The Care Our Communities Deserve

Reflecting on National Minority Health Month at HCN

Every April, we celebrate National Minority Health Month, an observance that traces its roots to 1915, when Booker T. Washington organized National Negro Health Week to address a health crisis Black Americans were navigating without federal support, without local support, and often without anything beyond what the community could provide for itself. This year, that history feels closer than it has in a long time.

Funding streams that once supported health equity, culturally responsive care, and minority-led service providers are being narrowed, paused, or pulled back, and peer organizations across San Francisco are scaling down programs, laying off staff, and in some cases closing their doors. The communities with the greatest need are once again the first to feel what gets cut, and the institutions that have spent decades earning the trust of those communities are being asked to absorb the impact while the need keeps rising.

The data on what is at stake remains sobering. In San Francisco, Black/African American mothers account for about 4% of births but 15% of infant deaths over the past decade, Black San Franciscans live more than ten years less on average than their white, Asian, and Latine neighbors, and Black residents make up roughly 5% of the city’s population while accounting for 37% of its homeless families. These are the families who walk through HCN’s doors, and the disparities they live with are precisely the disparities that culturally responsive care was built to address.

Why culturally responsive care is the work

HCN’s approach begins with a simple commitment to meet people where they are, with the relationships and the histories they bring with them, with the favorite songs and the grandmothers who raised them and the teachers who notice when they go quiet. That commitment is what makes culturally responsive care effective rather than performative, because a child carrying the weight of housing instability is held by a clinician who understands the specific weight of that history, and a parent navigating substance use is met by someone who recognizes the parent first.

Meeting people where they are also means understanding that healing rarely arrives in the order a treatment plan would predict. A child may need to talk about a favorite cousin before they can talk about what happened at the shelter, and a parent may need to be reminded of who they were before the crisis before they can imagine who they want to be after it. Care that holds room for all of who someone is, before naming what is wrong, is the kind of care that moves families from surviving to actually healing.

"A parent in our Ma’at program put it this way: “I have a better understanding of how important it [mental health] is. And I try to prioritize it a whole lot more, not just for my children but for myself as well."

That shift, from treating mental health as something that happens to a child in a clinic to treating it as something the whole family practices together, is the shift that culturally responsive care makes possible.

Care that holds the whole family

When healing is shared across a family, it begins to change the way generations relate to one another, because children who watch their parents do hard work learn that struggle carries no shame, parents who see their children met with patience learn to extend the same patience to themselves, and grandparents who carried what they could not name often find language for it, sometimes for the first time. The healing moves through the family the way the harm did, but in the opposite direction.

A clinician in our General EPSDT program described what shifts when this kind of care takes hold:

"When clients see their caregivers acknowledging and working through [personal trauma and intergenerational patterns], it often deepens mutual understanding and fosters greater compassion within the family."

This is what whole-person care looks like in practice, treating families as partners in their own healing rather than cases to be processed, and refusing to lump people into categories when what they actually need is to be known.

It is also work that takes time, and time is precisely what shrinking budgets and stop-and-start funding cycles take away. A family that has just begun to trust a clinician should not have that relationship interrupted because a contract did not get renewed, and a child who has just started to open up should not lose access to the program that finally felt like home. Continuity is its own form of medicine, and protecting it requires the kind of stable, sustained investment that minority-led providers have rarely been given.

What this month asks of us

National Minority Health Month is a chance to name the gap loudly and recommit to the kind of care that closes it, and this year, that recommitment has to translate into resources, because the institutions that have spent decades building trust with San Francisco’s minority communities are the ones being asked to absorb the impact of cuts they did not cause. HCN is one of those institutions, and we are still here, still showing up for the children, youth, and families our nation has historically failed.

Help us keep this work going. HCN depends on community support to sustain culturally affirming mental and behavioral health services for the families who count on us. Donate today to help us continue funding the programs that meet families where they are, every day, one child, one parent, one neighborhood at a time.