IMPORTANCE OF RACISM AND HOW IT'S IMPACTS CHILD HEALTH. TODAY EVERYBODY OR MOST PEOPLE ACCEPT THAT, RACISM IS IMPORTANT. IT'S A THING THAT'S STILL PRESENT IN 2021 AND THAT YOU SHOULD PAY ATTENTION. SO I THINK WE ARE MOVING TOWARDS THE RIGHT DIRECTION AFFIRMING STILL MATTERS. >> AWESOME. WE ARE JUST ONE MINUTE OVER SO NOT TOO BAD. RELATED TO THE QUESTION OF MATERNAL AND CHILD HEALTH IN RACE WHICH IS WHAT DR. CALHOUN SPOKE ABOUT, WEIGHED INTO THAT, CHECK OUT A PIECE BY JOURNALIST LINDA VILLARO, ISA WHO DID EXPOSE ON BLACK WOMEN AND CHILDBIRTH WOMEN DIENING CHILDBIRTH. THAT'S ONE BIG ISSUE WE WANT TO DIVE IN TODAY. THAT'S WHERE I START AND GO TO SCIENTIFIC LITERATURE. WE ARE NOW NEEDING TO START A BREAK SO WE WILL CLOSE OUT THIS FABULOUS SESSION, LIKE I SAID WE COULD GO ALL DAY WITH EACH OF THESE TOPICS AND I THANK OUR SPEAKERS FOR PACKING A LOT OF VALUABLE INFORMATION IN. I HOPE THAT YOU ALL ENJOYED IT AND GOT A LOT FROM IT. I CERTAINLY DID AND I HOPE THE MEET Y'ALL IN PERSON SOME DAY POST WHATEVER THE NEW NORMAL IS. THANK YOU SO MUCH FOR COMING AND ENJOY YOUR BREAK. I WANT TO TAKE A MOMENT TO THANK DR. BYNUM AND THE SESSION THREE SPEAKERS FOR INSIGHTS AN SUGGESTIONS HOW THE ROLE OF BIAS AND HEALTH DISPARITIES CAN BE ACKNOWLEDGED AND ADDRESSED. IT IS NOW MY PLEASURE TO INTRODUCE SESSION 4 CHALLENGES IN DEFINING AND MEASURING IDENTITY AND INTERSEXUALITY. IN THIS SESSION WE WILL HEAR FROM THE FOLLOWING SPEAKERS ABOUT CONCEPTUALIZING INTERSECTIONALTIVE FROM DR. EZEKIAL DIXON ROMAN, CHALLENGES IN BEST PRACTICES MANY MEASURING INTERSECTIONALITY DR. CAR LOSS SANTOS, UNDERSTAND UNDERSTANDING IMPACT OF DR. DR. ELEANOR SEATON AND COMPLEX OF IDENTITIES AND MULTI-DIMENSIONAL IMPACTS ON YOUTH FROM DR. YOONSUN CHOI. THE MISSION IS MODERATED BY DR. PARSAPAR WHO COCOA LED THE WORKSHOP AND THE DEVELOPMENTAL PSYCHOLOGIST AND COMPLETING EXECUTIVE BRANCH POLICY FELLOWSHIP WITH NICHD THROUGH SOCIETY OF RESEARCH AND CHILD DEVELOPMENT. I ALSO WANT THE TAKE A MOMENT TO NOTE THAT NOT ONLY FROM THE SESSION TODAY BUT ALSO PAST AND CURRENT EVENTS AND CRISES IS MADE CLEAR THE NEED FOR UNDERSTANDING OF THE CONCEPTUAL AND METHOD LOGICAL CHALLENGES AROUND SOCIAL IDENTITIES, THEIR INTERSECTIONALITIES, AND IDENTITY RELATED BIASES TO PROMOTE HEALTH AND REDUCE DISPARITIES ACROSS POPULATIONS LIFE SPANS AND GENERATIONS. AS WE CLOSE OUT THE DAY WITH OUR FINAL SESSION, DISCUSSION AND CLOSING REMARKS, I URGE ALL OF YOU TO CONTINUE THESE CONVERSATIONS VIA TWITTER, FACEBOOK, THE NICHD, IDEAL STILL CAMPAIGN AND OTHER OUTLETS. I NOW PASS THE FLOOR TO DR. EZEKIEL DIXON-ROMAN. >> THANK YOU. LET ME DO THE SHARE SCREEN HERE. ARE Y'ALL ABLE TO SEE -- >> YES. JUST PRESENTER MODE. >> OKAY. GIVE ME ONE -- OH MAN, I JUST REALIZED WHAT I DID HERE. OKAY. HOW DO WE BEGIN TO MAKE SENSE OF THE ONGOING IDEA LOGICAL CONSTITUTION OF PEOPLE THAT ARE AFFECT OF SOCIAL AND POLITICAL PROCESSES, HOW MIGHT WE MAKE SENSE OF THE MULTI-POLICETY OF SYSTEMIC OPPRESSIONS THAT WE INHERIT AND MAKE UP AND THAT WE INHERIT AND MAKE UP OUR SOCIAL EXISTENCE. WE ARE BORN INTO THE WORLD WE ARE NAMED GENDERED, RAISED, CLASSED, ABLED OR DISABLED, OR MAYBE AND/OR DISABLED AND VERDICTLY SEXUALIZED AND NATIONALIZED IRITTIBILITY OF IDENTITIES ARE SITUATIONAL. HOW CAN WE UNDERSTAND THE THE ON THE LOGICAL COMPLEXITY OF MULTIPLICITY OF FORCES OF BECOMING, I SEE A PRESENTATION -- >> HI, I JUST WANTED TO LET YOU MOW YOU JUST DIDN'T PUT IT BACK INTO PRESENTER MODE. THE LITTLE ICON AT THE BOTTOM RIGHT NEXT TO THE SCROLL WHERE YOU CAN ENLARGE THE SIZE OF THE SCREEN. IT LOOKS LIKE A STANDING PRESENTATION. >> I SEE IT. >> THERE WE GO. >> LET ME SEE IF THERE IS A WAY I CAN -- IT'S STILL -- OKAY. LET ME CONTINUE ON LIKE THIS BECAUSE -- YEAH. MY NOTES ARE RIGHT HERE IN FRONT OF ME UNFORTUNATELY, SORRY. THESE QUESTIONS HAVE OFTEN BEEN THEORETICALLY UNDERSTOOD FROM THE INTERSEXUALITY LENS -- SORRY, WE ARE BORN INTO THE WORLD WE ARE NAMED GENDERED CLASSED IT IS ABLED AND SEXUALIZED AND NATIONALIZED AT THE IRRITABLE OF IDENTITIES ARE SITUATIONAL. HOW CAN WE UNDERSTAND THE ON THE LOGICAL COMPLEXITIES OF THE MULTIPLICITY OF VARIOUS SOCIAL FORCES THAT MAKE UP OUR VERY BEING AND BECOMING? THESE QUESTIONS HAVE OFTEN BEEN THEORETICALLY UNDERSTOOD, UNDERSTOOD FROM THE INTERSECTION INTERSEXUALITY LENGS PUT FORTH BY THIRD WAY FEMINISTS AND CRITICAL RACE STUDIES. AS THEORY TO UNDERSTAND THE MULTIPLICITY OF DIFFERENCE, THE INTERSEXUALITY LENGS WAS A BLACK FEMINIST INTERVENTION TO SUBVERT THE HEGEMONIC CONFIGURATION OF RACE CLASS AN GENDER AS WELL AS SEXUALITY AND DISABILITY AMONG OTHER CATEGORIES OF SOCIALLY CONSTITUTESSED DIFFERENCE. CONSTITUTED DIFFERENCE. BLACK FEMINIST SCHOLARS FROM 1980s AND 90s STUDIED BY EXAMINING INTERGROUP DIFFERENCES WITHIN LARGE SOCIAL IDENTITY GROUPS SUCH AS RACE AN GENDER. IN 84 BELL BELL HOOKS HIGHLIGHTED THE IMPORTANCE OF A LENS THAT TOOK INTO ACCOUNT THE MULTIPLE FORMS OF OPPRESSION THAT SOME INDIVIDUALS SUCH AS BLACK WOMEN FACE. SINCE FOR MUCH OF HISTORY IN THE WESTERN WORLD THE FEMINIST MOVEMENT IS DOMINATED BY AND DIRECTED BY WHITE MIDDLE CLASS WOMEN. THE MOVEMENT'S GOALS AND ACTIVITIES WERE DREICH BY THE NEEDS OF WHITE BOURGEOIS WOMEN, THESE WOMEN BECAUSE OF RELATIVE PRIVILEGE COMPARED TO WOMEN OF COLOR ARGUED THAT GENDER WAS THE PRIMARY FORM OF OPPRESSION. THUS SEXISM NEEDED TO BE ERADICATED BEFORE ATTENTION COULD BE FOCUSED ON RACISM AND CLASSISM. IN HER SEMINOLE TEXT SHE ARGUED ONE KEY CONCEPT OF INTERSECTIONALITY THEORY WITHOUT CALLING IT THAT STATING THAT THIS PERSON ZIEFED HIERARCHY OF OPPRESSION IS UNNECESSARY AND INVALID IN FACT HOOKS CLAIMED IN WESTERN CULTURE ALL FORMS OF OPPRESSION ARE LINKED AND SUPPORTED BY THE CULTURAL BELIEF THE SUPERIOR SHOULD CONTROL THE INFERIOR. THUS IN ALL FORMS OF OPPRESSION, THUS SINCE ALL FORMS OF HOP PRESENTATION ARE LINKED ONE SYSTEM WITH NOT BE ERADICATED WITHOUT WHILE THE OTHERS REMAIN. THE CONTRIBUTION OF PATRICIA COLLINS AND MARGARET ANDERSON AND MARGARET ANDERSON AND PATRICIA COLLINS IN COLLABORATION EXPANDED ON THIS DISCUSSION BY DELVING INTO THE THEORETICAL SHIFT BLACK FEMINISTS INITIATED THROUGH EXAMINATION OF INTERSECTING OPPRESSION OF RACE CLAUSE GENDER SEXUALITY LANGUAGE NATURAL ORIGIN AND SO FORTH. CATHY COHEN LOOKED HOW LARGE MARGINALIZED GROUPS FORM BASED ON CHARACTERISTICS SUCH AS RACE OR GENDER ADOPT AN REINFORCE VARIOUS EXTRA LEVELS OF SUBORDINATION. IN SHORT COHEN ARGUED MARGALIZED GROUPS ADOPT SYSTEMS OF SECONDARY MARGINALIZATION IN ORDER TO BE ACCEPTED BY THE DOMINANT GROUP. SECONDARY MARGINALIZATION THOSE IN THE MARGINAL GROUP WHO HAVE MORE POWER AND CONFORM MORE CLOSELY TO CHARACTERISTICS DEEMED ACCEPTABLE BY THE DOMINANT CLASS, POLICE THEIR OWN GROUP. THUS CREATING INTERNAL DIVISIONS. COHEN CLAIMS THIS IS DEMON INVESTIGATED IN THE AFRICAN AMERICAN COMMUNITY WHEN LEADERS IN THIS GROUP LAUD MIDDLE CLASS FAMILIES AS TRUE EXAMPLES OF BLACK SOCIETY AT THE SAME TIME THAT PROMINENT BLACK LEADERS AUTHORS AND ACADEMICS LARGELY IGNORE OR VILIFY BLACK LESBIANS AND GAY MEN OR BLACK WOMEN ON WELFARE. KIMBERLY CRENSHAW PROVIDE AD SPECIFIC EXAMPLE HOW INTERSEXUALITY EXPERIENCE IN HER EXAMINATION OF VIOLENCE AGAINST WOMEN OF COLOR. SHAH ASSERT THAT QUOTE THE INTERSECTION OF RACISM AND SEXISM FACTORS TO BLACK WOMEN'S LIVES THAT CANNOT BE CAPTURED BY LOOKING AT THE RACE OR GENDER DIMENSIONS, OF THOSE EXPERIENCES SEPARATELY. LOOKING AT RACE AND GENDER SEPARATELY FOR INDIVIDUAL WHOSE ARE MARGINALIZED ON BOTH LEVELS PROVIDES AN INCOMPLETE PICTURE THEORETICALLY AND PRACTICALLY BECAUSE BURDENS THAT RESULT FROM EACH ASPECT OF OPPRESSION INTERACT TO CREATE A NEW DIMENSION OF DISEMPOWERMENT. ONE POWERFUL STORY THAT CRENSHAW TELLS IS OF AN IMMIGRANT WOMAN IN NEW YORK WHO TRIED TO GAIN ACCESS TO A DOMESTIC VIOLENCE SHELTER AFTER FLEEING HER HUSBAND. WHO THREATENED HER AND HER SON'S LIVES. HER ACCEPTANCE IN TO A SHELTER WAS HELD FOR TWO NIGHTS BECAUSE OF REQUIRED SHE PROVE CERTAIN LEVEL OF ENGLISH PROFICIENCY. AND IN THE THE MEANTIME SHE AND HER SON WERE OUT ON THE STREETS, AND WERE MUGGED SEVERAL TIMES. HER ADVOCATE A LATINA SERVICES ORGANIZATION LOST CONTACT WITH THE WOMAN BEFORE THE SHELTER WOULD TAKE HER IN. THIS IS A STORY THAT HIGHLIGHTS BOTH THE SYSTEM LAYERTIES AMONG WOMEN IE POTENTIAL FOR ALL WOMEN TO BE VICTIMS OF DOMESTIC VIOLENCE AND THE DIFFERENT EXPERIENCES AT VARIOUS GROUPS OF WOMEN ENCOUNTER AND IN THIS CASE THE ADDITIONAL MARGINALIZATION CREATED BY NOT SPEAKING THE DOMINANT LANGUAGE FLUENTLY. INTERSEXUALITY HAS HAD TREMENDOUS INFLUENCE IN THE SOCIAL SCIENTIFIC STUDY OF IDENTITY DIFFERENCE AND PROCESSES OF OPPRESSION. AND HAS MADE IMPORTANT INTERVENTIONS AND DISCOURSE ON IDENTITY POLITICS AND SOCIAL MOVEMENTS. THERE IS A MARGINALIZATION AND RESEARCH ON MARGINALIZED GROUPS AND INTERSECTIONAL SUBJECTIVITIES WHILE HELPFUL AND IMPORTANT THE TAKE UP OF INTERSEXUALITY HAD TENDENCIES IN SCHOLARLY PUBLIC DISCOURSE THAT FOCUS MOSTLY ON IDENTITY INDIFFERENCE AND ONE ARGUE. -- ARGUMENT IS INTERSEXUALITY IS LESS IDENTITY AND DIFFERENCE AND SEEKS TO DECONSTRUCT AND TO DISRUPT THE VERY DISCOURSES OF THAT IDENTITY INDIFFERENCE AND HAS A PARTICULAR FOCUS ON THE SOCIAL PROCESSES OF SYSTEMS OF ON RELATION, MANY -- OPPRESSION, THE MATRIX OF OPPRESSION THAT PRODUCES BY-PRODUCTS OF IDENTITY INDIFFERENCE. AS A RESULT WHEN THIS SCHOLARLY TENDENCY TO FOCUS ON IDENTITY INDIFFERENCE IN THE POLICY DISCOURSE WHEN THERE IS A FOCUS ON IDENTITY INDIFFERENCE IT HAS A WAY OF SLIPPING INTO THE TRAPPINGS OF ESSENTIALIZING THESE CATEGORIES. AND ALSO FALLING INTO A POLITICS OF INCLUSION THAT FUNDAMENTALLY DOES NOT ACTUALLY CHANGE THE LOGIC OF DECISION MAKING OF NORMATIVE PROCESSES OF DECISION MAKING OF POWER. SO EVEN THOUGH WE MIGHT INCLUDE DIFFERENT IDENTITIES TO THE TABLE, THAT DOESN'T NECESSARILY MEAN IT'S GOING TO CHANGE THE ACTUAL NORMATIVE STRUCTURE RULES AND PROCESSES OF DECISION MAKING. IN ADDITION, THE OTHER SUBSEQUENT CONSEQUENCE OF THE SCHOLARLY FOCUS ON IDENTITY IN RESEARCH IN PARTICULAR CAN HAVE A WAY OF ACTUALLY FOCUSING SPECIFICALLY ON IDENTITY CATEGORIES AT THE COST OF OR THE OVERLOOKING OF THE VARIOUS SOCIAL PROCESSES THAT IN FACT INTERSEXUALITIES SPECIFICALLY INTERESTED IN. THAT IS TO SAY THE FOCUS ON SYSTEMS OF OPPRESSION THEMSELVES, A VERY FORCES AND PROCESSES OF OPPRESSION THAT MAKE UP THAT EVEN PRODUCE THESE VERY -- THE VERY IDENTITY CATEGORIES THAT BECOME THE FOCUS OF RESEARCH. ONE TENDENCY IS TO EVEN FOCUS IN QUANTITATIVE RESEARCH ON WHAT ARE KNOWN AS INTERACTION OR MULTIPLICATIVE EFFECTS. THIS POTENTIALLY HAS THE PLAUSIBILITY OF GETTING AT INTERSEXUALITY IF THE INTERACTION MULTIPLICATIVE EFFECT IS GETTING AT SOCIAL PROCESS ISING OF SYSTEMS OF OPPRESSION. AND NOT SIMPLY AN INTERACTION OF IDENTITIES. THE INTERACTION OF IDENTITIES IS GETTING US SOMETHING BUT IT IS NOT I WOULD ARGUE NOT FULLY GETTING US AT THE VERY SYSTEMIC PROCESSES OF OPPRESSION THAT INTERSEXUALITY IS FOCUSING ON AND INTERESTED IN. AND LASTLY, THE ONE OF THE HARDEST ISSUES OF DOING RESEARCH ON INTERSEXUALITY IS THE MEASUREMENT OF SYSTEMS AND MATRICES -- MATRIX OF OPPRESSION PARTICULARLY ON THE LEVEL THAT IS TO SAY THE WAYS IN WHICH SYSTEMS OF OPPRESSION PLAY OUT IN EVERY DAY QUOTIDIAN AFFECT ACTS AND AFFECTS THAT RUN SEEN BUT LITERALLY WORK UNDER UNDER THE SKIN AND SHAPING OUR VERY LIVES. WITH THAT I WILL STOP AND THANK YOU FOR FOR THE TIME AND OPPORTUNITY TO SHARE. >> THANK YOU, DR. DIXON ROMAN. NOW WE'LL PASS THE FLOOR TO DR. SANTOS. >> ALL RIGHT. THANK YOU ALL FOR HAVING ME ON THIS IMPORTANT MEETING AND I'M DELIGHTED TO SPEAK TO YOU ABOUT THIS TOPIC IN PARTICULAR ON CHALLENGES AN BEST PRACTICES MEASURING INTERSEXUALITY. SO HERE ARE SOME OF THE ISSUES I'M GOING TO TRY TO ADDRESS. GOING TO START WITH GROUP DISCUSSION AND ISSUES PERTINENT TO DISCUSSION OF INTERSEXUALITY AND MEASUREMENT AND TALK ABOUT SOME BROADER ISSUES IN MEASUREMENT THAT I THINK ARE WORTH CONSIDERING PARTICULARLY AS RELATES TO THE MEASUREMENT TOOLS AND CONTEXT AND RELATIONAL APPROACH. I'M ALSO GOING TO TALK ABOUT EXPLICITLY ABOUT INTERSECTION A.M. PHENOMENAL MEASUREMENT, INTRODUCE WORK WE'RE DOING AROUND CAPTURING INTERSECTIONAL CONSCIOUSNESS AND ISSUE WITNESS THE LITERATURE AND WITH SOME OF MY RECOMMENDATIONS WERE WHAT NIH AND NICHD CAN DO TO GO FORWARD IN TERMS OF METRICS. SO SOME BROADER ISSUES CONCERNING IDENTITY AND OPPRESSIONS IN PARTICULAR. THERE IS A TRADITION THAT'S PARTICULARLY PROMINENT IN PSYCHOLOGY RELATED FIELDS AROUND MEASURING IDENTITIES SORT OF IN SOME WAYS ALONE AND NOT ALWAYS CAPTURING THE OPPRESSION, THE ON PRESSSIVE FORCES ASSOCIATED WITH SOCIAL IDENTITIES. I WANT TO CAUTION AGAINST THAT NOT NECESSARILY TO SAY THAT WE SHOULDN'T DO IT, BUT AT LEAST TO BE CLEAR HOW INTERPRETATION DIFFERS FROM COMMON INTERPRETATIONS OF INTERSEXUALITY HOW ON PRESSSIVE SOURCES OVERLAP TO CREATE UNIQUE CONDITIONS SO SORT OF I ALWAYS SAY THINK OF KIMBERLY CRENSHAW AND COLLINS AND HAVING A DISCUSSION WITH INTERSEXUALITY VOID OF OPPRESSION AND SIMPLY ABOUT HAVING MULTIPLE SOCIAL IDENTITIES. I'M ASKED TO GIVE PAPERS AN GRANTS IN WHICH FOLKS ASSUME THEY ARE CAPTURING ENTERSEXALTY WORK BY FOCUSING ON IDENTITIES ALONE AND NOT CAPTURING THE OPPRESSION (INAUDIBLE). SO I'M GOING TO PUT IN A WORD FOR THAT. ANOTHER ISSUE THAT I THINK IS IMPORTANT TO CONSIDER IN TERMS THAT HAS IMPLICATION FOR MEASUREMENT, IS A POINT THAT'S BEEN MADE, IN THIS MEETING ALREADY CONCERNING THE REALITY THAT NOT ALL ON PRESENTATIONS ARE EXPERIENCED IN THE SAME WAY. IN PARTICULAR, GIVEN INTERSECTIONALITIES IN CRITICAL RACE THEORY, MIGHT BE PARTICULARLY IMPORTANT RELEVANT TO CONSIDER CENTERING ANTI-BLACKNESS AN RACISM AS A KEY SOCIAL FORCE AND ALSO TO AVOID IN OUR WRITING EVEN IF MEASUREMENT MIGHT NOT READILY REFLECT THIS DIRECTLY, NOT ALL OPPRESSION FORCES ARE NOT THE SAME OR EXPERIENCE IN THE SAME WAY. THIS WILL MAKE A LITTLE MORE SENSE AS I MOVE FORWARD ON THIS DISCUSSION. SOME OTHER BROADER ISSUES THAT ARE PERTINENT I THINK WE NEED TO (INAUDIBLE) QUANTITY MEASURES CONSIST OF WORDS OF LIVED EXPERIENCE, CAPTURE COMPLEX PHENOMENA EXPERIENCE IN DIVERSE WAYS ACROSS CONTACTS, ACROSS SPACE, ACROSS TIME. AND LIKELY ALWAYS REFLECT A SET OF PERSPECTIVES THAT BIAS IN SOME WAY SO THE PRESUMPTION OF BIAS FREE RESEARCH HAS TO BE CHALLENGED I BELIEVE FOR US TO DO GOOD MEASUREMENT WORK. AND I ALSO THINK IT'S IMPORTANT ENGAGE IN THESE ISSUES TO KNOWLEDGE THEY BRING QUANTITATIVE METHODS OVER QUALITATIVE METHODS IN TERMS OF WHETHER A WE CONSIDER VALID OR I GUESS TO BE EVIDENCE THAT'S WORTH OUR ATTENTION. SO I THINK IT'S IMPORTANT TO BE (INAUDIBLE) ROLES AND BUYIASES TO VALUE O BIASES TO VALUE ONE OVER THE OTHER AND CONSIDER MEASURES IN A WAY THAT ACKNOWLEDGES THE WAYS IN WHICH IT ALSO CAPTURES BIASES AND PERSPECTIVES AND THEREFORE (INAUDIBLE) ANOTHER IMPORTANT ISSUE. ANOTHER CRITICAL ISSUE I BELIEVE CONCERNS THE SORT OF IMPORTANCE OF THE NEED TO CONTEXT IN RELATIONSHIPS. WHICH IS NOT ALWAYS REFLECTED IN THE WAY THAT WE APPROACH OR THINK ABOUT METRICS. SO IF WE ARE TALKING ABOUT MULTIPLE OVERLAPPING ON PRESSSIVE FORCES OR MULTIPLE OVERLAPPING SOCIAL IDENTITIES, I THINK IT'S IMPORTANT TO ACKNOWLEDGE THERE EXPERIENCE CONCEPTUALLY AND THEIR EXPERIENCE (INAUDIBLE) SO WE WANT TO CONSIDER HOW WE MIGHT BEST CAPTURE ACTUAL NATURE OF HOW OPPRESSION AND IDENTITIES ARE EXPERIENCED IN RELATION TO (INAUDIBLE). SO WHAT DOES THAT LOOK LIKE OR WHAT DOES THAT MEAN? OFTEN SIMPLE MODIFICATIONS TO MEASURES CAN AFFORD A LITTLE MORE PRECISE CAPTURING OF CONTEXT OF RELATIONSHIPS SO ONE (INAUDIBLE) SOCIAL RESEARCH IS THAT WE OFTEN TEND TO RELY ON MEASURES THAT ARE FOCUSED ON SELF-EXPERIENCES. SELDOM ARE WE SPECIFYING EITHER CONTEXT OR RELATIONSHIPS. IN HOW WE MIGHT ASSESS THINGS LIKE RACIAL SEN RAILTY OR -- SO ONE SOMETIMES SIMPLE MODIFICATIONS LIKE GETTING A CONTACT FOR ANY PARTICULAR FRIENDS HOW WE MIGHT DEAL WITH RACIAL IDENTITY WITH FRIENDS AND MEASUREMENT ITSELF IS SOMETHING THAT CAN BE -- OF COURSE THERE'S BEEN VERY IMPORTANT WORK THAT (INAUDIBLE) IN TERMS OF THINKING ABOUT CONTACTS AND (INAUDIBLE) BUT MEASUREMENT LEVEL WE CAN ALSO BE CREATIVE MANY TERMS OF HOW WE THINK ABOUT THIS ISSUE OF SOCIAL ON PRESSSIVE FORCES (INAUDIBLE). SO I WANT TO PUT IN A PLUG FOR PUSHING OURSELVES TO THINK MORE ABOUT WAYS WE CAN -- MEASUREMENT ITSELF CAPTURE (INAUDIBLE). AGAIN THIS FEEDS INTO THIS LARGER BROADER ISSUE SOMETIMES TAKE PARTICULAR PSYCHOLOGY (INAUDIBLE) TEND THE TAKE VERY RIGID FIELDS ON MEASURING -- USEFUL IN SOME WAYS WE FIND OURSELVES IN STRONG IN TERMS OF MEASUREMENTS, CERTAIN SUBJECTS PSYCHOLOGY MORE SO THAN OTHERS. BUT OF COURSE DISCIPLINES OUTLETS PUBLICATION, AGENCIES VARY HOW RIGID THEY MIGHT BE IN TERMS OF PSYCHOMETRIC TESTING OF MODIFICATIONS ADAPTATIONS. THERE'S A LOT OF GRAY AREAS THERE (INAUDIBLE) IN YOUR GRANTS OR WORKING FOR PROJECTS AND SO WHICH SHOULD TECHNICALLY WANT OR HOPE USING THAT GREATNESS TO ADVANCE THE FIELD A WAYS AND WE ARE ALSO DOING RIGID RIGOROUS WORK TO TEST MEASURES PSYCHO METRICALLY EVALUATE WHAT WE ARE PROPOSING TO DO. IN TERMS OF THINKING ABOUT INTERSECTIONAL PHENOMENA, MEASURES IN PARTICULAR ANOTHER REALLY IMPORTANT ISSUE IS CONSIDERATION THAT ON PRESSSIVE FORCES AND SOCIAL IDENTITY IDENTITIES ARE NOT EXPERIENCED IN ISOLATION. IT IS IMPORTANT MOVING FORWARD WE CONSIDER HOW MEASUREMENT HAVE, HOW MUCH WE CAN BEST CAPTURE INTERSECTIONAL PHENOMENA, PUT UP SOME EXAMPLES OF PROBLEMS THAT ARE REALLY GREAT WORK, IN TERMS OF PUSHING THE ENVELOPE IN TERMS OF HOW WE MIGHT CAPTURE INTERSECTIONAL PHENOMENA, MY COLLEAGUE JIONNI LOUIS HAVE BEEN DEVELOPING MEASURES OF RACISM AMONG BLACK WOMEN (INAUDIBLE) SHE -- THIS IS WHAT I MEAN BY WE NEED TO BE CREATIVE ABOUT MEASUREMENT SHE DID A SIMPLE ADAPTATION FOR SPECIAL (INAUDIBLE) TOGETHER SHE SUBMITTED A MANUSCRIPT, SHE DID ANNOTATIONS TO SELLERS MAYBE MEASURE OF RACIAL IDENTITY SO ITEMS LIKE BEING BLACK, BEING A BLACK WOMAN AND (INAUDIBLE) MAKES SENSE. THAT'S -- THOSE ARE SIMPLE ADAPTATION MODIFICATIONS WE MIGHT NEED TO MAKE. THAT MIGHT BE OF COURSE AGAIN IF YOU WANT TO CONSIDER RIGOROUS TESTING OF THESE MODIFICATIONS ADAPTATIONS IN ORDER TO ENSURE THEY WILL THE -- PART OF THE ISSUE WITH WHAT WE LOOKING FORWARD IN TERMS OF INTERSECTIONALITIES THAT WE ARE PUSHING (INAUDIBLE) ON MEASURES IN THIS WAY. (INAUDIBLE) RESEARCH PERCEIVED RACISM IN THE LGBT COMMUNITY OR CONFLICT (INAUDIBLE) RACIAL AND ONE IS SEXUAL'S MINORITY IDENTITY SO TALK ABOUT INTERSECTIONAL PHENOMENA BUT REALLY TALKING ABOUT THESE MEASURES THAT ARE VERY EXPLICITLY TRYING TO CAPTURE IN WAYS IN WHICH MULTIPLE SOCIAL (INAUDIBLE) ARE EXPERIENCED. (INAUDIBLE) THAT BRIDGES THE ON AWARENESS SELF-EFFICACY AND ACTION WITH INTERSEXUALITY AND OUR PARTICULAR APPROACH WE DEFINE INTERSEXUALITY ROUGHLY AS WAYS WHICH MULTIPLE FORMS OF OPPRESSION OVERLAP AND EXPERIENCES WITH THAT AND WE ASKED FOR MORE AWARENESS INTERSECTIONAL CONSCIOUSNESS FOLLOWING THAT, IN THE CONTEXT OF AWARENESS OF INTERSECTIONAL ISSUE, SELF-EFFICACY OR (INAUDIBLE) ACTIONS WORTHWHILE AND ACTUAL EXPERIENCE ENGAGING (INAUDIBLE) NEGATIVE EFFECTS. AND WE HAD TO BE CREATIVE. WE ADDED SO WHEN YOU TALK ABOUT ACTUAL EXPERIENCES, WE MEASURED (INAUDIBLE) SO SURVEY VARIOUS FOLKS, THERE IS A CHALLENGE THERE LISTING VERY SPECIFIC ACTIONS FOLKS MIGHT TAKE THAT IN THAT (INAUDIBLE) WE BELIEVE RELEVANT BUT THEY ARE NOT CAPTURED. SO WE ACTUALLY TALK ABOUT -- WE CAPTURE ACTION (INAUDIBLE). THERE ARE CONS AN PROS TO ALL OF THESE APPROACH. APPROACHES. ONE RISK THAT IS CRITICALLY IMPORTANT TO REMIND PEOPLE ABOUT EXTENSIVELY IS THE RISK OF (INAUDIBLE) HOW OPPRESSION AND (INAUDIBLE) MEASUREMENT AS MODELS THAT WE TEST, ET CETERA, ARE NEVER PERFECT, THERE'S ALWAYS OPPORTUNITIES FOR (INAUDIBLE). PROS THAT ALLOW FOR (INAUDIBLE) WIDESPREAD COMPLETION OF SURVEY MEASURES (INAUDIBLE) IN CONTRAST TO MEASURE (INAUDIBLE). DEVELOP OPPRESSION SPECIFIC MEASURES OF CRITICAL CONSCIOUSNESS OF INTERSECTIONALITY. THE (INAUDIBLE) APPLICABLE TO ALL -- SELF-EXPERIENCE IN TIME LARGER SURVEY, THAT MIGHT BE A CHALLENGE. BUT PRECISE FOCUS ON CERTAIN ON PRESSSIVE FORCES. -- OPPRESSIVE FORCES. I'M ABOUT OUT OF TIME SO I WANT TO ENWITH RECOMMENDATIONS ON WHAT NIH AND NICHD CAN DO IN TERMS OF MEASURES IN INTERSECTIONALITY. I WANT TO ENCOURAGE BUILDING ON EXISTING CALLINGS SUCH AS THOSE THAT LIST A FOCUS ON EFFECTS ON HEALTH. (INAUDIBLE) REMEMBER TALKING (INAUDIBLE) HIV AIDS FOLKS LIVING WITH -- TAKING A LITTLE BIT OF MOVING FORWARD A LITTLE BIT PERHAPS MORE SO THAN (INAUDIBLE) ALTHOUGH THAT MAY HAVE CHANGED. . BUT THERE'S BEEN EXPLICIT CALLS ON MEASURING INTERSECTION, (INAUDIBLE) ENCOURAGE THAT AND HOPE TO SEE THAT WITHIN NICHD. I THINK SOCIALIZING REVIEWERS IN ORDER TO MEET DEMAND OF INTERSECTIONALITY IS (INAUDIBLE) CREATED AND DEBATED IN ORDER TO MEET MEASUREMENT DEMANDS. I THINK CONSIDERING WHETHER -- IS A BROADER ISSUE BUT RELEVANT FOR MEASUREMENT SCHOLARSHIP AND (INAUDIBLE). INFORMING INTERSECTIONAL MEASUREMENT AND SCHOLARSHIP KNOWING THAT THERE ARE VARIOUS WAYS WHICH FOLKS HAVE TRACED THE ROOTS FROM (INAUDIBLE) DATA COLLECTED IN THE '70s AND FOLKS THAT HAVE SHAPED WHAT WE NOW REFER TO AS INTERSEXUALITY. AND ALTHOUGH ACKNOWLEDGE REPRESENTATION DO NOT ITSELF ADDRESS ALL THE ISSUES INTERSEXUALITY FACES IT MATTERS SO I THINK (INAUDIBLE) MEMBERSHIP OF WHO THEY AIM TO STUDY. USUALLY MEANS THEY ARE ATTUNING THEMSELVES TO VARIOUS ISSUES, THE TERMS OF MEASUREMENT RELEVANT TO (INAUDIBLE) EXPERIENCES. FINALLY CONSIDERING HOW APPLICANTS NAVIGATE ISSUE CENTRIC BLACKNESS AN RACE -- ANTI-BLACKNESS AND RACISM, NOT ALL OPPRESSIVE FORCES ARE EXPERIENCED THE SAME WAY, RACISM TIDE TO FORCES THAT ARE DEEPLY PERVASIVE ACROSS GENDER SEXUALITY ET CETERA. CONSIDER WHETHER STUDIES TAKE ON ADDITIVE OR MULTIPLICATIVE OR ASSESSMENT APPROACH, DIFFERENT MEASURES OR (INAUDIBLE) PERCEPTION PHENOMENA. CERTAINLY CAN TAKE UP EVIDENCE OF MULTIPLICATIVE APPROACHES SO MEASURING INDIVIDUAL SOCIAL IDENTITIES FOR EXAMPLE IS ANOTHER SORT OF APPROACH. BUT (INAUDIBLE) SO WITH THAT I WILL STOP HERE AND LOOK FORWARD TO QUESTIONS. >> THANK YOU, DR. SANTOS. I WILL NOW PASS THE FLOOR TO DR. ELEANOR SEATON FOR HER TALK. >> GOOD AFTERNOON, EVERYONE. I WANT TO THANK SAMANTHA AND PARISA FOR INVITING ME TO THIS TALK. THIS HAS BEEN AN AMAZING SET OF TALKS TODAY. AND I'M VERY GRATEFUL TO JOIN MY COLLEAGUES IN THESE VERY IMPORTANT CONVERSATIONS. SO THE TITLE OF MY TALK WHAT'S IDENTITY HAVE TO DO WITH IT. I'M A BIG TINA TURNER FAN FOR THOSE WHO MAY RECOGNIZE THAT TITLE. NEXT STEPS FOR UNDERSTANDING THE IMPACT OF SOCIAL IDENTITY ON YOUTH HEALTH DISPARITIES. I DON'T HAVE TO GIVE THE BACKGROUND I INTENDED TO GIVE BECAUSE OF CAR CARLOS. I WANTED TO REMIND OUR AUDIENCE THAT THE INTERSEXUALITY FRAMEWORK ORIGINATE IN BLACK FEMINIST SCHOLARSHIP AND KIMBERLY CRENSHAW THOUGH THE FIRST PERSON TO COIN THE TERM INTERSECTIONALITY THIS GOES BACK TO -- RIVER COLLECTIVE, AUDREY LORD. SO AGAIN JUST REMINDING THE AUDIENCE OF WHAT INTERSEXUALITY IS. AND THAT IT FOCUSES ON SYSTEMS OF INEQUALITY OR SYSTEMS OF OPPRESSION, AT THE ROOT AND HOW THAT MANIFESTS AS IDENTITIES. THESE SYSTEMS OF OPPRESSION MAKE SOCIAL IDENTITIES RELEVANT ESPECIALLY THOSE LINKED TO THE SPECIFIC SYSTEMS OF OPPRESSION. SO RACISM MEANS THAT RACIAL IDENTITY MATTERS. SEXISM MEANS THAT GENDER IDENTITY MATTERS. SO I WANT TO JUST REMIND THE AUDIENCE WHAT INTERSEXUALITY IS ABOUT WHICH AGAIN INTERSECTAL SYSTEMS OF INEQUALITY, THAT ULTIMATELY ADVANTAGE AND DISADVANTAGE INDIVIDUALS BASED ON THEIR SPECIFIC SOCIAL LOCATIONS. BUT I THINK MY COLLEAGUE CARLOS DID AN EXCELLENT JOB REMINDING YOU THAT IT HAS ROOTS IN BLACK FEMINIST SCHOLARSHIP. THAT'S REALLY, REALLY IMPORTANT TO KEEP IN MIND. I ALSO WANT TO I DON'T KNOW WHY THIS IS HAPPENING. I ALSO WANT TO DO A RECAP ON THE LITERATURE AS FAR AS SOCIAL IDENTITIES ARE CONCERNED. THERE WAS A META ANALYSIS THAT FOUND THAT INDIVIDUALS WHO ARE HIGHLY IDENTIFIED WITH THE REPORTED IDENTITY GROUP REPORT LESS DEPRESSIVE SYMPTOMATOLOGY. THIS MORNING WE HEARD FROM OUR COLLEAGUE WHO CONDUCTED ONE OF THE EARLIER META ANALYSIS OF ETHNIC RACIAL IDENTITY FOUND IT IS ALSO ONE OF THE MORE STUDIED SOCIAL IDENTITIES PARTICULARLY FOR THOSE WHO ARE NOT WHITE, AND THAT ETHNIC RACIAL IDENTITY IS LINKED TO POSITIVE MENTAL HEALTH AMONG MINORITY YOUTH AND ALSO ETHNIC RACIAL MINORITY ADULTS SO IN GENERAL ETHNIC RACIAL IDENTITY WHICH IS ALSO ONE OF MY AREAS OF EXPERTISE HAS POSITIVE IMPLICATIONS FOR HEALTH FOR NOT JUST CHILDREN AND ADOLESCENTS BUT ALSO ADULTS. NOW THAT I HAVE GIVEN A BRIEF RECAP, REDUNDANT FROM WILL WHAT YOU HEARD EARLIER, I WANT TO TALK ABOUT THE IDEAS THAT I HAVE FOR NICHD OR IDEAS THAT I HAVE WHERE THE FIELD NEEDS TO GO. I WANT TO START WITH CONTENT AREAS AND END ON THINGS RELATED TO THE RESEARCH PROCESS. FIRST AS CARLOS MENTIONED THESE WERE INTERSECTING SYSTEMS OF OPPRESSION. WE HAVEN'T REALLY FOCUSED ON INTERSECTING SOCIAL IDENTITIES. SO ONE WHAT ARE THE MEANING AND SIGNIFICANCE OF RACIAL IDENTITY AND GENDER IDENTITY AND SEXUAL IDENTITY AND CLASS IDENTITY? DO THESE INTERSECTING SOCIAL IDENTITIES RESULT IN PROFILES OF INDIVIDUAL WHOSE VARY ALONG DEMOGRAPHIC CONTEXTUAL AND FAMILY CHARACTERISTICS AND MORE IMPORTANTLY, WHAT IMPACT DO THESE INTERSECTING SOCIAL IDENTITIES HAVE ON PHYSICAL AND MENTAL HEALTH OUTCOMES? I'LL COME BACK TO WHY RESEARCH IS LIMITED BUT WE HAVE BEGUN TO SCRATCH SURFACE WHAT IT MEANS TO THINK ABOUT INTERSECTING SOCIAL IDENTITIES TO STOP TAKING A VERY SIMILAR APPROACH AND FOCUSING ON RACIAL IDENTITY OR GENDER IDENTITY BUT THINKING ABOUT HOW THESE OPERATE AT THE SAME TIME INTERSECTIONALITY TO ADVANTAGED OR DISADVANTAGED INDIVIDUALS. WE NEED TO GIVE SPACE TO THINKING ABOUT HOW THESE IDENTITIES OPERATE INTERSECTIONALLY. BECAUSE THAT IS THE WAY THEY OPERATE AND LIVED EXPERIENCES FOR PEOPLE PARTICULARLY THOSE WHO ARE MARGINALIZED IN OUR CURRENT ITERATION OF SOCIETY. I ALSO WANT TO THINK ABOUT THE RELATION BETWEEN INTERSECTING SOCIAL IDENTITIES AND MACRO EVENTS? THIS PAST YEAR AND A HALF HAS BEEN THE MOST CHALLENGING YEAR AND A HALF FOR MANY OF US. WE HAVE SEEN THE PANDEMIC, WE HAVE SEEN THE ILLUSTRATION OF MACRO RACISM, WE SEE RACIAL MACRO STRESSORS WITH UNARMED AFRICAN AMERICANS CONTINUOUSLY BEING KILLED BY WHITE POLICE OFFICERS. WHAT IMPACT DOES THIS HAVE ON INTERSECTING SOCIAL IDENTITIES? WE HAVE ALSO SEEN THE RISE OF TWITTER HASH TAGS AND OTHER SOCIAL MEDIA PLATFORMS, BLACK LIVES MATTER, NO DAPPLE, ME TWO, ALL THESE HIGHLIGHTING INSTITUTIONALIZEDDISMS LIKE RACISM, SEXISM, AND ALSO THE POWER BEHIND THESE MOVEMENTS, WHAT IMPACT DO THESE MACRO EVENTS HAVE ON INTERSECTING SOCIAL IDENTITY? WE ARE IN THE MIDST OF A GLOBAL PANDEMIC. WHAT IMPACT DOES COVID-19 HAVE ON INTERSECTING SOCIAL IDENTITIES WHEN WE KNOW THAT BLACK AND BROWN POPULATIONS HAVE BEEN REPEATEDLY AND CONTINUOUSLY DEVASTATED COMPARED TO THE WHITE POPULATION. SO IT IS TIME FOR US TO THINK ABOUT THIS ON A MULTI-DIMENSIONAL LEVEL AS WE START TO UNDERSTAND WHAT IS THE MEANING AND IMPACT OF INTERSECTING SOCIAL IDENTITIES. I ALSO WANT US TO THINK ABOUT CHANGING SOCIAL IDENTITIES, BILL CROSS WHO IS A MENTOR OF MINE, TALKS ABOUT FLUCTUATION AND SOCIAL IDENTITIES. THESE ARE NOT STATIC IDENTITIES, THEY CHANGE OVER TIME, THEY ALSO CHANGE OVER SMALL PERIODS OF TIME. SO WHAT ARE THE ANTECEDENTS AND CONSEQUENCES OF CHANGING SOCIAL IDENTITIES? I PUBLISHED AD PAPER TWO YEARS AGO LOOKING AT FLUCTUATIONS IN ETHNIC RACIAL IDENTITY AND IT HAD NEGATIVE CONSEQUENCES FOR THE MENTAL HEALTH BLACK ADOLESCENTS. THESE ARE NOT STATIC IDENTITIES. IF WE START TO TAKE THE IDEA THAT THEY CHANGE SERIOUSLY WHAT DOES THAT MEAN IN CONTEXT OF INTERSECTING SOCIAL IDENTITY? ARE THOSE FLUCTUATIONS OR FLUCTUATIONS IN ONE SOCIAL IDENTITY LINKED TO FLUCTUATIONS IN OTHER SOCIAL IDENTITY? I FOCUSED ON FLUCTUATIONS IN ETHNIC RACIAL IDENTITY. WHAT WOULD THAT MEAN FOR FLUCTUATIONS IN SAY SEXUAL IDENTITY? AND AS BILL CROSS PROPOSED, DO THESE FLUCTUATING SOCIAL SIDETIES SERVE MULTIPLE PURPOSES? BILL CROSS FOCUSED ON ETHNIC RACIAL IDENTITY AND THE FACT THAT CHANGES CAN SERVE MULTIPLE PURPOSES. IF WE TAKE INTERSECTING SOCIAL IDENTITIES SERIOUSLY, DO THESE FLUCTUATING IDENTITIES THEN SERVE MULTIPLE PURPOSES SUCH AS BUFFERING OR CO-SWITCHING OR BELONGING. SO DRILLING DOWN FOR THE MEANING AND PURPOSE OF INTERSECTING SOCIAL IDENTITIES TO UNDERSTAND HOW THIS CHANGES OVER TIME, AND WHAT PURPOSE IT SERVES. TIFFANY MENTIONED THIS EARLIER THIS MORNING BUT WHAT IMPACT DO INTERSECTING SOCIAL IDENTITIES HAVE ON NORMATIVE DEVELOPMENT OF PROCESSES LIKE PUBERTAL DEVELOPMENT? I DO WORK WITH RONA CARTER AT UNIVERSITY OF MICHIGAN B AND WE LOOK AT ETHNIC RACIAL IDENTITY AS AN IMPORTANT MECHANISM IN THE RELATION BETWEEN PUBERTAL DEVELOPMENT AND MENTAL HEALTH. SO IF WE TAKE NORMATIVE CHANGES PUBERTY IS A NORMAL -- NORMATIVE CHANGE FOR ALL MAMMALS, HOW THEN DO WE THINK ABOUT INTERSECTING IDENTITIES BEYOND ETHNIC AND RACIAL? I ALSO DO WORK WITH KATIE WHERE WE LOOK AT IMPACT OF ETHNIC RACIAL IDENTITY, UPON BIOLOGICAL AND PHYSIOLOGICAL STRESS PROCESSES. AND SO WE FOUND USING THE EXPERIENTIAL PROCEDURE THE IMPACT OF DAILY RACE IS EXPERIENCES WAS ALTERED BECAUSE OF ETHNIC RACIAL IDENTITY SO THE RELATIONSHIP BETWEEN DAILY RACIAL EXPERIENCES AND COURT SAL OUTCOMES WHICH ARE LARGELY UNCONSCIOUS PHYSIOLOGICAL PROCESSES, WAS ALTERED HOW BLACK ADULTS FELT ABOUT THEIR BLACKNESS. SO WE NEED TO TAKE SERIOUSLY THE ROLE THAT THESE SOCIAL IDENTITIES HAVE EVEN IN BIOLOGICAL PHYSIOLOGICAL PROCESSES, THAT OCCUR OUTSIDE OF OUR NORMAL CONSCIOUSNESS. SO HOW THEN DO WE CONNECT SOCIAL IDENTITIES WITH BIOLOGICAL AND PHYSIOLOGICAL HEALTH WHICH THEN ULTIMATELY CONNECT WITH MENTAL HEALTH. SO THIS HOPEFULLY WILL MOVE US IN THE DIRECTION OF UNDERSTANDING HEALTH DISPARITIES. AND LAST BUT NOT LEAST AS FAR AS THE CONTENT WE WANT UNEXPLORED AREAS OF CONCERNS WHITE IDENTITIES. IA NET HELMS HAS A THEORETICAL MODEL ABOUT 20 YEARS OLD TALKING ABOUT THE DEVELOPMENT OF AN IDENTITY FOR WHITE AMERICANS. BUT YET THIS IS AN AREA THAT IS STILL VERY MUCH UNEXPLORED IN THE DEVELOPMENTAL SCIENCE, AS WELL AS IN THE ADULT RESEARCH. SO WHAT DOES A WHITE IDENTITY MEAN IN THE CONTEXT OF WHITE SUPREMACY, RACISM AND COLONIALISM? WHAT ROLE DOES POWER AND PRIVILEGE PLAY IN MAINTAINING A COLOR BLIND WHITE IDENTITY? AND WHEN WE TALK ABOUT WIDE INDIVIDUALS WE KNOW THAT IN THE WHITE POPULATION SOME INDIVIDUAL VERSUS MARGINALIZED IDENTITIES GENDER IDENTITY FOR WOMEN, CLASS IDENTITY FOR LOW INCOME WHITES OR SEXUAL IDENTITY FOR WHITE MEMBERS OF THE LGBTQ POPULATION. WHAT ROLE DO THESE INTERSECTING SOCIAL IDENTITIES PLAY FOR THESE INDIVIDUALS? AGAIN, THIS IS A VERY MUCH UNDEREXPLORED AREA IN THE LITERATURE. WE NEED TO TAKE SERIOUSLY THE ROLE OF WHITE IDENTITY IN THE CONTEXT OF WHITE SUPREMACY RACISM AND COLONIALISM, ET CETERA. SO NOW I WANT TO OFFER RECOMMENDATIONS FOR NICHD, AND ANY OTHER LISTENERS ABOUT THE RESEARCH PROCESS. SO IN SHORT, HOW CAN WE TRANSFORM SOCIAL IDENTITY RESEARCH? MY COLLEAGUE CARLOS MENTIONED WE NEED NEW MEASURES OF VARIOUS SOCIAL IDENTITIES. WE NEED THEM FOR SPECIFIC DEVELOPMENTAL PERIODS THAT WOULD BE MIDDLE CHILDHOOD, ADOLESCENTS, EMERGING ADULTS MIDDLE AGE, WE ALSO NEED FOR SPECIFIC ETHNIC RACIAL GROUPS. AFTER CAN AMERICAN, LATINX ASIAN AMERICAN NATIVE AMERICAN, ET CETERA. I KNOW THE TRAINING DEVELOPMENTAL SCIENCE IS TO DEVELOP ONE MEASURE AND USE IT FOR ALL POPULATIONS. IF WE TAKE INTERSEXUALITY SERIOUSLY, THAT APPROACH IS INCONSISTENT BECAUSE OF HEART OF INTERSECTIONALITY IT TELLS US PEOPLE HAVE EXPERIENCES THAT VARY QUALITATIVELY. NOT QUANTITATIVELY. SO WE NEED MEASURES THAT CAPTURE THE IDENTITIES AND THE LIVED EXPERIENCES OF INDIVIDUALS IN RESPECTIVE GROUPS, A ONE SIZE FITS ALL IS NOT GOING TO WORK. WE ALSO NEED NEW MEASURES THAT ASSESS INTERSECTING SOCIAL IDENTITIES. DR. CARLOS SANTOS MENTIONED LOUIS TO CAPTURE THE INTERSECTION OF RACE AND GENDER, ALSO MENTIONED RICHARD CHEN AND COLLEAGUES. I TAKE THIS SERIOUSLY BECAUSE I HAVE BEEN TRYING TO DEVELOP A MEASURE OF CAPTURING THE INTERSECTION OF RACE AND GENDER FOR BLACK ADOLESCENTS FOR ABOUT TEN YEARS NOW, WITH NO SUCCESS IN FUNDING FROM NICHD. SO I HOPE SERIOUSLY THAT NICHD UNDERSTANDS MEASUREMENT DEVELOPMENT IS CRUCIAL IN ORDER TO TRANSFORM SOCIAL IDENTITY RESEARCH. ANOTHER WAY IN WHICH WE CAN TRANSFORM SOCIAL IDENTIFY RESEARCH IS THAT WE NEED NATIONALLY REPRESENTATIVE SAMPLES. PRIOR RESEARCH FOR THE MOST PART RELIES ON OVERSAMPLING URBAN AREAS LIKE MY HOMETOWN OF CHICAGO, RURAL AREAS AND/OR IMPOVERISHED SETTINGS WHEN STUDYING ETHNIC RACIAL MINORITY CHILDREN AND ADOLESCENTS. THOSE APPROACHES DO NOT CAPTURE THE DIVERSITY WITHIN COMMUNITY AND THEY PROVIDE INFORMATION THAT CANNOT GENERALIZE TO LARGER POPULATIONS. JUST LIKE WE NEED NEW MEASURES WE NEED NATIONAL DATA SO THAT WE CAN FULLY UNDERSTAND THE IMPACT OF SOCIAL IDENTITIES ON THE HEALTH AND WELL BEING OF CHILDREN AND ADOLESCENTS ACROSS UNITED STATES. FOR EXAMPLE, BLACK CHILDREN DO NOT ONLY LIVE IN PREDOMINANTLY BLACK STUDIES, SOMETIMES THEY ALSO LIVE IN PREDOMINANTLY WHITE SETTINGS. SOMETIMES THEY LIVE IN RACIALLY INTEGRATED SETTINGS. SOMETIMES THEY LIVE IN RURAL SETTINGS SO WE NEED NATIONAL DATA TO REALLY UNPACK AND UNDERSTAND AND MORE IMPORTANTLY TRANSFORM SOCIAL IDENTITY RESEARCH. ADDITIONALLY, MY COLLEAGUE EARLIER I BELIEVE DR. CALHOUN STATED THIS, FUND BLACK SCIENCES, MANY OF THESE IDEAS THAT I'M OFFERING ARE NOT NEW, THEY ARE SIMPLY UNFUNDED. BILL CROSS HAS BEEN TALKING ABOUT FLUCTUATING SOCIAL IDENTITIES FOR OVER 20 YEARS. I PUBLISHED A PAPER WITH MANY OF THESE RECOMMENDATIONS ON SOCIAL IDENTITY RESEARCH FOUR YEARS AGO. WE ALL KNOW NIH HAS A RECOGNIZED BIAS AGAINST SCHOLARS OF AFRICAN DESCENT. I'LL FULLY AWARE NIH IS TRYING TO MITIGATE THAT BIAS WITH THE STRIVE INITIATIVE, THE UNITE INITIATIVE, THERE WAS A RECENT CALL FOR RESEARCH ON STRUCTURAL RACISM AND THAT'S FINE. HOWEVER, I WILL BELIEVE THE MONEY -- THE TRUTH WHEN THE BIASES IS NO LONGER EVIDENT, BLACK SCHOLARS LIKE MYSELF CAN'T GET FUNDING WHICH HAS RESULTED IN STAGNANT SOCIAL IDENTITY RESEARCH. I WANT TO REITERATE, THESE ARE NOT NOVEL IDEAS. THESE ARE UNFUNDED IDEAS. SO IF WE ARE SERIOUS ABOUT TRANSFORMING SOCIAL IDENTITY RESEARCH, YOU HAVE TO FUND BLACK SCIENTISTS. THESE IDEAS HAVE EXISTED AND THEY ARE OUT IN THE LITERATURE. LAST BUT NOT LEAST, WE NEED ANTI-RACIST TRAINING. I'M SO HAPPY THAT MANY OF MY COLLEAGUES DR. CALHOUN, DR. HEARD GARRIS DR. SANTOS MENTION THE ANTI-BLACK BIAS AT THE ROOT OF WHITE SUPREMACY AND RACISM I WILL SUBMIT TO EVERYONE LISTENING TO ME, ALL NICHD SHOULD WATCH A WEBINAR THAT I ORGANIZED AND CO-HOSTED LAST SUMMER ON BUILDING AN ANTI-RACIST RESEARCH AGENDA, IN DEVELOPMENTAL SCIENCE. ANTI-RACIST TRAINING IS ESSENTIAL FOR NICHD TO TRANSFORM SOCIAL IDENTITY RESEARCH ADVANCE HEALTH DISPARITIES RESEARCH, AND TO PUSH FORWARD MANY OF THE IDEAINGS THAT HAVE RECENTLY COME OUT OF NIH RELATED TO UNITE AND/OR STRIVE. THIS IS AVAILABLE ON YOUTUBE, WE TALK EXTENSIVELY ABOUT WHAT NEEDS TO HAPPEN TO HAVE TRULY ANTI-RACIST SCIENCE AND DEVELOPMENTAL SCIENCE. I WANT TO THANK SAMANTHA AND PARISA FOR INVITING ME. IT HAS BEEN A PLEASURE TO SPEAK WITH YOU TODAY AND I LOOK FORWARD TO YOUR EXCELLENT COMMENTS AND QUESTIONS. DURING THE Q&A. THANK YOU. >> THANK YOU VERY MUCH, DR. SEATON, WILL PASS THE ZOOM FLOOR OFF TO YOONSUN CHOI TO PASS OFF BEFORE THE Q&A. THANK YOU. >> ALL RIGHT. DO YOU GUYS SEE THE VIDEO? AND THEN THE SLIDE AND ME? >> YES, LOOKS GREAT. >> GREAT, I HAD SOME TROUBLE YESTERDAY WITH THE MICROPHONE SO I WANT TO JUST DOUBLE CHECK. I'M YOONSUN CHOI I'M AT THE UNIVERSITY OF CHICAGO, IT IS A GREAT HONOR TO BE PART OF THIS PRESENTATION AND WORKSHOP TODAY AND THANKS FOR ALL THOSE OF YOU WHO ARE STILL STAYING, I KNOW I'M LAST PRESENTER. E PANELIST FOR THE DAY. AS MUCH AS IT'S SO EXCITING AND THE CONTENTS ARE INTENSE. I WILL TRY MY BEST NOT TO REPEAT WHAT HAS BEEN ALREADY SHARED AND TALKED ABOUT. WE AGREE SOCIAL IDENTITIES ARE MULTIPLE AND IT IS CONTEXT SPECIFIC. AND IDENTITY MATTERS. IT IS COMPLEX AND SOME OF YOU MAY SAY WE HAVE ALWAYS HEARD THIS IS COMPLEX AND TO THE POINT WHAT AM I GOING TO DO WITH THE COMPLEXITIES. BUT IT IS ALSO A ONEROUS PROCESS BUT THAT MAKES IT MORE FUN. ONLY IF WE MAKE ALL THESE SOCIAL IDENTITIES ADDRESSED, THAT'S WHEN WE HAVE THE KNOWLEDGE RELEVANT TO THIS EVER CHANGING DEMOGRAPHICS OF THE POPULATION. OUT OF THESE THINGS, IDENTITY WERE DIFFERENT WAYS IDENTITY WORKS MOST INTERESTED IN WAYS WHICH THE RACIAL AND ETHNIC IDENTITY WORKS AS A BUFFER OR RESILIENCE BUILDER. WHAT I MEAN IS WE ARE LIVING IN A RACIALIZED SOCIETY. IN THE FACE OF THIS HOSTILITY AND INTENSE SOCIAL POLITICAL CLIMATE WE WANT MAKE SURE WE HELP OUR YOUTH AND YOUNG ADULTS NAVIGATE WITHOUT DAMAGING THEMSELVES TOO MUCH. RIGHT? OF COURSE WE ALSO SAY WHAT DOESN'T BREAK US WILL MAKE US STRONGER. TO WHAT EXTENT AND HOW LONG? SO WE CERTAINLY WANT THE ADDRESS THE STRUCTURAL CHANGES NOT JUST AT THE INDIVIDUAL LEVEL BUT STRUCTURAL LEVEL BUT STILL IN THE MEANTIME I WANT TO SEE WHETHER WE CAN USE THE IDENTITY AS A PLATFORM AND MITIGATOR. I WOULD LIKE TO SHARE MY STUDIES ON ASIAN AMERICANS. AND SHARE MAJOR FINDINGS TO HIGHLIGHT THE CHALLENGES OF ADDRESSING THE INTERSEXUALITY OF IDENTITIES. SO ONE OF THE THINGS THAT I WANTED TO TALK ABOUT IS THAT ASIAN AMERICANS DO HAVE SERIOUS HEALTH DISPARITIES AND ALMOST I FEEL SILLY THAT I HAVE BEEN SAYING THIS FOR 30 YEARS, AND MORE, THE ASIAN AMERICANS, NOT A MYTH, IT IS A MYTH, IT IS A STEREOTYPE. BUT NONETHELESS IT PERSISTS. IT IS QUITE FRUSTRATING BUT ACTUALLY NIH REPORTS SHOWS THAT BETWEEN 1998 AND 2018 THERE HAS BEEN 140% INCREASE IN SUICIDE AMONG ASIAN AMERICANS. SO THIS REPORT WAS INCLUDED IN A TABLE BUT IT WAS NOT ELABORATED OR DISCUSSED IN NIH REPORT SO ALMOST AS IF WE ARE ASIAN AMERICANS ARE SYMBOL OF BEING BURIED OVERLOOKED IGNORED. AND DURING THIS SPECIFIC PERIOD BETWEEN 1998 AND 2018, 0.17% OF NIH FUNDING WENT TO SUPPORT STUDIES OF ASIAN AMERICANS OR STUDIES THAT INCLUDE ASIAN AMERICANS AS ONE ONE OF THE SUB GROUPS. SO YOU SEE THE SERIOUS HEALTH DISPARITIES AND THEN DIRECTLY UNDERSTUDIED UNDERFUNDED AREA OF RESEARCH. I'M LEADING A LONGITUDINAL STUDY WITH PHILIPPINO AMERICAN AND KOREAN AMERICAN FAMILIES. IT STARTED IN 2014 WITH A LITTLE SHY AWAY FROM 1600 PEOPLE. AND WE COLLECTED A DATA 2 AND 3 AND CURRENTLY AT WEEK 4 AND THIS DATA TOO, THAT WE HAVE FOUND, THIS WAS SUICIDAL IDEATION INCREASED FROM LESS THAN 10% IN 2014 TO 16% IN WAVE 3. THE CURRENT DATA THAT WE HAVE WE ARE COLLECTING ALSO SHOWS THAT IT IS CONTINUOUSLY ON THE RISE. ESPECIALLY IN 2018, THE YOUTH BETWEEN 18 AND 19, 22% REPORTED SUICIDAL IDEATION, WHICH WAS THE DOUBLE OF THE NATIONAL AVERAGE THAT YEAR. SO MY DATA SHOWS SERIOUS HEALTH DISPARITIES AND ALSO WE HAVE FOUND ONE OF THE TWO DRIVING REASONS MIGHT BE TO CULTIVATE STRESS AND RACIAL DISCRIMINATION. THESE ARE SOME OF THE FINDINGS SPECIFICALLY ON IDENTITY ISSUES HERE. THOUGH THE PANELISTS TODAY THROUGHOUT THE DAY HIGHLIGHTED THE BENEFIT OF THE STRONG AND POSITIVE RACIAL ETHNIC IDENTITY, ALSO MY STUDY SUPPORTS ESPECIALLY AROUND PSYCHOLOGICAL BENEFIT, IT DOES HELP MENTAL HEALTH AND EXTENSIVELY. HOWEVER WE ALSO HAVE A FINDING THAT IT COULD INCREASE ANTI-SOCIAL BEHAVIORS AND YOUTH WITH HIGHER RACE ETHNIC IDENTITY CAN SEE MORE RACIAL DISCRIMINATION. CAN WE SAY THIS IS BAD? IF IT'S INCREASE VIOLENCE OR ANTI-SOCIAL BEHAVIORS MAYBE IS IT SHORT TERM, IS IT LONG TERM. IF SOMEBODY FOR INSTANCE DISCRIMINATE YOU AND IF YOU DON'T REACT, IS THAT A GOOD POSITIVE ADAPTATION OR BETTER TO REACT AND SAY EVEN GET INTO FIGHT? I DON'T KNOW. WE WILL PROBABLY HAVE A DIFFERENT REACTION TO THE ANSWERS. AT THE SAME TIME WHEN THESE YOUNG PEOPLE EXPERIENCE RACE -- RACIAL DISCRIMINATION, PEOPLE HAVE A DIFFERENT REACTION. SOME WILL TAKE IT AND THEN THAT WILL STRENGTHEN THEIR IDENTITY RACIAL ETHNIC IDENTITY OR SOME PEOPLE MAY BE BROKEN, SO TO SPEAK. IT WILL COMPROMISE THEIR IDENTITY. SO IT HAS A DIVERGENT PATHWAY. WHICH PATHWAYS IS -- WILL LEAD TO EVENTUALLY TO THE POSITIVE ADJUSTMENT. THAT'S ONE OF MY LEADING RECENT QUESTIONS. FOR ASIAN AMERICANS WHO HAVE BEEN TREATED AS UNAUTHENTIC AMERICANS AND TREATED AS A FOREIGNER AND THE PANDEMIC HIGHLIGHTED HOW MUCH THAT HAS BEEN THE CASE, FOR THESE YOUTH UNHYPHENATED IDENTITIES, AMERICAN IDENTITY IS EQUALLY IMPORTANT NOT TO JUST ETHNIC RACIAL IDENTITY. THE ERI AMONG ASIAN AMERICANS THAT INTERACT WITH IMMIGRATION, STATUS, CULTURE, IMMIGRANT GENERATION. THEY EXPERIENCE QUITE A DIFFERENT EXPERIENCE FOR THE PARENTS MANY OF THE PARENTS WERE FOREIGN BORN MAY DON'T SEE THEMSELVES AS ASIAN. THAT'S A FOREIGN TERM TO ME. TO THEM. THE PARENTS TEND TO SEE THEMSELVES AS THEIR OWN ETHNIC GROUP OR NATIONALITY ORIGIN, WHILE THE U.S. BORN ASIAN AMERICAN YOUTH WILL SEE THEMSELVES AS ASIAN AMERICANS. INTERGENERATIONAL GAP IS PALPABLE AMONG THESE FAMILIES. WE SEE THIS HYBRID IDENTITY, THAT'S YOUTH GENERATION, IS GROWING UP AS HYPHENATED AMERICANS. WHAT THAT MEANS IS HIGHLY ACCULTURATED IN TERMS OF LANGUAGE AND AMERICAN IDENTITY, THEY ARE AMERICANS, ALMOST SILLY TO SAY THIS BUT I HAVE TO SAY THIS BUT THEY ALSO STRONGLY UPHOLD ETHNICITY AND ITS CULTURE. SO BASICALLY PHILIPPINO AMERICANS OR ASIAN AMERICANS THESE HYPHENATED AMERICANS BUT WHAT MY RESEARCH ALSO FINDS THE PRESERVATION OF ETHNICITY AND CO-WHOLE CULTURE IS NOT ALWAYS BENEFICIAL IN ALL ACCOUNTS. THIS IS IMPORTANT TO IDENTIFY IF THERE IS A WAYS IN WHICH WE CAN MODIFY CULTURE FOR BETTER, WHY NOT? IN THE PROCESS OF ACCULTURATION. BOTTOM LINE, WE REALLY NEED AN IN INCREASE SPECIFICITY AND GRANULAR LEVEL OF ANALYSIS. VERY DETAILED, OTHERWISE IT IS NOT REALLY GOING TO PRODUCE REAL IMPACTFUL RESEARCH FINDINGS. THIS IS JUST ONE OF THE MANY MECHANISMS THAT I EXAMINE. I PROVIDE IT HERE JUST TO HIGHLIGHT WHEN YOUTH AND YOUNG ADULTS EXPERIENCE RACIAL EXPERIENCES, NEGATIVE ONES LIKE HERE AND THE BLACK LIVES MATTER MOVEMENT HAS HAD GREAT IMPACT ON ASIAN AMERICANS AS A COMMUNITY, THEY SEE THE RACIAL RECKONING, IT'S BROUGHT THEM RACIAL RECKONING AND THEIR PARTICIPATION IN IT AND SO I GUESS AGAIN CAN'T GO INTO DETAILS BECAUSE OF TIME BUT ANYWAY, THESE SORT OF SET OF NOT JUST ADVERSE OR GENERAL RACIAL EXPERIENCES HAS PRODUCED QUITE DIVERGENT PATHWAYS AND AGAIN AS I SAID EARLIER, FOR SOME THIS HAS BECOME AN OPPORTUNITY TO REALLY STRENGTHEN THEIR IDENTITY WHILE FOR SOME OTHERS IT HAS BEEN THE THE CASES THEY HAVE -- BECOME DISHEARTENED BY THE EXPERIENCE. IT WILL IMPACT THEIR OUTCOMES. BUT WHAT I WANT TO BE ABLE TO HIGHLIGHT HERE IS INTERSECTION MODERATORS. WE CAN THINK OF IT AS ANOTHER SET OF SOCIAL IDENTITIES, ALSO SEE IT AS THE MODERATORS. BUT IN ANY CASE, THESE JUST ONE EXAMPLE SHOWS HOW COMPLEX PATHWAYS WOULD BE AMONG THE YOUNG POPULATION. THE CHALLENGES IN THE MEASUREMENTS WHICH IS THE MAIN TOPIC OF THE TALK, WHEN WE TALK HYBRID IDENTIFY, IT IS NOT A COMBINATION OF TWO DISCREET IDENTITIES. I THINK CARLOS AND OTHERS HAVE TALKED ABOUT THOSE BUT IT IS NOT JUST ADDITION OF DIFFERENT THINGS, IT IS SOMETHING QUITE DIFFERENT. SO FOR PHILIPPINO AMERICAN AMERICANS IT IS NOT JUST FILIPINO AND AMERICAN TWO SEPARATE THINGS, IT IS FILIPINO AMERICANS, IT IS SOMETHING HYBRID. OR ASIAN AMERICAN, PAN ETHNICITY OR PAN RACIAL IDENTITY. OFTEN WE TALK ABOUT HOW INTERSECTION OF GENDER AND RACE IS SO CRUCIAL. AND IN MY MOST RECENT STUDY WE HAVE ADDED THE SCALES TO SEPARATE SETS ALMOST PARALLEL. THAT SPECIFIC TO ASIAN AMERICAN WOMEN AND ALSO ASIAN AMERICAN MEN. THEIR EXPERIENCE THE RACIAL EXPERIENCE IS ALMOST THE OPPOSITE. SO ONE EXAMPLE IS ASIAN AMERICAN WOMEN ARE HYPERSEXUALIZED WHILE ASIAN MALE ARE HYPOSEXUALIZED. SO THEIR EXPERIENCE WILL BE VERY DIFFERENT SO HAVING A DIFFERENT SET OF MEASURES ARE JUST ONLY MAKE SENSE. AS A CLOSING, SOME OF THE SUGGESTIONS TO NIH NICHD WE REALLY NEED TO PRODUCE SOME DATA TO PRODUCE RIGOROUS IMPERFECT DATA TO MAKE REAL IMPACT. THIS SOUNDS LIKE THIS TEXTBOOK LINE. AS ELEANOR SAID EARLIER, THIS IS NOTHING NEW. THE RECOMMENDATIONS WE ARE MAKING ARE NOTHING NEW, WE HAVE BEEN SAYING IT AS ALMOST AS IF WE ARE BROKEN RECORD. BUT THE REVIEWS AND WHOLE PROCESS SHOULDN'T BE DRIVEN BY STEREOTYPES AND MISPERCEPTIONS. THE FUNDING SHOULD FUND THE STUDY WHEN THE PROPOSAL IS SOUND AND STRONG. WE NEED MANY OF THESE MINORITIZED GROUPS, DON'T LUMP GROUPS, THAT'S ALL SCIENTIFIC AND EVEN DAMAGING FOR THOSE WHO ARE LUMPED TOGETHER AND THEIR VULNERABILITIES ARE OBSCURE. WE DEFINITELY NEED MORE LONGITUDINAL DATA. ALL THESE REQUIRE FUNDING AND SUPPORT FROM NIH AND NICHD. WE HAVE ALWAYS PERSISTENTLY URGENT NEEDS TO ENHANCE NEW SERIES. WE NEED NEW MEASURES, I THINK SO MANY OF US HAVE TALKED ABOUT IT THROUGHOUT THE DAY. THAT HOW COMPLEX IT IS THE PHENOMENON WE ARE TALKING ABOUT AND HOW MUCH OF DOWN UP TYPE APPROACH IS NEEDED. FOR INSTANCE, I HAVE SPENT MY EARLY CAREER JUST DEVELOPING MEASURES, TO CAPTURE WHAT PEOPLE HAVE TALKED ABOUT. LIKE THE PEOPLE THAT IS CORRECTLY IMPACTED BY -- DIRECTLY IMPACTED BY IDENTITY ISSUES. NOT TOP DOWN BY GROUND UP, THAT TAKES QUALITATIVE QUANTITATIVE WHATEVER METHOD IT MAY BE THAT WE CAN'T USE EXISTING THEORIES LIGHTLY. I'M SURE THERE IS A LOT TO -- A LOT OF UTILITY AND THAT EXISTING THEORIES. WE CAN'T ASSUME THE RIGHT MID -- WHITE MIDDLE CLASS MALE SAMPLES ARE THE NORM. THEY ARE JUST SO MANY OF US THAT WERE NOT THAT. AND AS EARLIER TALKED ABOUT THAT THERE IS A SOMEWHAT INEQUALITY THAT WE REALLY NEED MEASURES THAT CAN CAPTURE AND EXPLAIN THAT INEQUALITY AND FIND THE WAYS TO REMEDY THESE INEQUALITIES. ENHANCED AND NUANCED KNOWLEDGE GENERATED FROM UNDERSTUDY GROUP WILL ADVANCE SCIENCE OF DEVELOPMENT SO NOT JUST FOR JUSTICE, OF COURSE IT WILL ADDRESS SOCIAL JUSTICE ISSUE BUT THIS WILL ONLY ADVANCE THE SCIENCE THAT WILL BENEFIT THE REAL AMERICAN, ALL AMERICANS. THANK YOU. >> THANK YOU SO MUCH FOR THAT EXCELLENT TALK AND FOR YOUR SUGGESTIONS. AS WE MOVE INTO THE QUESTION AND ANSWER, THIS WILL BE FOR ALL OF THE PANELISTS FOR THIS SESSION, I WANT TO PIGGY BACK OFF OF SOME OF WHAT WAS JUST MENTIONED AND ASK WHAT NEEDS TO HAPPEN? WHAT NEEDS TO CLANG IN TERMS OF THE WAY THAT WE ARE THINKING ABOUT DOING RESEARCH AND CONDUCTING AND SUPPORTING RESEARCH SO THAT THAT FOUNDATIONAL DATA SETS THAT YOU ARE DESCRIBING WE ARE ABLE TO COLLECT THAT. >> TO BE ABLE TO DEVELOP MEASURES USED MORE IN PRACTICE. THIS IS A QUESTION FOR ANY PANELISTS FEEL FREE TO ANSWER. >> SAMANTHA, I'LL TAKE A START. YOU ARE ASKING WHAT NEEDS TO HAPPEN IN ORDER TO DEVELOP THE TYPE OF DATA THAT WE ARE CALLING FOR? >> YES. >> OKAY. I HAVE SOME IDEAS. I HOPE YOUR LEADERSHIP IS LISTENING. SO FIRST ALL THE BIAS THAT EXISTS IN NIH NEEDS TO BE ALLEVIATED AND MITIGATED AND ERADICATED. I BELIEVE BASED ON MY EXPERIENCE OF SUBMITTING GRANTS FOR THE PAST 15, 16 YEARS SINCE I WAS A POST DOC THERE'S ISSUES IN THE STUDY SECTION. I'M NOT GOING TO GO INTO TYPE OF COMMENTS I RECEIVED ON MY PROPOSALS, BUT I THINK THAT YOU HAVE REVIEWERS ACTING AS GATE KEEPERS WHO FUNDAMENTALLY DON'T UNDERSTAND THESE ISSUES, DON'T UNDERSTAND THESE POPULATIONS. AGAIN, I SAY THAT BASED ON SOME OF THE REVIEWS THAT I HAVE RECEIVED. BUT THEY ARE THE GATE KEEPERS BECAUSE THEY SERVE ON STUDY SECTION AND THEY HAVE THE POWER TO DING MY PROPOSALS WHICH IN ALL LIKELIHOOD THEY MAY NOT EVEN UNDERSTAND WHICH MEANS I CAN'T GET FUNDED AND IF I CAN'T GET AN RO1 WHICH IS PROVEN THROUGH YOUR OWN RESEARCH I CAN'T SERVE ON STUDY SECTION. SO THESE ARE INSTITUTIONAL POLICIES WHICH I WOULD SAY IS INSTITUTIONAL RACISM AND THAT REQUIRES INSTITUTIONAL SOLUTIONS SO FIRST OF ALL THE POLICY THAT YOU CAN ONLY SERVE ON STUDY SECTION WHEN YOU HAVE AN RO1 NEEDS TO BE ERADICATED. BECAUSE IT MEANS THIS IS RE-- IF I CAN'T GET AN RO1 I CAN'T SERVE ON STUDY SECTION, THE EXPERTISE I NEED FROM MY PROPOSAL IS NEVER PRESENT. SO THERE ARE POLICIES THAT NIH HAS THAT ARE REAFIED, THEY REAFIE INSTITUTIONAL RACISM, THAT'S THE FIRST IMPEDIMENT THAT I SEE. BUT SECONDLY, I THINK IN DEVELOPMENTAL SCIENCE IN GENERAL, THERE IS THE -- THESE FALSE ASSUMPTIONS WHICH PLACE WHITENESS AT THE CENTER OF DEVELOPMENT. WHITENESS AS THE NORM. WHITENESS AS A DEFAULT. AND THAT HAS TO BE EXPLICITLY ADDRESSED AND ALSO ERADICATED. BECAUSE ONE OTHER PERNICIOUS I RECEIVED IS WHERE IS YOUR WHITE CONTROL GROUP. IF YOU KNOW ABOUT INTERSEXUALITY YOU SHOULD KNOW I DON'T NEED A WHITE CONTROL GROUP BUT THE FACT THIS IS UTTERED BY REVIEWERS AND PROGRAM OFFICERS SPEAKS TO A SERIOUS LACK OF EDUCATION, THAT ALSO SPEAKS TO THE INHERENT RACISM WITHIN THE CONTEXT OF THESE INSTITUTIONS. SO ONE NIH HAS SOME SERIOUS PROGRAMMING, SOCIALIZATION AND LEARNING TO DO. THAT'S THE FIRST STEP. NOW LET'S SAY THAT HAPPENS, YEAH, THEN WE HAVE TO TALK ABOUT WHAT GETS FUNDED. AND I DON'T BELIEVE LARGE SCALE PROJECTS LIKE A B C D OR ECHO SHOULD BE FUNDED IF THEY DO NOT HAVE SCHOLARS OF COLOR IN THE LEADERSHIP TEAM. LET ME SAY THAT AGAIN FOR THE PEOPLE IN THE BACK. A B C D, AND ECHO, TWO LARGE SCALE PROJECTS THAT NIH IS SPENDING A LOT OF MONEY ON, SHOULD NOT BE FUNDED IF THEY DO NOT HAVE SCHOLARS OF COLOR ON THE LEADERSHIP TEAM. THAT'S PROBLEMATIC BECAUSE HERE IS THE TRUTH NICHD MAY NOT KNOW, AS OF LAST YEAR, THE MAJORITY OF CHILDREN UNDER THE AGE OF 18 ARE NON-WHITE. NICHD'S FUNDING PROPOSALS LEADERSHIP TEAM AND FUNDED SCHOLARSHIP SHOULD REFLECT THAT. I'LL STOP THERE BECAUSE I DON'T WANT TO DOMINATE THE CONVERSATION. BUT I'M HAPPY TO TO TALK FURTHER TO ANYBODY AT NICHD LEADERSHIP WHO WANTS THE SPEAK WITH ME ABOUT WHAT THEY CAN DO RIGHT NOW. >> I CAN'T AGREE MORE ELEANOR. YOU ALREADY SPOKE VOLUMES AND THERE IS A LOT OF SHARED EXPERIENCE, SOME OF THE COMMENTS WE GET LIKE SOME OF THEM JUST APPALLING, YOU CAN'T BELIEVE WE ARE STILL HAVING TO SAY AND DEFEND NOT HAVING A WHITE FOLKS AS A COMPARISON GROUP. AND WHAT RACE MEANS FOR WHITES COMPARED TO FOR INSTANCE US AND JUST GETTING TIRED. ALSO I THINK THE FACT THAT I HAVE BEEN ASKED OFTEN TO PROVE THAT ASIAN AMERICANS ARE DISCRIMINATED, AND IT TAKES ATLANTA SHOOTING TYPE OF THINGS TO TAKE SOME ATTENTION ABOUT THE RACISM PEOPLE EXPERIENCE. WHAT'S REALLY UNFORTUNATE IS IF WE ARE ALL FIGHTING A VERY LIMITED SLICE OF FUNDING. THAT MINORITY -- MINOR ADVERTISED GROUPS LIKE -- MINORITIZED GROUPS, WHO SUFFER IT IS MOST, WHY AND WHO TO JUSTIFY FOR FUNDING YOU HAVE TO SHOW THAT YOU ALMOST ARE DYING OTHERWISE YOU ARE NOT WORTHY. I THINK THE MULTIPLE, MULTIPLE WAYS STUDY SECTIONS IF THERE IS A ONE ASIAN GUY SIT OKAY THAT'S TAKEN CARE OF, DOESN'T MATTER WHETHER THE PERSON IS A STATISTICIAN AND CAN'T UNDERSTAND ANY THINGS WE HAVE TO SAY. SO THERE IS A FUNDAMENTAL LEVEL AND FUNDAMENTAL WAY, MULTIPLE WAYS, THAT RACISM WORKS. AGAINST US. >> IF I MAY ADD REALLY QUICK I ALSO WOULD -- IT IS SOMETHING I DIDN'T TOUCH UPON I AGREE ALREADY MUCH WITH ALL POINTS MADE. I WOULD ADD I THINK AT AN INSTITUTIONAL LEVEL I WOULD HOPE THAT NIH IN TRYING TO ADDRESS THE CHALLENGE THAT INTERSEXUALITY AND SIMILAR PERSPECTIVES BRING, AND OTHER CRITICAL PERSPECTIVES, RACE, I WOULD HOPE WE ARE ALSO CONSIDERING IMPORT OF ADOPTING PRINCIPLES OF COMMUNITY BASED PARTICIPATORY ACTION WORK IN THE TYPE OF WORK THAT GETS FUNDED. NOT TO BASTARDIES WHAT IS A VERY IMPORTANT REVOLUTIONARY IN SOME WAYS TRADITION, AND I REALIZE NOT ALL OF US ARE TRAINED IN PAR OR CB PAR APPROACHES, BUT THERE ARE PRINCIPLES THAT GUIDE THAT LINE OF RESEARCH THAT I THINK ARE ALSO IMPORTANT. PART OF THAT BEGINS I BELIEVE AND I AGREE WITH DR. SEATON, BEGINS WITH WHO IS THE GATEKEEPER, WHO IS DOING THE RESEARCH, WHO IS EVALUATING THE RESEARCH. AND AS AN AGENCY I HOPE THAT MOVING FORWARD THIS ISSUE IS TAKEN ON VERY SERIOUSLY BECAUSE IT HAS IMPLICATIONS FOR WHAT GETS FUNDED AND YEAH. SO THANK YOU. >> I'LL ADD A COUPLE OF WORDS TO WHAT HAS ALREADY RICHLY AND SHARPLY BEEN STATED. BASICALLY, VALUE ALL WAY OF KNOWING RESEARCH AND RESEARCH FUNDING. PERIOD. SUPPORT DECOLONIZING RESEARCH. SEEK TO ACTUALLY SUPPORT SCHOLARSHIP THAT IS ACTUALLY TAKEN ON ALTERNATIVE APPROACHES TO ER SEARCH AND INQUIRY THAT GOES BEYOND THE TRADITIONAL QUANTITATIVE IMPERATIVE. ONE WAY OF GOING ABOUT DOING THIS AND ADDRESSING SOME OF THE CONCERNS THAT HAVE BEEN ADDRESSED ALREADY MENTIONED IS TO SHIFT FEDERAL RESEARCH FUNDING TO INSTITUTES, CENTERS AND AGENT IS THAT HAVE THE FOCUS OF ADDRESSING INEQUITIES WITH ACTION ORIENTED PLANS TO FUND BLACK INDIGENOUS PACIFIC ISLANDER, LATINX AND ASIAN SCHOLARS. INCREASE FUNDING FOR RESEARCH, EMPLOY METHODS THAT VALUE THE VARIOUS WAYS OF KNOWING AND EXPERIENCING THE WORLD. I CAN MENTION A WHOLE BUNCH OF OTHER THINGS BUT JUST SUCCINCTLY ON THAT, FIND -- HAVE A PRIORITY AND FOCUS ON VALUING ALL WAYS OF KNOWING YOUR RESEARCH AND RESEARCH FUNDING ALLOW MECHANISMS THAT YOU GO ABOUT DOING THAT PROCESS TO BE INFORMED BY THAT. >> THANK YOU SO MUCH. I APPRECIATE ALL OF YOUR COMMENTS AND I JUST WANT TO SAY THAT'S WE REALLY APPRECIATE YOU BRINGING THESE ALL TO OUR ATTENTION AND VOICING IT. THAT'S PART OF THE REASON WE ARE KICKING OFF THIS WHOLE INITIATIVE AND WITH UNITE AS AS WELL IS REALLY HOPING THE HEAR SEE WHERE WE ARE AT AND WHAT WE HAVE BEEN DOING AND COURSE CORRECT AND MAKE CHANGES GOING FORWARD TO THE FUTURE. SO IT'S REALLY IMPORTANT THAT YOU ARE ALL BRINGING THIS UP AND WE APPRECIATE YOUR COMMENTS. SORT OF BUILDING OFF OF THIS IDEA, WE DO HAVE SOME QUESTIONS THAT CAME IN AND ONE OF THEM IS ASSOCIATED WITH THE MEASURES THAT WE CURRENT WILL I DO HAVE, TO MEASURE INTERSECTIONALITY AND CURRENT UNDERSTANDING OF OF THAT CONSTRUCT, WHAT ARE WAYS THAT PEOPLE WHO ARE DOING APPLIED RESEARCH OR IN PRACTICE CAN BE USING THE IDEA OF INTERSEXUALITY CURRENTLY TO IMPROVE UPON THE HEALTH OUTCOMES FOR CHILDREN YOUTH WOMEN ET CETERA. WHAT ARE YOUR THOUGHTS ON THAT? >> I CAN BRIEFLY -- BECAUSE THIS IS PARTLY TIED TO THE POINT JUST MADE. ONE ASSUMPTION, PART -- I GUESS YOU COULD SUMMARIZE A LOT OF THE THEMES OF MY TALK AROUND YES YOU CAN DO THESE THINGS. YES WE SHOULD BE DOING THESE THINGS. YES WE SHOULD BE CHALLENGING WAYS THAT WE THINK ABOUT MEASUREMENT AND THE POINTS AROUND CONSIDERING CONTEXT OR -- CONTACTS OR RELATIONSHIPS AND ADAPTING MEASURES OR CREATING MEASURES THAT ARE IN GROUP SPECIFIC OR ISSUE SPECIFIC THAT MIGHT BEST CAPTURE THOSE ISSUES. I THINK ONE OF THE THINGS -- ONE REASON I MADE THE POINT OF EMPLOYS PRINCIPLES OF PARTICIPATORY ACTION WORK IN TO OUR OWN RESEARCH IS THAT WE ASSUME SOMETIMES MEASUREMENT IS OUT OF REACH FOR CERTAIN FOLKS. NEED A CERTAIN LEVEL OF TRAINING IN ORDER TO BE ABLE TO UNDERSTAND ISSUES AROUND MEASUREMENT BUT AGAIN THAT'S PART OF DISRUPTING THE THING, ULTIMATELY CAPTURING LIVED EXPERIENCE WE NEED TO DEVELOP MEASURES VETTED BY COMMUNITY MEMBERS. AND WE CAN DO THAT BY SIMPLY EXPLAINING THE NATURE OF WHAT WE TRYING TO DO SO YOU CAN SAY YEAH, IT CAN'T BE TWO SENTENCES BUT HERE ARE WAYS THAT WE CAN SORT OF WORK TOGETHER TO MAKE THIS A BETTER PROXY OF WHAT THESE ACTUAL EXPERIENCES ARE. AND SO I COULDN'T STRESS ENOUGH I THINK THE ROLE OF MAKING SURE THAT WE ARE INCLUSIVE IN TERMS OF FOLKS THAT ARE SITTING ON OUR TABLES AND DISCUSSING THINGS LIKE MEASUREMENT RELATED TO INTERSEXUALITY SO WE CAN BETTER CAPTURE. SO I THINK THE DIVIDE BETWEEN PRACTICERS AND RESEARCHERS THEN BECOMES BY DEFINITION BLURRED BECAUSE YOUR FUNDAMENTALLY APPROACHING RESEARCH AS PROJECT FOR ALL, AS A PROJECT THAT IS INCLUSIVE, THAT AIMS TO CAPTURE THE DIVERSITY OF EXPERIENCES THAT ULTIMATELY INFORMS EXPERIENCES OF THOSE WE DEEM TO STUDY. >> IF YOU CAN ADD SO I STARTED THE WHOLE THIS LINE OF RESEARCH AFTER WORKING IN THE FIELD AND I WAS FRUSTRATED WITH LACK OF GUIDELINES. WHAT I HAVE FOUND IS ALTHOUGH WE SORT OF AS RESEARCHER HOPING AND ASSUMING THE PRACTITIONERS WILL LEARN FROM WHAT WE OFFEREDDED IN THE RESEARCH, OFTEN WE HAVE SO MUCH TO LEARN FROM THE PRACTICERS AND FROM THE FIELD THAT OFTEN THEY ARE MUCH MORE ADVANCED BECAUSE THEY ARE THE ONES FOR THE INDIVIDUAL AN COMPLEX LIFE AND WE ARE HERE IN OUR OFFICE ALL LIKE TRYING TO THEORIZE THINGS AND UNLESS WE GO HAND IN HAND, WE HAVE CERTAIN TOOLS THAT PRACTICERS MAY NOT HAVE OR MAY NOT HAVE TIME TO THINK ABOUT, BUT WE HAVE THOSE. AND I ONLY WHEN WE CAN WORK TOGETHER IN COLLABORATION, I THINK THAT'S WHEN WE CAN MAKE ACTUALLY REALLY MEANINGFUL MEASURES AND ADVANCEMENT AND THEORIES. >> I WANT TO ADD TOE WHAT MY COLLEAGUES HAVE SAID, I AGREE WITH EVERYTHING ELSE. I'M GOING TO OFFER TWO THINGS. ONE, YOU SHOULD BE IN COMMUNITY WITH THE POPULATION YOU STUDY. OUTSIDE OF RESEARCH. I STUDY BLACK YOUTH, I VOLUNTEER WITH YOUTH PROGRAMS, I VOLUNTEER WITH MY SORORITY'S YOUTH PROGRAM SO YOU SHOULD BE IN COMMUNITY OUTSIDE OF BEING AN ACADEMIC. I THINK THAT'S THE PROBLEM WITH A LOT OF RESEARCHERS, THEY ONLY ENCOUNTER PARTICIPANTS AS PARTICIPANTS, THAT'S A PROBLEM AND IT IS ALSO A TERM WADE NOBLES CALLS ACADEMIC COLONIAL ITCH. WE SHOULDN'T DO THAT. THE SECOND POINT, THIS IS TO A LOT OF COLLEAGUES WE NEED TO USE FULLY QUALITATIVE METHODS AS I MENTIONED EARLIER, FOR THE PAST TEN YEARS I HAVE BEEN DEVELOPING AN INTERSECTIONAL MEASURE FOR BLACK YOUTH. MOST OF MY FINDINGS HAVE COME FROM MY QUALITATIVE WORK. THERE ARE INCIDENTS THAT HAPPEN TO BLACK YOUTH AT THE INTERSECTION OF RACE AND GENDER THAT ARE NOT CURRENTLY CAPTURED THROUGH OUR MEASURES THAT I GLEAN FROM MY QUALITATIVE WORK. SO WE NEED TO BRING QUALITATIVE METHODS TO OUR WORK MIX MISS -- METHODS, IT IS NOT SEEN AS BASTARDIZED PRACTICES BUT LEGITIMATE PRACTICES WITH HE SHOULD USE IN ADDITION TO THE QUANTITATIVE METHODS WE USE, I'M A QUANTITATIVELY TRAINED EYE PSYCHOLOGIST BUT I USE MIXED AND QUALITATIVE METHODS BECAUSE I KNOW QUANTITATIVELY I CANNOT GET THE INFORMATION I NEED FROM MY PARTICIPANTS WITH MY RESEARCH SO WE HAVE GOT TO THINK BEYOND THIS QUANTITATIVE BOX. THE LAST THING I WANT TO SAY, I BELIEVE WE ARE RUNNING OUT OF TIME, EZEKIAL MENTION MENTIONED EZEKIAL MENTIONED DECOLONIZATION, I THINK THAT OOH WHAT WE HAVE TO DO. PARTICULARLY THOSE TRAINED IN PSYCHOLOGICAL SCIENCE AND THERE IS A REASON QUALITATIVE WORK IS MINIMIZE BECAUSE QUALITATIVE SCIENCE IS MORE LIKELY AKIN TO BIPOC CULTURES QUANTITATIVE MORE LIKELY TO WHITE CULTURE SO WE HAVE TO DO DECOLONIZATION IN OUR MINDS AND IN OUR SCIENCES AND MORE IMPORTANTLY AT NIH. THE LAST THING I WANT TO SAY PARISA I PROMISE TO SHUT UP, I THINK NICHD SHOULD START LISTENING SESSIONS, IF YOU ARE HEARING THIS FOR THE FIRST TIME, THAT'S A PROBLEM. IF YOU ARE HEARING ABOUT THE ISSUES THAT BIPOC SCHOLARS HAVE WITH NICHD FOR THE FIRST TIME, THAT IS A PROBLEM. SO I SUGGEST NICHD SPONSOR LISTENING SESSIONS WITH EPIPOO L LIKE US SO YOU CAN HEAR EXACTLY WHAT OUR EXPERIENCES HAVE BEEN LIKE AND TRYING TO SOLICIT FUNDING FROM YOUR AGENCY. I CAN ATTEST NIMH IS DOING A SERIES OF LISTENING SESSIONS; I PARTICIPATED IN ONE. SO IF YOU ARE HEARING THIS FOR THE FIRST TIME THAT, IS A PROBLEM AND YOU SHOULD RECTIFY THAT EXPEDITIOUSLY. AGAIN THANK YOU FOR HAVING ME. >> I WOULD ADD REALLY QUICK, THIS GETS AT THE LAST POINT YOU WERE MAKING ELEANOR, I THINK BRILLIANTLY GETS AT THE QUESTION POSED BY TIFFANY ON THE CHAT FUNCTION IN TERMS OF THE KINDS OF THINGS WE CAN DO TO ENSURE REVIEWERS ARE MORE ADEQUATELY REVIEWING THIS RESEARCH. SO JUST TO MAKE THAT CONNECTION QUICK. BUT THE OTHER THING I WANT TO SAY RELATED TO THE PREVIOUS QUESTION, ANOTHER THING WORTH CONSIDERING IS WE NEED TO LOOK AT OUR BUDGETS CLOSELY AND WE NEED TO CONSIDER THE WAYS WHICH WE ARE INVESTING IN THE TIME AND EFFORT IT TAKES FOR COMMUNITY AND COMMUNITY MEMBERS TO BE PART OF OUR WORK TO FURTHER OUR WORK. THINK OF BUDGETS AND HOW MUCH RESOURCES GET ALLOCATED TO THINGS LIKE SALARY, HOW LITTLE OFTEN GETS TO THE HANDS OF GROUPS AND ORGANIZATIONS THAT WE MAY EVEN CHARACTERIZE BEING CRITICAL TO THE RESEARCH PROCESS. SO I THINK PEOPLE SOMETIMES USE THE MORE SUBVERSIVE TERM DIVESTING AS A WAY TO KIND OF THINK HOW TO CHANNEL RESOURCE -- INSTITUTIONAL RESOURCES TOWARDS COMMUNITIES. I THINK WE NEED TO -- I THINK TO ME IT IS JUST INVESTING. INVESTING IN COMMUNITIES, AND SO I THINK THINKING SERIOUSLY ABOUT JUST THE WAYS THAT WE RELATE TO ORGANIZATIONS AND ORGANIZATION AND GROUPS THAT ARE CENTRAL TO OUR WORK. JUST ANOTHER -- >> THANK YOU FOR THAT. THANK YOU, VERY MUCH FOR THAT, DR. SANTOS. THE POINT ABOUT COMMUNITY BASED RESEARCH IN COLLABORATING WITH THE COMMUNITIES IS WELL HEARD. I'M GOING TO PASS IT OFF TO NOW THANK YOU ALL FOR YOUR COMMENTS, DR. DICKERSON FOR THE MEETING CLOSE. >> THANK YOU, SO MUCH. WE RA REALLY EXCITED TO HAVE Y'ALL STAY WITH US THROUGHOUT THIS WORKSHOP, THANK YOU FOR BEING WITH US FOR THE CLOSING OF THIS SESSION. AND WE ARE JUST REALLY THANKFUL TO BE ABLE TO WRAP UP WITH SUCH A ROBUST DISCUSSION ABOUT THE THINGS WE NEED TO BE THINKING ABOUT AND CONSIDERING, AS WELL ARE TRYING TO ENHANCE HEALTH DISPARITIES RESEARCH PLANNING EFFORTS OVER THE NEXT SEVERAL YEARS. I WOULD LIKE TO SAY ON BEHALF OF THE OFFICE OF HEALTH EQUITY AT THE NICHD, I WOULD LIKE TO THANK YOU ALL FOR NOT ONLY JOINING US FOR THIS WORKSHOP, BUT ALSO SPECIAL GRATITUDE EXTENDED TO EACH OF OUR MODERATORS AND PRESENTERS FOR SHARING THEIR PERSPECTIVES AND THOUGHTS THROUGHOUT EACH OF THESE SESSIONS. I ESPECIALLY WANT TO EXPRESS A SPECIAL APPRECIATION TO OUR YOUTH PANELISTS WHO JOINED US EARLIER TODAY, FOR SHARING THEIR LIVED EXPERIENCES AND IDEAS. THEIR CONTRIBUTIONS AND SUGGESTIONS FOR HOW TO THINK ABOUT HOW RESEARCH SHOULD BE IMPROVED AND NEED FOR RESEARCH TO BE MORE HUMAN CENTER CENTERED ARE SO POWERFUL. WE ARE REMINDED CHANGE STARTS WITH THE YOUTH. AND AS WE ARE THINKING ABOUT THESE DIFFICULT TOPICS, THAT WE NEED TO THINK ABOUT HOW DO WE ADDRESS THESE BETTER, WE REALLY WANT TO MAKE SURE WE ARE CENTERING OR CONVERSATIONS AROUND THOSE WHO ARE IMPACTED BY OUR RESEARCH. THAT MEANS BY HEARING FROM THE VOICES OF THE VARIOUS COMMUNITIES THAT WE ARE ENGAGING WITH, AND THOSE COMMUNITIES ARE BEING IMPACTED BY THE RESEARCH EFFORTS WE ARE LEADING. AND MAKING SURE THAT WE ARE ENGAGING THESE COMMUNITIES IS CRITICALLY IMPORTANT. WE WERE ABLE TO HEAR THOUGHT PROVOKING PRESENTATIONS AND DISCUSSIONS DUE TO THE MANY PERSPECTIVES AND INSIGHTS THAT WERE SHARED FROM INDIVIDUALS TODAY WHO REPRESENT MANY DIFFERENT RESEARCH DISCIPLINES. AS WELL AS DIVERSE EXPERIENCES AND BACKGROUNDS. AS WE CONTINUE THIS WORKSHOP SERIES WE NEED TO CONTINUE THE THINK ANT WAYS OUR RESEARCH -- ABOUT WAYS RESEARCH EFFORTS PROMOTE EQUITY, REDUCE DISPARITIES ACROSS POPULATIONS, LIFE SPANS AND GENERATIONS. IT IS IMPORTANT FOR US TO KEEP IN THE FOREFRONT WHAT CONCEPTS AN TOPICS WE HEARD ABOUT TODAY HOW WE IMPROVE HEALTH DISPARITIES NOT ONLY WITH IDENTIFICATION BUT MITIGATION OF THESE DISPARITIES. SOME EXAMPLES OF THINGS WE HEARD TODAY REALLY HIGHLIGHT THE IMPORTANCE OF CONSIDERING HOW ETHNIC RACIAL GENDER SEXUAL AND CLASS IDENTITIES AND INTERSEXUALITIES HAVE IMPLICATIONS ON NOT ONLY YOUTH DEVELOPMENT BUT HAVE DIS-- HEALTH DISPARITIES ACROSS THE LIFE SPAN AND RESEARCH DATA COLLECTION AS WELL AS IMPLICATIONS FOR WHAT THOSE STUDY FINDINGS ARE. WE REALLY NEED TO THINK ABOUT HOW WE ENGAGE WITH COMMUNITIES, SO THAT WE ARE ABLE TO INFORM POLICY, TREATMENT AND PREVENTION PROGRAMS AND THINKING HOW DO WE INTEGRATE TRADITIONAL PRACTICES, OF INDIGENOUS POPULATIONS WITHIN OUR INTERVENTIONS. AND HOW WE CAN BE MORE INCLUSIVE OF THE GROUPS REPRESENTED ACROSS THIS COUNTRY AND NOT JUST LUMPING DATA TOGETHER. BECAUSE NO ONE GROUP IS HOMOGENOUS. WE ALSO WANT TO THINK ABOUT THE FACT THAT THERE MAYBE SOME SIGNIFICANT CHANGES THAT MAY NEED TO TAKE PLACE AT INSTITUTIONAL LEVEL. WE NEED TO REVISIT HOW WE ARE LOOKING AT REVIEW PROCESS, WHAT TYPES OF SCIENCE IS BEING FUNDED, AND HOW WE ARE STRUCTURING THE INVESTMENTS WE ARE MAKING. THROUGHOUT THIS WORKSHOP SERIES WE WILL CONTINUE TO HEAR FROM A VARIETY OF VIEW POINTS AND DIFFERENT SECTORS ABOUT HOW WE NEED TO THINK ABOUT BOLD INNOVATIVE IDEAS TO MITIGATE HEALTH DISPARITIES FOR NICHD POPULATIONS, AND ULTIMATELY HOW CAN WE DO THIS TO PROMOTE HEALTH EQUITY. WE HAVE THREE MORE WORKSHOPS REMAINING ON THIS SERIES, SO WE HOPE THOSE WHO JOINED US TODAY WILL CONTINUE AND RETURN BACK FOR THE REMAINING THREE SESSIONS THAT WE HAVE, WE'LL BE COVERING TOPICS ON SOCIETAL INFLUENCES, DURING CHILDHOOD, COMMUNITY ENGAGE RESEARCH STRATEGIES AND CLOSING SESSION WILL FOCUS ON TRANSLATION AND IMPLEMENTATION SCIENCE. SO I ENCOURAGE YOU IF YOU HAVEN'T ALREADY REGISTERED FOR THE REMAINING SESSIONS THAT YOU PLEASE DO SO. WE ALSO LIKE TO REMIND FOLKS IF YOU DIDN'T HAVE AN OPPORTUNITY TO HEAR SOME OF THE RESPONSES TO SOME OF THE QUESTIONS THAT WERE POSED, WE DO HAVE ADDITIONAL PLATFORMS FOR ENGAGEMENT IN OUR ENCOURAGE YOU TO GO TO OUR STRIVE IDEAL SCALE CAMPAIGN SITE, THERE YOU WILL BE ABLE TO USE THAT PLATFORM TO SUBMIT IDEAS AND FEEDBACK TO INFORM NICHD RESEARCH PLANNING EFFORTS TO ENHANCE OUR HEALTH DISPARITIES RESEARCH PORTFOLIOS. AND SO WE REALLY APPRECIATE Y'ALL SPENDING TIME WITH US TODAY. I WOULD LIKE TO CLOSE WITH THANKING THE NICHD DIRECTOR AND DEPUTY DIRECTOR, DR.S BIANCI AND CERNICH AND DR. LAMAR, ALONG WITH THE WORKSHOP CO-LEADS AND PLANNING GROUP MEMBERS, AND THE CONTRACTOR TEAMS FOR ALL EFFORTS FOR MAKING THIS WORKSHOP A SUCCESS. HAVE A GREAT REST OF YOUR DAY AND THANK YOU FOR JOINING US.