Scaling Up: From Direct Service to Systems Analysis in Health Equity

By Michael White

"How could our government institutions, meant to act as a safety net for the most vulnerable among us, actively work against our collective well-being?" writes White (W&L 2010).

“How could our government institutions, meant to act as a safety net for the most vulnerable among us, actively work against our collective well-being?” writes White (W&L 2010).


My Shepherd breakthrough moment happened, as it has for many of us, in the classroom. But it wasn’t in the hallowed halls of my alma mater. Rather, it happened at a rural preschool in the economically disadvantaged outskirts of our idyllic college town. As part of my Shepherd field placement, I volunteered weekly in a Head Start classroom for children experiencing extreme poverty. I was heartbroken to learn that the teachers would discretely slip some of the children granola bars at the end of each day, as they barely got fed at home. One morning that heartbreak turned to outrage as I saw the teachers bringing out pizza for breakfast. Reheated pizza might be an acceptable meal for a college student struggling through exams, but something felt viscerally wrong watching toddlers devour such an unhealthy meal to start their day. Worse yet, I learned that this meal was federally subsidized. How could tax payer dollars go towards something so objectively detrimental to the health of our nation’s children? How could our government institutions, meant to act as a safety net for the most vulnerable among us, actively work against our collective well-being?

As I delved into the cross-section of food insecurity, poverty, obesity and neurological development, I felt as though I was uncovering a big, dirty secret. Our nation’s institutions, from our judicial system to the way in which we feed the poor, can have insidious consequences in the absence of proper advocacy on behalf of those they serve. My interest in food equality sparked a dramatic career turn from photojournalism to direct service and I have never looked back. My senior year I applied for post-graduate fellowship through the Shepherd Program to continue exploring the relationship between food and poverty at the Alliance for a Healthier Generation in Washington, DC. In my work over the following years, I came to experience firsthand the nearly impossible structural barriers families in the lowest socioeconomic strata deal with to get quality nutrition.

Without Washington and Lee’s Shepherd Program on poverty studies I would likely have viewed health issues of the poor, from obesity and high blood pressure to lack of dental care, as maladies of persons lacking individual responsibility. I could not have understood the interwoven structural problems in our country that prevent the full realization of the American Dream for so many of us. I would have chalked up good health and economic success to following the rules and path before me, blissfully unaware of the rigged system in which so many live. Above all, I would have never taken up the mission to eliminate these structural barriers to health equity as my profession.

We live in a country where the zip code in which an individual is born can largely dictate both the quality and length of his or her life. For me, knowing and confronting the great disparities across America started with the Shepherd Consortium. The internship introduced me to poverty firsthand, while poverty studies in undergraduate and graduate school overall gave me the empirical and theoretical backing I will use in my work on health equity at the Robert Wood Johnson Foundation. I took Poverty 101 from the current Executive Director of the Shepherd Consortium. He said to us on the first day: “I just want you to know, before we get started, that you’re probably not going to change the world.” While many took that off-hand quip as a fact or a lighthearted joke, I took it as a challenge. That challenge has become my life’s work, and I have the Shepherd Program to thank for it.

Mr. White graduated in 2010 with a B.A. from Washington and Lee University, where he double majored in Photography and Journalism while completing work in the Shepherd Program. During his time at W&L, he completed his Shepherd internship writing for the business desk of the Lexington Herald-Leader, focusing on the economic ramifications of the 2008 recession in rural Kentucky. He also led a first-year orientation program in is college town for entering first-year students Washington and Lee. The Alliance for a Healthier Generation is a joint venture between the Clinton Foundation and the American Heart Association. He currently works for the Robert Wood Johnson Foundation, the nation’s largest private philanthropy focused on domestic health issues. He focuses on health equity programming. He recently finished his Master’s in Public Health at Columbia University’s Mailman School of Public Health specializing in Population and Family Health.

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