During the last legislative session, state lawmakers eliminated funding for the Office of Minority Health Statistics and Engagement. It's last day was Aug. 31.
The agency was small. Its budget was about $2 million. It had about two dozen full-time employees. Yet, it was trying to solve one of the biggest problems facing the state: racial inequities in government services. In other words, the agency was trying to tackle institutional racism.
“It was revolutionary when Texas opened this office,” said Lauren Lluveras, who worked as an equity and inclusion specialist at the Office of Minority Health for a little more than a year. “We were one of the first states to create – not an office of minority health, but – an office that had this holistic approach toward disparities, institutional disparities.”
Lluveras is now a senior postdoctoral fellow at the Institute for Urban Policy Research and Analysis at UT Austin. During her time working for the state, she talked to people in different communities about what issues they were dealing with. And she often talked to people in government about how environmental factors, not individual behavior, were making their programs less effective for certain populations.
“So trying to get a lot of people with institutional power to recognize some of these institutional barriers to having good health outcomes,” she said.
Community Outreach
When it was created in 2010, the agency – initially called the Center for Elimination of Disproportionality and Disparities – was groundbreaking. It worked like this: Agency officials would look at data, find something that wasn’t working for a certain population, and then send people like Lluveras to talk to the community to find out why.
In one case, the center found communities of color had higher rates of run-ins with Child Protective Services over alleged medical neglect issues. By talking to the community, it found the transportation the state provided didn't work with families' schedules and didn't accommodate larger families. Once those issues were addressed, the state saw fewer mothers foregoing medical care for their children.
“One reason why that office was so community focused was that we felt that policies and programs shouldn’t be created for marginalized communities without their voice at the table,” Lluveras said.
"People don't care what you have to offer until they know you care about their situation."
One of the community leaders Lluveras turned to in Central Texas was Ray Hendricks, pastor at the Rehoboth Church in Austin.
Hendricks said this setup fixed a problem that had existed for years. Finally, his community, which is predominately black, could give advice to the agencies that were failing to serve them.
“Instead of running off into our communities, telling us what needs to be fixed and what’s broken," he said. "All they need to do is include us, and we will tell you what is going on in our communities."
Hendricks said the state had been wasting millions of dollars by shutting out community input – and was straining relationships in the process.
“Nobody likes somebody coming into your house telling you what’s wrong with your place,” he said. “People don’t care what you have to offer until they know you care about their situation.”
And so, for years, Hendricks and other community leaders representing different regions in Texas started working with state officials to make their programs better.
"[Bad health outcomes] went down when we got engaged,” he said.
The center started out working with Child Protective Services; then the Legislature expanded that work to cover additional state agencies. "And we were doing well," Hendricks said.
While most people didn’t know all this was happening, it felt important for people like Lluveras.
“Working in that office was the most punk rock thing I have ever done,” she said. "[It felt] like it was something that needed to be done, something that the state didn’t necessarily agree with had value.”
“There wasn’t a day where I think any of us showed up to work and didn’t feel proud of what we were doing. There wasn’t a day ... where I had any doubts that that program was creating change,” Lluveras said.
'A Very Huge Void'
But last year, lawmakers faced a budget shortfall. Instead of raising taxes, they trimmed down agencies. They decided to fund the Office of Minority Health for only one year, forcing it to close.
Hendricks said he reached out to a lot of lawmakers last session, but no one would talk to him.
“It makes me feel just disappointed with our Legislature that nobody out of all the state of Texas – no legislator, no senator, no representative – were willing to come and say, ‘We can’t do that. We can’t let it go. What else are we going to put in its place?’” he said.
"I think that defunding that office was cosigning for all these health outcomes to get worse in communities of color across the state."
KUT reached out to a couple lawmakers Hendricks mentioned, but they didn’t respond.
Hendricks, who had volunteered his time for a decade, said he still doesn’t really know why it all ended.
“I know a lot of times programs that are designed to help people – and especially people of color – tend to become less of a priority,” he said. “We are not looking for handouts; we are looking for equity.”
Because lawmakers put nothing in the center's place, Lluveras said she’s worried Texas will start to backslide.
“I think that defunding that office was cosigning for all these health outcomes to get worse in communities of color across the state,” she said.
Michele Rountree, associate director of the Institute for Urban Policy Research and Analysis at UT Austin, said she's most disappointed that the state didn’t find a way to make sure at least a version of the Office of Minority Health’s work was taken up by other agencies.
“It’s going to leave a very huge void, and I am not quite sure how that’s necessarily going to be filled,” she said.
Rountree said lawmakers should be worried about what happens next.
“A lot went into actually creating the center in the first place," she said, "and my fear is that we are going to see poorer outcomes until there is an emergency."
A Mission Of Health Equity
There are some publicly available notes that were taken of a phone call between Hendricks, other community leaders and state officials while the Legislature was considering cutting the office.
According to the notes, the Legislature’s justification was that other health and state agencies could address these issues.
Reginald Tucker-Seeley, an assistant professor and public health expert at the University of Southern California, said he thinks it’s unlikely agencies will start doing that on their own.
“Unless they have a policy that ensures that health equity is a part of the mission of those particular organizations, then that is not necessarily going to be something that is a part of the policies and programs of those particular organizations,” he said.
Hendricks said he’s still in touch with the other community leaders around the state. Right now they are healing – and they are strategizing.
If the state won’t commit to fixing inequities, he said, maybe other people will. In the meantime, though, he said the Office of Minority Health’s closure sent a clear message about Texas’ priorities.
