Jamila Michener On How State Interference with Local Housing Policy Impacts Tenant Health and Racial Equity

Siers-Poisson [00:00:06] Hello and thanks for joining us for the Poverty Research and Policy podcast from the Institute for Research on Poverty at the University of Wisconsin-Madison. I’m Judith Siers-Poisson. For this episode, we’re going to be talking with Dr. Jamila Michener about housing equity and how that affects health and health equity. Dr. Michener has written extensively on these topics, especially their racial and economic dimensions. We’ll be focusing in particular on two of her recent papers, “Entrenching Inequity, Eroding Democracy: State Preemption of Local Housing Policy,” and “Racism, Power and Health Equity: The Case of Tenant Organizing.” You’ll find links to both papers in the show note for this episode. Jamila Michener is an associate professor of government and public policy at Cornell University. She is associate dean for public engagement at the Brooks School of Public Policy, and she’s just been named the inaugural director of Cornell’s Racial Justice and Equitable Futures Center. She’s also a former IRP emerging poverty scholar and a current IRP affiliate. Jamila, thanks for joining us today.

Michener [00:01:10] Thank you for having me. It’s great to be here.

Siers-Poisson [00:01:13] I’d like to start with what health equity means. How do you define it in your work?

Michener [00:01:19] I usually define health equity in the most simple, I think, and straightforward way, which is everyone having a sort of fair and equal chance to live as healthy a life as possible. Right. So it doesn’t mean that everyone is exactly the same on every metric and every outcome, because the sort of diversity and range of humanity doesn’t allow for that. But it means that people have a fair and equal chance to have as much of a healthy life as possible. And really, at the root of that, it means that there are not kind of systemic barriers outside of what what may be uncontrollable on an individual level, that there aren’t systemic barriers on a societal level and economic level and so forth that stop people from being able to have access not only to health care but to health more broadly.

Siers-Poisson [00:02:14] So speaking of systemic barriers, I’m sure in the US context, we have to look at things like racism and economic inequality. Can you tell us how those factor in?

Michener [00:02:25] Yeah, absolutely. You know, I mean, health equity, I always tell people is both an outcome and a process. Like we want to get to a place where everyone can be as healthy as possible. But in order to get there, we have to go through some processes because that’s not the place that we are now. And when you think about health equity as a process, you start to think about, well, what are the elements of the process? Like, what are the actual things that are going on that are preventing people from having that fair and just chance to be as healthy as possible? And when you start to break those things down, you know, racism and economic inequality really emerge as key factors, especially in the US context, right? So even on the most basic level, like not being able to have access to a doctor, not being able to have access to a hospital, to prescription medication, to treatment of various sorts right. In the US. like those things are very much contingent, for example, on having the resources to pay for those things or having access to government or other programs that allow you to access those benefits. Right. And again, that is a function of income. It’s a function of wealth. And often, intentionally or not, it can be a function of sort of what racial demographic you are ostensibly a part of, not because of anything biological or genetic or essential about race, but because race has come to have meaning in our society. It affects where you live, so are you close to a hospital to be able to get care, it affects where you live, are you in a state that has expanded Medicaid and will you therefore be able to have health insurance that allows you to get care? Now, that’s just looking at the health-systems level like hospitals, doctors, medication, etc.. We can start to think about other kinds of structures, whether it’s, you know, the role that you play in the labor market. Do you have a job? Are you able to make a wage that allows you to get access to the food, to the housing, to the other things that you need to have a healthy lifestyle? And to our relationship — both race and class affect our relationship — to a number of institutions that structure and determine health, right? So we know it’s not healthy, for example, when people come into contact with carceral institutions, the police, jail, prisons, having experiences with those institutions make it less likely that you’re going to be in good health. We have lots of research to suggest that whether you have those experiences depend on whether you’re someone who is racialized as Black, depend on whether you’re someone who has access to income, to certain kinds of neighborhoods and so on and so forth. I mean, I could fill up the whole space of this podcast with examples of how race and racism and class and economic inequality translate into less access to the things that we need to live healthy lives, and not because of anything inherent about people who are living in poverty or people of color, but because of the systems that they have to navigate in order to have health and the ways that we make it so that those systems are disadvantaged in the face of sort of our racialized processes and our expectations around kind of economic resources.

Siers-Poisson [00:05:43] In the two papers we’re discussing today, you focus on health equity issues that are connected to housing specifically, and where the power lies to promote equitable housing policy. So first, what are the ways that inadequate housing affects health?

Michener [00:05:59] Yeah. You know, I think  if you haven’t lived in inadequate housing, it may be as easy to overlook this sort of thing. But there are so many ways it’s almost overwhelming. Right. Whether your home, for example, is appropriately heated and cooled affects all sorts of health outcomes. Right. We know that, for example, being in an overly cold apartment can trigger things like asthma. The quality of the air in your apartment can affect your health, the kind of safety of the structures in your home where you live. Are you able to safely get around, are there falling and other kinds of hazards, right? And so on and so forth. So in the paper in Health Affairs that focuses on racism, power and health equity, I give some examples of people who are living with mold in their apartment, with various kinds of challenges around, you know, fires that are starting because there are hazards that are there, are things that are not taken care of. The water isn’t running. You don’t have heat, you don’t have air conditioner in or any form of temperature control during seasons where that can sometimes be the difference between life and death. And there’s almost sort of no end to the number of things that can go wrong in a home. And for many people they can just intervene and fix those things. And so you don’t even think about it. But when that’s not able to happen, especially when you’re renting the home and you don’t own it, it can be sort of what can feel like an endless barrage of threats, honestly, to your health. Right. Because health, it does not have much meaning. If we don’t have a safe place to live in, to sleep in, to exist in, outside of the work place and what have you.

Siers-Poisson [00:07:44] Well, And you make the point, too, that all of this really came to a head with the COVID-19 pandemic. How did you see housing equity, especially with those racial and economic dimensions, influence how people experienced the pandemic?

Michener [00:08:00] Yeah. I mean, it’s so interesting as far as the pandemic is concerned. I mean, we saw the concerns around eviction really emerge and be sort of put into sharp relief during the pandemic, because here we have people who, many of whom, for perfectly understandable reasons, there are things that have happened in the economy that have taken away their ability to earn an income in the same way they were before, who are perhaps facing a scenario where they can’t pay rent and now they’re potentially facing an eviction. Right. And then people are just home more during the pandemic. Many people, not all people, many people still have to work and they’re out there sort of facing the conditions of vulnerability as front-line workers. But many people also are spending more time at home. Right. And so now if your house is inadequately heated, if it’s not adequately cooled, if you don’t have a functioning stove, if you have mold, if you have a bug infestation, all of those things are going to be more challenging to deal with. When you’re home more you have fewer options in terms of where you can go. And so on the one hand, people are being displaced through eviction because they didn’t have the resources to remain in their home. And on the other hand, people are having to confront the conditions of habitability. What it’s like when you have to be in your home more, when you can’t escape it. And so I think that those were just two examples of the sort of facets through which the pandemic brought into sharp relief the many struggles that people have inside of their homes and the intersections between those struggles and their health.

Siers-Poisson [00:09:39] I want to dig into the idea of power in relation to promoting or hindering housing equity and then as a result, health equity. You look specifically at housing policy and who is able to control that. So let’s start at the local municipal level. What does housing policy look like there?

Michener [00:09:58] On the most fundamental level, housing is a local issue, right? And oftentimes local governments and sometimes like right down to the community level, you can have community boards and neighborhood boards and city governments and municipal governments, and housing is fundamentally a local issue, although it has a kind of inter-governmental implications. Right. So there are things that can happen at the state level and even the federal level that can structure the nature of housing all the way down. But the people with the most at stake, the people with the most to lose, are often the folks that are operating on a local level. And sometimes this is people who are invested in housing in various ways and are hoping to make a profit from it. It really matters to them who gets to live where, how those communities are zoned, what that’s going to mean for their bottom line. And at the same time, just regular people who may not be looking to make a profit from housing, but who have an idea about the kind of community they want to live in or who have an idea about wanting to feel a certain way about their community, feel comfortable in their community, what have you. Right down to the people who have very few choices and who are the most marginalized and are simply trying to survive across the spectrum of different ways that people are positioned. Housing on the local level is really quite crucial. And so a lot of local level actors from government officials, municipal officials, city officials, neighborhood boards, community groups, tenant organizations, which I focus on a lot in these papers, policy, local policymakers and, of course, landlords, apartment associations. I mean, there really is this proliferation of people who have an interest in what’s happening with housing on a local level. Right. And sometimes those interests are in conflict. Sometimes those interests are at odds. And so what we end up seeing when we look at local housing policy quite frequently is power struggle, people who have different interests in how they want to see housing unfold, how they want it to be used, how they want it to be built, what they want it to cost, what conditions they want, people who are who are in, for example, apartments or rented homes to face. There are very conflicting interests across that array of actors, and that’s where politics and power come in.

Siers-Poisson [00:12:23] So there are a lot of different interests and agendas at the local level. But then all of those groups and all of those municipalities are also within states, and the political actors at that level might have a very different view of housing policy as well. What do you see happening when state level policymakers see what’s going on in the cities and towns?

Michener [00:12:46] Yeah, so this is a really important feature of our politics more generally as a kind of federated polity, right? Like we live in a country where the national government sets broad contours of our laws, but there is a lot of room left for state governments. And often state governments leave some room for local governments. But each level has the power in a variety of ways to constrain the other levels. So state governments have the power to constrain local governments. And often this becomes part of the kind of political negotiations and compromises and interactions between state and local governments, because it’s not uncommon, for example, to have a state legislature that is much more conservative than a given city legislature. Right? You can think about Texas. The state legislature in Texas is likely going to be more conservative than Austin. Okay. And now think through North Carolina and so on and so forth. We can almost imagine this for nearly every state that there are major cities in the state that have a different political set of political preferences and policy preferences than the state government. Now, sometimes state governments are content to let localities do what it is that they want to do, but sometimes for political or ideological or other reasons, they want to limit city governments or local governments from doing certain things. And housing is a space where we see this a lot. Rent control is probably the primary example. At some point, when rent control started to take hold in more and more cities, state governments started doing what we call preempting it. At the state level, you pass a law that says “No localities can do this. You cannot regulate the cost of rent at the local level. We as the state legislature are telling you this.” And now there may have been three or four or five cities in that state that would have eventually done that. And the legislature preempts all of it and says, now none of you are doing it. And it really changes the realm of possibilities for localities. It changes the way that they can govern. And often localities have ideas about how they want to, for example, advance prerogatives around health equity, how they want to make housing more equitable, fill in the blank, and preemption can limit them from doing so. To be fair, there’s a flipside to preemption, too. Sometimes states and localities want to do bad things that are inequitable, and preemption can stop them from doing that as well. You can preempt states and say no discriminatory laws against X or Y categories of people. Right. And so preemption itself, it’s an institutional feature. It doesn’t have like a moral or ethical or even political valence one way or the other. Democrats use preemption. Republicans use it. It can be used for good or ill. But it’s worth thinking about it on an institutional level, what it’s doing in specific domains, and how that matters for what sorts of policies can unfold, and who gets to exercise power in influencing and affecting those policies.

Siers-Poisson [00:15:52] Well, And I thought it was especially interesting that you say that not just the reality of preemption, but even just the threat or possibility of it being used can have an impact. What does that look like in concrete terms when we’re talking about people who might be advocating on a more local level for particular housing policy and working towards housing equity?

Michener [00:16:15] That’s a great question. You know, one of the key things to remember here is that policy change at any level is actually quite hard. It isn’t easy to get policies that you might want to see happen to help communities. And this is especially true in relation to racially and economically marginalized communities. So when you think about the configurations of organizations and people that might be working to try to advance policy to create more equitable outcomes for racially and economically marginalized communities in these papers, I really focus on tenant organizations, and I use tenant organizations and tenant organizing as a way to think about this. Tenant organizations are facing an uphill battle. They’re trying to create more equitable conditions in a context of housing, where there are lots of folks who they have to contend with. I mentioned all of those different players earlier, apartment associations and landlords and property developers and property managers. And so if you’re a tenant organization or any organization, but in this case, I was talking about tenant organizations, and you have limited resources and you have a limited time and you’re a membership based organization where the members of your organization are people who have concrete needs, right. Who have issues that they really want to address. What you want to do in many ways is focus on the issues where you really actually have a chance in the short- to medium-term of making some kind of positive change. You don’t want to pick a campaign that you have no hope of winning or a campaign that even if you win, it can be overturned or undermined through state preemption in a second. Right. And so it may be that as a membership-based organization, your members are like, “we’re tenants. And the biggest problem is that rent is too high. The biggest problem is really that we need our rent to stop going up.” And you may be tempted as a tenant organization to say, okay, our policy campaign is rent control, but maybe rent control is preempted in the state and you can’t have that as your policy campaign, no matter how much the people that you’re working with and for want it. Because the state has already said that you can’t have it, or perhaps the state hasn’t said that. But you know it can and you know it might. And so do you want to put all the effort and energy that it’s going to take to get rent control in your city if six months later or a year later, the state legislature can say, no, you can’t have that thing after all? And so it really is a calculus. We have limited energy and time and resources, and we have people with real needs. We want wins that are going to get those needs met. And how do we do that? Not by picking issues that are either already preempted or could easily be preempted. That doesn’t always stop tenant organizers or people in advocacy spaces or what have you, but it certainly causes pause. It certainly makes them rethink their strategies and sometimes reorient their strategies. And it makes them work in different and sometimes harder, sometimes less effective, sometimes more creative. Right. It can it can cut in a number of different ways, but it makes them operate differently because they’re working in an institutional context that puts pretty striking constraints on them.

Siers-Poisson [00:19:46] So in your research, you’ve documented how both individual tenants and tenant organizations attempt to counter inequitable housing policy and those unhealthy living conditions. I want to talk a little bit about those individual tenants, because as we were describing earlier, these are people who are facing challenges on multiple levels. Often they are subject to racism, because of their economic status they are perhaps living in substandard housing and are unable to get those repairs done. Their family’s health and well being is at stake. Given all of those challenges and demands on their time and that’s beyond childcare and working and taking care of family members. What are the ways that those individuals become activated, motivated to act on these issues when there’s so much else probably going on in their lives?

Michener [00:20:43] Yeah, I think this is a good question and there are a few different pathways for people, right? One of the pathways that really stands out to me and is often the most devastating to hear about honestly, is just desperation, right? Because some of these scenarios are putting people’s lives in danger and the lives of their children. So I can think of not one but many conversations I’ve had with tenants who tell me about, for example, lead poisoning. There’s a woman that I talked to in central New York not too long ago who took her son to the doctor. Her son was having a variety of different symptoms, and they did a battery of tests. And it turns out that her son has dangerously high levels of lead toxicity in his blood. She didn’t realize that there was a lead problem in her rented home and now her, you know, three- going on four-year-old is facing the prospect of life-long cognitive damage as a result of this. And she has three other kids. Right. And so now you got to get all the kids to the doctor. You got to get… Now, with limited success, she was persistent around pushing back against her landlord, you know, talking to the local health department, going and seeking out an attorney and seeing if she had any legal recourse, calling her landlord constantly, showing up at places where the property manager would be, within the bounds of what was possible for her. It wasn’t like, “I’m going to do this because I’m politically activated.” It was “My children are going to be ill.” Like, I want this lead abated, right? I mean, she was in a position financially where it was going to be very hard for her to move anywhere else. And so you’re here and you want to make what you can of this life. So often it’s the desperation that drives people who honestly don’t have the time or the energy or the inclination to push back. But they absolutely have to because their lives are and their well-being and their children’s lives and well-being depend on it. And the other thing that activates people, honestly, is really being brought into something larger than themselves. Right? And so there is a limit to how much can happen at an individual level. And in part because at an individual level, it’s like you and there’s a problem with your landlord, you know, and it’s hard to see that like, hey, 60% of the people in the census, of the children in the census tract are exposed to lead. 80% of Black children in this neighborhood have high levels of lead toxicity. You don’t know that when you’re fighting your individual battle necessarily. You’re not understanding it as a larger problem that goes beyond you. And when people come into contact with not only narratives that help them to see this as a larger problem, but organizations that help them to get a sense of what they can do about the problem, that really makes a difference. Otherwise it’s just you facing off against people that are more powerful than you, and you’ll do what you can, but you’ll hit a ceiling, right? You’ll hit a ceiling. And even when you do what you can. Right. I talk in one of the papers about a woman who I call her Sheila in the paper, after lots of lots of harm being perpetrated against her by her landlord that she sort of ignored because she was she knew she was in a point of sort of precarity and vulnerability. But then there’s a fire that breaks out in the home and it’s like, I can’t do this anymore. Like, my children are literally in danger. And so her individual level act is to report to the landlord to code enforcement. And code enforcement does not do very much. And then she’s living with the retaliation of the landlord. You know, you can act on an individual level. There are things that people can and do attempt to do in order to exercise that kind of power and control in their lives on an individual level. And it doesn’t take long for people to hit the limit of that. And that’s when they sort of start to understand the importance of of some collective movement in action.

Siers-Poisson [00:24:45] So let’s talk more about that collective action and the insights that you got in interviewing leaders and members of tenant unions, tenant organizations. Where were they coming from in viewing this issue of housing equity and health equity?

Michener [00:25:02] Yeah. So, I mean, the the housing space and the housing equity space is sort of the space that people within tenant organizations, whether they’re members of those organizations, whether they’re leaders within those organizations, they’re always thinking about housing. And often what brings those tenant organizations or those tenant unions into existence is a recognition of the ways that people are struggling with their housing, either to maintain their housing, to actually stay housed in the context of rising costs and less and less affordability, or the kind of conditions of the housing. Right? You don’t just want to have some place to live. You want to be able to live humanely. And both of those things — being displaced from your housing because you can’t afford it or living in housing conditions that are terrible — both of those things are a threat to your health. And one thing that’s interesting is when I was talking to people from tenant organizations, I didn’t say, tell me about how this affects your health. Right? Instead, I said, tell me about what motivates the work that you do. Tell me about your experience as a tenant. And people would bring health into the conversation themselves. So it wasn’t a frame I was dictating for anyone. It was a reality that emerged as central and pivotal to the way that people understood the relationship between housing and their lives. Right. And so once you realize that this is pivotal for your health, for the health of your family, for the health of your community, you of course, want to do something to address the problems that are emerging. But many people don’t have the time and they don’t have the energy, they don’t have the capacity. They don’t even know where to start. You know, the problems feel so much bigger than any one person’s ability to face them. But when people understand that, they can collectively work together. Right. So I’ll give you an example. I gave that example just now of the woman who was facing the issue with lead in her apartment and was as an individual trying to kind of figure out how to get her landlord to change some things. And that was a really difficult and frankly, losing battle for her. Right. Even when she got legal services and lawyers involved, they were like, oh, well, we can’t do lead cases. That’s not what we can do. Eviction cases. That’s what where that’s what’s in our ambit. And so every path that she took was really quite cut off. Now, there are a different set of tenants that I interviewed in a building where they found out that there was massive, massive amounts of lead exposure, again, because the children in the building started to get sick and then doctors identified the problem and people realized there’s a lead problem in the building. Those tenants realized that they could not do it alone. They got together, they formed a tenant organization and they started acting collectively. They started sending the landlord collective notices. They started withholding their rent. Right. And they withheld their rent in a way that protected them legally. They were still paying it, right. But they were paying it into a set of resources held by the court. And they wanted the landlord to sort of be prompted, to be forced by the court to address the lead problem. And once they did, hey, there’s our rent, it’s right there. You can get it back. And as long as tenants are paying into that court-held fund, they can’t be evicted. Right. They’re protected from eviction because it’s not like they’re just not paying their rent, but they’re leveraging. And those are just a few examples of the things that those tenants did. But collectively, they could leverage. One person stops paying their rent, they’re getting evicted, three-quarters of the building, stops paying the rent and pays it into an escrow account with the court, well, now either the landlord has to pay attention or is going to suffer a massive, massive loss. And the difference between individual action and collective action in this space is like night and day. And tenant organizations recognize that, and they figure out how to channel the collective action in ways that give tenants leverage over changing the problems that are threatening their health. Right. And whether they frame it that way or not, when you talk to them, health comes up again and again. People talk about their mental health, they talk about their emotional health, they talk about their physical health, they talk about their children’s health. They talk about the health of the community without it even being brought up. And so it’s clear that the health dimensions and how those intersect with the inequity dimensions is a primary thing that people are interested in addressing. And that collective action is a primary channel through which they can more effectively address it.

Siers-Poisson [00:29:43] And that discussion of collective versus individual action actually reminds me of a different angle to this. Earlier, we talked about preemption from a state level down to a local level. And one of the tactics that the tenant organizations you spoke with said they found effective or at least gave them a better chance of winning was to form statewide coalitions. So it wasn’t just a tenant organization in one city, but it was a coalition of maybe several cities and smaller towns and other organizations. Can you talk a little bit about that?

Michener [00:30:20] Absolutely. So often, you know, it’s the scale of the of the solution and the scale of the kind of collective action in many ways needs to align with the scale of the problem. Right. And the scale of the problem is shaped not just by kind of individual tenants and the circumstances they’re facing, but the larger political context they’re in. So, for example, if I’m an individual tenant and my landlord is a bad actor, there’s like harmful mold growing in my apartment. My lease says that it’s the landlord’s responsibility to fix that. They will not because it cost them money. They don’t want to pay that money. It’s just little ol’ me. There’s not much I can do to change that. I live with the mold. Perhaps I’m sick or my children are sick as a result. Well, now some of the people in my building get together because it turns out that many of us have mold and we put pressure on the landlord. We can now put a different kind of pressure on the landlord together. We can say, we’re going to all report this to code enforcement. Together. We can say we’re going to all withhold our help rent until you fix this. Different kind of pressure and maybe the landlord will respond to that kind of pressure. Right. But if there are kind of state level policies, maybe that there’s not much regulation that forces that landlords hand, there’s not much of a way to kind of push that landlord to actually be responsive to tenants. Now, even your association isn’t going to be able to do much, right? Because why should they listen to even 20 of you? To even 50 of you? Right. And perhaps you need state policies, state law changes in order to leverage more influence or exercise more power over that landlord. And that might mean you have to think about some different political configurations. You have to look around and say, well, now several of us from across the state have to be working together. We have to build coalitions. We have to operate in a different way in response to the scale and the nature of the problem. And rent control is a great example of this. Like when rent control is preempted at the state level, tenant organizations on the local level can say, we want rent control. It doesn’t matter. You just can’t do it. That’s what state law says. But now, if there are tenant organizations all over the state and they all get together and say together we can try to influence state law. And once that state law is changed, it opens up new realms of possibility for all of us. Right? Otherwise, you’re stuck, not really being able to go after the policy that people most want to go after. And if you need to find political solutions around that while working in coalition, working regionally, working across the state is one of the ways that that tenant organizers have just been savvy in creating political formations that match the scale and the scope of the problems that they’re trying to address.

Siers-Poisson [00:33:07] You position these issues of equity, whether it’s racial or economic or health equity, as vital to democracy and to engagement in political processes in the large sense. Can you tell us more about that and what’s at stake when those inequities are allowed to continue, and especially when they become what you call entrenched in our society?

Michener [00:33:31] Yeah, Yeah. You know, there’s so many linkages to democracy here, and I think it’s something we can often overlook. So when it comes to health equity, I think a tendency is to think about disparities in health outcomes. Right. Or disparities more generally. Oh, there are disparities in who’s exposed to lead or who’s exposed to asbestos or who’s living in unsafe housing conditions or who’s being evicted. And there are disparities in health conditions related to those things, things like asthma, things like rates of cancer, things like other forms of sickness, home fires, who’s harmed in home fires. So we have all these disparities in who faces housing conditions that are health undermining. And then we have corresponding disparities in who actually suffers from deleterious health conditions. And we can look at those disparities and say, these things are terrible and we can chart them and we can chronicle them and we can make note of them. But if we want to get to the point of changing them, that requires navigating political processes. And so automatically it implicates democracy, because the question, the core questions are who gets a say over how those political processes unfold? Is it the people who are the ones breathing in the asbestos, whose children are being poisoned by the lead, who have the mold growing in their apartment? Do they get a say? Or is it the people that will profit from their rent? Right. And often we want everybody to be happy. But these are sometimes incommensurable interests. Right? And so when we have incommensurable interests like that, the outcomes get determined in the domain of politics. And so the nature of our democracy, of who gets a say in that political domain and who does it is a fundamental determinant of these health outcomes that we’re all interested in improving and changing. Right. And so when we think about these organizations like tenant organizations and structural features of our democratic processes like preemption, how do those structural features of our democratic processes affect the way tenant organizations can operate? How do they affect what those organizations can and cannot do? What kinds of policy campaigns they can or cannot run? That’s essentially a question about democracy. And there are institutions within democracy. And I would say that preemption is an institution like this, for better or worse. And sometimes it’s for better and sometimes it’s for worse, that are entrenching institutions, they’re institutions that help to keep things the way they are, that make it more difficult for things to be different. And entrenchment is not always, but is often a proliferator of the kind of status quo of whatever disparities or whatever biases we’re currently facing. And so you can see these linkages between how our political systems are structured, right? What sorts of policies are possible, and whose voices are incorporated into our policy. Right. All of those things are pretty intricately and directly linked in very concrete ways. And so if we can identify health outcomes or health disparities that we want to be different, we then have to identify the processes to get there. And those processes are political and they’re happening in the context of political institutions. And we should name those institutions, things like federalism and things like preemption. Right? And we should name the actors that are at play, actors like tenant organizations and policy makers. And we should think about the relationships between all of those things and what they imply for whether our democracy is full and fair and equal and equitable. Right. And there are some hard questions in there and some complex questions in there, but we have to know enough to at least ask the questions and to be looking in the right direction, in the right places for the answers. And in these papers, I try to offer some pointers on where we should be looking for some of these answers, not always to the top, to economic elites as our saviors, but sometimes to the quote unquote bottom, to the people in communities, the people experiencing the things who are making attempts to organize and to collectively act on their own behalf. Right. And it means we have to think about politics, not just in general terms or in terms of horse race elections, but really in terms of the nature of our institutions, things like preemption. And so some of the nuances around what to pay attention to, what to think about, what to sort of look at, so that we can better understand these relationships between health equity and democracy in the context of structures like racism and economic inequality. You know, it’s not easy to to tackle these things, but there are patterns and there are processes that we can attend to that point us to possibilities for real transformative change.

Siers-Poisson [00:38:19] Given all of those connections and implications that you just laid out for democracy itself and for those people at the grassroots that you’re talking about who are especially impacted by these issues, what kind of research would you like to do going forward or see done on these topics that will help advance these issues?

Michener [00:38:41] Yeah. I mean, I’m excited to see and I think we’re in a space now where this is what’s more and more happening, and I’m excited to see it. I’m excited to see research that moves us beyond the kind of chronicling of disparities and to the kind of nitty gritty on the state level, on the local level, and then on the national level, nitty gritty analyses of processes and of who’s exercising power within those processes that can actually lead to change or perhaps processes that are forestalling change. Right? To really understand the political processes that undergird the kind of policies that we want to see either be different or we want to see more of in order to advance health equity and to understand who gets a say in these policies and who gets to have voice and power within those processes. We’re just scratching the surface of this. We’re just scratching the surface. And I think about this through the lens of housing and I think about it with the case of tenant organizing. And that’s one lens and one case, right? We can think about it with respect to organizing around health care expansion and Medicaid expansion and whose voices get in and engaged in those policies and what the political processes are for that. Right. We can think about it in terms of work and labor, because access to a living wage and income is such an important part of health equity. And how do those processes, those political processes that determine wages and and access to living wages, how do those unfold? And so on and so forth. You name the issue, underneath every issue that we think of as critical to racial and economic equity are a set of processes, political processes. And within those processes, there are power dynamics unfolding. And until we understand those dynamics closely and carefully, we won’t understand how to catalyze change. Right? And but I think we are entering into a phase of research, interdisciplinary, multidisciplinary research, where we’re thinking much more closely about those processes of change. And we’re contending, I think, much more directly with the importance of politics and power in structuring the outcomes around health equity that are sometimes most troubling, most worrisome. So I want that research to continue today and to build and to grow, and I’m excited to see that happen.

Siers-Poisson [00:41:05] Jamila, thank you so much for sharing your research and insights with us. I really appreciate it.

Michener [00:41:11] Thanks for having me here today. I love to be able to have these kinds of conversations.

Siers-Poisson [00:41:17] Thanks so much to Dr. Jamila Michener, associate professor of government and public policy at Cornell University. She joined us to discuss two recent papers entrenching inequity, eroding democracy, state preemption of local housing policy and racism, power and health equity. The Case of tenant organizing. You’ll find links to both in the show note for this episode. The production of this podcast was supported in part by funding from the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. But its contents don’t necessarily represent the opinions or policies of that office, any other agency of the federal government or the Institute for Research on Poverty. Music for the episode is by Poi Dog Pondering. Thanks for listening.