>>WELCOME TO ALL OF YOU. THANK YOU FOR JOINING US AT THE MODIFIABLE FACTORS AND SOCIAL DETERMINANTS OF HEALTH SESSION. WE'RE GOING TO BEGIN TODAY WITH PRELIMINARY REMARKS FROM OUR CHAIR, DR. REBECCA JORDAN YOUNG, THAT WILL BE FOLLOWED BY THREE PRESENTATIONS AND A PANEL DISCUSSION AND DR. JORDAN-YOUNG WILL INTRODUCE EACH OF THE THREE SPEAKERS. PLEASE FEEL FREE TO ASK QUESTIONS DURING THE PRESENTATION VIA THE Q&A CHAT BOX. AND WE'LL COMPILE THOSE AS WE GO ALONG AND HAVE THE Q&A SESSION AT THE END. I'M THRILLED TO INTRODUCE DR. REBECCA JORDAN-YOUNG, ANN WHITNEY OLDEN PROFESSOR AND CHAIR OF WOMEN'S GENDER AND SEXUALITY STUDIES AT BARNARD COLLEGE, AN INTERDISCIPLINARY FEMINIST SCIENTIST, AND SCIENCE STUDY SCHOLAR, EXPLORING RELATIONS BETWEEN SCIENCE AND SOCIAL DETERMINANTS AND SOCIAL HIERARCHIES OF GENDER, CLASS, RACE. THE FULL BIO CAN BE FOUND IN THE LINK IN THE CHAT THAT WE WILL CENTERPIECE IN JUST A MOMENT. THANKS VERY MUCH, EVERYONE, AND WELCOME. >>THANK YOU, DR. POPKIN. IT'S A DELIGHT AND PLEASURE TO BE HERE. I'M SO MUCH LOOKING FORWARD TO THE PRESENTATIONS WE HAVE TODAY. I WILL SAY THAT I'VE DECIDED TO KEEP MY OWN COMMENTS QUITE BRIEF. WE HAVE WONDERFUL SPEAKERS, I'D RATHER SPEND MOST OF OUR TIME HEARING ABOUT THEIR CONCRETE RESEARCH PROGRAMS AS WE'VE ALREADY HAD SUCH STRONG PLENARY SPEAKERS TO SET THE OVERALL STAGE. THAT SAID, I HAVE ONLY A FEW SMALL OVERARCHING POINTS TO GIVE SOME ADDITIONAL CONTEXT AND FRAMING TO WHAT WILL COME. FIRST, I'M DELIGHTED OUR PANEL WILL MAKE IT ABSOLUTELY EXPLICIT THAT GENDER ISN'T JUST A FANCY WORD FOR WOMEN. MEN HAVE GENDER TOO. AND THE CROSS-CUTTING NATURE OF SOCIAL HIERARCHIES MEANS THAT MEN DO NOT AS A BROAD CLASS HOLD PRIVILEGE AND ALWAYS OVER WOMEN AS BROAD CLASS, IT'S NOT USEFUL TO THINK THAT WAY. SINGLE DIMENSION THINKING IS PROBLEMATIC IN THE FIELD SO I'M DELIGHTED WE HAVE A PAPER THAT'S GOING TO THINK ABOUT MEN'S HEALTH. SECOND, I WANT TO TOUCH ON THE DEFINITION OF GENDER THAT NANCY KRIEGER PRESENTED THIS MORNING, OFFER A FEW ADDITIONAL THOUGHTS ABOUT HOW WE MIGHT DEFINE AND UNDERSTAND GENDER. NANCY PRESENTED DEFINITION THAT CAME FROM RAY WYNN CONNELL, WHO DEFINES GENDER IN THIS CASE AS EMBODIED SOCIAL STRUCTURE WHICH I THINK IS A SUPER INTERESTING AND HELPFUL WAY TO THINK ABOUT WHAT GENDER IS, AND IT'S ALSO -- WHEN I'M TEACHING STUDENTS, OFTEN THIS DEFINITION CAN CONFUSE THEM AT FIRST, VERY MUCH. WHAT DOES IT MEAN A SOCIAL STRUCTURE IS EMBODIED? IS THIS THIS PERSONAL INDIVIDUAL BIOLOGICAL LEVEL THING? OR IS IT A SOCIAL STRUCTURE? AND THIS ONE TERM, THIS PHRASE, DOES A REALLY GOOD JOB OF IMMEDIATELY CONVEYING WHAT A LOT OF FEAR RISKS OF GENDER, SEX, SEXUALITY AND HEALTH HAVE SAID AS OUR GOAL WHICH IS TO UNDERSTAND THAT THE WAY OUR BODIES IMBIBE SOCIAL STRUCTURE AND TRANSFORM OUR SOCIAL ENVIRONMENTS INTO INDIVIDUAL LEVEL AND GROUP LEVEL PATTERNS OF HEALTH. SO I THINK THAT'S JUST SUPER USEFUL FOR US. I HAVE IN THE PAST SOMETIMES IDENTIFIED OR DEFINED GENDER AS A PERVASIVE DEVELOPMENTAL ENVIRONMENT. IT CAN BE HELPFUL TO THINK ABOUT GENDER AS STRUCTURED, NOT JUST IN THE OUTCOME, AND THE REASON I RAISE THIS NOW IS THAT OUR PAPERS AND I THINK THE DAY AS A WHOLE ARE REALLY LOOKING AT BY AND LARGE ADULT OUTCOMES. WE'RE LOOKING AT PATTERNS OF GENDER AND HEALTH, AS ADULTS. IT'S REALLY INTERESTING AND USEFUL TO REMEMBER THAT THERE ARE DEVELOPMENTAL PATHWAYS AND PROCESSES, AND GENDER SOCIALIZATION AND THE RULES ABOUT GENDER, NOT JUST SOCIALIZATION, BUT DE FACTO AND DEJURE RULES ARE CUMULATIVE AND ITERATIVE OVER TIME. PERVASIVE, BUT I WANT TO EMPHASIZE THAT DOESN'T MEAN MONOLITHTIC, BECAUSE OF THE WAY GENDER IS CROSS-CUT AS WE'VE BEEN TALKING ABOUT ALL DAY, RACE, CLASS, IMMIGRATION STATUS, SEXUALITY, PHYSICAL ABILITY, SO ON. THERE ARE OTHER FORMS OF VARIATION AND VARIABLE VARIGATION, SIMPLY ABOUT POCKETS OF VARIATION, THERE'S A HUMAN AMOUNT OF VARIEGATION IN THE WAYS GENDER OPERATES TO PRODUCE LARGE PATTERN EFFECTS, AND THAT I THINK IT'S USEFUL TO REMEMBER THAT. AS A SOCIAL STRUCTURE, KRIEGER POINTED OUT GENDER IS A PRODUCT OF HISTORY. THAT'S WHAT MAKES THIS PANEL POSSIBLE. IT OPENS IT UP TO OUR INTERVENTIONS. BUT OF COURSE BECAUSE GENDER IS CROSS-CUT BY VIRTUALLY ALL OTHER SOCIAL HIERARCHIES AND STRUCTURES, UNDERSTANDING THE POTENTIAL POINTS OF INTERVENTION IN GENDER-RELATED INEQUITIES WILL REQUIRE LOOKING AT THE SPECIFIC GENDERED POSITIONS WITHIN ANY TARGET DOMAIN. SO, THIS IS A FIELD WHERE EMPIRICAL INVESTIGATIONS ARE ESPECIALLY CRUCIAL. GENERAL PRINCIPLES WILL NOT BE ADEQUATE TO PREDICT EFFECTS ACROSS MOST DOMAINS, BECAUSE THE WAY THAT SYSTEMS OF POWER AND HIERARCHY INTERACT IS OFTEN DOMAIN SPECIFIC. I THINK THAT I'LL JUST THROW THAT OUT THERE, I THINK THE PARTICULAR CASES THAT WE'RE GOING TO HEAR ABOUT WILL GIVE US CONCRETE WAYS TO TALK ABOUT THAT, IF PEOPLE WOULD LIKE TO TAKE UP THAT CLAIM. AND I'M LOOKING AT TIME. I WANT TO SAY ONE LAST THING. BECAUSE OF TIME I'M GOING TO ASSERT IT AND WE CAN TALK ABOUT IT LATER. THERE'S A LOT OF WONDERFUL RECENT WORK THAT DEMONSTRATES THE WAY THAT ATTEMPTS AT RACE BLIND INTERVENTIONS IN FACT, OR RACE NEUTRAL INTERVENTION EXACERBATED OUTCOME. TAYLOR'S WORK ON HOUSING FINANCING IS A REALLY GREAT EXAMPLE OF THAT. HELENA HANSON'S WORK ON THE OPIOID EPIDEMIC IS ANOTHER EXCELLENT EXAMPLE. THERE ARE MANY MORE. BUT I THINK THAT THIS GENERAL DYNAMIC ABOUT HOW WHEN YOU TRY TO INTERVENE IN A HIERARCHICAL SYSTEM IN A WAY WHERE YOUR INTERVENTION DOES NOT EXPLICITLY TARGET THE GROUNDS OF THE HIERARCHY THAT YOU'RE ACTUALLY GOING TO EXACERBATE THE INEQUALITIES AT THE END. IN OTHER WORDS, THESE RACE BLIND OR RACE NEUTRAL INTERVENTIONS EXACERBATE RACISM. I BELIEVE WE SEE AND CAN EXPECT THE SAME FOR GENDER BLIND INTERVENTIONS AND SEXISM. SO, WITH THAT, LET ME JUST SAY A FEW -- WHAT I'LL DO IS IDENTIFY EACH PANELIST, ONE AT A TIME, JUST BEFORE THEY SPEAK. WE'RE GOING TO START WITH GOLEEN SAMARI, ASSISTANT PROFESSOR OF POPULATION AND FAMILY HEALTH AT COLUMBIA UNIVERSITY MAILMAN SCHOOL OF PUBLIC HEALTH, ALSO A FACULTY AFFILIATE OF THE COLUMBIA PROGRAM ON FORCED MIGRATION AND HEALTH, COLUMBIA PROM ON GLOBAL HEALTH, JUSTICE AND GOVERNANCE, AND COLUMBIA POPULATION RESEARCH CENTER. HER RESEARCH CONSIDERS HOW RACISM, GENDER AND MIGRATION BASIN EQUITIES SHAPE REPRODUCTIVE AND POPULATION WITH FOCUS ON MIDDLE EAST AND NORTH AFRICA. AS WITH EVERYONE ELSE HER FULL BIO IS ON THE CONFERENCE PAGE. DR. SAMARI, I WELCOME YOU TO THE SESSION. >>THANK YOU, DR. JORDAN-YOUNG, FOR THAT INTRODUCTION AND FOR SETTING THE STAGE FOR THE SESSION. SO TODAY I'M GOING TO TALK ABOUT A BODY OF WORK AROUND STRUCTURAL XENOPHOBIA AND IMMIGRATION, SOCIAL DETERMINANTS OF SEXUAL AND REPRODUCTIVE HEALTH. IT'S IMPORTANT TO NAME THAT THIS TALK IS GOING TO PRIMARILY FOCUS ON THE EXPERIENCES OF CISGENDER FEMALE IMMIGRANTS. IMMIGRANTS ACCOUNT FOR 14% OF THE FEMALE POPULATION. AND IN 2019, 52% OF ALL U.S. IMMIGRANTS WERE FEMALE, WHICH IS A SMALL MAJORITY. NEARLY HALF OF ALL FEMALE U.S. IMMIGRANTS ARE OF REPRODUCTIVE AGE, IMMIGRANTS ACCOUNT FOR 23% OF ALL BIRTHS, 6.4 MILLION NON-CITIZEN IMMIGRANT WOMEN OF REPRODUCTIVE AGE ARE NOT INSURED. SO, IN 2020, SHEILA AND MYSELF PUBLISHED A PIECE TO DRAW ATTENTION TO HOW COVID-19 COMPOUNDS EXISTING STRUCTURAL INEQUITIES FOR IMMIGRANTS WITH IMPLICATIONS FOR SEXUAL AND REPRODUCTIVE HEALTH. IMMIGRANT WOMEN OF REPRODUCTIVE AGE REALLY FACE SIGNIFICANT CHALLENGES OBTAINING COMPREHENSIVE SEXUAL AND REPRODUCTIVE HEALTH CARE AS COMPARED TO U.S. BORN WOMEN BECAUSE OF POLICY AND STRUCTURAL FACTORS. WE FOCUSED ON HOW SOCIETY CODIFIES STRUCTURAL DISADVANTAGES FOR RACIALIZED IMMIGRANTS INTO GOVERNMENTAL AND INSTITUTIONAL POLICIES AND HOW THAT AFFECTS SEXUAL AND REPRODUCTIVE HEALTH. SO THIS IS A SMALL SAMPLE OF THE SOCIAL AND STRUCTURAL DETERMINANTS. IMMIGRANTS FACE SOCIAL, ECONOMIC, POLITICAL BARRIERS TO OBTAINING SEXUAL REPRODUCTIVE HEALTH CARE. THEY WERE EXCLUDED FROM COVID RELIEF EFFORTS ON TOP OF THESE THINGS. THESE ARE SOME STRUCTURAL AND SOCIAL BARRIERS, EMPLOYMENT, PLACE OF RESIDENCE, RACISM, XENOPHOBIA, IMMIGRATION POLICY, EXCLUSION FROM PUBLIC HEALTH PROBLEMS, ERODING ACCESS TO SRH AND SRH POLICY. RESPONDING TO A CALL TO FURTHER THE RESEARCH AGENDA ON IMPACT OF STATE LEVEL IMMIGRATION POLICIES AND SOCIAL POLICIES, SEVERAL STUDIES HAVE AGGREGATED IMMIGRATION POLICY AT THE STATE LEVEL TO CAPTURE EXCLUSIONARY CONTEXT FOR IMMIGRANTS. EXPANDING ON THIS WORK AND REALLY CALLING FOR BETTER MEASURES OF STRUCTURAL RACISM AND XENOPHOBIA, IMMIGRATION POLICY INDEX WHICH I'LL DETAIL IN THE NEXT FEW SLIDES PROVIDE A THEORETICAL AND POLICY-INFORMED MEASURE OF STRUCTURAL XENOPHOBIA FOR USE IN POPULATION HEALTH RESEARCH. I'M GOING TO DESCRIBE THE MEASURE AND HOW IT WAS CREATED AND LINK IT BACK TO SEXUAL, REPRODUCTIVE, AND MATERNAL HEALTH. STRUCTURAL XENOPHOBIA IS SYSTEMIC RACISM AND REQUIRES GOING BEYOND INDIVIDUAL MEASURES OF ANTI-IMMIGRANT SENTIMENT AND SOCIAL AND ECONOMIC AND DEMOGRAPHIC INDICATORS LIKE NATIVITY. IT'S ROOTED IN A FEAR AND HATRED OF IMMIGRANTS AS WELL AS RACIALIZATION OF IMMIGRANT EXPERIENCE. THINKING ABOUT MEASURING STRUCTURAL XENOPHOBIA IT'S IMPORTANT TO THINK ABOUT WHAT IS THE AERIAL UNIT OR WHAT GEOGRAPHIC BOUNDARIES OF THE STRUCTURAL ENVIRONMENT ARE OF PARTICULAR IMPORTANCE. THIS IS AN AREA OF AN UNSETTLED DEBATE AMONG SCHOLARS. MEASURING STRUCTURAL PHENOMENON AT DIFFERENT GEOGRAPHIC SCALES, THAT IS CENSUS TRACTS OR COUNTIES OR STATES, CAUSES SOMETHING CALLED THE MODIFIABLE AREA UNIT PROBLEM, WHICH CAN LEAD TO INCONSISTENT FINDINGS CONCERNING HEALTH. YOU HAVE TO BE THEORETICALLY INFORMED, AND IN THIS CASE IMMIGRATION STATUS IS DETERMINED AT THE FEDERAL LEVEL BUT STATE LEVEL POLICIES SERVE AS SYMBOLIC MARKERS WHO IS ALLOWED TO INHABIT A CERTAIN SPACE AND GIVE AN ACCESS TO A WIDE VARIETY OF SERVICES. MUCH OF THE PUBLIC HEALTH RESEARCH FOCUSES ON INDIVIDUAL LEVEL FACTORS. WE ALSO NEED TO UNDERSTAND THE BROADER CLIMATE AND THE STATE LEVEL CLIMATE FOR IMMIGRATION HAS SUBSTANTIAL IMPLICATIONS. MOTIVATION FOR THE CLIMATE POLICY INDEX WAS REALLY TO BE INCLUSIVE TO ALL IMMIGRANT GROUPS FOCUSING ON GROUPS IMMIGRANTS AND INDEX IS APPLICABLE TO ALL. IT'S LONGITUDINAL, COVERS 2009 TO 2019. THEORETICALLY BASED IN RESEARCH, SIMPLE IN APPLICATION, POLICIES AREN'T WEIGHTED A CERTAIN WAY SCALED THAT MAKES THEM DIFFICULT TO APPLY. THIS IS A MEASURE OF OF THE XENOPHOBIA AND RACISM EXPERIENCE, WHICH POLICIES ARE IMPORTANT, INCLUDING THOSE THAT HAVE A DIFFERENTIAL INFORMATION ON LEGAL STATUS. WE INCLUDED POLICIES BASED ON CONTENT AND NOT NECESSARILY THE METHOD ENACTED. POTENTIAL METHODS COULD INCLUDE LAW, REGULATION, COURT DECISION. THIS ACTUALLY ENABLED AGGREGATION ACROSS STATES THAT ENACT POLICIES IN VERY DIFFERENT WAYS. THE POLICY TOPICS INYOU INCLUDED PUBLIC HEALTH AND WELFARE, EDUCATION, LABOR, IDENTIFICATION, ENFORCEMENT. WE DID A FACTOR ANALYSIS, 14 POLICIES ACROSS THE DOMAINS. FIVE-FACTOR MODEL IS SUPPORTED ALIGNING WITH THESE POLICY TOPICS. SO THESE ARE SOME OF THE SOURCES THAT WERE USED ACROSS THE DOMAIN. WE CODED 714 U.S. STATE POLICIES RELATED TO STRUCTURAL XENOPHOBIA ACROSS 50 THE CITIES AND DISTRICT OF COLUMBIA FROM 2009 TO 2019. GENERALLY A POLICY WAS CODED AS INCLUSIONARY WHEN A STATE TOOK ACTION TO EXTEND THE BENEFIT THAT WAS NON-ACCESSIBLE TO NON-CITIZENS AS PART OF A FEDERAL PROGRAM. OR WHEN A STATE LIMITED PARTICIPATION WITH A MANDATORY EXCLUSIVE FEDERAL POLICY, YOU CAN SEE CODING BREAKDOWN ON THE SLIDE, DESIGNED INTENTIONALLY TO INCLUDE EXCLUSIONARY DOMAIN AND AN INCLUSIONARY DOMAIN, IN ORDER TO ENABLE RESEARCHERS WHO ARE ASKING DIFFERENT TYPES OF QUESTIONS TO LEVERAGE THE USE OF THIS TYPE OF MEASURE. SO SOMETIMES IT'S MORE PERTINENT TO KNOW IF A MOVEMENT TOWARDS INCLUSION HAS BENEFITS, AND FOR OTHER RESEARCH QUESTIONS TO KNOW IF EXCLUSIONARY AND RACIST AND DISCRIMINATORY ENVIRONMENTS HAVE NEGATIVE EFFECTS ON HEALTH. SO WHAT WERE THE RESULTS WHEN WE DID THIS CODING? GENERALLY TWO-THIRDS ADOPTED AT THE STATE LEVEL ARE EXCLUSIONARY TOWARDS IMMIGRANTS. FROM 2009 TO 2019, 33 STATES HAD ON AVERAGE EXCLUSIVE POLICIES. RACIAL INCLUSIVE AND EXCLUSIVE NARROWS OVER TIME. IN 2009 IT WAS 32% INCLUSIVE, 68% EXCLUSIVE. IN 2019, 39 PER CENT INCLUSIVE, 61% EXCLUSIVE. GENERALLY SPEAKING EXCLUSIVE STATES BECAME MORE EXCLUSIVE, MORE DISCRIMINATORY, OTHERS WERE MORE INCLUSIVE, GIVING A SNAPSHOT OF THE STATES IN 2019. SO, EIGHT STATES HAD NO POLICIES IN PLACE THAT ARE CONSIDERED INCLUSIVE. FOUR MOST INCLUSIVE STATES ARE CALIFORNIA, OREGON, WASHINGTON, NEW YORK. THEY HAD 7 TO 10 INCLUSIVE POLICIES IN PLACE, BETWEEN ZERO AND 1 EXCLUSIVE POLICIES IN PLACE. FOUR MOST EXCLUSIVE STATES, ALABAMA, GEORGIA, INDIANA, IDAHO, HAD 8 TO 10 EXCLUSIVE POLICIES IN PLACE WITH ZERO INCLUSIVE POLICIES. THIS SHOWS A MAP OF THE U.S. FOR THE SAME RESULTS IN 2019. THESE ARE CODED BASED ON CONCEPTUAL IDEA WHAT IT MEANS TO HAVE AN INCLUSIVE OR EXCLUSIVE CLIMATE, THAT IS ANYBODY WITH FOUR OR MORE INCLUSIVE POLICIES IN BLUE, LESS IN DARK GRAY, AND GRAY SHADE IS NEITHER. SOME STATES WERE REALLY VERY INCLUSIVE, IN 2019, SO CALIFORNIA AND OREGON SCORED MORE THAN 10. MANY MORE STATES ARE EXCLUSIVE AS YOU CAN SEE ON THIS MAP. THE COAST ALSO HAD THE MOST BLUE OR INCLUSIVE ENVIRONMENT. THIS GOES TO SHOW THAT THE CONTINUOUS IMMIGRATION POLICY CLIMATE INDEX, IPC INDEX, INCLUDES ANALYZE INFORMATION ACROSS FIVE DOMAINS THAT ARE ROOTED IN YOUR SOCIAL DETERMINANTS OF HEALTH FOR ALL 50 STATES AND D.C. OVER TIME, 2019 TO 2019. IT CAN EXPAND TO RIGOROUSLY EVALUATE THE MULTI-LEVEL AND LONGITUDINAL EFFECTS OF STRUCTURAL XENOPHOBIA ON IMMIGRANT LIVES AND HEALTH. WHAT DOES THIS LOOK LIKE FOR IMMIGRANT WOMEN AND PRENATAL CARE AND BIRTH OUTCOMES? MANY ASPECTS OF SEXUAL REPRODUCTIVE HEALTH. THIS SHOWS WHEN WE ASSIGN STATE IMMIGRATION POLICY CLIMATE TO PREGNANT INDIVIDUALS WITH SINGLETON BIRTHS ON BASIS OF THE POLICY CLIMATE IN STATE OF RESIDENCE, SIX MONTHS PRIOR TO THE START OF THE PREGNANCY. YOU CAN OBSERVE DIFFERENCES, SO THE BLUE LINE, GREENISH BLUE LINE FOR U.S. BORN LATINX COMMUNITIES ACTUALLY LIVE IN MORE INCLUSIVE CLIMATES WHERE THE Y-AXIS IS SHOWING POSITIVE. AND THE ORANGISH LINE IS MORE EXCLUSIVE. SO YOU CAN SEE THAT THERE ARE MORE DIFFERENCES BETWEEN THE U.S. BORN LATINX VERSUS U.S. BORN WHITE VERSUS THOSE FOREIGN BORN IN COLUMN ON THE RIGHT-HAND SIDE. THIS COULD BE, YOU KNOW, INDIVIDUALS HAVE SOME AGENCY WHEN GIVEN STRUCTURAL CONSTRAINTS SO THEY COULD BE CHOOSING TO LIVE IN AREAS THAT ARE MORE INCLUSIONARY OR NEUTRAL IN TERMS OF IMMIGRATION POLICY. LET ME PRESENT SOME OF THE FINDINGS. THIS SHOWS -- THIS IS MODELING PRENATAL CARE AS OUTCOME. FINDINGS SUGGEST THAT OVERALL, LIVING IN AN EXCLUSIONARY STATE YOU'RE LESS LIKELY TO HAVE INADEQUATE CARE THAN INCLUSIONARY STATE. HOWEVER WHEN YOU START EXPLORING THE DIFFERENCES BY U.S. BORN LATINX VERSUS FOREIGN BORN LATINX RISK OF INADEQUATE CARE IS HIGHER FOR EXCLUSIONARY SAFE. IT MATTERS FOR THE FOREIGN BORN INDIVIDUAL AS OPPOSED TO THE U.S. BORN INDIVIDUAL. WE CONDUCTED SIMILAR ANALYSIS BUT CHANGED EXPOSURE TO THE DOMAIN OF HEALTH POLICY, SPECIFICALLY, SO IMMIGRATION POLICY IN HEALTH POLICY, WHICH CONSISTED OF FOUR POLICIES TO REGULATE HEALTH. THE FINDINGS WERE QUITE SIMILAR. THIS ANALYSIS IS ONGOING TO LOOK AT THE RELATIONSHIP BETWEEN PRE-TERM BIRTH AND A LOT OF THE RESEARCH IN THIS SPACE SHOWS CLEAR NEGATIVE OUTCOMES BETWEEN STRUCTURAL RACISM AND PRE-TERM BIRTH, IMMIGRATION POLICY AND PRE-TERM BIRTH, BUT INTERESTINGLY ENOUGH WE'RE SEEING LOOKING OVER TIME FROM 2009 TO 2019 WE'RE SEEING INVERSE. AND SO AS WE START TO EXPLORE THIS RELATIONSHIP, THIS IS REALLY PRELIMINARY, BUT WE'RE DIGGING DEEPER INTO DIFFERENT MODELING APPROACHES AND POTENTIAL REASONS THAT WE'RE SEEING THAT BIRTH OUTCOMES ARE ACTUALLY BETTER IN EXCLUSIONARY ENVIRONMENTS. I WANT TO TAKE A MOMENT TO ACTUALLY ELEVATE THE VOICES OF IMMIGRANT WOMEN AND HOW WE'RE DEFINING AND MEASURING STRUCTURAL XENOPHOBIA AND RACIALIZATION OF MIGRANTS. DOES HOW I PROPOSE TO MEASURE STRUCTURAL XENOPHOBIA RESONATE WITH IMMIGRANT WOMEN. I CONDUCTED A STUDY THAT INVOLVED INTERVIEWS WITH 44 IMMIGRANT WOMEN FROM DIVERSE NATIONAL ORIGINALS, 19 DIRECT SERVICE PROVIDERS, FOR THE IMMIGRANT COMMUNITY. AND WHEN IMMIGRANT WOMEN WERE EXPLAINING HOW STRUCTURAL XENOPHOBIA SHAPES THEIR LIVES, FOUR MAJOR THEMES EMERGED INCLUDING IMMIGRATION POLICY, IMMIGRATION ENFORCEMENT, INTERPERSONAL RACISM, AND ECONOMIC EXPLOITATION. SO I'M GOING TO SHOW SOME OF THEIR QUOTES. IN TERMS OF ECONOMIC EXPLOITATION, THERE'S A SAYING THAT WE'RE LIKE ORANGES, WE COME HERE, THEY SQUEEZE US, SEND THE PEEL BACK TO OUR COUNTRY TO DIE BECAUSE ALL OUR STRENGTH, YOUTH AND HEALTH STAYS HERE AND WE DON'T EVEN HAVE HEALTH INSURANCE. WE DON'T HAVE A LIVING WAGE. WE ARE NOT RESPECTED AS PEOPLE. FOR INTERPERSONAL RACISM, I DON'T WANT TO GO TO A HOSPITAL AND HAVE THEM STARE AND ASK ME WHAT'S GOING ON, BEING PREGNANT WITHOUT BEING ABLE TO COMMUNICATE, SOMETIMES I ASK DO YOU SPEAK SPANISH OR IS THERE SOMEONE WHO DOES, I ASK IN ENGLISH, THEY SAY HERE IS THIS STUPID WOMAN COMING TO A HOSPITAL ANDS SHE CAN'T SPEAK ENGLISH. WE THINK ABOUT BENEFITS, WHEN YOU START TO FILL IN INFORMATION SOMETIMES I DON'T PUT MUCH BECAUSE THERE MAY BE PEOPLE WHO MAY CALL IMMIGRATION OR SOMETHING, THERE ARE BAD PEOPLE BECAUSE SOMETIMES THEY DO THINGS ANONYMOUSLY. SO NO. LASTLY IN THE IMMIGRATION ENFORCEMENT DOMAIN, I AM NOT AMERICAN, THEY TOOK ME TO AN EXTREME DETENTION FOR CHILDBIRTH, I WAS PREGNANT AND THERE WERE A LOT OF COMPLICATIONS, I LOST MY BABY, I WAS VERY AFFECTED AT THAT TIME. THEY REALLY ELEVATE THESE DIFFERENT THEMES THROUGHOUT THEIR EXPLANATIONS OF HOW STRUCTURAL XENOPHOBIA HAS IMPACTED THEIR LEVELS. AND WE REALLY FIND THAT PANDEMIC-RELATED FEARS AS WELL AS STRUCTURAL INEQUITIES, THOSE THAT I NAMED, RELATED TO HEALTH MIGRATION AND GENDER SHAPED SHIFTS IN CONTRACEPTIVE USE AND PREFERENCES AMONG PARTICIPANTS. WE FOUND CONTRACEPTIVE USE WAS SHAPED BY HEALTH, SAFETY, RACE INCH, XENOPHOBIA. PREGNANCY PREFERENCES WERE SHAPED BY HEALTH AND SAFETY, AS WELL AS LEGAL BARRIERS, ECONOMIC CONSTRAINTS. AND LASTLY I JUST WANT TO HIGHLIGHT THAT WHILE WE'VE TALKED ABOUT STRUCTURAL XENOPHOBIA AND SPEND THE DAY THINKING ABOUT GENDER AND SEXUAL MEASURES, STRUCTURAL XENOPHOBIA HAS DIFFERENTIAL EFFECTS BY SEX, RACE, SEXUAL ORIENTATION AND SO ON, INTERSECTIONALITY AT ITS CORE. STRUCTURAL XENOPHOBIA AS A DETERMINANT OF HEALTH INTERPLAYS WITH OTHER STRUCTURAL MEASURES TO SHAPE HEALTH AND IT'S IMPORTANT TO THINK ABOUT THESE STRUCTURAL MEASURES AS INTERLOCKING OPPRESSIVE SYSTEMS THAT INFLUENCE HEALTH. WITH THAT I WOULD LIKE TO ACKNOWLEDGE MY FUNDERS AND MANY COLLABORATORS THAT MAKE THIS WORK POSSIBLE. THANK YOU AL FOR YOUR TIME TODAY. >>THANKS, DR. SAMARI. YOU'VE GIVEN US A LOT TO THINK ABOUT AND CHEW ON. WE'RE GOING TO GO -- I BELIEVE WE OUGHT TO GO THROUGH ALL OF THE DIFFERENT TALKS AND THEN WE WILL HAVE OUR QUESTIONS AND DISCUSSION AT THE END. SO, THANK YOU SO MUCH FOR THAT. NOW I'M GOING TO MOVE TO DR. DEREK GRIFFITH, THE FOUNDER AND CO-DIRECTOR OF THE RACIAL JUSTICE INSTITUTE, FOUNDER AND DIRECTOR OF CENTER FOR MEN'S HEALTH EQUITY, MEMBER OF THE LOMBARDI COMPREHENSIVE CANCER CENTER, TENURED PROFESSOR OF HEALTH SYSTEMS ADMINISTRATION AND ONCOLOGY AT GEORGETOWN UNIVERSITY, HAS BEEN A LEADER IN CONCEPTUALIZING RACISM AS A DETERMINANT OF HEALTH UTILIZING ANTI-RACISM LENS TO MITIGATE AND UNDO HEALTH EFFECTS OF STRUCTURAL RACISM PROMOTING BLACK AMERICAN MEN'S HEALTH AND WELL-BEING AND ADVANCING THE FIELD. THE REST OF HIS BIO IS AVAILABLE ONLINE. I WILL LEAVE IT THERE. WELCOME, THANK YOU SO MUCH FOR BEING PART OF THIS PANEL, DR. GRIFFITH. >>THANK YOU. I APPRECIATE THE OPENING REMARKS AND INTRODUCTION. LET ME ALSO SAY THANK YOU IN PARTICULAR TO DOCTORS POPKIN, BARR, TIMKEN FOR INFORMATION AND SUPPORT. SO, AS I ENTER THIS CONVERSATION AND JOIN YOU IN THIS CONVERSATION, LET ME OF COURSE BEGIN BY ACKNOWLEDGING HOW STRUCTURAL RACISM SHAPES THE CONTEXT IN WHICH WE'RE TALKING ABOUT. AS WE'VE HEARD, THE ROLE OF STRUCTURAL SEXISM AND INTERSECTION IS REALLY CRITICAL, LOU WE'RE GOING TO HOPEFULLY ACHIEVE HEALTH EQUITY. I'M TRYING TO GET TO THE MORE PRAGMATIC OF HOW DO WE DEAL WITH THESE ISSUES, TO RAISE A PARTICULAR ISSUE AROUND A SPECIFIC POPULATION AND NO SURPRISE THIS WILL BE SPECIFICALLY BLACK MEN. SO, OKAY. AGAIN, THIS IS AGAIN THANK YOU TO DR. JORDAN-YOUNG FOR SETTING THE STAGE FOR THIS TALK AND THIS SESSION. I WON'T BELABOR THIS BUT OFTEN MEN'S AND WOMEN'S HEALTH ARE TREATED AS COMPETITORS IN A ZERO SUM CONTEST FOR SCARCE RESOURCES. WE'RE TRYING TO TREAT IT AS THOUGH IT TAKES AWAY FROM THE OTHER. WHAT WE CLEARLY SAW FROM EARLIER PRESENTATIONS THAT THIS SYSTEM THAT WE HAVE IS NOT SERVING ANY ANYONE WELL, NOT MEN OR WOMEN OR THOSE IN MINORITIES. WE NEED TO UNDERSTAND NOT THE SYSTEM IS AFFECTING BUT WHAT WE NEED TO DO UNIQUELY ACROSS -- FOR EACH SPECIFIC GROUP. PROMOTING EFFORTS, IF WE THINK ABOUT THE WAY MEN'S AND WOMEN'S HEALTH CAN BE STRATEGIC ALLIES, THIS IDEA OF GENDER DISAGGREGATION, WAYS TO CREATE GENDER-SENSITIVE PROGRAMMING AND POLICY METRICS, RECOGNIZING GENDER IDENTITY AND EXPRESSIONS EXIST BEYOND THE TRADITIONALLY OFFAL GENDER BINARY AND INTERSECTING WITH RACE AND ETHNICITY, IMMIGRATION, SO FORTH, ALL THINGS THAT WE CAN SHARE EFFORTS, WAYS WE CAN POINT TO AGREEMENT TO BUILD FROM IN TERMS OF THIS EFFORT OF INCLUDING MEN IN THIS GENDER CONVERSATION. WE'VE DONE THIS WORK TO A DEGREE, I'M BEEN FORTUNATE TO COLLABORATE WITH FOLKS. THIS IS THANK YOU TO ROSEMARY MORGAN AND LEADERS OF THE GENDER AND COVID WORKING GROUP GOING IN 020 AND 2021. AND DR. MORGAN AND OTHERS ORGANIZED THIS GROUP AND WE LOOKED AT BASICALLY THE WAYS COVID WAS AFFECTING THE HEALTH OF SPECIFIC POPULATIONS. AND WE SAW THAT THERE WAS THIS COMPETING NARRATIVE, THESE THINGS PLAYING OUT, THAT THE WAYS THE CONVERSATION AROUND GENDER WERE GOING IN OUR LARGER -- IN THE LARGER COVID CONTEXT WERE REALLY THIS COMPETING NARRATIVE AND ZERO SUM GAME UNTIL WE WANTED TO COME TOGETHER AS SCHOLARS IN WOMEN'S HEALTH, MEN'S HEALTH, SEXUAL AND GENDER MINORITY HEALTH TO THINK ABOUT RECOMMENDATIONS WE MIGHT OFFER THAT WOULD SERVE EVERYONE AND WAYS TO THINK ABOUT THOSE RECOMMENDATIONS AND POLICIES WE WOULD PROPOSE GOING FORWARD. WITHOUT GETTING INTO THE WEEDS, OFFERING THAT AS A WAY WE'VE THOUGHT ABOUT THESE BROAD PICTURES. IN THE GENDER CONVERSATION I'M GOING TO SPEND MY REMARKS AND MY TIME AGAIN TALKING SPECIFICALLY ABOUT BLACK MEN'S HEALTH AS A WAY TO BRING MEN'S HEALTH INTO THE CONVERSATION AROUND GENDER. VERY EXPLICITLY. AND TO GO INTO DEPTH ABOUT WHY MAKE A CASE FOR WHY MEN'S HEALTH NEEDS TO BE MORE CENTRAL TO THE CONVERSATION, THINKING ABOUT IT THROUGH MUCH MORE OF AN INTERSECTIONAL LENS THAN MANY WAYS THAT OFTEN MEN'S HEALTH IS OFTEN PRESENTED. I BEGIN WITH THIS QUOTE FROM PROBABLY VERY FAMILIAR TO MANY OF YOU, FROM THE PREFACE OF RALPH ELLISON'S INVISIBLE MAN THAT SORT OF -- THIS IS WRITTEN 70 YEARS AGO, SPEAKING TO INTENTIONAL INVISIBILITY THAT COMES WITH IGNORING CERTAIN POPULATION GROUPS. THE PIECE THAT CAME UP FOR ME AS I WAS PREPARING THIS WAS ONE OF THE THINGS THAT CAME UP IN CONVERSATION WITH ATTENTION THAT HAPPENED WITH GEORGE FLOYD AND THOSE FACTORS, AS A STRONG RACIAL NARRATIVE WE DIDN'T SEE HOW RACE INTERSECTED WITH GENDER, GEORGE PLOYED WAS BLACK AND A MAN, AFFECTING THE PRACTICE OF THE POLICE IN THE LARGER CONVERSATION AFTER. THIS IDEA OF READING BRIEFLY, I'M A MAN OF SUBSTANCE, FLESH AND BONE, FIBER AND LIQUIDS, I MIGHT EVEN BE SAID TO POSSESS A MIND. I'M INVISIBLE, UNDERSTAND, BECAUSE PEOPLE REFUSE TO SEE ME. WHEN THEY APPROACH THEY SEE MY SURROUNDINGS, THEMSELVES, EVERYTHING AND ANYTHING EXCEPT ME. IT SPEAKS TO THE WHOLENESS OF HOW WE TEND TO THINK ABOUT BLACK MEN AND MEN IN GENERAL, I'M GOING TO CENTER ON BLACK MEN. STARTING ALSO INTO THIS CONVERSATION, I WANT TO SPEAK TO THE NARRATIVE AROUND MEN'S HEALTH, THE REASON MEN HAVE POOR HEALTH IN GENERAL IS BECAUSE WE'RE BASICALLY -- IT'S OUR BELIEF AND EMBODIMENT OF AND WILLINGNESS TO BUY INTO TRADITIONAL GENDER NORMS HETERONORMATIVE IDEALS, HEGOMONIC MENTALITY, THAT WOULD SOLVE OUR HEALTH PROBLEMS, THAT'S ALL WE NEED TO DO, THAT HAS DRIVEN THE WAY WE THINK ABOUT POLICIES AND PROGRAMS IF MEN ARE INVOLVED. WE HAVE A SYSTEM THAT ADVANTAGED MALE BODIES WE'VE NOT SEEN MEN AS GENDERED BODIES IN THAT SYSTEM SO WE HAVEN'T LOOKED THROUGH A GENDERED LENS, THE GENDER PIECE IS CENTRAL TO THE CONVERSATION WHY THE OFFICE OF WOMEN'S HEALTH PUT FORWARD THIS WEBINAR AND SERIES ALSO TO THE LARGER CONVERSATION. IT'S BEEN THESE NARRATIVES, I'VE RECEIVED THIS WHEN I WAS OFFERED SUGGESTIONS OF HOW WE CAN THINK ABOUT IN MY OWN WORK CANCER PREVENTION, INTERVENTIONS, PARTICULARLY AS RELATED TO EATING AND PHYSICAL ACTIVITY, THAT WE'RE NOT EQUALLY REACHING MEN AND WOMEN, THAT OFTEN THE RESPONSE I GOT FROM COLLEAGUES WHO DID THIS WORK IN OBESITY AND RELATED ISSUES WAS THAT INTERVENTIONS WERE FINE, IT WAS JUST THAT MEN WERE NOT PARTICIPATING, IT WAS NOTHING WE NEEDED TO DO AS A SCHOLARLY COMMUNITY DO INTERVENE, TO CHANGE THE WAY WE'RE GENDERING APPROACHES, INTERVENTIONS AND COMPONENTS OF THE INTERVENTION, IT WAS JUST THAT WE NEEDED TO CHANGE MEN. THE IDEA WE HAVE NO ROLE AS A SCIENTIFIC COMMUNITY IS ALSO PROBLEMATIC. ONE OF THE WAYS I WANT TO ENTER THAT PART OF THE CONVERSATION IS TO MOVE INTO, AGAIN, THIS IDEA OF COVID AND HOW WE THOUGHT ABOUT SOME OF THESE ISSUES. THIS IS COMING FROM THE PROBLEMATIC ASPECT OF THIS APPROACH IS THAN IT PAINTS ALL MEN WITH THE SAME HOMOGENIZING BROAD BRUSH AND ASSUMES OUR ATTITUDES, IDENTITIES, BELIEFS, BEHAVIORS ARE CONSISTENT WITH THIS HEGOMONI IDEAL, SIMPLY NOT TRUE. THIS WAS CHARACTERIZING BLACK MEN WHO DIED DISPROPORTIONATELY IN THE COVID PANDEMIC, I'LL SHOW THAT YOU IN JUST A MINUTE, A REPORTER WHO WORKS FOR THE "WASHINGTON POST" WROTE THIS BEES THAT WAS CHARACTERIZING WHAT IT MEANT TO LOSE THIS GENERATION OF YOUNG BLACK MEN IN THESE COMMUNITIES. WHAT I WANT TO BRING YOUR ATTENTION TO IS THESE CHARACTERISTICS THAT SHE'S HIGHLIGHTING ARE NOT CONSISTENT OR EXCLUSIVELY CONSISTENT THINKING ABOUT GENDER AND IDEALS AS RELATES TO MEN. HARD WORKING, AMBITIOUS, OPTIMISTIC, TRYING TO LIFT OTHERS WITH THEMSELVES ARE NOT NECESSARILY CONSISTENT WITH THE WAYS WE CHARACTERIZE HEGOMONIC I DEALS. I DO A LOT OF QUALITATIVE WORK, THIS IS FROM THE WORK WE'VE DONE OVER THE YEARS, THIS IDEA OF MEN PUTTING -- PART OF THE REASON THAT COUNTERS THIS NARRATIVE THAT IT'S ALL ABOUT MEN'S ABILITY, DESIRE TO BUY INTO LARGER HEGOMONIC IDEALS, HOW DO MEN TALK ABOUT WHAT THEY ARE ASPIRING TO, WHAT ARE THEIR GOALS AND IDEALS? THIS IS FROM A MAN TALKING ABOUT THIS IDEA THAT I'M GOING -- I'M NOT GOING TO READ BUT HIGHLIGHT KEY PARTS THAT A MAN WAS TALKING ABOUT THE MESSAGES, GENDER SOCIALIZATION FROM HIS FATHER, AND THIS IDEA OF HIS FAMILY CAME FEATHER, HEALTH SECOND. HE DIDN'T FOCUS ON HIS HEALTH. IT WAS NOT A PRIORITY, THAT IT WAS SOMETHING HE WAS SUPPOSED TO DO AND INVEST IN THIS RELATIONAL IDEA OF WHAT MASCULINITY AND HEALTH MEANT THAT THOSE ARE THE THINGS HE WAS SUPPOSED TO TRY TO EMBODY AND LIVE OUT AND PART OF HIS IDEALS. THIS IDEA OF BEING A MAN IS ABOUT CHARACTER. WHEN YOU ASK MEN ABOUT THESE IDEALS, THESE ARE THE THINGS WE'VE HEARD WHEN WE'VE TALKED TO THEM AND PUBLISHED ON THIS WORK, THAT WHAT DEFINES A MAN, A PARTICULAR MAN SAID IT'S CHARACTER, HOW YOU TREAT OTHER PEOPLE, HOW HE TREATS OTHER PEOPLE, HIS CHARACTER, HIS IDENTITY, WHO IS AROUND HIM, WHAT HE GIVES OF HIMSELF, AND LOVE, NOT THE TYPICAL WORDS YOU HEAR WITH HEGOMONIC ACTIVITY, HOW MUCH LOVE THESE ABLE TO GIVE AND INSPIRE SOMEONE IS MORE CONSISTENT WITH HOW MEN, IF YOU ASK WHAT THEY ARE TRYING TO DO AROUND MASCULINITY, THESE ARE THE THINGS THAT WE'RE ACTUALLY TRYING TO DO. SO WE BUILD OUR INTERVENTIONS FROM THIS STANDPOINT BECAUSE THESE ARE THE THINGS MEN ARE TELLING US. WE'RE TRIAL TO BALANCE STRUCTURAL AND INDIVIDUAL INTERVENTIONS, IN THE STRUCTURAL CONTEXT HOW DO MEN OPERATE AND PERFORM, LOOKING AT MICRODETAILS AND TRY TO MARRY THAT IN THE WORK WE'RE DOING TO LOOK AT OUR INTERVENTIONS, HOW DO WE EXPLORE HOW MEN THINK ABOUT AND ADDRESS THESE ISSUES IN THEIR OWN LIVES, CONNECT IT TO THE STRUCTURAL CONSTRAINTS AND BARRIERS THEY FACE IN THE WORLD. SO JUST TO HIGHLIGHT THIS, ONE OF THE THINGS WE DID TO EXPLAIN THE PATTERNS WE SAW OF COVID AND BLACK MEN DYING DISPROPORTIONATELY DURING THE COVID-19 PANDEMIC, MEN DIED THROUGHOUT THE PANDEMIC FROM THE EARLIEST REPORTS IN CHINA AND ITALY, THAT WERE PUBLISHED IN "THE LANCET" OR THROUGHOUT EVERYWHERE ELSE WE SAW FAIRLY, FOR THE MOST PART IN THE WORLD, MEN WERE DYING AT HIGHER RATES THAN WOMEN, PARTICULARLY MEN OF COLOR, WHETHER IN THE U.K. AND OTHER PLACES THAT MEN OF COLOR WERE DYING AT HIGHER RATES. WHAT ARE THE STRUCTURAL FACTORS LIKE STRUCTURAL RACISM, HOW STRUCTURAL RACISM, THE INTERSECTION OF STRUCTURAL RACISM, SYNDEMICS AND INTERSECTIONALITY REQUIRED US TO THINK ABOUT HOW DO WE THINK ABOUT AND DESCRIBE STRUCTURAL CONTEXT MORE PRECISELY THAN STRUCTURAL RACISM? TO UNDERSTAND THE UNIQUE EXPERIENCE OF BLACK MEN WE NEEDED TO THINK ABOUT ANTI-BLACK RACISM AND HOW THAT'S GENDERED, HOW THAT CONTEXT AND THOSE UNIQUE PARTS REALLY DO SHAPE THE LIVES OF BLACK MEN. SO YOU HAVE THIS GROUP THAT HAS A HIGHER CONCENTRATION OF THESE VARIOUS CHRONIC DISEASES THAT PUT YOU FUNDAMENTALLY AT RISK FOR COVID IN ADDITION TO LIVING IN COMMUNITIES AND CONTEXTS WHERE THERE'S A HIGHER RISK AND INFECTION RATE OF COVID AS WELL AS FEWER RESOURCES TO MITIGATE COVID, MUCH LESS ALSO LESS ACCESS TO THE VACCINE, THIS WAS EVEN PRIOR TO THE VACCINE, BUT EVEN WHEN VACCINE WAS AVAILABLE, VACCINE ACCESS CERTAINLY WAS SHAPED BY THESE FACTORS LIKE RACE, PLACE, GENDER. THIS IDEA OF STRUCTURAL INTERACTION LOOKING AT STRESS RESPONSE, WE'RE TALKING ABOUT STRUCTURAL RACISM AS ROOT CAUSE, HELPED TO EXPLAIN HOW WE THOUGHT ABOUT THIS IDEA OF MEN'S INCREASED MORTALITY FROM COVID, AND MEN'S INCREASED MORTALITY DURING THE COVID CONTEXT, BECAUSE THERE WERE HIGHER RATES OF CHRONIC DISEASE MORTALITY FROM HEART DISEASE DURING COVID EVEN IF MEN DID NOT DIE OF COVID. SO WHAT WE DID IS APPLIED KIMBERLE CRENSHAW'S FRAMEWORK OF INTERSECTIONALITY, A WAY DESCRIBED IT IN THE 1991 PAPER, THREE COMPONENTS OF INTERSECTIONALITY, AND, AGAIN, RATHER THAN USING INTERSECTIONALITY AS A BROAD TERM, WE REALLY WANTED TO BE MUCH MORE PRECISE AND THINK ABOUT SPECIFICALLY HOW DO WE THINK ABOUT THESE DIFFERENT COMPONENTS AND WHAT DO THEY HAVE TO DO WITH CONTEXT OF COVID AS WELL AS JUST OVERALL MORTALITY. SO THE WAY WE APPLIED IT, WE USED HER FRAMEWORK OF STRUCTURAL AND POLITICAL REPRESENTATION INTERSECTIONALITY, AND TALKED ABOUT BASICALLY THE STRUCTURAL -- THE WAY SHE DESCRIBED IS WAS THE LARGER CHARACTERIZATION, POLITICAL IS WHO WAS PRIORITIZED, WHERE THE POWER WENT, WHO IS RENDERED INVISIBLE AND VISIBLE, IN TERMS OF POLICY AND PRACTICE AND HOW WE DIDN'T THINK ABOUT -- USUALLY WHEN WE PRESENT DATA WE HERE, MEANING THE NIH, AND CDC, WHEN DATA WERE PRESENTED AT A FEDERAL LEVEL OR MOST SOURCES WE SAW OF COURSE THE TYPICAL, YOU HAVE A LINE FOR SEX, SEPARATE LINE FOR RACE, YOU DIDN'T SEE THE INTERSECTION. GENDER WAS NOT REPRESENTED IN THAT PICTURE AT ALL BUT THE IDEA THAT WE PRESENTED THOSE THINGS IN THOSE WAYS LED TO THE INVISIBILITY, INTERSECTIONALITY TO ADDRESS. REPRESENTATION, WE'RE SPEAKING TO THE WAITS IMAGES OF BLACK MEN WERE REPRODUCED, HOW THAT HELPED TO MARGINALIZE BLACK MEN IN THIS PICTURE. JUST TO HIGHLIGHT ONE OF THE MORE COMPLEX THINGS ABOUT APPLYING THIS IDEA OF INTERSECTIONALITY TO MEN AND MEN'S HEALTH IS CLEARLY MEN ARE NOT UNIVERSALLY ADVANTAGED, THE IDEA OF HOW TO THINK ABOUT STRUCTURAL ADVANTAGES MEN HAVE AS A RESULT OF NOT FACING SEXISM AND BENEFITING FROM A SYSTEM THAT DIFFERENTIALLY BENEFITS MEN IS IMPORTANT TO THINK ABOUT HOW IN THOSE CONTEXTS THAT ALSO INTERSECTS WITH THINGS LIKE RACE. AND SO A CONCEPT THAT CAME FROM THE WORK OF AN INTERVIEW, MEN AND WOMEN BUT THEN HER BOOK WAS JUST ABOUT BLACK MEN IN THIS CONTEXT WHO WERE SUCCESS IN PARTICULAR FIELDS AND THEIR PARTICULAR CHOSEN FIELDS, AND SUCCESSFUL IN THIS CONTEXT MEANT LEADERS IN, SAY, CORRESPONDENT AMERICA, HIGHER LEVEL BUSINESS ADMINISTRATION, WHITE COLLAR JOBS AND SO FORTH. THAT SHE CAME UP WITH THIS TERM, PARTIAL TOKENISM, THAT I FOUND REALLY USEFUL, THAT HIGHLIGHTS EVEN THOUGH THEY WERE SUCCESSFUL IN ONE AREA OF THEIR LIFE, HEIGHTENED VISIBILITY AND CONSPICUOUSNESS THAT CAME FROM BEING IN THAT SPACE, FROM BEING SUCCESSFUL, LET TO HEIGHTENED LEVEL OF TREES. IN-- STRESS. IF YOU THINK ABOUT THE WAYS THE CONTEXT IS CREATED BEFORE HEALTH IT HAS TO DO WITH OPERATING THROUGH STRESS MECHANISMS. IF WE THINK THROUGH THAT LENS, THE EFFORTS THAT IN THIS CASE BLACK MEN IN HIGHER MORE SUCCESSFUL ENVIRONMENTS GOING OUT OF THEIR WAY TO APPEAR SAFE AND NOT THREATENING THE IDEA OF DOING THE WORK WAS SO IMPORTANT THEY FELT THEY WERE DOING THINGS, HEIGHTENED VISIBILITY WAS IMPORTANT FOR THEM TO OFFER WAYS, ENACT WAYS THEY HAD TO BE HYPERVISIBLE, THE IDEA OF VIGILANCE BY DAVID WILLIAMS AND OTHERS TALK ABOUT THAT THE IDEA OF VIGILANCE, THAT YOU'RE PAYING ATTENTION AND GOING OUT OF YOUR WAY TO WORK STEREOTYPES AND IDEAS THAT COUNTER THIS IDEA THAT YOU ACTUALLY HAVE CHARACTER AND ACTUALLY ARE REPRESENTATIVE WELL WITHIN A PARTICULAR GROUP. SPEAKING TO DR. JORDAN-YOUNG'S OPENING, HIGHLIGHTING SOME REMARKS FROM DR. KRIEGER, THAT THIS IDEA OF, YOU KNOW, GENDER BEING A PRODUCT OF HISTORY, THIS IDEA OF BLACK MEN, HAVING A SHORTER LIFE EXPECTANCY, IS SOMETHING THAT WE'VE SEEN BASICALLY SINCE WE'VE HAD DATA, CERTAINLY SINCE WE'VE HAD THIS PERIOD OF OVER 120 YEARS, OF LOOKING AT THINGS LIKE LIFE EXPECTANCY. IF I HOED YOU THE GRAPH YOU WOULD SEE BLACK MEN FROM 1900 THROUGH 2021 HAVING A SHORTER LIFE EXPECTANCY. NOT QUITE AS INTERESTING AS SHOWING HOW GAPS BETWEEN BLACK MEN AND WHITE MEN WERE CHANGING OVER TIME. MY WAY OF DESCRIBING WHAT WE SEE HERE WAS BLACK MEN AS REFERENCE GROUP IS THAT THE RACIAL DIFFERENCE BASICALLY HAS DECLINED OVER THIS 120-YEAR PERIOD, WHILE THE GENDER DIFFERENCE IN TERMS OF MORTALITY AND LIFE EXPERIENCE HAS GROWN. PART OF THE QUESTION, THIS IS CONSISTENT WITH LARGER WORK THAT TALKED ABOUT SEX DIFFERENCE IN MORTALITY AND LIFE EXPECTANCY IS A 20th CENTURY PHENOMENON. WE HAVEN'T TALKED ABOUT WHAT IS IT ABOUT GENDER AND HOW IS IT OF IS IT OUR LIVES HAVE BEEN GENDERED THROUGH TECHNOLOGY, PUBLIC HEALTH INNOVATION AND OTHER THINGS THAT PROVIDED CONTEXT FOR US TO UNDERSTAND WHY THESE PATS EARNS AND WHY -- PATTERNS, AND WHY EVERYONE HAS NOT BENEFITED OVER TIME. ONE OF THE THINGS I WANT TO HIGHLIGHT IN THIS CONTEXT IS THIS IDEA OF GENDER AND WHO GETS TO BE COUNTED AS A DISPARITY POPULATION, IF WE WANT TO USE THAT LANGUAGE, THAT IF WE THINK ABOUT THE WAYS THAT GENDER AND, I'M SORRY, HEALTH DISPARITIES AND WHAT THAT MEANS IN TERMS OF IDENTIFYING A SPECIFIC POPULATION THAT IS WORTHY OF ADDITIONAL RESOURCE ATTENTION AND SO FORTH, MEN BECAUSE WE'RE NOT STRUCTURALLY DISADVANTAGED IN OUR SOCIETY DON'T COUNT IN THE CONVERSATION AROUND HEALTH EQUITY AND THOSE THINGS. BLACK MEN DON'T MAKE THEIR WAY INTO THESE CONVERSATIONS UNLESS THEY ENTER THROUGH THE DOOR OF RACE. IF INEQUITIES AND DISPARITIES AND THROUGH THINGS LIKE NIMHD ARE NOT THE WAYS THAT MEN AND PARTICULARLY BLACK MEN CAN ENTER INTO A CONVERSATION AND INTERVENTIONS AND FUNDING FOR THESE RESOURCES WHERE ARE WE SUPPOSED TO GET RESOURCES FOR THESE GROUPS? AS WE THINK ABOUT ISSUES LIKE THE LACK OF INFRASTRUCTURE AROUND MEN'S HEALTH THAT WE HAVE IN STATE AND LOCAL HEALTH DEPARTMENTS, IT MATTERS THAT WE HAVE NO OFFICES OF MEN'S HEALTH AT THE FEDERAL LEVEL, AND THE FACT THAT WE HAVE NONE OF THESE OFFICES AT THAT LEVEL, THE FACT THAT WHEN WE LOOK AT THINGS LIKE HEALTHY PEOPLE, THAT NONE OF THE OBJECTIVES OF HEALTHY PEOPLE WITH THE EXCEPTION OF POTENTIALLY PROSTATE CANCER ACTUALLY LINK TO LEADING CAUSE OF DEATH FOR MEN, AND SO WE HAVE THESE STRUCTURAL PROBLEMS THAT ARE FEEDING INTO AND INTERCONNECTING WITH THE WAYS WE'RE TALKING ABOUT THESE ISSUES, THAT WE ALSO NEED TO FACTOR INTO THIS CONVERSATION. SO, IT REALLY IS CRITICAL TO THINK ABOUT GENDER AND HOW BOYS AND MEN FIT INTO THE CONVERSATION. I HOPE WE'RE ABLE TO CONTINUE TO HAVE MORE OF A DISCUSSION. THANK YOU. >>THANK YOU, DR. GRIFFITH. YOU'VE GIVEN US A LOT OF NEW MATERIAL TO THINK WITH. I APPRECIATE THAT A LOT. WE'RE GOING TO KEEP MOVING AND GATHER THE QUESTIONS AT THE END. SO, NEXT I'M HAPPY TO PRESENT DR. HEATHER BULLOCK, PROFESSOR OF PSYCHOLOGY, DIRECTOR OF THE BLUM CENTER ON POVERTY, SOCIAL ENTERPRISE AND GOVERNANCE AT U.C. SANTA CRUZ. DR. BULLOCK IS EXPERT ON SOCIAL PSYCHOLOGY OF SOCIAL CLASS AND POVERTY, SERVED AS THE INAUGURAL CHAIR OF AMERICANPSYCHOLOGICAL COMMITTEE, A MEMBER OF DEEP POVERTY INITIATIVE WORKING GROUP. I'LL LEAVE MY INTRO THERE AND LET YOU READ THE REST BECAUSE THERE'S PLENTY TO SAY WE DON'T HAVE TIME. DR. BULLOCK, WELCOME. WE LOOK FORWARD TO HEARING FROM YOU. >>THANK YOU TO THE CONFERENCE ORGANIZERS FOR BRINGING US TOGETHER AND EVERYONE JOINING TODAY. IT'S A REAL HONOR TO SPEAK WITH YOU. FEMINIZATION OF POSER REFERS TO UNEQUAL STATE OF MEP'S AND WOMEN'S POVERTY RATES AND PROCESSES BY WHICH WOMEN'S RISK OF POVERTY HAS INCREASINGLY EXCEEDED THAT OF MEN'S. DIANA PIERCE COINED THE TERM THE FEMINIZATION OF POVERTY, IN 1978 BASED ON HER RESEARCH DOCUMENTING RELATIONSHIP BETWEEN GENDER AND POVERTY. SPECIFICALLY, INCREASING CONCENTRATION OF POVERTY AMONG WOMEN. THE FEMINIZATION OF POVERTY PERSISTS WITH WOMEN ACROSS ALL REGIONS OF THE WORLD, EXPERIENCING HIGHER RATES OF POVERTY THAN MEN. WE DON'T HAVE TO LOOK FAR TO FIND EVIDENCE OF THE FEMINIZATION OF POVERTY IN THE UNITED STATES. IN THE U.S., WOMEN ARE MORE LIKELY TO LIVE IN POVERTY THAN MEN, IN 2020, 11.5% OF WOMEN LIVED BELOW THE POVERTY THRESHOLDS COMPARED TO 8.6% OF MEN. APPROXIMATELY 19% OF BLACK WOMEN, 16.8% OF LATINX WOMEN, 8.9% OF WHITE WOMEN, 8.7% OF ASIAN WOMEN EXPERIENCED POVERTY, COMPARED TO 6.8% OF WHITE MEN. WOMEN OUTSIDE THE U.S. EXPERIENCE HIGH RATES OF POVERTY. FURTHER EVIDENCE COMES FROM EXAMINING POVERTY RATES IN CONJUNCTION ARE PARENTAL AND FAMILY STATUS. FAMILIES WITH CHILDREN HEADED BY SINGLE MOTHERS EXPERIENCE HIGHER POVERTY RATES THAN FAMILIES HEADED BY SINGLE FATHERS OR MARRIED FAMILIES. IN 2020 THE POVERTY RATE FOR FAMILIES WITH CHILDREN HEADED BY SINGLE MOTHERS WAS 32.1%, COMPARED TO 14.3% FOR FAMILIES WITH CHILDREN HEADED BY SINGLE FATHERS, AND 5.9% FOR MARRIED FAMILIES WITH CHILDREN. POVERTY RATES ARE CONSISTENTLY HIGHEST AMONG FEMALE-HEADED HOUSEHOLDS OF COLOR. FOOD AND HOUSING INSECURITY ARE ALSO POWERFUL INDICATORS OF THE FEMINIZATION OF POVERTY. IN THE FIRST HALF OF MARCH 2022, MORE THAN 1 IN 5 BLACK MEN AND 1 IN 6 LATINAS REPORTED SOMETIMES OR OFTEN NOT HAVING ENOUGH FOOD TO EAT IN THE PRIOR SEVEN DAYS. RATES OF HOUSING INSECURITY ARE EQUALLY TROUBLING. OVER 4.5 MILLION WOMEN WHO ARE RENTERS REPORT BEING BEHIND ON RENT PAYMENTS IN THE FIRST HALF OF MARCH. HIGHER PERCENTAGES OF BLACK AND LATINA WOMEN WERE BEHIND ON THEIR RENT, THAN WHITE WOMEN AND MEN. AS WITH POVERTY, HOMELESSNESS IS ALSO FEMINIZED. THE TYPICAL UNHOUSE THE FAMILY IS HEADED BY LOW INCOME SINGLE MOTHERS, CARING FOR TWO CHILDREN UNDER THE AGE OF 6, WITH FAMILIES OF COLOR OVERREPRESENTED. THESE INEQUITIES ARE INDICATIVE OF STRUCTURAL RACISM, SEXISM, CLASSISM. AND OCCUR IN THE CONTEXT OF CONCENTRATED INCOME AND WEALTH THAT DR. KRIEGER DISCUSSED THIS MORNING. POVERTY IS A MODIFIABLE SOCIAL DETERMINANT OF HEALTH. AS THESE STATISTICS MAKE CLEAR, WOMEN'S POVERTY MUST BE UNDERSTOOD THROUGH INTERSECTIONAL LENS. INTERSECTIONALITY IS AN ANALYTIC FRAMEWORK THAT SIMULTANEOUSLY CONSIDERS THE MEANINGS AND CONSEQUENCES OF MULTIPLE CATEGORIES OF IDENTITY, DIFFERENCE, MARGINALIZATION, UNLIKE SINGLE ACCESS ANALYSES THAT FOCUS ON ONE DIMENSION OF IDENTITY, INTERSECTIONALITY, ILLUMINATES THE COMPLEXITIES OF MULTIPLE OPPRESSION ALSO. IMPORTANTLY, INTERSECTIONAL LENS TREATS SYSTEMS OF POWER AS INTERLOCKING, WORKING TOGETHER TO SHAPE INEQUALITIES. SYSTEMS OF POWER OPERATE AT THE MACRO LEVEL, VIA INSTITUTIONS AND POLICIES, AT THE MESO LEVEL, INTRAGROUP RELATIONS, MICRO LEVEL VIA PREJUDICE AND INTERNALIZED OPPRESSION. INTERSECTING CLASSES AND RACES AND SEXISM, ARE THE ROOTS OF THE FEMINIZATION OF POVERTY, MANIFESTED IN LABOR MARKET INEQUITIES, SOCIETAL DEVALUATION OF CAREGIVING LABOR, GENDERED VIOLENCE, POLITICAL AND SOCIAL EXCLUSION, WEAK SAFETY NET PROGRAMS, AS WELL AS MANY OTHER POWER DYNAMICS, TOO MANY TO LIST HERE. INTERSECTIONALITY COMPLEMENTS OUR UNDERSTANDING OF SOCIAL DETERMINANTS OF HEALTH, BY DRAWING ATTENTION TO THE ROOT CAUSES OF INEQUITIES. YOU'RE LIKELY FAMILIAR WITH HEALTH-FREE MODELS SUCH AS THIS PORTRAYING SOCIAL DETERMINANTS OF HEALTH AND RELATIONSHIPS TO HEALTH OUTCOMES. WHAT SETS THIS BY THE HEALTH RESEARCH IN ACTION APART FROM OTHERS IS THAT EMPHASIS ON THE ROOT CAUSES OF INEQUITIES. NOTICE THAT THIS MODEL INCLUDES THE TREE'S SOIL, DOMINANT SOCIOCULTURAL VALUES AND BELIEFS, SUCH AS INDIVIDUALISM, PATRIARCHY, WHITE SUPREMACY, AS WELL AS THE TREE'S ROOTS, DISCRIMINATION AND UNEQUAL DISTRIBUTION OF RESOURCES. OBVIOUSLY, THERE ARE FAR TOO MANY ROOTS AND TOO MUCH SOIL TO POSSIBLY DISPLAY HERE. THIS IS A NECESSARILY INCOMPLETE LIST, ENCOURAGING TO US DIG DEEPER TO EXPOSE THE STRUCTURAL ROOTS OF SOCIAL DETERMINANTS OF HEALTH THEMSELVES AND ATTITUDES AND BELIEFS THAT LEGITIMIZE INEQUITIES. FOR THE REMAINDER OF MY TALK I'LL ILLUSTRATE HOW INTERSECTING CLASSES AND RACISM AND SEXISM CONTRIBUTE TO FEMINIZATION OF POVERTY AND HOMELESSNESS AND STRATEGIES FOR ALLEVIATING WOMEN'S POVERTY. I HIGHLIGHT FINDINGS FROM INTERVIEWS WITH 46 CURRENTLY AND FORMERLY UNHOUSED MOTHERS WHO PARTICIPATED IN COMPLEMENTARY INTERVIEW STUDIES. ONE PORTION CAME FROM INTERVIEWS WITH MOTHERS LIVING IN A RESIDENTIAL SHELTER THAT HOUSES FAMILIES FOR UP TO SIX MONTHS. THE OTHER PORTION COMES FROM INTERVIEWS WITH FORMERLY UNHOUSED MOTHERS WHO LIVED WITH THEIR CHILDREN IN RESIDENTIAL SHELTERS FOR 30 DAYS OR MORE, OVER THE PAST TWO YEARS. INTERVIEWS FOCUSED ON LIFE HISTORIES, EXPERIENCES OF HOMELESSNESS, PUBLIC ASSISTANCE USE, UNMET NEEDS. WE IDENTIFIED TWO PATHWAYS THAT CONTRIBUTE TO WOMEN'S ECONOMIC AND HOUSING PRE-CARITY FOCUSED ON VIOLENCE, REPORTING ABUSIVE EXPERIENCES THAT PRECIPITATED MOST RECENT EPISODES OF HOMELESSNESS INCLUDING PHYSICAL AND SEXUALITY ASSAULT, KIDNAPPING, FORCED IMPRISONMENT, EMOTIONAL ABUSE, COERCED DRUG USE, FINANCIAL EXPLOITATION. ABUSE WAS RARELY ISOLATED OR SINGULAR, INSTEAD MULTIPLE CO-OCCURRING FORMS OF IPV WORKED IN CONCERT TO DEEPEN HARDSHIP. COMMON CONSEQUENCES OF ABUSE, COMPROMISED HEALTH, REDUCE CAPACITY TO WORK OR PURSUE EDUCATIONAL GOALS, MEDICAL AND LEGAL BILLS ALL HEIGHTENED THE RISK OF HOMELESSNESS, INTERACTING WITH EACH OTHER AND CULMINATING ACROSS ABUSIVE RELATIONSHIPS. OF COURSE RACE, CLASS, GENDER ALSO INTERSECT TO INFLUENCE WOMEN'S EXPERIENCES OF IPV, FOLLOWING ASSAULT WOMEN OF COLOR ARE LESS LIKELY TO RECEIVE APPROPRIATE RECOVERY SERVICES, FURTHER UNDERMINING ECONOMIC AND PSYCHOLOGICAL RECOVERY. IT'S ALSO CASE LOW INCOME WOMEN ARE DISPROPORTIONATELY VULNERABLE TO RACIST, SEXIST, CLASSIST HOUSING PRACTICES. IPV EXACERBATES THESE VULNERABILITIES. LANDLORDS MAY JUSTIFY EVICTING WOMEN WHO EXPERIENCED IPV BASED ON ALLEGED OR PERCEIVED DANGER THEY PRESENT TO OTHER RESIDENTS, MAY BE MORE INCLINED TO EVICT FAMILIES WITH CHILDREN BECAUSE CPS OR CASE WORKER VISITS MAY DRAW UNWANTED ATTENTION TO SUBSTANDARD LIVING CONDITIONS. THE FIRST QUOTE ILLUSTRATES THE RELATIONSHIP BETWEEN IPV AND HOUSING INSECURITY. HE CAME DRUNK TO THE HOUSE, NEIGHBORS COMPLAINED TO MY LANDLORD, SO HE THOUGHT IT WAS IN OUR BEST INTEREST IF I MOVED, I ENDED UP MOVING AND BEING HOMELESS. IN THIS CASE, HER PARTNER'S BEHAVIOR RESULTED IN HER LOSING HER HOME. OTHER PARTICIPANTS HAD TO LEAVE FAMILY SHELTERS BECAUSE OF THEIR PARTNER'S BEHAVIOR. ONE STRIKE HOUSING POLICIES ARE INTENDED TO BAR PEOPLE WITH SPECIFIC CRIMINAL RECORDS, FROM LIVING IN PUBLIC HOUSING, HOWEVER BACKGROUND CHECKS ARE OFTEN EMPLOYED MORE BROADLY TO DISQUALIFY ANYONE WITH CRIMINAL HISTORY. PERHAPS MOST DAMAGING TO WOMEN IS PRACTICE OF EVICTING THE ENTIRE HOUSEHOLD IF ANY HOUSEHOLD MEMBER OR VISITOR ENGAGES IN ILLEGAL SUBSTANCE USE OR OTHER CRIMINAL ACTIVITY. REFERRED TO AS VICARIOUS LIABILITY, WOMEN CAN BE EVICTED FOR BEHAVIORS OF A RELATIVE, PARTNER, FRIEND OR GUEST EVEN IF THEY ARE UNAWARE OF THE ACTIVITIES OR DO NOT PARTICIPATE. THIS IS ILLUSTRATED BY THE SECOND QUOTE. I HAD STABLE HOUSING AND THEN SITUATIONS HAPPENED WITH DOMESTIC VIOLENCE, I LOST MY HOUSING BECAUSE OF THAT. I WASN'T WITH THEIR DAD BUT HE WAS COMING AROUND. HE WASN'T SUPPOSED TO. I GUESS HE HAD A WARRANT. THE POLICE HAPPENED TO KNOCK ON THE DOOR. I WAS IN THE SHOWER. SO I DIDN'T EVEN KNOW HE WAS THERE. LOW INCOME PEOPLE OF COLOR PARTICULARLY AFRICAN AMERICANS ARE DISPROPORTIONATELY AFFECTED BY ONE STRIKE EVICTIONS. AND DESPITE AMPLE EVIDENCE DEMONSTRATING IPV DIRECTLY AND INDIRECTLY CONTRIBUTES TO WOMEN'S POVERTY AND HOMELESSNESS, LAW ENFORCEMENT AND SURVIVOR SERVICES ARE NOT NECESSARILY WELL EQUIPPED TO ADDRESS STRUCTURAL FACTORS OR FINANCIAL CONSEQUENCES OF LEAVING A RELATIONSHIP. ONE INTERVIEWEE OBSERVED, SOMEONE TALKS TRASH TO YOU. IT MAY NOT HURT, SHOW PHYSICAL BRUISES, BUT IT HURTS THE HEART. I HAD TO GET PHYSICALLY ABUSED FOR THEM, THE LEGAL SYSTEM. AND I THINK TO COME IN, AND I THINK THAT'S WRONG. WHY SHOULD WE WAIT UNTIL THAT PERSON IS DEAD, UNTIL THAT PERSON'S BRUISED, WHY SHOULD WE WAIT UNTIL THAT PERSON'S BONES GET BROKEN? THE SECOND PATHWAY FOCUSES ON INTERSECTIONS OF WEAK SAFETY NET PROGRAMS WITH RACIST, CLASSIST, AND SEXIST STEREO TIMES AND SOCIAL CONTROL. GROUNDED IN INTERSECTING STEREOTYPES THAT PORTRAY LOW INCOME MOTHERS, STRICT TIME LIMITS MEAN THAT A FAMILY MAY NO LONGER RECEIVE BENEFITS, EVEN IF THEY REMAIN IN NEED. DESPITE HIGH HOUSING COSTS, FEDERAL HOUSING ASSISTANCE PROGRAMS ARE UNDERFUNDED AND NEED OUTPACES ACCESS OR AVAILABILITY. MANY ELIGIBLE LOW INCOME RENTERS DO NOT RECEIVE RENTAL ASSISTANCE. HIGH DEMAND MEANS THAT WAITLISTS FOR PROGRAMS ARE CLOSED, AND FAMILIES MAY WAIT YEARS FOR AN OPENING OR VOUCHER. AND HOUSING VOUCHERS ONLY WORK IF LANDLORDS WILL RENT TO LOW INCOME FAMILIES. THE FIRST QUOTE ILLUSTRATES EMPLOYERS MAY NEGATIVELY STEREOTYPE JOB APPLICANTS WITH HISTORY OF HOMELESSNESS. FINDING A JOB, THAT'S REALLY HARD WHEN YOU PUT DOWN SHELTER ADDRESS ON APPLICATION. THEY WILL TAKE THE LEAST EXPERIENCED PERSON OVER THE HOMELESS PERSON WITH EXPERIENCE. I'M APPLIED FOR JOBS WHICH I WAS PERFECTLY QUALIFIED FOR. EMPLOYER LOOKED AMOUNT MY RƒSUMƒ, IT WAS GREAT. LOOKED AT MY ADDRESS, OH, IT'S THE HOMELESS SHELTER, IT WENT DOWNHILL FROM THERE. BAN THE ADDRESS CAMPAIGNS WHICH SEEK TO PREVENT DISCRIMINATION HAVE NOT GAINED WIDESPREAD MOMENTUM. WEAK SAFETY NET PROGRAMS INCREASE DIFFICULTY OF LEAVING ABUSIVE RELATIONSHIPS, TNF BENEFITS ARE BASED ON SIZE AND FIGURE INTO CALCULATIONS ABOUT WHETHER OR NOT TO REMAIN IN AN ABUSIVE RELATIONSHIP. ONE RESPONDENT EXPERIENCED A DOUBLE ECONOMIC LOSS, HER PARTNER LEFT, SHE LOST HER INCOME AND HER FAMILY'S BENEFITS WERE REDUCED. WHEN HE DRANK, HE BEAT ME, I CALLED THE COPS FINALLY. AFTER HE LEFT, I LOST THE INCOME HE HAD FROM HIS JOB, I CALLED AND REPORTED THAT HE'S NO LONGER IN THE HOUSE TO WELFARE. THEY CUT THAT MONEY SO I COULDN'T PAY RENT. I PLAYED OUT THE WHOLE EVICTION THING. I STAYED AS LONG AS I COULD. FURTHER DEEPENING HARDSHIP IS THAT DISADVANTAGED ACCUMULATES, MINOR BILLS BECOME MAJOR ONES WHEN LATE FEES AND FINES ARE ADDED, MAKING IT INCREASINGLY DIFFICULT TO EXIT POVERTY. THE CREDIT AGENCY TRIED TO MAKE A SETTLEMENT WITH ME. IF I PAID $1,300 UP FRONT, THEY WOULD CANCEL IT. WHERE AM I GOING TO GET THAT FROM? PUBLIC ASSISTANCE PROGRAMS HAVE NOT BEEN GENEROUS OR WELCOMING TO FEMALE-HEADED HOUSE HOLDS, PARTICULARLY THOSE OF COLOR. WELFARE REFORM FURTHER ERODED ACCESS TO AND VALUE OF BENEFITS. PRIOR TO TANF'S ENACTMENT IN 1986, 68 FAMILIES RECEIVED ASSISTANCE FOR EVERY 100 IN POVERTY. BY 2020, 21 ELIGIBLE FAMILIES RECEIVED TANF BENEFITS OUT OF EVERY 100 POOR FAMILIES. EQUALLY DAMAGING IS THE BENEFITS ARE LOW AND DO NOT KEEP UP WITH INFLATION. THE BOTTOM LINE IS THAT WOMEN'S POVERTY CAN BE REDUCED, AND ONE SOURCE OF LEARNING IS INVESTMENTS MADE DURING THE COVID-19 PANDEMIC. FOR EXAMPLE, THE CENTER ON BUDGET AND POLICY PRIORITIES ESTIMATES THAT INCOME FROM UNEMPLOYMENT INSURANCE AND ECONOMIC IMPACT PAYMENTS LIFTED 2020 INCOMES OF 17 MILLION PEOPLE ABOVE THE POVERTY LINE. CLEARLY SIGNIFICANT HARDSHIP CONTINUES, MUCH, MUCH MORE WAS AND IS NEEDED BUT INVESTING IN ANTI-POVERTY PROGRAMS CAN REDUCE POVERTY. TO THE LEFT YOU SEE SOME STRATEGIC INVESTMENTS, THAT COULD REDUCE WOMEN'S POVERTY, STRENGTHENING SAFETY NET PROGRAMS, EXPANDING HOUSE, PAYING SELF-SUFFICIENCY WAGES, ENFORCING LEGAL PROTECTION, VALUE AND COMPENSATING CAREGIVING LABOR, ADOPTING JUST PROGRAMS AND POLL SILLS THAT ADDRESS STRUCTURAL RACISM, CLASSISM, SEXISM, RATHER THAN REINSCRIBE IT. INTERSECTING STEREOTYPES ARE A SIGNIFICANT BEARER TO ADOPTING PROGRAMS AND POLICIES THAT COULD REDUCE STRUCTURAL INEQUITIES. IN OUR BOOK WE EXAMINE COMMON MYTHS ABOUT POVERTY AND DEBUNK THEM. THIS IS A START. WITH RESPECT TO THE HEALTH TREE MODEL, WE NEED TO THINK ABOUT HOW WE CAN CHANGE THE SOIL OR IDEOLOGIES THAT NOURISH AND LEGITIMIZE INEQUITIES. I WANT TO CLOSE BY HIGHLIGHTING COMMUNITY UNIVERSITY RESEARCH PARTNERSHIPS AS ONE STRATEGY FOR EXPOSING AND REDUCING STRUCTURAL INEQUITIES. THE IMPETUS WAS CONCERN ABOUT HIGH RATES OF BEING UNDERBANKED, UNBANKED, IN A LOWER INCOME AREA OF SANTA CRUZ COUNTY. TO LEARN MORE ABOUT THESE EXPERIENCES, AND THEIR IMPACT, WE EXAMINED LOW INCOME LATINA MOTHERS EXPERIENCES WITH MAINSTREAM AND ALTERNATIVE FINANCIAL SERVICES. WE MAPPED LOCATIONS OF FINANCIAL SERVICE PROVIDERS IN CITIES OF SANTA CRUZ AND WATSONVILLE, CALIFORNIA, INCLUDING TRADITIONAL FINANCIAL SERVICES, SUCH AS BANKS AND CREDIT UNIONS AND ALTERNATIVES SUCH AS PAY-DAY LOANS, CHECK CASHING, MONEY TRANSFER SERVICES, PAWN SHOPS. WE ALSO CONDUCTED FOCUS GROUPS WITH 108 LATINA MOTHERS ABOUT THEIR FINANCIAL SERVICE USE. THIS IS A LITTLE BIT HARD TO TAKE IN BLUE REPRESENTS MAINSTREAM, CORAL IS ALTERNATIVE. THE SIZE INDICATES THE NUMBER OF SERVICES CONCENTRATED IN EACH AREA. WE FOUND THAT IN SANTA SCREWS, FOR EVERY BANK OR CREDIT, YOU KNOW, THERE WERE 1.5 ALTERNATIVES. IN WATSONVILLE, WITH LARGER NUMBER OF IMMIGRANT HOUSEHOLDS THERE WERE 3.2, THIS IS A POWERFUL VISUALIZATION OF DIFFERENTIAL ACCESS TO SERVICES IN THE TWO AREAS, THAT MIRRORS SIMILAR RESEARCH FINDINGS ACROSS THE UNITED STATES, DOCUMENTING RACIAL AND ECONOMIC INEQUITIES. OUR FOCUS GROUPS CONTEXTUALIZE THESE FINDINGS. ILLUMINATING BARRIERS AND COMMUNITY ASSETS. BARRIERS INCLUDED PUNITIVE FEES, UNCLEAR POLICIES AND POOR COMMUNICATION, INSTITUTIONAL DISTRUST, LIMITED CULTURAL COMPETENCE TO SUPPORT IMMIGRANT POPULATIONS, INTERSECTING GENDER, RACE, CLASS, ANTI-IMMIGRATION BIAS, AND ASSET LIMITS FOR ASSISTANCE PROGRAMS, POTENTIAL POINTS OF INTERVENTION. COMMUNITY ASSETS INCLUDED WOMEN'S REJECTION OF DEFICIT UNDERSTANDINGS OF POVERTY AND MONEY MANAGEMENT, RELATIONAL SUPPORT, COMMUNITY SERVICES AND PROGRAMS. WE SEE THESE ASSETS AS POINTS OF CRITICAL RESISTANCE AND OPPORTUNITY. WE'VE LEVERAGED TO INFORM PROGRAMMING AND RAISE COUNTYWIDE AWARENESS OF PREDATORY SERVICES AND IMPACT ON WOMEN AND FAMILIES. POVERTY UNDERMINES WOMEN'S HEALTH AND WELL BEING. THERE ARE MANY DIRECTIONS FOR FUTURE RESEARCH. INTERSECTIONAL RESEARCH IN AND OUT OF POVERTY AND HOMELESSNESS ARE ESSENTIAL, PARTICULARLY PATHWAYS OUT OF HOMELESSNESS AND POVERTY WHICH I THINK ARE OFTEN NEGLECTED. WE NEED INTERSECTIONAL ANALYSES OF HEALTH AND WELL-BEING THAT APPROACH WOMEN'S LIVES AND EXPERIENCES HOLISTICALLY, INCLUDING THEIR ECONOMIC STATUS, AND WE NEED INTERSECTIONAL ANALYSES OF EXPERIENCES AND IMPACT OF POLICIES AND PROGRAMS AT ALL LEVELS, INCLUDING LOCALLY. AND PARTNERSHIPS ARE ESSENTIAL AND CAN HELP RESEARCH HAVE AN IMPACT. THANK YOU SO MUCH. I'LL STOP HERE. I LOOK FORWARD TO OUR CONVERSATION. >>FANTASTIC. THANK YOU SO MUCH, DR. BULLOCK. I DON'T CURRENTLY SEE QUESTIONS IN OUR LINEUP SO I'M GOING TO THROW OUT A FEW THINGS THAT THE PANELISTS I HOPE CAN SPEAK TO TOGETHER. I'LL JUST NOTE THAT A FEW OF THE THEMES THAT CAME OUT AND ITEMS THAT WERE REALLY INTRIGUING TO ME, IN THE CONCRETE PRESENTATIONS WE HAD SPECIFIC EXAMINATION OF STATE LEVEL POLICIES AND LOOKING AT THEM ACROSS A WIDE RANGE OF APPROACHES THAT STATES HAVE MADE TOWARDS IMMIGRATION AS AN EXAMPLE THAT I REALLY LIKED WHAT YOU DID WITH THAT, DR. SAMARI, AND YOUR FINDINGS WERE INTERESTING AND TROUBLING. I WOULD LOVE TO INVITE YOU TO SPEAK MORE ABOUT THAT, IF WE HAVE SOME TIME, IN TERMS OF YOU FOUND A PARADOXICALLY CORRELATION WHERE THE MORE INCLUSIVE AND LESS EXCLUSIVE POLICIES WERE ACTUALLY ASSOCIATED WITH WORSE OUTCOMES AND I WONDERS IF I COULD ASK YOU TO SPEAK TO A FEW THINGS ABOUT THAT. BEFORE WE GET THERE I WANT TO NOTE OTHER THINGS THAT MAYBE WE CAN TIE IN SOME PIECES TOGETHER. DR. GRIFFITH BROUGHT OUR ATTENTION TO THINKING ABOUT INTERSECTIONALITY IN A FINER GRAINED WAY, INSTEAD OF THINKING ABOUT THE WAY INTERLOCKING SOCIAL STRUCTURES AND SYSTEMS CO-DEFINE EACH OTHER OR SPECIFY THE PARTICULAR EXPERIENCES AND PRESSURES AND MATERIAL REALITIES AND RESOURCES OF PEOPLE THAT INHABIT PARTICULAR INTERSECTIONS, HE REMINDED US OF KIMBERLY RENNE KIMBERLE CRENSHAW'S STRUCTURAL INTERSECTIONALITY, WONDERING IF THE OTHER TWO PANELISTS COULD BREAK APART SOME ANNUAL EAST AND -- ANALYSES AFFECTING THE HEALTH OUTCOMES YOU'RE ENGAGING WITH IN THOSE THREE WAYS, STRUCTURAL, POLITICAL, REPRESENTATIONAL. I'LL STOP THERE. THERE'S A LOT ON THE TABLE BUT I WANT TO LEAVE ROOM. COULD WE BEGIN WITH EXPLORING A LITTLE MORE DEEPLY THAT RELATIONSHIP THAT YOU FOUND, DR. SAMARI? >>YEAH, SURE. IT'S INTERESTING IN TERMS OF PRENATAL CARE, WE'RE OBSERVING WHAT WE WOULD EXPECT, BETTER PRENATAL CARE IN INCLUSIONARY ENVIRONMENTS. BIRTH OUTCOMES, IT'S IMPORTANT TO NOTE MOST OF THE RESEARCH ON BIRTH OUTCOMES THAT HAS LOOKED AT ACUTE SHOCKS OR POLICIES BEING PASSED, BIRTH OUTCOMES, IT'S CROSS-SEXUAL, MY OWN WORK, MUSLIM BAN AND IMPACT ON WOMEN FROM THE BANNED COUNTRIES IN THE U.S., 6.8% INCREASE IN PRE-TERM BIRTH. BUT IT'S ONE POLICY, ONE EVENT, AND THE OUTCOME. USING THE INDEX TO LOOK AT BIRTH OUTCOMES, TEN YEARS OF IMMIGRATION POLICIES, 14 IMMIGRATION POLICIES AT STATE LEVEL ALL SORT OF CHANGING AND MOVING AND BEING ENACTED SO THE SAME STATE THAT TAKES ON TWO EXCLUSIONARY POLICIES COULD ALSO BE PASSING A POLICY THAT'S INCLUSIONARY, SO IT BRINGS UP THE QUESTION ABOUT WHAT IS CREATING THE CLIMATE OR HOW IS THE CLIMATE, IMMIGRATION POLICY CLIMATE, EXPERIENCED FOR IMMIGRANT WOMEN SHOULD CERTAIN POLICIES HAVE MORE WEIGHT THAN OTHERS, AND THINGS OF THAT NATURE. ALSO BRINGS UP THIS OTHER PIECE WHICH IS THAT IMMIGRANTS STILL HAVE AGENCY AND CHOOSE WHERE TO LIVE AND WE KNOW THERE'S NOT AN EQUAL DISTRIBUTION OF IMMIGRANT COMMUNITIES ACROSS STATES IN THE UNITED STATES, WE KNOW THAT IMMIGRANT COMMUNITIES OFTEN GO WHERE THEY HAVE FRIENDS OR FAMILY AND THERE IS A SELECTION ISSUE TO STATES AND TO STATES THAT HAVE INCLUSIONARY CLIMATE. THAT'S HAPPENING IN THE BACKGROUND AS WE TRY TO DO THIS ANALYSIS. AND THEN THE OTHER PIECE THAT I THINK IS RELEVANT IS THAT WE'VE SEEN A CHANGE IN FERTILITY RATE IN THE LAST 10 YEARS, PARTICULARLY AMONG LATINX COMMUNITIES AND ADOLESCENT FERTILITY AND SO THE CHANGING FERTILITY AS A BACKDROP, THERE'S A LOT OF DIFFERENT SORT OF PIECES TO THIS AND I THINK IT'S TOO EARLY TO SAY THAT WE'VE ABSOLUTELY SEEN THE INVERSE AND THAT'S IT. IT JUST IS A STARTING POINT TO EXPLORE AND THINK ABOUT SOME SEQUENTIAL MODELING METHODS, AND TO THINK ABOUT, YOU KNOW, IT COULD BE THE INVERSE AND COULD BE A SELECTION ISSUE COMPLETELY BUT WE JUST DON'T WANT TO SPEAK ON IT QUITE YET. DEFINITELY IT'S A COMPLICATED STORY, BRINGS UP OTHER ASPECT OF IMMIGRANT LIVES. >>THANK YOU. I CAN'T HELP THINKING ABOUT YOUR FOCUS, IN PART, YOUR OWN RESEARCH INTERESTS AND WHERE YOU ARE INSTITUTIONALLY, REALLY IN REPRODUCTIVE HEALTH OUTCOMES BROADLY AND REPRODUCTIVE HEALTH, I CAN'T HELP BUT WONDERING HOW GIVEN THE VARIEGATION YOU MAY NOT SEE PATTERNS IF YOU'RE LOOKING AT OCCUPATIONAL HEALTH OUTCOMES, OTHER THINGS, IT'S A FANTASTIC RESEARCH PROGRAM, I APPRECIATE YOU TAKING THAT QUESTION MORE DEEPLY. WE HAVE SEVERAL OTHER QUESTIONS, I'LL START WITH ONE FOR DR. BULLOCK. YOUR TALK HIGHLIGHTED WAYS THE SAFETY NET PROGRAM AND PROGRAMS WITH STRUCTURED BY SEXISM AND RACISM. IF YOU ENCOUNTERED PROGRAMS THAT INTERVENE IN THIS CYCLE? AND IF SO WHAT ARE SOME KEY LEVERAGE POINTS? >>THAT'S A GREAT QUESTION. WE ARE VERY FAR FROM ADOPTING PROGRAMS ON A LARGE SCALE BUT I THINK PROGRAMS THAT PROVIDE UNIVERSAL BENEFITS AT LEAST INTERRUPT STIGMATIZING ELEMENTS. YOU MIGHT THINK ABOUT GUARANTEED INCOME, OR BASIC INCOME, WHICH I THINK IS GAINING SOME TRACTION, AMAZING DEMONSTRATION PROJECTS GOING ON. , ACROSS THE UNITED STATES AND OTHER COUNTRIES SHOWING POSITIVE BENEFITS. YOU MIGHT THINK OF UNIVERSAL SCHOOL LUNCH, AND OTHER PROGRAMS, WHICH ARE PROVIDING MEALS TO ALL CHILDREN OR STUDENTS. YOU KNOW, REGARDLESS OF THEIR INCOME STATUS OR ANY OTHER CHARACTERISTICS. SO, I DO THINK THAT THERE ARE SOME PROGRAMS THAT CAN PUSH AGAINST AND CREATE A MORE INCLUSIVE SAFETY NET, SOME OF THOSE ARE UNIVERSAL. AND I THINK A STRENGTH OF THOSE IS THAT THEY DON'T ACTIVATE SOME OF THE SAME STEREOTYPES. >>YEAH, THANK YOU. THAT MAKES A LOT OF SENSE. WE HAVE BOTH A SPECIFIC QUESTION FOR DR. GRIFFITH AND A FINAL QUESTION IF WE HAVE A MINUTE LEFT FOR EVERYBODY. DR. GRIFFITH, WHAT ARE SOME INTERVENTIONAL STRATEGIES TO COUNTER THE GENDER NORMS OF MASCULINITY AND OTHER BARRIERS FOR MEN INCLUDING OF COURSE STRUCTURAL RACISM THAT CAN PROMOTE HEALTH-SEEKING BEHAVIORS FOR MEN? >>I'LL SPEAK TO ONE ABOUT A YEAR AGO, I WORKED WITH THE NOVEMBER FOUNDATION TO A PROGRAM, ROOTED AND RISING COLLECTIVE, WORKING WITH THEM TO DEVELOP SOME MATERIAL AROUND MEANT WELL-BEING FOR YOUNG BLACK MEN, 18-25, A WAY TO TRY TO THINK ABOUT THE WAYS TO INTERVENE ON HIGH RATES OF SUICIDE AND MENTAL HEALTH IN THAT POPULATION. WE WORKED TO IDENTIFY A GROUP OF -- A PILOT STUDY -- A GROUP OF 10 SOCIAL MEDIA INFLUENCERS IN THE L.A. AREA WHO ALREADY HAD A STRONG FOLLOWING SO COLLECTIVELY THEY HAD A SOCIAL MEDIA FOLLOWING OF ABOUT A MILLION AND A HALF PEOPLE. SO THE JOB WAS BASICALLY GO IN AND HOW DO WE INFUSE HEALTH PROMOTION MESSAGES, MENTAL HEALTH WELL-BEING MESSAGES IN THEIR WORK, AND SO HOW DO WE HELP THEM IN THEIR LIVES AS WELL AS TO ALSO HELP STRENGTHEN THEIR BUSINESS. WE HAD A PROFESSIONAL WHOSE JOB IT WAS TO HELP THEM WITH THE BUSINESS SIDE, MY JOB TO HELP THEM WITH THE MENTAL HEALTH AND WELL-BEING SIDE, AND WE FOUND THAT IT WAS ACTUALLY -- IT WAS EFFECTIVE IN THE SENSE THAT IT HELPED TO INCREASE THE RELATABILITY OF THE ART, THE PIECES THEY PUT OUT WHERE THEY INCLUDED THAT CONTENT, NOT ONLY DID THEY GET MORE VIEWS, THEY WERE SEEMING TO -- PEOPLE SAID THE SELF-REPORTED CHANGES THAT WERE THERE FOR THE PARTICULAR POPULATION AS WELL AS YOUNG MEN SAID THEY ALSO THEIR BEHAVIOR WAS CHANGING. SO THOSE ARE THE KINDS OF THINGS THAT I THINK WE CAN DO IS TO UTILIZE THOSE UBIQUITOUS SPACES TO ADDRESS THOSE BECAUSE WE HAVE TO ADDRESS IT AS A NORMATIVE LEVEL AND HELP PEOPLE TO MAKE SOME OF THE INDIVIDUAL CHANGES WITH SOME OF THE AGENCY THAT DR. SAMARI AND OTHERS TALKED ABOUT. >>THANK YOU, GREAT EXAMPLE. WE DO HAVE A FEW MINUTES TO MAYBE JUST GET SOME FINAL COMMENTS FROM EACH PANELIST. MAYBE I HAVE A ANOTHER -- NO, WE'RE FINE. THIS WHOLE PANEL HELPED ILLUSTRATE AND PUT SOME REAL TEXT HERE ON THE OBSERVATION THAT GENDER IS NOT A ONE-DIMENSIONAL HIERARCHY, AND INSTEAD IT'S A SET OF SOCIAL PROCESSES THAT ARE ALWAYS EVOLVING AND CHANGING THAT ARE DISTRIBUTED UNEVENLY, EVEN THE SOCIAL PROCESS OF GENDER THEMSELVES ARE UNEVENLY DISTRIBUTED ACROSS POPULATIONS AND THEN THE CONTENT OF THOSE PROCESSES IS CO-DETERMINED WITH OTHER HIERARCHIES, MOVING ALONG, RIGHT? AND THIS PANEL MADE THAT SO CLEAR. SO, IF WE ARE MOVING TOWARDS THINKING OF GENDER IN THIS WAY AS NOT THIS ONE-DIMENSIONAL HIERARCHY BUT AS THESE EMERGENT POSITIONS THAT ARE GENERATED BY MULTIPLE EVOLVING SYSTEMS, THAT GENERATE SPECIFIC VULNERABILITY AND SO ON, I WONDER WHAT WOULD HAPPEN IN EACH OF YOUR RESEARCH AREAS, WHAT INSIGHT COULD YOU GIVE US ABOUT THIS ONE COMPLICATION, TO THINK ABOUT GENDER -- THE GENDER SPECTRUM ITSELF AND QUESTIONS IN PARTICULAR OF GENDER NON-CONFORMITY AND THE ENFORCEMENT OF GENDERED NORMS IN EACH OF YOUR DOMAINS THAT YOU'VE WORKED WITH. HOW DO YOU SEE, DR. SAMARI, HOW THAT MIGHT AFFECT THINGS IN THE REALM OF IMMIGRATION, DR. BULLOCK, HOW IS THAT INVOLVED IN POVERTY, DR. GRIFFITH IN PARTICULAR SOME INSIGHTS IN MEN'S HEALTH. FOR YEARS AND YEARS, I DID RESEARCH, IN HARM REDUCTION, AND VULNERABILITIES PARTICULARLY WITH INJECTION DRUG USERS AND STREET-BASED SEX WORKERS. WHAT WE FOUND OVER AND OVER AGAIN WAS THAT GENDER NON-CONFORMITY AMPLIFIED THE RISKS THAT PEOPLE FACED IN EVERY SINGLE DOMAIN OF STREET LIFE. SO, I WOULD LOVE TO HEAR WHAT YOUR THOUGHTS ARE FOR EACH OF YOUR OWN RESEARCH AREAS. DR. SAMARI, WOULD YOU LIKE TO START? >>SURE, I'LL GIVE IT A TRY. I'M STRUCK BY EARLIER IN THE DAY WE HEARD DR. HELMAN SPEAK, I'VE ENGAGED IN WORKS THAT GETS AT THE SEXISM PIECE BUT NOT GENDER AND GENDER NON-CONFORMITY, WE'VE HEARD ABOUT INTERSECTIONALITY AND DIFFERENT FRAMEWORKS, ALL REALLY TRYING TO ELEVATE KIMBERLE CRENSHAW'S WORK BUT I THINK WE NEED PARTICULARLY IN MY STRUCTURAL MEASUREMENT SPACE, I'M THINKING ABOUT HOW TO SORT OF CRITICALLY INTEGRATE THESE THINGS IN A STRUCTURAL SPACE BUT THEN ALSO HEAR IN THIS MIXED METHOD APPROACH ABOUT THE LIVED EXPERIENCES OF THOSE THINGS. YOU DON'T WANT IT TO BE REALLY LOST IN TRANSLATION, I CAN SAY THIS SUBSET OF POLICIES THAT HAS GENDER EMBEDDED IN IT REALLY AFFECTS PEOPLE'S LIVES BUT UNTIL YOU ACTUALLY ASK THOSE INDIVIDUALS HOW IT'S MANIFESTING, SO I THINK CONTINUING TO MOVE FORWARD IN THIS DUAL PATH THAT DOES BOTH OF THOSE THINGS, I THINK WE HAVE A LOT OF ADDITIONAL LAYERS OF COMPLICATION IN THE REPRODUCTIVE HEALTH SPACE GIVEN THE DIRECTION OF REPRODUCTIVE HEALTH POLICY AND HOW THAT'S INCREASINGLY ACTIVE AT THE STATE LEVEL AND SO WE HAVE TO THINK LONG AND HARD ABOUT THE ROLE OF ABORTION CRIMINALIZATION AND ALL OF THESE TYPES OF MEASURES AND HOW IT ENTERS THE SORT OF STRUCTURAL SPACE AND STRUCTURAL MEASURES AS WELL. NOT REALLY AN ANSWER TO YOUR QUESTION BUT THAT'S SORT OF MY STRATEGY IN WHAT I'M THINKING ABOUT MOVING FORWARD. >>THAT'S THE KIND OF ANSWER I WAS HOPING FOR. HOW IS THIS AFFECTING YOUR STRATEGIC THINKING. THAT'S GREAT. DR. GRIFFITH, DO YOU HAVE SOME THOUGHTS TO SHARE? >>SURE. QUICKLY, THIS HAS BEEN PART OF THE REASON WHY I SORT OF PUSHED THIS NOTION OF MEN'S HEALTH EQUITY, THE IDEA OF MOVING THESE POPULATIONS LIKE THOSE WHO ARE GENDER NON-CONFORMING FROM MARGINS TO THE CENTER, BLACK MEN ARE PART OF THAT GROUP, GENDER NON-CONFORMING AS WELL. BOTH IN THE BOOK WE DID AND SPECIAL ISSUES ABOUT PROMOTING MEN'S HEALTH EQUALITY, GENDER NON-CONFORMING HAVE BEEN CENTERED, BROUGHT INTO THAT CONVERSATION, SO I THINK THE OTHER TWO -- ONE IS WE'RE DOING IT IN THE WORK ALREADY, TRYING TO. I THINK A KEY PART IS GOING TO BE IDENTIFYING ASSETS AND STRENGTHS OF THOSE POPULATIONS THAT WE CAN BUILD FROM AND DON'T ALWAYS LOOK AT THEM AS DEFICITS, THE THIRD PART IS I THINK USING THE THREE-PART FRAMEWORK, FROM KIMBERLE CRENSHAW COULD BE POWERFUL AND USEFUL TO CENTER THE POPULATION AND THINK ABOUT WHAT ARE THE UNIQUE BARRIERS THEY ARE FACING AND WHAT ARE THE THINGS WE MIGHT DO TO MOVE THEIR HEALTH PROMOTION FORWARD. >>THANK YOU. I'M GETTING A NUDGE HERE AND DO WE HAVE ANY TIME THAT WE CAN HEAR FROM DR. BULLOCK OR WE HAVE TO GO BACK? >>I'M SO SORRY BUT WE'RE THE LAST, I GOT NOTICE WE'RE THE LAST SESSION. I DON'T WANT TO CUT THIS CONVERSATION, DR. BULLOCK, JOIN US IN THE NEXT ROOM AND WE WILL FIND WAYS TO KEEP GOING WITH THIS CONVERSATION AND JUST THANK YOU ALL SO MUCH FOR YOUR REALLY THOUGHTFUL AND ENGAGING PRESENTATIONS. I WILL SEE YOU BACK IN THE OTHER WEBINARS. WE HAVE TO LOG OFF AND LOG IN TO THAT OTHER ROOM. THANK YOU ALL SO MUCH. >>THANK YOU.