Jallicia Jolly-Grindley | A black immigrant girl’s quest for health equity

Health inequality is a legacy I did not want to inherit, yet it invaded my earliest memories as a black girl in Jamaica and an adult in the United States. I learned that race, class, and colour can determine your access to resources and quality health care, which significantly shapes health outcomes and survival.

This fact became even clearer when I learned about my grandmother’s forced sterilisation in Jamaica, her lack of access to quality prenatal care, and the death of my mother’s infant twin brother. I observed this when I received the heartbreaking news about the passing of a friend who was living with HIV who had complained about the negligence of staff in a public health facility as she sat in her own faeces without any clean sheets or anyone to bathe her. I witnessed this when I saw my 22-year-old cousin and her newborn in a casket following her abrupt death while seeking care for the birth of her second child – her death was ruled inconclusive.

All of these women were black and working-poor, and most were single mothers. I have often wondered, would they have been treated with better care if they were middle-class, married women with resources? Even as an “educated,” middle-class woman with a PhD, I still experienced reproductive coercion and medical racism while giving birth in the United States, which confirms research findings that having a higher income does not protect American black women from harm. In both the US and Jamaica, the most vulnerable girls and women of our society remain deprioritised in healthcare and social services because of the underlying views that they are not worthy of protection and basic resources to sustain their lives.

From the lack of access to quality healthcare to reports of reproductive harm in health institutions, these experiences make it clear that power and privilege can make the crucial difference between life and death. Contrary to popular understandings of health, it is not just the absence or presence of sickness. Rather, it includes our cumulative exposure to violence, poverty, gender inequality, and class and colour discrimination over time. It is the direct outcome of broader processes of marginalisation that include eviction and lack of stable housing, unemployment, and underemployment that reduces earning potential, lack of education, and environmental risks that heighten trauma and undermine wellness. Ultimately, we embody the inequalities we live with on a daily basis differently based on who we are, where we live, what we know, and who we know.

JAMAICAN ROOTS, IMMIGRANT ROUTES

As a black immigrant girl, I wanted deeply to disrupt these cycles of health inequality. Now, as a professor of Black Studies and American Studies who teaches and researches black women’s health and reproductive justice in Jamaica and the United States, I help combat health inequities through education and mentorship as well as mobilisation and community organising.

I am from Rae Town, a fishing village in downtown Kingston. Here, Sunday mornings meant ackee and saltfish and lingering tunes from an oldies session. I am from the routine sounds of market women and pushcart boys roaming Kingston streets to mek a living. I am from a community of single mothers who travelled far for the rare shot at upward mobility in the United States. We held these dreams in black suitcases upon entrance to JFK airport with hopes that we would someday redeem the sacrifices. Contrary to popular expectations, America was no green pasture.

After immigrating to the United States, I grew up in a low-income neighbourhood in Brooklyn, New York. Home was a congested, one-bedroom apartment that housed my 16 relatives. We created a home away from home as I lived with my mother, sisters, aunts, cousins, uncle, and grandmother. Like most of the women in my family, my mother juggled multiple jobs as a home healthcare aid, babysitter, and fast-food worker. Babysitting for wealthy families often provided immigrant women with more stable income than other low-wage jobs. When my mom moved out with my sisters and me shortly before 9/11 in our first apartment together, we struggled to avoid eviction. We almost lost that battle. I remember the bright red, bold “EVICTION” warnings that filled our mailboxes until we saved enough donations from relatives and friends to pay four months of back rent. At a young age, English as second language classes became a familiar community. I felt a sense of belonging being amid other immigrant children “fresh off the boat” in our search for homes away from home. Amid the grave feelings of loss and isolation and hope and possibility that accompanied my family’s quest for mobility in the US, communal support and organising became critical for our survival.

LIVING LEGACIES

The generational impacts of health inequalities became stepping stones for legacies of health advocacy and activism. I saw these legacies in the work of my grandmother, Petrona Harris (Mama Pet), who mobilised home healthcare workers nationally to elevate their needs and interests for respectful and liveable wages. I saw them in the leadership of my mother, Suzette Mcleod, who served as an union delegate representing the voices of workers and mobilising members to support collective bargaining. I experienced them in my own work as an HIV peer educator sharing health knowledge and services in low-income black and Latino high schools and communities in Brooklyn. I also experienced this as a Fulbright Scholar to Jamaica conducting research on the health outcomes and political leadership of Jamaican girls and women living with and impacted by HIV/AIDS. During this time, the innovative advocacy and mobilisation of organisations such as EVE for Life provided an inspiring model of health equity.

I was able to return to Rae Town to launch “JamHealth: Encouraging Holistic Health & Empowering Communities,” a holistic health initiative that used research and community engagement to support and elevate the needs of marginalised inner-city communities. We provided sexual and reproductive health services, HIV/STI testing, mental health information, and screening for non-communicable diseases in collaboration with Jamaican grass-roots organisations, health agencies, and medical practitioners of the Jamaican diaspora. We made these services accessible and youth-friendly through partnerships with entities such as the US Embassy in Kingston, Jamaica AIDS Support for Life, the Ministry of Health, EVE for Life, the Diabetes Association of Jamaica, the Social Development Commission, and the Registrar General’s Department.

“JamHealth” was profound. I witnessed everyday people come together to advocate for their health needs and support community mobilisation. I saw firsthand the power of multisectoral partnerships investing in health equity by meeting people where they are and connecting them to resources. I experienced Jamaicans who live locally and abroad unite to voice their needs and work together to enhance their individual and collective well-being.

I am determined, with all my heart, to create new legacies beyond inequality. From Rae Town to Brooklyn, these legacies continue to carry me forward.

- Jallicia Jolly-Grindley is assistant professor of black studies and American studies at Amherst College. Send feedback to jjolly@amherst.edu.