DAY 11:

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You may have heard about the wealth gap, but have you heard about the wealth-health gap?

According to the NY Times 1619 Project, “racial health disparities are as foundational as democracy itself.” Socioeconomic status and institutional racism lead to disparities across living conditions, limit access to quality health care, and contribute to chronic stress. These factors lead to shorter life spans and higher likelihood of adverse health outcomes for people living in poverty and people of color.

The newly updated ACEs (Adverse Childhood Experiences) pyramid recognizes the influence of historical trauma and toxic stress on future generations and their health outcomes.

ACEs 360

Source: Healing Iowa, Iowa ACEs 360

Healthcare costs also make up a significant portion of a household’s annual budget, placing additional stress on families that may or may not have insurance and access to quality care. Iowa’s 2018 ALICE Report indicates that the most significant driver of increases in the Household Survival Budget from 2007 to 2014 was health care costs, including an average 43 percent increase in out-of-pocket costs.

Compounding these factors that worsen health outcomes for people of color, Black Americans are much less likely to trust their healthcare providers and healthcare institutions. The Tuskegee Syphilis Study is one of the most egregious demonstrations of the origins of distrust.

Did you know? 
  • Only 63.2% of Black Iowans and 49.5% of Latinx Iowans have a personal doctor compared to 77.9% of white peers (Source: Behavioral Risk Factor Surveillance System (BRFSS), 2018)
  • Black women are two times more likely to endure a stillbirth than their white counterparts (Source: One Economy, 2020)
  • Adults of color, women, and low-income individuals report higher rates of childhood trauma compared to other racial and socio-economic groups (Source: Iowa ACEs 360, 2020) 
  • Only 1 in 3 Black Americans who needs mental health care receives it (Source: American Psychiatric Association, 2017) 
  • 34% of Black Trans and Nonbinary individuals have had one or more negative experiences with a healthcare provider in the last year (Source: National Center for Transgender Equality, 2015)

TODAY’S CHALLENGE: Do one or more of the following…

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Watch What is Historical Trauma? by University of Minnesota Extension and read more about how it affects the well-being of generations. (5:52)

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Hear from Des Moines University’s faculty and students about the education and training that DMU provides healthcare providers to ensure they practice inclusive, culturally responsive healthcare. DMU is the second oldest osteopathic medical school in the United States. (6:01)

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Watch the Make It OK and One Economy panel discussion "Week 4"  on mental health in the Black community, and the work happening to eliminate disparities in central Iowa. You’ll hear from several community leaders as they share their lived experiences and information related to mental health and well-being. (58:54)



Learn more about central Iowa organizations that are working to reduce disparities in stillbirths: Black Women’s Maternal Health Collective, the Iowa Black Doula Collective, and Iowa Healthy Birth Day.


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Ask your healthcare provider what they are doing to create an inclusive, LGBTQ-friendly practice using the support and resources from One Iowa or using these guidelines from the American Medical Association.


Capture what you learned by journaling your thoughts and feelings about today's content. Click below to download a free journal page for today.

Journal Page


If you are participating in the Challenge as part of a group, download this free discussion guide to help facilitate discussion.

Journal Page



CONVERSATION PIECE: Art Addressing Equity


Artist: Andre Davis

Title: “Too Sober to Live” from the album “When it Rains”

Date of piece: September, 2019

Description: “When it Rains” is the debut full length album from Andre Davis.

“Every song on this album has a profound message. It’s powerful and cuts to the core every time you hear it. The song “Too Sober to Live” ties to Healthcare."

Thomas Kutz
Station 1 Records, Inc.


Thank you to the members of BRAVO Greater Des Moines for curating the Equity Challenge Gallery, a collection of art in various media that speaks to the issues of equity in our society.

BRAVO Greater Des Moines