To combat the adverse health outcomes seen in the impacted fruit, we must begin to remove the corrupted soil and heal the roots. The inequity we are witnessing across various communities can’t be fixed by simply treating poor health with other "downstream" and "mid-stream"* efforts, such as health education or behavior change efforts. This amounts to removing the fruit or cutting off a branch of the tree, leaving the roots and soil intact. Despite efforts and spending on healthcare in the U.S., health disparities within marginalized, historically oppressed communities have not improved. This shift can only happen, and our communities can only begin to thrive when we tackle inequity by going "upstream," going beyond simply looking at the social conditions that impact health, and by transforming the foundation of the tree—the soil and the roots. The “shovels” represent community-based approaches and values that help dismantle these frameworks and transform adverse conditions. These approaches center grassroots and community-level organizing and advocacy for reform and justice within the systems of oppression (soil) and the conditions underlying community health (roots). These organic, community-led public health efforts open the door for communities to regain power and agency over their lives.
