Board and staff of The L.A. Trust examine equity issues

Dr. Nooshin Valizadeh is facilitating The L.A. Trust’s equity, diversity and inclusion effort. 

Officers, board members and staff of The Los Angeles Trust for Children’s Health unpacked issues of equity, diversity and inclusion at a special online meeting May 24.  

Intersectionality expert, educator and “Artivist” Dr. Nooshin Valizadeh led the discussion, which was designed to foster thought exchange; define racism and understand its history and impact; and to name, challenge and change racial biases.  

In one exercise, the 28 participants filled in the statement, “As a [blank person] I do not know what it is to navigate our society as [a minoritized identity].” The workshop explained the difference between equality (everyone getting the same thing) and equity (everyone getting what they need to reach fair outcomes and opportunities).  

Dr. Valizadeh shared a chart demonstrating that overt white supremacy like hate crimes is only the tip of a large foundation of more subtle forms of racism, from cultural appropriation to so-called color-blindness.   

The roots of racism   

The participants filled in a “racism tree” that showed the seeds and roots of racism (slavery, colonialism and biased laws, policies and practices) to the sustaining trunk of racism (from the criminal justice system to underfunded schools and healthcare).   

Participants then named the branches (results) that have grown from the tree that’s been sustained over hundreds of years, including shorter life spans, mass incarceration and disparities in healthcare and education. Dr. Valizadeh cited Ibram Kendi’s book, Stamped from the Beginning, to share that the actual foundation of racism was self-interest.  

Several participants said they left the two-hour event feeling both inspired and challenged. The session was part of a larger equity exploration by The L.A. Trust, included a series of staff trainings.  

Dr. Valizadeh has a background in equity and education, and has been teaching race and gender equity courses for USC and UCLA since 2015. She works with local schools and districts to facilitate professional development and address structural barriers that disproportionately impact students of color and their success.  

She also helps school leaders impact change through her innovative and trauma-informed approaches to restorative justice and serves on the Diversity, Equity and Inclusion Committee for the Long Beach PTA Council and is the DEI Chair at Fremont Elementary School.

Mission Report: The L.A. Trust pivoted during pandemic

Our lockdown year (clockwise from top left): The L.A. Trust attended an on-campus healthcare rally; distributed PPE at St. John’s; taught little ones to brush on KLCS; handed out 100,000 toothbrushes during Operation Tooth Fairy; engaged students on Zoom; and helped promote the online CSHA Conference with State Superintendent Tony Thurmond.

The Los Angeles Trust for Children’s Health has released its 2021 Mission Report documenting an extraordinary year for the nonprofit agency and its stakeholders. 

“Last year was challenging, especially for our underserved communities,” Maryjane Puffer, executive director of The L.A. Trust, told stakeholders. “But it was not a lost year.” 

“Like our students, teachers, school staff and healthcare providers, we found new strength, learned new skills and made new connections online,” Puffer said. “Like them, we found new ways of accomplishing our mission.”  

View Report

The 16-page Mission Report details how the L.A. Trust pivoted during the quarantine. It transferred in-person meetings to online platforms like Zoom; expanded education campaigns on social media and television; and distributed more than 100,000 oral healthcare items and PPE at Wellness Centers and schools.  

The L.A. Trust launched a new Student Mental Health Initiative and educated legislators about the need for school-based healthcare. It also convened experts and stakeholders at online forums and engaged student health advocates at virtual events. The L.A. Trust also launched a new website and rallying cry, “Putting the care in student healthcare.”  

Students the unsung heroes 

“Our partners stepped up to support us as we pivoted,” the report notes. “Los Angeles Unified School District emerged as a national leader in handling the crisis, and healthcare providers saved lives, while risking their own.”  

An introductory message from Puffer and Board Chair Will Grice said, “The unsung heroes of the pandemic were our young people, who managed online education, nursed sick loved ones and shouldered increased family responsibilities.”    

The Mission Report documents The L.A. Trust’s activities in nine key areas: Advocacy, healthy living/nutrition, mental health, oral health, research, sexual and reproductive health, student engagement, substance use prevention and support for L.A. Unified’s 17 Wellness Centers. 

The report also lists key funders of The L.A. Trust, board members, Wellness Centers and Student Advisory Boards. It includes a financial report for the 12 months ended June 30, 2020 showing how the organization withstood the economic downturn by lowering overhead and raising funds through new grants and individual donations. 

“I especially want to thank our executive committee and board for guiding us through this tumultuous year,” Puffer said. “Their expertise, counsel and personal fundraising activities were indispensable.” 

Wellness Centers eagerly prepare for school re-openings

Dr. Kevin Fang of CHLA spoke about healthcare inequities at The L.A. Trust Learning Collaborative.

The word of the day was “hopeful” as L.A. Unified representatives, Wellness Center operators and staff from The L.A. Trust prepared for school re-openings at the fourth pandemic-period Wellness Network Learning Collaborative, March 10 on Zoom.

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, conducted a roll call of representatives from the 17 LAUSD Wellness Centers, noting The L.A. Trust has been hosting the collaboratives for more than a decade.

Health equals success

Guest speaker Dr. Kevin Fang addressed healthcare inequities, saying, “Zip Codes are better determinants of health outcomes than genetic codes.” Children of parents without a high school diploma are more likely to live in an environment with health barriers, Fang said, noting the direct correlation between education and life expectancy, income and smoking.

Fang said chronic absenteeism was a strong predictor of poor academic achievement. COVID-19 has exacerbated an already high chronic absenteeism rate among California public schools, he said, noting it has risen 89%. Proven solutions include school nurses and other forms of school-based health, physical education and individual education plans. Fang suggested ways to increase collaboration between schools and the medical community, including ACES (adverse childhood experiences) training for pediatricians and Wellness Center clinicians and in-class visits by doctors and medical students.

Fang is an attending physician and an assistant program director for the Pediatric Residency Program at CHLA. The former high school biology teacher is also Fellowship Director for the General Academic Pediatrics Fellowship in Health Equity and assistant clinical professor of pediatrics at USC’s Keck School of Medicine.

Report card

Victor Luna, organization facilitator for LAUSD Student Health and Human Services,  provided a 2020 report card for the Wellness Network.

Visits to the Wellness Centers were down dramatically due the pandemic and facility closures. Visits varied widely — some clinics never closed and some remained closed for most of the year. Organization Facilitator Gloria Velasquez observed that 2020 was not a good year to determine trend lines in the network.

The two-hour collaborative concluded with a group discussion among the clinicians, educators, Student Advisory Board Adult Allies and The L.A. Trust staff. Topics included telehealth, getting students to make and keep medical appointments, and sexual and reproductive health services.

Appointments for STI prevention and birth control have been most impacted by the pandemic. Without outreach and the confidential setting of the school Wellness Center, students may be reluctant to reach out or use telehealth from home. LAUSD Organization Facilitator Ana Griffin said Wellness Centers and students were countering this through outreach campaigns. “We emphasize to students (who have sexual health questions) that the Wellness Center is a no-judgment zone.”

School-based health conference focuses on multiple threats

California State Superintendent of Public Instruction Tony Thurmond addressed nearly 1,000 registered guests at this year’s CSHA statewide School-Based Health Conference.  

Nearly 1,000 student health advocates addressed the multiple pandemics facing California’s kids, teens and communities at “School Health on the Frontlines: Navigating Pandemics & Building Equity,” the California School-Based Health Alliance’s first-ever virtual School-Based Health Conference October 6-8. 

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health and board vice president of CSHA, opened the conference by stating, “School-based health centers have always been on the frontlines of healthcare by serving students and communities with the most challenges and least access to our healthcare. This year has been a real test of that system.” 

She pointed to the COVID-19 pandemic, which “has brought families to the brink,” and to “the unending racial injustices faced by Black, Indigenous and People of Color.” She said, “Our youth are resilient, but they are under incredible strain.”  

She noted that not one of the state’s one thousand local education entities has the recommended number of mental health professionals and only 4% of California school children have access to school–based health centers. 

“The ultimate equity issue” 

Dr. Tony Thurmond, California State Superintendent of Public Instruction said, “These are some of the toughest challenges we’ll see in our lifetimes.” He called “healthcare the ultimate equity issue” and said school-based health was “a top priority.”  

The opening keynote speaker was Dr. Elisha Smith Arrillaga, executive director of The Education Trust–West, a research and advocacy organization focused on educational justice and supporting the high achievement of all California students. She said, “I want my son to say in the face of this epidemic that we stood by him. We must do much better, much faster. We must be co-conspirators for justice.” 

The closing keynote was given by Dr. Tichianaa Armah, medical director of Behavioral Health at the Community Health Center Inc., one of Connecticut’s top school-based health center providers, and assistant clinical professor at the Yale School of Medicine. Armah outlined the impact of racism on the health and mental health of BIPOC students and communities. She shared compelling evidence of how stress of racial injustice has real health consequences, from stress and negative emotions to low-grade inflammation and chronic disease. 

The CSHA Convention included three days of sessions on topics ranging from sexual and reproductive health to school mental health. The L.A. Trust’s Program Manager Robert Renteria headed a panel on “Implementing SBIRT in SBHCs” and three staff members from The L.A. Trust served as room hosts. Sixty attendees registered for the conference as guests of The L.A. Trust. 

A special message: Our young people are hurting

The death of George Floyd has brought the issue of racism and police brutality to the forefront once again. But our Black and Brown students do not need reminding — they live the reality of racism every day.

Racism affects every aspect of American life, from policing and criminal justice to our healthcare and education systems. Its legacy is economic inequality, underfunded schools and inadequate healthcare.

The Los Angeles Trust for Children’s Health was founded 19 years ago to help address disparities in access to healthcare and prevention programs. With the COVID crisis and economic recession, these inequities are getting worse, not better.

Our families are hurting. Our young people are angry. Well-meaning proclamations will not do. We need real reform in criminal justice, healthcare and education. We cannot do this overnight, but we must begin.

Maryjane Puffer
Executive Director