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Closing Remarks and Reflections
Kirsten Bibbins-Domingo, professor of medicine and epidemiology at the University of California, San Francisco, then provided closing remarks and reflections. She first acknowledged the Ramaytush Ohlone people as “the traditional custodians of this land” and thanked their community for their stewardship and support. Bibbins-Domingo noted the roundtable is committed to sponsoring population health workshops and that “we have just finished a rich, riveting, and deeply nuanced discussion of spatial justice.” She thanked organizers, speakers, moderators, staff, and audience for their help in developing the themes that arose from this discussion.
Bibbins-Domingo recapped some of these key themes, noting that “we have learned about our history and why history is not just a series of events, but rather entrenched and reinforcing structures that include serial displacement, rupture, and dispossession of many marginalized communities.” She added that events cannot be disassociated from these structures, which need to be made visible to engage in spatial justice. She explained, “repairing these inequities requires an arc of healing, not just managing one event to another,” and noted that workshop speakers challenged everyone to not simply applaud when new houses are built to address homelessness, but rather to ask about where houses are built, who is building them, and who can access them. “Bricks and mortar do not [make] a thriving community,” Bibbins-Domingo added.
She said, “our speakers asked us to avoid conventional wisdom and narratives and easy solutions,” including “even seemingly sustainable solutions that themselves lead to displacement and dispossession,” such
as when bike racks are used to displace those living in an area. Bibbins-Domingo also noted that the speakers urged everyone to explore solutions that reconnect people to the land, such as among youth offenders in Hawaii, street vendors in Los Angeles, and Indigenous communities. She added that speakers encouraged embracing and sustaining long-term solutions “that will require effective, high-level, and systemic approaches that acknowledge the past and ongoing inequities, and have clear rationale, benefits, and accountability.”
Bibbins-Domingo said the roundtable has focused on health and that this workshop has elucidated the connection between spatial injustice and population health and inequities. She noted that speakers reminded everyone about the “real and imminent” health consequences of serial forced displacement. She asked, “whether we are talking about the impacts and ongoing realities of the global pandemic, the impending lifting of the eviction moratorium, or the latest manifestations of the climate crisis in heat, fire, and water events, who suffers, who dies, and who is displaced?” Bibbins-Domingo noted that “the urgency of these crises and the … deep inequities in our responses” requires recommitting to and centering the following principles: that “all individuals have the right to be protected from climate-induced events”; that the burden must shift “away from individuals to systemic processes, organizational policies, and management practices” that deliberately focus on historically marginalized communities; and that a public health model of prevention be adopted “as the preferred strategy to eliminate threats before they occur.”
Bibbins-Domingo noted that the workshop conversations have been interdisciplinary and that solutions to the problems discussed “will require the same type of interdisciplinary discussions and cross-sector collaborations,” including many professions and types of knowledge, joint advocacy, and “community knowledge and representation of those disproportionately affected by these crises.” She concluded the workshop by noting the challenge for those in the health sector “is to engage and to help foster this collective action to address the very urgent population health crises that we are facing, grounded in the principles of spatial justice.”
