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"The hurrier I go, the behinder I get," said the white rabbit in Alice's Adventures in Wonderland. So many people in public health could be forgiven if they expressed this sentiment as well. While the public health sector has made substantial progress in fostering healthy communities by identifying and, more importantly, addressing the social determinants of health, the nation has moved backwards.

Every day, I wake up with a deep sense of purpose: to play a role in nurturing communities, particularly those marginalized and underserved, so that they may thrive, find healing, and grow in love, hope and fulfillment. Over 35 years ago, the Sisters of St. Joseph of Orange had a similar vision when they founded the St. Joseph Fund. Their mission was clear: Every individual must be healthy for society to flourish.

Cheryl Johnson, the sixth of seven children, grew up on the far south side of Chicago, tagging along with her mother as she went to community meetings. "I grew up in a period where whatever your mother said to do, you do it," Johnson said. And so she did. Johnson was there as her mom investigated the industrial waste facilities surrounding their public housing complex and demanded attention for community health concerns. Hazel Johnson came to be known as the "mother of the environmental justice movement" for her work helping to launch grassroots efforts to address environmental issues in the United States.

On my first day as a public health civil servant in the Bronx, New York, the assistant commissioner gave me a tour and brief history of our district office, which had just opened two years earlier. The building was certainly older than that, so I asked what had previously occupied the space. She said it had always had a health focus and, although nonprofit organizations were the immediate past tenants (and some remained), there had been another public health office located in it some 20 years ago. "We're still trying to get past that," she noted. I asked what she meant. "We left. We set up, built relationships, provided services, and then an administration changed, budgets tightened, and we left. They don't trust us."

Nonprofit hospitals, representing nearly 60% of all U.S. hospitals, are enduring increasing pressure to demonstrate the value they offer to the communities they serve and whether (or not) they deserve their tax-exempt status. In fact, the Ways and Means Subcommittee on Oversight held a hearing on tax-exempt hospitals and the community benefit standard in April 2023. During the hearing, Congressman Brad R. Wenstrup, R-Ohio, said: "Nonprofit hospitals should be providing a level of community benefit that aligns with the value they are receiving from their tax-exempt status. Taxpayers who are on the hook for providing this benefit deserve to know what they are getting in return.

Health care providers have a responsibility to ensure that every patient receives equitable care with cultural humility, which includes a commitment to self-reflection and learning, reducing power imbalances and improving institutional accountability. At CHRISTUS Health, we recognize the importance of integrating a health equity lens into our daily routine. To achieve health equity, it is essential to consider the patient's environment, lived experiences, support and resources at every step of the process. And in our work for healthy and equitable communities, we've expanded and refined our data analysis and strategic responses.

Humans have a complicated relationship with alcohol. We drink when we're happy, and we drink when we're sad. We drink with others, and we drink in isolation. In fact, we have a complicated relationship with most psychoactive substances. We eat, drink, swallow, snort, inhale and inject them. We advertise them, compare our favorite brands, and use them in family traditions and religious ceremonies. Some of our substances are legal, some are legal and regulated, and others are illegal, yet still commonly used.