COMMENTARY: California Surgeon General advocates for health equity in Kern

June 6, 2019 /


California’s first Surgeon General Dr. Nadine Burke Harris held a listening in Bakersfield in May, with hopes to hear about local challenges and to share the Administration’s priorities, which advocate for health equity, advancing the social determinants of health and screening for Adverse Childhood Experiences (ACES) from lifelong exposure to toxic environments (social, physical, and natural).

The stress that comes from racial discrimination, housing insecurity, food insecurity and domestic violence, among others, actually alters biology. Addressing these multiple factors that affect health is often described as the social determinants of health. Burke Harris framed social determinants of health as the 21st Century’s major health challenge likening it to the 20th Century’s challenge to fight infectious diseases.

This is a potentially paradigm shifting discussion to look at prevention and treatment in a more comprehensive way.  The people gathered around the table represented several sectors of the Kern County health community, from elected officials and their staff, health care providers, educators, social services providers and social justice advocates.  

As Burke Harris described we are all touching different parts of the elephant of health.  But in Kern County, we have often operated separately. Working with the social determinants of health and the ACE framework provides opportunities to address cumulative impacts and recognizes that being subject to lifelong exposures to toxic environments impairs people’s physical health, reducing their personal resilience in the face of pollution.

Hearing Burke Harris state this reality — as confirmed by scientific research and data — was incredibly powerful. I have been an  environmental justice advocate in Kern County for twenty years.  Throughout that time, I have attended countless hearings where community members testify about the negative impacts air and water pollution have on their health and environment.

In response, white affluent often male members of the community and elected officials have said the equivalent of, “well I don’t have asthma” or “I have been fine” to undermine the communities’ experience.  It was powerful to sit in a room in Kern County where the Surgeon General of the California was validating the communities’ experience and that we are not all starting from the same baseline of health.

In addition to validating community knowledge, Burke Harris offered us a pathway forward inviting us to work together to address root causes. This involves improving diagnostic tools, deploying ACE screening tools, improving the physical and natural environments, combating racism and discrimination, and fighting poverty.  

In order to reach these goals, it requires all of the public health actors in Kern County to see our work as integrated and create new solutions to persistent problems. I hope this is the start of a new paradigm shift to create a healthier Kern County. It will certainly help me and my colleagues at CRPE see our work in a new way, with new opportunities for partnerships and interventions to protect public health.

Caroline Farrell is the Executive Director of the Center on Race, Poverty & the Environment based out of CRPE’s Delano office. For more than 14 years, she has assisted low income communities and communities of color in the south San Joaquin Valley and throughout the country in their struggle for environmental justice.  

South Kern Sol is a youth-led journalism organization in Kern County. In their stories, youth reporters shine light on health and racial disparities in under-served communities across Kern. For more stories by South Kern Sol, head to

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